Leadership Development: Hiring A Clinic Director – FB Live Event With Adam Robin And Nathan Shields

Any Physical Therapy owner looking to grow and expand will need strong, aligned Clinic Directors to lead teams. In this episode of the Physical Therapy Owners Club, Nathan Shields and Adam Robin share their experiences of what it takes to successfully develop clinic directors who will carry out the purpose and vision of the clinic in the owner’s place. They also provide insights on what to look for in hiring a clinical director and explain why you should hire one sooner rather than finding the person doesn’t work. Don’t miss this opportunity to gain insights valuable for your PT business.

(This episode is taken from a Facebook Live event in the Physical Therapy Owners Club Facebook Group).

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In this episode, we’re talking about building out leadership teams. We’re going to start with what it takes to put a clinic director in place. For those who are reading, I am joined by Adam Robin , a good buddy and partner on the Physical Therapy Owners Club. Let’s talk about it. Let’s get into it. That’s something that everyone knows at some point as they are growing their team, and as the owners are moving their way up the organization, they need to fill in the leadership posts behind them. One of those posts is a clinic director. Where do you want to start with this?

People get stuck here. There are these little crossroads where you have to clone yourself. Everything you’ve learned, now, you have to teach somebody else. The student becomes the teacher. It’s a transition. It’s a challenge to redefine your role again in the company and enter into a higher-level delegation and not just strategically offloading that hat but the leadership piece getting alignment on the culture and values, measuring the dynamic between the visionary and the integrator, being comfortable with being told no, and learning to let go of things and all that mindset stuff that comes with it.

Do you know where I think it starts? As I look back on my journey in those and the journey of other clients that we’ve worked with, I see that the planning for an eventual clinic director to come into play doesn’t start soon enough. As you’re a single practitioner in a clinic and if you have plans for growth and eventually expand to more than just you and another practitioner, especially if you want to expand to another site altogether, you’re going to have to have a clinic director in place.

Owners, and I’m thinking about myself especially, don’t think about hiring a future clinic director in the first place. They go in to hire just to find a physical therapist that aligns, will be productive, can teach and train, and whatnot. Maybe you’re not looking at that new grad in such a light that they eventually become a clinic director but they very well could within 2 to 3 years. Maybe it’s not in their mind as they’re looking at these physical therapy hires in the first place. “What are some of the skill sets that I’m looking for that aren’t just meeting my needs now, but could I see this person in a potential leadership position?”

Unfortunately, when they need a clinic director, they’re going to start to look and hire for the clinic director to come on rather soon and I haven’t seen that work out so well a lot of times. Typically, you want to grow that person from within and it’s going to take some time to ramp them up to a position where you can feel comfortable. You have to make sure that their value is aligned and that they mesh with the culture. That’s going to take a couple of years to get used to.

You’re going to want to ensure that they’re one of the most productive people on your team, ideally. You got to give him some time to train them on how you want them to lead. “Follow these policies, and procedures, and track these stats. Here’s how we hold people accountable.” That all takes some time. I wonder if we don’t start early enough in the hiring process to look for future clinic directors.

I think so, but it’s hard for me to have too much input on this because I only have my experience. I know that when I was growing the practice, I was figuring it out, and I had Nathan Shields telling me to build a KPI dashboard, to do this for marketing, and so on. I was so focused on learning, implementing, and pushing through discomfort that I couldn’t see it. I was so stuck in the day-to-day that I couldn’t see it.

I remember very vividly asking you because I wanted to take over the world. I wanted to open 500 clinics but I didn’t know how to get there. I remember asking you, “What do I need to open up a second location?” You said, “You’re going to need a leadership team.” I remember thinking to myself, “What is that? What do you mean by a leadership team?” It’s hard to get too far ahead of that when you don’t even know what it is.

It’s exactly what you’re talking about. It’s, “How do I feel how do I find people that are clones of myself?” One of the hardest things to do for owners is to learn to write down or iterate exactly what you do because it comes so naturally that I just do it but in my mind, I’m not checking off boxes. I just naturally go through these processes. That can be hard. It might take some support from a coach like you and me to say, “What are you doing in this situation? How do you want to address this? Have you considered this?”

Also, maybe give you some guidance, “Let’s write that out. Here’s how you collect stats. Here’s how you have a monthly meeting with your providers. Here’s how you run a staff meeting.” That can be the most difficult part, but you tell me because you’ve just gone through it. Once you start to figure those things out and iterate them, the process starts becoming easier in terms of developing the systems over and over in different areas of the clinic. Is that about right? Is that how you felt?

Once you start to figure things out and iterate them, developing the systems again becomes easier.
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Yeah. You have to get in there and start getting your hands dirty just like anything else. The first time I decided, “My clinic was 200-ish visits a week. I had maybe four and a half FTEs. I wasn’t treating much, if at all.” I was in a place where I was like, “I’m going to start to build what I need to open up my second location.” On a Monday morning, the first thing on my list was to have a meeting with the person who I thought would be great and tell them, “I don’t know what I’m doing, but we’re going to figure out how to turn you into a clinical director. Do you want to do this with me?”

I didn’t have it all figured out. It goes back to that thing of like, “Don’t wait until you have it all perfect before you start jumping in.” That’s how it starts. You go in there and you debate. You say, “I see it like this,” and, “But I see it like this.” “Okay. Can we meet in the middle? What can we let go of?” You go through that journey of slowly giving that person what they need to be successful until they get to a place where it’s like, “I can do this better than you can. You need to leave now.”

Developing a mentorship program, even if you don’t have something written out, if someone followed you as you went through some of these things or maybe they shadowed you, you don’t want to take them off the floor too much. I understand that because maybe they’re losing productivity and doing but if you could hand over little things here and there. You’ve seen us do staff meetings. I’m going to turn them over to you now. “Come sit with me while I put together the stats. Here’s the stat sheet that I used and this is where I find them in our EMR to fill this out. This is what the front desk or my VA provides me. Let’s review it together like I do every other week. Just be there with me.”

“Let’s do this in concert so I can talk you through it as I go.” As you’re doing some meetings with providers, they can sit in on those meetings. We learned pretty quickly that giving someone a clinic director title because they’re the most experienced and/or the most productive is not necessarily the smartest thing to do because not every super-productive physical therapist is appropriately trained in leadership. You can’t equate a good therapist equals a good leader. Those are two different skill sets.

Not every super-productive physical therapist is appropriately trained in leadership.
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Some of the best therapists I had, the team didn’t want to follow them. They weren’t leadership material. We would give them the title of clinic director-in-charge or clinic director-in-training. It did not come with a salary bump but we made it known to the team. “Here’s our clinic director in training,” and that’s something that people can buy for if you’ve got a number of providers on your team. If you’re smaller, you have these conversations ahead of time.

“Are you interested in the leadership path?” “Yes.” “This is what that looks like. Here are some books to read. Let’s talk about them.” You can then give them a clinic director-in-training title and they can start doing some of these shadows for you. They can start managing staff meetings. They can sit in on some of these meetings and the team understands why they’re there.

This is part of what’s happening. They can also give you feedback at the same time as to how well they are fulfilling those responsibilities. There are opportunities there to build those out. It doesn’t have to be written out as you said. It doesn’t have to be perfect, especially but you can start doing some of those things to mentor them in what leadership looks like in your clinic.

I’m a fan of writing things out, but I’m not a fan of making them 500 pages long. I can make it two pages long. Let’s keep it simple. That’s how I’ve always operated and that’s always served me well, but having a loose framework that also provides you with a little bit of flexibility.

Have you had some of those people that you’ve worked with do the writing of it for you? During their mentorship, they could be just taking notes and this is how we do things. You don’t have to sit down and do the writing yourself. Have you ever done that?

We have a leadership program that we’ve built out and it’s robust. I spent a long time putting it together. I’m glad that I did because now we use the same terminology. We use the same language. We think the same way. When we define problems or challenges, we approach them with the same perspective but as more and more people have gone through it, then they’re like, “This isn’t quite what we do anymore.” They modify it.

They are responsible for updating it and whatnot.

“That book doesn’t hit where we want it. This one is what we like.” We’ll change out the books and we’ll do that. What I find is, and you can tell me if I’m wrong here but, once you’re a really good therapist and you can get the leadership piece, becoming a clinical director is putting the two together. You’re applying leadership as a great therapist. You are somebody who can sell the plan of care, is productive, can bill, can manage the metric, and knows how to run the practice so when you apply the leadership, you’ve got it. You’ve built out the role. You’re 95% there.

What is cool is when you find that person, the teams would respond better to them than they did to me.

I’ve got a theory on why that’s true.

Tell me about it. What do you think? I knew that there was a different vibe in response to the good clinic directors that I had. They knew how to rally the troops seemingly better than I could. Is that what you’ve experienced?

Here’s my philosophy. As the CEO, I’m the visionary. I’m good at ideas, making changes, and generating excitement but I suck at being clear. I suck at holding people accountable. Sometimes people can walk away after I visionary vomit all over them. They can be like, “What did he just say? This guy’s in fantasyland,” but the director that we started with. Her name is Heidi and she’s amazing.

What she’s great at is like, “Nathan, I need you to do X, Y, Z. Are you good? Thank you.” She is getting more things done with clarity and direction. People are like, Yes, I understand you. I get it.” They’re good at making things digestible. That’s why they like hearing from them and they respond because they’re less confused.

I also think they appreciate somewhat of a peer being their leader and not the management or the ownership being the leader. There’s a level of comfort but also respect that’s given because they recognize that here’s someone who deservedly has stepped into leadership because of their technical traits or maybe even their productivity traits. I’m willing to give that respect to them not because they’re an owner but because I choose to give that respect. It’s not because I’m forced to give respect to the owner because they’re the owner.

It’s theoretical and practice essentially but there’s a benefit there and they’re able to talk to them on a level that is not necessarily self-serving. That’s one of the issues as we’re talking about stats and numbers for an owner to present to the teams they could very easily make the connection between improving these stats and money in the owner’s pockets. I’ve said it so many times. It’s very important that you make that connection between stats and the purpose of the company.

Your clinic director needs to do the same thing but then the team isn’t able to easily draw the distinction between stats and money in the clinic director’s pockets. They shouldn’t necessarily know what the compensation packages are. There may be a profit-sharing situation or some bonus for the performance of the clinic but they can’t as easily tie that push for improved statistics and productivity, increased results for our patients, the purpose of it, and the lining of the owner’s pockets. There’s an acceptance of that as well from the teams that they’re able to recognize that we’re doing this in the best interest of the business and the patients. It’s not necessarily in the best interest of the owner.

It comes down to the social proof of, “The owner has been telling us this for a long time, and now there’s another person. Now, there are two people. The more people that you can rally around you to support the vision, the more social proof there is for the team to believe in. People are more bought in as opposed to you being the only person with all the answers who’s got an emotional and financial incentive. It can be interpreted a lot. It could be harder to navigate that scene.

As you’re looking at hiring clinic directors and you’ve been successful and failed a couple of times. What are some things now that you’ve gone through that experience that you’re looking for a potential clinic director? What are some of the boxes they’ve got to check?

That comes down to your values just like everything, but I need a killer. I need somebody who’s gritty, who’s going to do whatever it takes, but has a servant’s heart and cares about people more than anything else. It’s like that ferocious humble servant. I’m looking for people who can inspire, rally, and get the team to do hard things and still like being here. They can embrace challenge and hard work, and see the good in that. Production is the base of our morale. To understand that hard work is part of growth. That’s it. If I can have that alignment and that commitment to that, then the culture is going to be there and we can do whatever we want.

I can parallel with what you said there. People, number one, have shown the technical capability to perform. Production is the person you can give a task and they’re going to get it done.

We want patients to come to your clinic. They want to see them because they’re the best therapist there.

That’s huge, and just to follow up on that. Part of our leadership training is to give them some homework assignments. If they know that they’re on the leadership path and we’ve talked about it with them about being on the leadership path is to give them homework. The people who can see a problem and recommend a couple of solutions without seeing the problem and saying, “I’m not the owner so I won’t take care of it.”

That’s a deal breaker.

You do have to train them on that and say, “If you were the leader and you recognized the problem that you brought up, what would you do about it?” You let them come up with some of the solutions and then say, “Which one do you recommend we follow?” You recommend that one. Do you feel good about following through on that and I’ll provide you all the resources that you need?”

It could be something as simple as laundry or managing the texts if you use texts and stuff like that. Homework assignment is like that. The people who can follow through and get things done, people who can who are willing to do the work on behalf of the clinic, and their first question not be, “How much are you going to pay me for that?” Have you had a negative experience? I’m going to say from my perspective, the clinic directors that didn’t work out were the ones that were focused on the money.

I haven’t had those.

They were never satisfied.

I can see how that would be hard.

There was always some kind of exchange that had to happen. I’m willing to pay more for things if you’re able to show that it leads to more production.

A statistical change.

The people who are focused on that usually don’t work out too well. They also have to follow along with the values. They’ve got to be professional in their attitudes, workplace habits, and interactions with the teams. They tend to stand out. These are typically your A players. They are not necessarily your B players. Your B players are great physical therapists, but maybe not great leaders. They have to check some boxes. You talked about your leadership training program. What are some of the basics of it? If you were a coaching client of ours, it would be in the vault so you can access it that way but what are some of the highlights of your leadership program as you’re training them?

Mindset is going to be a piece of it, understanding abundance versus scarcity, and managing risk and managing. There are some mindset pieces and also, some personality assessments so you can understand a little bit about different types of people and different ways people tick. Number two is going to be time management. How do you manage your time? It might not all be documented, but everybody has a system in a way of managing their priorities. In our company, this is how we do it. We manage our priorities like this. These are the tools that we use. It’s getting us some alignment on that. Leadership Principles, Leadership and Self-Deception , The 7 Habits of Highly Effective People , and reading some books.

The books that have been influential to you.

I would say that another big piece is going to be the statistical side of the business. A little bit more of a deeper dive into the statistics, what they mean, and how they tie to the financial aspect of the business. Also, make sure that they’re ready to have conversations about money and its significance. Those are some of the big highlights that we have. Also, managing conflict with the team, values, and how to cast a vision in the team meetings.

It’s very similar stuff. Ours were along the same lines. They would go through this process and honestly, it doesn’t take a super long time to put that together, I’m assuming. Yours is fairly robust so you’ve added to it over time. It’s something that ideally if this owner had their 4 to 8 hours per week, they could build something out over the course of a few weeks, if not 1 week or 2. Is that what you’ve experienced? As you initially lay down the skeleton structure of the leadership program, how long did that take you?

It took me less time to build it but it took me a lot more time to envision it. We’re talking about that stage three owner who’s over $1 million a year or getting close and you don’t have a high-stress life. Your clinics are doing pretty well financially. You’re eating well. You get home one time. Maybe you’re mornings are starting a little later. I’ll ask them, “What are you going to do to develop your clinical director?” It’s like, “I don’t know. How do I how do I teach them?”

I always ask them, “What are all the things that you’ve learned over the last year about business? What are the books that you’ve read? What are the podcasts that you’ve listened to? What are the ways that you manage your time? What are the ways you managed your fear, your insecurities, and having hard conversations with your team? Do you remember all that stuff?” They’re like, “Yeah.” I’m like, “That’s what you teach them.” There’s a mindset shift. I didn’t have a lot of structure when I built it so it took me a little while to put it all that together. If you sit down there and jot down your favorite books and your favorite podcast episodes, you can just fill in the blanks.

That’s a great place to start and start talking. Hopefully, if you’re reading, you’re part of a network of some kind or another. Whether it’s on Facebook, with peer-to-peer networking groups, or a mastermind group of your own with small business owners, start talking to people about some ideas that you have in regard to leadership development and what are some things you recommend. One of the first things you highlight is value alignment. We say that over and over again. Value alignment plays out over time as you’ve worked with this person over the course of 1, 2, or 3 years.

You should have your values written out and explain what they are. Also, you’re living by them, and you’re talking about them regularly. You’re also hiring and firing according to your values. I’m taking all that for granted, but if you haven’t done that, it’s worth the effort. You can start there and start talking to them about values.

If it’s a one-on-one meeting with them, you could say, “How could we better live out our values,” and start working with them in that regard. You start getting there two cents. That right there is part of leadership. What I’m saying there and what you were saying as well Adam is that it will take you becoming the coach. You’re going to coach them in time for the clinic director position.

This unlocks so much. When you learn to sit in the role of a coach, I’m going to tell you the first thing that gets better is recruiting. You learn to recruit like a monster because you’re coaching now. You’re above them.

Learn to recruit like a monster.
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You’re also serving them.

You’ve elevated your self-worth and your purpose. Now, you feel like you have something to give. Also, your ability to believe in yourself goes through the roof and you can start recruiting and influencing your team in a lot better ways.

I love how you said that and how you made the connection with recruiting because now you’re coming out of a place from trying to sell somebody on something versus trying to serve somebody to bless their lives. If you’re being pushed to be sold, naturally, our instincts are to push back against it. If someone walks into the retail store and says, “How can I help you?” “I’m just looking,” especially in a car dealership.

“What are you looking for?” “I’m just looking,” but when you come with a heart of service and you’re like, “I have something to offer. I’m willing to help you. I want to serve you and I will. If you’re wanting to do leadership, let’s talk about it. Where do you want to go and how fast do you want to make this because I’ve got all the time to help you along?” It takes a different mindset.

It takes a huge mindset shift, but it is a powerful one. It’s a lot of mindset work. I have one question for you, Nathan. You failed. I failed. We’ve seen others fail. What do you see as the biggest challenges that owners have with this? What’s the one they fail?

The ones that haven’t worked for me are the ones that I mentioned were a little bit more focused on money. The others that failed were ones that I assumed because of their level of experience in the field. They were aged physical therapists. I thought they were going to be great directors. I made the assumption. I didn’t have any leadership training stuff in place even for the experienced PT to transition over to clinical leadership.

However, I assumed that based on them being at multiple places and seeing how leadership was done in the multiple places, they could transfer the best parts of those leadership experiences and take them upon themselves to lead in my clinic, not necessarily the way I would lead. That didn’t work out well. It worked out horribly because it ruined the culture. The people who had been with me a long time were like, “What is going on here?”

I’m trying to give the guy the benefit of the doubt while the rest of the team is like, “This guy is sinking the ship and Nathan is oblivious to it.” I’m trying to be the kind-hearted guy that’s giving him opportunity after opportunity. I was looking past his mistakes. It wasn’t until he self-selected and quit before you left but luckily, he did for me and I was forced to look somewhere else.

It was those two things. Assuming that an aged physical therapist was going to take that on, the problem is with people who were focused on the money part of it. I’d say number three, I have to take the blame in that I didn’t prepare for those leadership call-ups essentially. I didn’t train them. I didn’t have a leadership training module in place, even a simple one to see if they vibe with me or i f they were willing to do the work.

You’re going to read a book on your own time and I’m not going to pay you for it. Maybe I’ll throw in the bone, “We have a library.” Anyone could have read our business books that we recommended and we’d pay the $50 if they read it and talk to us about it. We’re like, “We would love for you guys to learn about what we’re learning because we think it’s amazing stuff.”

If a PTA or a tech wanted to read those same books, go to it. That’s cool but if you wanted to be on leadership, you had to read them and that whttps://www.barnesandnoble.com/w/leadership-and-self-deception-the-arbinger-institute/1111253866as on your own time. We didn’t have those trainings in place and that was on me. Even a simple amount of mentoring or structure in place would have gone a long way.

If you can think back to when you were training your first director, eventually, there’s going to be some conflict. You’re the visionary and the integrator. There’s some there’s some debate. There’s some like, “I don’t think you’re right on this one, Nathan.” Nobody’s ever told you no before. Was that a hard thing?

I had some strong-headed employees that did. They go with my side.

Was that a hard thing for you to overcome and figure out?

You know me by this point. I’m willing to give in to make things go well. Whenever there was a conflict like that, it’s the point where I would say, “You think you’re right. I’m coming from this perspective. We’re going to do it my way unless you come at me with reasons and the statistics as to why we should do it your way.” If I could understand where they were coming from like, “We need to do this to improve cancellation rates.”

If I came from a place of experience, I would say, “I’ve tried that in the past. It’s not going to work.” If I’m not coming from a place of experience, it would be like, “I’m willing to try it, but you’re in charge of it.” If I don’t see their solution being the end of my company altogether and not creating any major damage, I’m willing to let them try it because we can always pivot.

That might be why you are such a good leader.

We always pivot and I could say, “How long are we going to give this? Let’s give it a try. How’s it going to work? What are you expecting? How long do we give it before we pull the plug if we have to? What are some of the things that we’re going to see that work? I want to give them ownership as much as possible. It might not be the way I would have done it, but I’ve got to feel comfortable with them doing it their way and owning it because you do want them to have some autonomy to a point. If you want to go on vacation for four weeks, which would be a great goal, you want them to be able to think for themselves and not wait for the owner to show up.

That was a hard thing for me to learn.

Where did you eventually land on that? How did you handle it?

I gave up.

Did you let them do it?

Yeah. I remember being the guy who was like, “Nathan, I’d like you to lead out on the team meeting. Here’s the agenda. This is exactly how I want you to say it. This is the time that I want you to say it and then I want you to report exactly that you did it exactly the way I would do it.” I see that a lot in owners and it’s hard to let go of your baby, of the thing that with blood, sweat, and tears, you have built from the ground up.

The hardest thing that I had to learn was the difference between debate and conflict, healthy debate and misalignment. Those are two different things. I had to learn this thing that when people would tell me, “No,” or, “You’re wrong. You shouldn’t do it like that,” I would get defensive. I’d be like, “You’re wrong.” It wasn’t until I fully let go and delegated the outcome. Delegate the outcome, but let them figure out the process. Once I started figuring that mindset piece out and showing what that type of approach was, people were like, “Adam’s pretty good boss. I like Adam,” and then things unlocked, and then I was able to run. That’s a hard thing for people to figure out.

I was talking to someone. There’s a difference between techniques and standards. They talk about that in the military quite a bit. There’s a certain standard that’s met and certain leaders within the military will use different techniques to meet that standard. The techniques in and of themselves can be fine as long as the standard is met. I think that’s what you’re getting at when you are going to get your outcome.

You do have to say, if they’re going to change the meeting agenda and you’re walking in or maybe you’re sitting in on a staff meeting that you don’t usually sit in on. Maybe the tone is a little bit low. Maybe it’s not as exciting or the culture is looking a little rough. Maybe it’s a little bit cold and they’ve totally revamped the agenda. It’s then time to come back and say, “What’s going on? What happened to the blankety-blank part of the agenda?

There are going to be some that are like, “This is going to happen whether you like it or not,” type of things. We’re going to discuss values in each team meeting or at least we’re going to talk about them. That’s not going away. We’re going to be professional and be on time. Let’s focus on at least those two things. Outside of those two things, I’m pretty open to whatever else you want to do as long as it’s productive for you and the team and the stats are maintaining their high levels.

There are some no rule breakers but typically, my good leaders agreed with me on the things that had to be done. When I pulled myself off the floor treating, I was still present. I was in a far back office room that was down a hallway about 30 feet and the PTAs would still come down the hallway even though I wasn’t treating on the floor and be like, “Mr. So-and-so is here. You worked with him in the past. You know his situation. I’m thinking about he’s got this, that, and the other thing.”

They’re like, “How do you think I should handle it?” I had to start over and over being like, “What do you think you should do about it?” They’d be like, “I’m I’ve come here to ask you what you should do about it because you’re the owner.” I’m like, “I hired you because you have a brain and I trust you. I think you can handle this. Tell me what you think you should do.” They say, “I would do this and that.” Sometimes they’d say what I would do and sometimes they wouldn’t.

I’d say, “Either way sounded good to me. Go ahead and do it however you like it. Tell me how it goes.” It wasn’t until they asked me that about ten times before they stopped coming back asking, “How should I handle this?” I come back at them with, “How do you think you should handle it?” Giving them that ownership and pushing it back on them. You can do it. You can try that technique. Let me know how it goes. Let’s make sure the standard is met though.

It’s amazing when you get a good leader in there.

When you get a good leader, it's a game changer.
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It’s a game-changer. It’s almost as important as an amazing front desk person.

Those are the two most important positions in the whole company. It’s your director and your front desk person. They drive the bus.

I think the front desk person saves you a ton of money and makes you a ton of money. The clinic director saves you a lot of headaches and heartache because they’re capable of maintaining a culture and productivity. Even though the providers should be, typically, it’s the front desk person who’s the face of the clinic especially if they’re good. They’re collecting the copays. They’re getting people to reschedule instead of cancel. They’re signing them up for the full plan of care at the initial eval, handling concerns, handling the phone call, being the face of the clinic, and that kind of stuff. They are so good but in different ways, those two positions can revamp your company altogether for good and bad.

Building a clone is what it is.

What else do you want to cover about clinic directors? Did we hit everything?

Yeah. We did talk about the leadership team, but the clinical director is the first leader that you train. If you can zoom out, eventually you’re going to open five locations. I have five directors and then you might also have a director of marketing, director of recruiting, director of administration, and director of finance. It’s all the same game like debate, conflict, time management, KPIs, and stats. Your ability to train and produce leadership in the company is the game. That’s how you win at business.

Also, it is where you start seeing a level of enjoyment from a different space. The fulfillment is different. What I recognized in the development of a team was a fulfillment that was different than getting patient results one-on-one. It was different and it was satisfying. To see that, my influence now started to pervade in a greater capacity than just the one-on-one relationship with my patient. It was intoxicating. That is what changed my mindset from, “I wish someone would take all the business headache off my plate so I could treat patients full time,” to, “I don’t want to treat anymore. I just want to grow this thing and build a team that I love in a culture that I am proud of and people that I have confidence in.”

That was more invigorating. My mindset shifted from one to the other which I would never have expected. I treated for ten years wishing someone would take the business stuff off my plate and I switched over to, “I’d rather work on the business, build this thing, go ahead, and take the treatment stuff off my plate because I get a ton of fulfillment and joy from seeing my team grow.”

That is exactly what you’re talking about. I took that leadership training program not just for a clinic director, but it was the same thing for my director of marketing. As you said, we have four clinics. We had a full-time director of marketing. She got trained just the same as my clinic directors did. It’s a similar process just different aspects of their job responsibilities.

I even had a lead technician in most of my clinics because we had a handful. We have 4 or 5 technicians. All are part-time with various schedules. It could be a huge headache for a clinic director. If one of them has a little bit of seniority, let them manage the schedules, the accountability, and the training of the techs and I’d pay them a little bit more but they went through the same process. They would do the same things, but just specific to their job.

As you said, that process and building out the team can lead to a lot more fulfillment, success, and joy for the owners. Expansion becomes a lot more easy and that’s what you noticed as you did develop that team. Opening the second and now opening the third clinic has become significantly easier for you as the owner.

It’s a journey, but in that journey, you have to do some hard stuff. You got to open up a clinic, work your butt off, be scared and nervous. You go through all the challenges and have sleepless nights and overcome them. Once you get on the other side, it’s like, “Now, I’ve got all this I can share with people.” You can then help other people have their many experiences. They’re not going to have palpitations like you did. They’re going to have their many challenges and growth. It then becomes fun.

I know we’re wrapping things up but I failed to mention. We also provided coaching for our leaders that was not specific to me.

I do the same thing. I’ve been thinking about that.

We hired a coach to work with them. What it did for them to be able to say what they could, to have a safe space where they could be open and honest about how they have to interact with me, Will, or both of us. It is beneficial for them. That coach could provide those strategies on how to approach us and also champion the owners because we were paying the coaches out of our own pockets. They were representing us to a point.

If the leader came to them with an idea that was a little bit fanciful, crazy, or maybe too expensive, the coach on our behalf would be able to say, “You’re a little bit crazy right there. There are some other options. We then didn’t have to handle and look like the bad guys. That was a level of investment that we took and honestly, we were big believers in coaching. We spent the money but our team appreciated it and their capabilities accelerated because they had one-on-one coaching or someone outside of ourselves.

There was an opportunity there. I have to ask before we finish. We mentioned some books and people routinely appreciate when we mentioned books that we’ve read and recommended. What are some in relationship to this that you have recommended? You said Leadership and Self-Deception. What were some others that you’d have your team read?

The Five Dysfunctions of a Team by Patrick Lencioni. That’s a great book. There are four books in our program. The 7 Habits of Highly Effective People is a good book. Leadership and Self-Deception is a fantastic book. I would say the majority of people who have read that book all tell me that it’s life-changing. It’s a great book and it’s a short read.

I usually go back and reread it.

I might do that too. The last one is The E-Myth . We also have some podcast episodes and we also have the cliff notes of some other books like Think and Grow Rich . That’s a hard read so I don’t make them read the whole book.

What I do with Think and Grow Rich is I tell them to read the first four chapters. That’s the most impactful part of the entire book. There is plenty of other stuff that’s good but if they wanted to keep the reading to a minimum and a lot of the concepts down, the first four chapters could do well.

We did Good to Great with Jim Collins. We don’t read that book but again, there’s a website. There are little videos of Level 5 Leadership and The Flywheel Effect. Also, learning all those things.

I love what you’re talking about there. You are giving them the YouTube clips that explain the concepts from the book.

We have a time management book in there and I’ll give you two. One is Essentialism . It’s a great book. The next one is The ONE Thing by Gary Keller. Those are two good books to help you wrap your head around how to prioritize or shift around prioritization.

For those of you who are thinking about leadership, it’s Who Not How .

That book is great, especially with delegation. If you have a delegation problem, it’s Who Not How.

It’s more mindset-specific to the owner. It’s not necessarily what your leadership team might need to read or watch. Unless you notice that your leadership team has a hard time delegating themselves, then you might want to have them read Who Not How. That’s another impactful one.

We have a few clients in our group that are building out clinical director roles, and I would highly recommend reading Rocket Fuel . If you and the director read it together, it’s 100 pages long. It’s not very long, but it’s such a good book to lay the foundation of the relationship.

Rocket Fuel is Gino Wickman, right?

Yes. It’s a great book.

Our time is up. It’s another great discussion in the bank. I appreciate it.

Until next time.

Where can people get in touch with you?

It’s at Adam@PTOClub.com.

I am at Nathan@PTOClub.com . Until next time. We’ll talk to you in the next episode.

He continues to work closely with business consultants to continue to grow Southern to be everything that it can. During his spare time, Adam enjoys spending time with his family and friends.

He enjoys challenging himself with an eager desire to continuously learn and grow both personally and professionally. Adam enjoys a commitment to recreational exercise, and nutrition, as well as his hobbies of playing golf and guitar.

Adam is inspired by people who set out to accomplish great things and then develop the discipline and lifestyle to achieve them. Adam focuses on empowering and coaching his team with the primary aim of developing “The Dream Team” that provides the absolute best patient experience possible.

He believes that when you can establish a strong culture of trust you can create an experience for your patients that will truly impact their lives in a positive way.

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