Keys To Growth And Expansion – FB Live Event With Adam Robin And Tanny Crawford

All of our experiences—the highs and the lows—build up to take us to this exact moment. We are on a never-ending journey of growth and expansion. Adam Robin, partner and coach with PT Owners Club, takes the reins on this episode of the Physical Therapy Owners Club and introduces Tanny Crawford – an experienced, new coach on the team. Tanny has been successful in PT ownership and management, and in this episode, he shares what some of the keys to his success have been. What he and Adam share are timeless truths for any business that desires to grow beyond the owners themselves. Tune in to learn about the lessons they took on their journeys to PT ownership.

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We have the new physical therapy owners club coach, my friend, Tanny Crawford . What’s up?

Thanks for having me. I’m glad to be here.

I thought it would be cool to bring you on and talk a little bit about your story, journey and approach to private practice. Not just private practice but leadership because I know that leadership’s a big piece of what you do and how you like to do things because your story is pretty cool and unique. It’s a little different than most of the people that I’ve talked to in the past. Tell me about your story, like becoming a PT, where you’re from and how you got started in this game.

That’s a nice way of saying my stories. I got a lot of twists and turns and forks on the road. I think everybody’s story’s got a little bit of that. I grew up in Jackson, Mississippi, a couple of generations deep in Mississippi, but I went to high school in Jackson. I ended up going to a couple of different colleges and universities before I figured out what I wanted to do. I thought I was going to go to medical school and then had some path corrections and went into physical therapy.

I had a summer job one summer. A good friend of mine persuaded me and introduced me to the PT world. I said, “That’s what I want to do.” I got into PT school way back in 2001. I went to the University of Mississippi Medical Center there. I graduated from a class and I always had this underlying voice or feeling or gut of whatever you want to call it. I always wanted to open my own clinic. Even as a physician, if I was going to be a doctor, I was like,” I want to run my own clinic.” I didn’t have that want or need to work for a large corporation.

Fast forward, I took a job out of PT school, worked for a little while, found some local partners and we started a company back in late 2003 called Performance Rehab. Over a 12 or 13-year period, we grew that. We started off with some assisted living home contracts and outpatient, centers and grew slowly but methodically over 12 or 13 good years and unbelievable relationships. God placed a number of people through that decade and our path. We were able to grow the company. We had some great physicians who supported us.

This is funny, but something I was thinking about the other day that I didn’t know much about emotional intelligence. I felt like I was gifted. Looking back, I know I was gifted in some of those aspects because I could tell if something was wrong with an employee or if a patient didn’t feel like they were getting the best treatment. There was something about them I could pick up on. I didn’t know what it was, but I would act on that. I would go talk to them and confront them. We had a good run there. I had an exit strategy with a larger PT organization called Drayer Physical Therapy who picked us up and acquired us in 2015.

How many clinics were you at at that time?

We had six outpatient clinics and about 20 or 21 assisted living contracts. We had about 100 employees. It’s a pretty good-sized organization. Drayer picked up our outpatient portion of the company. We sold our six clinics. I stayed on board with them. One of my partners did as well as an area manager managing clinics. We acquired a couple more clinics. In the next three years or so, we added another 15 or 18 clinics to the mix for Drayer. They ended up with 150 or 200 clinics.

During that transition from a clinic owner to an area manager for a larger corporation, they had some leadership coaching inside, but along the same lines, it was a friend of mine named Cory Lee, a John Maxwell executive coach now, he spurred my interest. He said, “You’ve been studying some leadership with the new company, why don’t you look at what John Maxwell offers?

I did and I got certified in John Maxwell leadership. This light bulb went off that was like, “This leadership stuff exists out in the world. What is personal development? What is leadership? What is clarity? What are goals?” All that stuff. I’m like, “Clarity?” I thought I could see pretty good. I went into the John Maxwell piece, got out and finished my three-year contract with Drayer. I had a non-compete. I moved in with a couple of physicians who opened a new direct primary care cash-based membership medicine model. I did some business development with them. I grew their clinics and then got picked up.

I’m speeding up a little bit here because now we’re 2019. I got picked up by a company here in Nashville. I live in Nashville now I bought a separate company out of bankruptcy. They hired me as a turnaround artist and COVID hit in 2020. We grew and turned those clinics around. We ended up selling a few. COVID hit and we put a damper on that. I took a chance to pivot into real estate here in Nashville and have loved it ever since.

That brings us up here to pretty much back in November when you guys reached out to me and talked about the Physical Therapy Owners Club and having a good idea of what you wanted, what I needed and it matched up. I’m glad to be a part of it. It pretty much brings us right up to still doing real estate and doing some coaching.

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You forgot to mention the best hire you ever made in your career. Do you remember who it was?

I do. Was it Adam Robin?

You hired me out of school. It was you and some of your guys with Drayer hired me. My first gig was with Drayer.

I didn’t know if you wanted me to mention you alive or not.

The greatest hire you ever made.

That’s why I said, phenomenal people. It’s been a fun journey. We can branch off into any of that if you want to. One thing I want to touch on real fast is we had that Slack channel. There’s been a couple of times when I had to pivot. Everybody has to pivot at some point. When maybe my partnership wasn’t working and we needed an exit strategy, it’s a pivot. When Drayer picks us up and the contract’s done, it’s time to pivot.

Pivot in basketball is changing directions with your foot still planted on a foundation. A pivot for us should also mean it’s a change in direction while remaining true to ourselves, staying connected to the foundation, changing directions while staying connected to the foundation, the core of who you are, what your business is, mission and vision. We talked about that a good bit, but it’s phenomenal. There’s something comforting knowing that you can change directions, but you still know I know who Tanny is, I know how I operate, and treat people, what my values and triggers are. We may not want to go that way, but we did.

You’ve had a ton of experience. I’m making this up on the fly everybody. I’ve got this broken down into you achieved some success with performance rehab. You had your partners. You were doing that for a while. you experienced some success. I’d love to learn a little more about, maybe bullet-pointing a few key pieces of how you did that, but then you had a transition, you pivoted, and it seems like during that transition is when you started to find a little bit more about leadership and personal growth. Maybe you were able to reflect back on some of your success and realize that that’s maybe some of what you were doing. Let’s talk about the first pieces of success or the first thirteen years. How’d you do that man? 6 clinics and 100 employees. That’s a lot. How’d you do that?

I didn’t view myself as successful when I was in the middle of all that. In fact, when the partnership started having a few issues, while I was in the middle of it, I viewed it as a failure. That’s pretty much a preaching moment right there that sometimes when you’re in the middle of something you view as a failure, it’s an experience that builds you up moving forward. I knew I wanted to start my own clinic, but I didn’t say in my mind when I was 25 years old that I wanted 6 clinics and 93 employees. I was like, “Let’s see if we can get a clinic going.”

Sometimes, when you're in the middle of something you view as a failure, it's literally an experience that builds you up moving forward.
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We found another guy, like another Adam Robin and I was like, “That dude could run a clinic by himself,” and then I light bulb went off and I’m like, “Let’s do another one because I feel comfortable. I trust this guy that he’s going to run this clinic the way they should be run.” We did number two. About two and a half years later, we found another guy and or girl. From that point, it was like, “We’ve done it twice.” Two and a half years later, “Let’s do it again.” We opened a third one and the same thing happened. It was literally about, we opened our first clinic in early ‘06 and another one in ‘08, ‘10, ‘11 and then the last one or was ‘12 and ‘14. It was about every 1.5 or 2 years. It was the people.

We didn’t build the building and then fill it up. We had the culture that another person that piece of the puzzle that fit. I was like, “Let’s get them plugged in over here because they’ll serve the whole community wherever it is.” If we were in Byron, Brandon, Madison, Clinton or whatever the area was, I was like, “This guy Adam, Russell, Jason or whoever it is, these guys are going to support this community and you don’t have to sell that. It’s a product that people need. That person was somebody that people need.”

I had a coaching call and we were talking briefly about Enneagrams. There’s another personality quiz system called Primal 7. It’s seven core questions that almost everybody asks at least one. There was one of them that some people asked this question, “Am I successful?” It’s part of some people’s core. They tend to ask that question all the time to the world, “Am I successful?”

All their quests, decisions and things that they do, they’re literally asking the world, “Am I successful?” In many people’s eyes, I was successful in the clinic. In my own eyes back then, I was not. In my own eyes back when my contract ended with Drayer and they didn’t ask me to be on their corporate board as like COO, which Tanmy’s plans may have been, that was to me a failure. The experience that I gained looking back, I’m like, “That was fantastic to have. That was a success in itself.” I think you’re successful. I think Robin is successful. Readers, I call him by his last name sometimes. Mr. Robin get down and give me 20, I think you are successful. Now if somebody were to ask you, you’d be like, “I’ve done some good things.”

It’s like, “We’re on the way. We’re working on it.”

You are the only one that can answer the question, “Am I secure? Am I safe? Am I wanted?” My Primal 7 question is, “Am I wanted.” You could answer that, but am I going to believe you? Probably, not. I can answer it for myself. I’m about the only one the way to answer that is to flip it into a statement. Instead of,  “Am I successful?”

It’s, “I am successful.”

Tell yourself you are successful.

I wrote down as you are talking a few things that resonated with me. 1) You said one step at a time. How’d you do that? You said, “We got one clinic going.” It’s like, “How do you eat elephants?” One bite at a time. One step at a time, then you mentioned it was less about your strategy and more about finding the right people. Somebody told me this one time and it stuck with me, “First who, then what.” Dan Sullivan wrote a book Who Not How .

Somebody said first, “Who then what.” I don’t know who it was, but it’s like at some point along the journey, once you figured out one clinic and it was time to go to 2 or maybe once you’re at 2 trying to go to 3, you’re eclipsing that you’re that evolving owner. At some point, it turns into a leadership game and it’s less about strategy. It’s not your marketing skills. It’s not your system as much. It’s more about like how do I get clear on who we are and what we want to do and find the right people who align with that and then get a massive alignment with my team. That’s the rocket ship that takes off. That’s when it gets fun.

We talked before we got on here about attracting. You attract people that want to be around you. Attraction versus chasing. You are the sum of the five people you hang around with the most. As you were talking about earlier, I don’t remember exactly how you put it, but at some point, people don’t hang out with you anymore. There are other people that come into your lives at the moment that they’re supposed to and then your cultural alignment, all of it works. It gives you much energy and passion. People can see it and it’s contagious.

This isn’t like traditional business advice. There’s so much power in this conversation. In the beginning, when you were at one clinic, before you had grown up, you were a little kid, I’m assuming you had some sleepless nights and were stressed out. You were gripping tight to things and you were trying to control things. You were trying to manipulate things and create the strategy. It’s overwhelmingly exhausting and unfun. A lot of people get stuck there.

Whenever we can get to this place of development where it’s like, “I want to like, ‘Let’s have fun. Let’s let go,’ and stop catastrophizing everything, have fun and get clear on who I am and who I want to be and be that person and start to attract more people around me who want to be similar to me, who have similar values as me, let go, trust them and stop micromanaging and like trust that process, that’s when things get fun.” That’s when things get like you get your life back. Your business grows.

Your leadership team comes around and they help you grow your clinic. You get to spend more time with your family. You find that freedom and fulfillment that we always try to help clients with. A lot of that has to do with setting up some foundational things in your business. The hard part is managing what’s in between your ears and getting you to think a little bit more clearly about like, “You don’t have to be the boss of everything. Let things chill for a little bit.” At least that’s been my experience. I don’t know about you.

When you have a dream and then you finally get ready to launch that dream, you’ve got this energy. It can get exhausting. It gets exhausting after a couple of months or maybe a year of the same old, but you run off this adrenaline rush of your first couple months and six months or whatever of having a new clinic open.

Thankfully, I had some partners who were phenomenal at bookkeeping and dotting the I’s crossing the T’s. I was a lot more of the relationship culture piece was fun. Most of that stress is somehow almost camouflage for a while when you’re running on adrenaline in like a candy store, “I’m doing it.” that was the beginning. Many years later out of school, that’s a self-renewed energy when you include to see other people grow in their businesses, whether it’s in the PT world or whatever line of work, it’s all the same.

There’s a method to it about the clarity, gaining the clarity piece and setting goals. that’s something I didn’t know when I was 24, 25, 28 or 33. I was a little bit late to the game but I’m glad I’m here. For instance, there’s a young guy that’s in one of my mastermind groups that’s 20, 23 or 24 years old. I tell him, “You are far ahead of most people that are 24 or 25 years old, starting to already look for that clarity, having the awareness that you even need clarity, goals and all that and culture.”

I would argue that is the answer to section three in the vault. It’s the answer like the lack of clarity is always the problem. It’s never not a problem. The lack of clarity is always the problem.

Confusion and inaction are just a lack of clarity.

Confusion and inaction are just a lack of clarity.
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Confused people don’t take action, buy or move forward. The art and rhythm of consistently allowing yourself to gain clarity is the key to self-awareness, leadership and to finding what you want.

You have to keep practicing that clarity. If anybody on here is a hunter, if you take your binoculars out of your bag and you haven’t had them for a couple of months, your scope on your gun, it’s not going to be clear. You have to readjust it. You have to have a consistent, intentional, deep work time for yourself. Keep clarity. Same thing with your eyes and glasses, you can’t have the same set of contacts for fifteen years. Your eye changes. You have to go back for adjustments. We have to have our own personal adjustments and consistent ones and intentional ones.

That’s where a coach comes in. I had a little connection call with a potential client and he’s like, “It’s an investment. You’re going to hire a coach. It hurts a little bit. You have to pay the money. It’s not going to break the bank but it is going to be a financial expense that is more than probably what you want to pay for most of the time. The guy was like, “Could you tell me a little bit about like what is it about coaching that has been astronomically great for you? Give me an example of something that you implemented in your business that was great.” I sat there.

I was like, “That’s a great question. It isn’t one thing, but what happens is I come to the call and I’m asked, ‘What is your focus and priority right now?’ I tell the coach and the coach tells me, ‘That’s probably not a great thing to focus on right now. Let’s replace this thing with this thing.’ The problem is that the new thing that you need to focus on, you have no idea, you have no knowledge of how to take action on that thing because you’ve never done it before. You say, I don’t know the first step to take regarding X.’ The coach says, ‘No problem. I have an entire blueprint and program for you to implement into your practice next week. I have a network of all these people who have mastered it that I can get you on the phone call with.’”

It’s a series of that over and over. It’s never one astronomical trick. It’s the process of showing up, shifting my priorities on what is most important and then being provided the resources to quickly implement every month. My competition is running around with a chicken with their head cut off. They’re not clear or focused. They are scared about the reimbursement cuts, this and COVID. They’re chasing thrown tail. I’m sitting there making one massive move every single month. Before you know it, you look up and you have 6 clinics and 100 employees. That’s been my experience.

You were talking about they don’t know how to operate. They may not even have known that X even existed. some of this coaching that I’ve learned from being coached myself was it’s almost like when you’re at the eye doctor, and I use this analogy all the time. You’re looking up there and you’re like, “I don’t know if those are letters, shapes, or numbers.”

He dials it in for you and it’s like, “A-E-B-R-Q-Z,” then he flips it over and does something else. You think you know what’s up there and then he clears it up for you or asks you the proverbial questions. He’s adjusting your lenses but you’re like, “I didn’t even know Z was an option up there.” It’s tThe same thing with coaching. It’s phenomenal the awareness and the clarity that questions can bring to people.

I’ve got a guy I work with here at the real estate office who used to book celebrities on cruises for colleges. He would have these big names, George W. Bucher and different people. He’d book them as the talent for the cruise they would, people would buy this cruise and get on there. Sometimes he said, “Do you know there are cruises that exist that are like cruises to nowhere?” I said, “No.” He said, “It leaves the dock, goes out, wanders around for 4 or 5 days and then comes back to shore.” I was like, “That’s a good leadership principle about goals.” If you don’t know where you’re going, you can’t see where you’re going, you’re going to float around out in the water. You’re busy. You’re chasing your tail.

You’re busy as heck. You’re tired at the end of the day.

You have seen all these patients and all this stuff. You’re about out of gas. It’s time to go back to doc. The goal piece is something that’s been huge and gnawing at those goals one little percent every week. Do one thing closer, one tiny thing that takes you a little bit closer to where you’re headed. That’s principles that I would’ve never known if I hadn’t gotten into coaching and been a coach myself.

I had a coaching call with a client. Let’s face it, especially small practice owners, they’re busy. There are a lot of practice owners that are in that stage of maybe you got like a part-time front desk person and you’re treating like 30 or 35 hours a week trying to work on your business on the weekends. That’s a hard place to be. If you’re there, welcome to be an entrepreneur.

You’re going to have to work a little. That’s the grind mode. You got to go for it here. The problem that we have is sometimes whenever we start to open up the door and help them paint a little bit of a vision of what they can focus on, you can see the to-do list. they start making like 27 to-dos instantly it becomes overwhelming.

It becomes like, “I’m always having a little bit of anxiety. I am mentally creating all this work for myself.” When you’re in that stage of business, you can only pick one thing at a time. Getting clear, comfortable and in the habit of learning, “If I have 27 things on my to-do list, I have to be brave and bold enough to say no 26 times,” so that you can say yes to the one right thing right now. That’s a good principle. It was the book Essentialism .

Prioritization is less about saying yes to the right thing and it’s more about saying no to all the wrong things. In the beginning, everything’s important. Everything is a ten. Everything is the most important thing. You’re working with a few clients. They’re all crushing it. What are you seeing in the industry right now with your clients? Are you seeing any common characteristics, traits or hurdles that you’re helping them overcome?

One thing that I’m seeing is that they are busy. They’re in the clinics. They are learning. they’re becoming more aware that they’ve got that death grip on treatment like, “I can’t not treat. I work 60 hours this week. I’ll work on my business outside this 40-hour hammer down treatment all week because we can’t lose that revenue.” That’s a very common piece and it’s very understandable.

At first glance, you would think that’s how 100% of people operate. The other thing is that if you think about developing others, one of the things that I like to do is to try to open people’s eyes and minds about developing other people so that they can take up any slack or mistreatments, always be hiring thing. Taking your time to back out a little bit and then allowing other people being able to delegate.

Give yourself permission for some people out there that’s hard to do. Give yourself permission to delegate. Another thing though is I’m finding, especially like I was, what’s common is they don’t know exactly who they are. They don’t know what their true core values are. they can’t articulate what their communication style is.

Give yourself permission to delegate. Allow somebody the opportunity to grow and give them the opportunity to mess up. It's okay.
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They can’t articulate what their leadership style is. that’s a common starting point that awareness is lacking in most everybody. As far as industry, it’s that treatment piece that 99% of people find it hard to work on the business because they’re spending 50, 45 or 50 hours a week working in the business. That’s two different mindsets. It’s the left side of the brain and the right side of the brain. It’s 30,000-foot view and it’s on the runway view. You can’t stand them both at the same time. you have to back off and get out. That’s one thing that’s common. People don’t back out work on the business. They steadily work in it. They’re down there on the runway, tightening up bolts on the tires and they never get out, take off and get up and look at it from a 30,000-foot view.

That’s a hard thing to do. I get it. I recall very vividly me being that guy of like, “We’ve got him in our group right now still.” The hardest challenge is to be brave enough to get out of treatment and try it. Your business will survive if you take a four-hour block of time, take a break and work on the business a little bit. I promise you it’ll survive. Everybody will be happy that you did that. Most people except you at first.

John Wayne said, “Courage is being scared to death, but saddling up anyway.”

That’s a good point. It’s not going to feel good. You’re going to be scared. At night you’re going to be thinking, “I’m going to lose money. I’m going to X, Y, Z.” You’re going to be looking over the shoulder of your people. that is exactly where the growth happens, that discomfort. that’s exactly where your team, even if you have one or two people on your team, your team has the opportunity to be themselves and learn how to work without you.

That’s a good point. If there’s anybody readings, if you find yourself exhausted and holding onto treatment and fearful about your whole world coming down if you step out, I encourage you to be brave and give it a shot and mark off some time on your counter you can work on your business because your business needs it.

If you can give yourself permission to delegate, allow somebody the opportunity to grow and give them the opportunity to mess up, it’s okay. If you would’ve done it yourself, probably wouldn’t have messed up, but then you wouldn’t have had that four-hour time period to work on your business and study to grow that thing.

They wouldn’t have learned. I think that we have delegation conversations in almost every coaching call because here’s the thing, there are two most important KPIs in your business. It’s 1) How much time free time do you have on your calendar every week? It’s probably the most important KPI. 2) Maybe not as objective, but how much bandwidth do you have? If you have four hours off every week, but you’re paying bills,  answering emails, calling the accountant and doing payroll and you’ve got all these things eating up your bandwidth, time is great. If you don’t have the ability to focus on something that’s going to move the needle in your business, it’s time to delegate.

Here’s the thing. You’re always going to be delegating what you’re doing. You’re always working yourself out of a job. You learn it, systemize it and give it away. You keep doing that until you’re up at the top of the mountain by yourself. What I always tell clients is, “When you give this thing away that’s scary and that’s your baby. You’ve been doing it this whole time, you’re going to be nervous about that. You’re going to have some emotions that everybody’s a little different.” It might be fear, paranoia or a little bit of anxiety.

It might be some worry. You’re going to want to look over the shoulder and you’re going to have this internal urge to jump in and look over the shoulder and try to make sure it’s right. The trick to that is to anticipate that. Anticipate those uncomfortable feelings and develop some strategies to hold yourself accountable and say, “I’m not going to be that micromanaging boss.” I you could do that over and over, then you start to learn, grow and do all the things we’re talking about.

It’s extra scary if you do it by yourself, but we’re here to help. You are not doing this by yourself. You’ve got kids. I’ve got kids. We went to the hospital, my wife had a baby and then they said, “It’s time to go home.” I’m like, “Crap,” especially on my first one. I was like, “What do we do?” They’re like, “Don’t worry. A nurse will call you. You’re going to come see us in a couple of days, it’ll be fine. Call us with any questions.” That’s what coaching’s all about. We’re here for you.

Readers,  always feel free to give me a shout. If you ever need anything, Adam@PtoClub.com . You can also join the Facebook group Physical Therapy Owners Club . Shoot me a direct message if you have any questions or challenges and if you need to be connected with anybody in my network. You can also email Tanny at Tanny@PtoClub.com . Shoot him a direct message. We built a system and a strategy that clearly defines and diagnosis exactly where you are at in your business. I can tell you the top three challenges that are bottlenecking your business with a quick phone call. I can give you the blueprint and point you in the right direction. All you got to do is reach out and I’m happy to do that for you. Tanny, do you have anything else for the folks?

If you’re wondering where you are right now and the path to success, you’re successful. Whether you’re in high school,  n college, you’ve started your first clinic and finished your first year, you’re five years, you’re a number five clinic, you’re in your 228 clinic, you are successful. We can help you get further. Thanks for having me.

Thanks. Let’s do this again.

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.

A physical therapist in practice and in administration, Tanny Crawford is impassioned to assist healthcare clients recover from illness and injury. In 2004 along with close partners, he launched Performance Rehab, an outpatient therapy practice that grew to 26 locations across the state. Crawford facilitated the 2015 acquisition of Performance Rehab by Drayer Physical Therapy Institute where he served as Area Manager and was responsible for clinical operations and growth. Crawford is instrumental in analyzing the health industry market and economic forces to determine growth and expansion opportunities. Tanny is currently Director of Business Development and Patient Experience at NewCare MD where he oversees clinical operations as well as maximizing the patient experience.

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