Mistakes To Avoid In An Add-On Cash-Based Service With Stephen Rapposelli, PT Of StretchPlex

In this exciting episode, we sit down with Stephen Rapposelli, a highly experienced physical therapy clinic owner who knows a thing or two about expanding clinic operations. Get ready to learn some practical tips and actionable advice that will help you scale your business effectively. Whether you’re a seasoned PT clinic owner or just starting, you won’t want to miss this!

During the podcast, you will discover the need to focus on cultivating a strong company culture that not only boosts employee morale but also improves patient satisfaction. And that’s not all – you also need to optimize your clinic’s workflow and streamline operational processes to increase productivity and profitability. But there’s more! By exploring innovative marketing techniques and patient acquisition strategies, you can stand out from your competitors and resonate with your target audience. Why settle for average when you can be exceptional?

What are you waiting for? Take your clinic to the next level. Empower your team and foster growth. Discover the most effective leadership and management practices that will help you achieve your goals!

Want to talk about improving your PT business, or have a burning question? Book a call with Nathan – https://calendly.com/ptoclub/discoverycall.

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We got a frequent flyer back on. He is one of our favorite guests in the past, Stephen Rapposelli, the CEO of StretchPlex , and Owner of Performance Physical Therapy Clinics in Delaware. Stephen, it’s awesome to have you back.

Thank you so much for having me, Nathan. It’s always a pleasure.

It’s been cool to speak with you over the last few years because you’re not only a big fan of the podcast, which I really appreciate, but you also have been able to share with us some of your growth as it’s related specifically to StretchPlex. If the people who are reading haven’t read our episode with you explaining StretchPlex, I recommend they go back and read that because you developed this cash-based program specifically for your company.

We’ve been able to watch you and you explained it. You talked to us a little bit last time about what the benefits of it were and how you made it successful. This time, I’m excited to have you on because you will be talking to us about some of the lessons that you’ve learned over the past three years. I know that you’re bringing this from a place of, “If you’re looking at any cash-based service, if you’re looking to do some add-ons to your physical therapy clinics, these are some of the things to consider,” or at least, I’m assuming. We haven’t talked about what you’re going to present, but this could extrapolate to other cash-based services as well, I assume.

Ye.

Let’s talk about it. Let’s give people a little bit of an idea. Give them a one-minute summary of what got you into StretchPlex, your cash-based service and then we can get into some of the lessons you’ve learned over the last few years.

I want to start with the early days of aviation. In the early days of aviation, there was a cockpit and that cockpit had walls to it. In the cockpit was the throttle and those throttles were pretty basic back then. It was a stick with a ball at the end of it. To go faster, you would push the throttle forward. You would go balls to the wall, which means you’re going to go very fast. In this show, we’re going to go balls to the wall, but now you know the meaning behind that phrase or that cliché.

I say that and I start with that not only to get your attention but to remind all of us that you need to check your understanding of what you think reality is. It’s because believe it or not, a lot of people think that balls to the walls mean something else, but it means pushing the balls of the throttle to the front wall of the cockpit to make the plane go faster. What story are you telling yourself that may not be true?

One story might be that physical therapists just do physical therapy. Another one might be, “I don’t have the time, resources, or talent to do something different.” A story might be, “I can’t increase my profit margin.” I wanted to come back to this show to be an example of a physical therapist who decided to open up his mindset and see what could be done.

I’ve proven that it can be done by physical therapists. As you know, I like to make fun of us a little bit as physical therapists and I can because I’m a physical therapist so I have every right to make fun of us. We have that Peace Corps gene in us where it seems like we just want to give it all away. Even if it’s a TheraBand bag, just take it.

It’s our bleeding hearts.

Right, or bark at the moon because some other business is taking away what we think is our turf. Also, to try to put that it’s on its head and say, “I can be that grouchy old man or woman, or I can do it and do it better and let’s see what happens.” Hopefully, your readers will come away with it and say, “If that guy can do it, I can do it,” because you can’t. It all happened to me when I was at Graham Sessions. I think it was in 2018 or 2019. I wish I knew the guy.

I like to tell the story of the guy who said, “Everybody pulls out your phone. I want you to type in StretchLab,” we’ve never heard of it. We typed it in and up comes the website and 200 PTs jaws dropped open, including mine. We were upset. We’re like, “How dare they? This is what we’re doing. This is what we should be doing. How can they do this,” and all these things. It’s your gut reaction, including mine. After I got over that, I said to myself, “Why can’t I do it? Why shouldn’t I do it? Why couldn’t I do it?” We went ahead and we did it. This also came from years of feedback from my patients who said, “I would pay you just a stretch of this knee replacement out after you discharge me.” I’m like, “Betty, come on. That’s silly.”

I can’t do that. That’s not physical therapy.

“Come on, Betty. Let’s just get through our session here.” After about fifteen years, it finally dawned on me of hearing that maybe the lady’s got something there. As a PT, tell me if you’ve never felt this way. The profit margins start going down, reimbursement isn’t going up, but everybody wants a raise and you’re like, “I’m wondering if I’m on a sinking ship here.” If you do nothing, it very well may be a sinking ship or you can do something about it. You can become a smith of your own fortune, a maker of your own fortune.

We started this, and I’ll be honest with you. I made up the name. We made up what the people who do the work are called. Half the things are just our creative side going crazy. It’s probably how they make South Bar. What we wanted to also avoid is the frustration of not being the gatekeeper. As much as we would like to be the gatekeepers in healthcare as physical therapists and all that, it is not happening.

I don’t know if you’ve ever heard it where a patient calls you back and says, “The doctor said I didn’t need physical therapy anymore so I’m discharging myself.” Can you imagine seeing somebody who’s seen a rheumatologist and say, “You don’t need to go to the rheumatologist anymore? You can discharge yourself from them.” That doesn’t happen, or an orthopedic surgeon.

They do that to you, but you don’t do it to them. It’s a little frustrating not being the first one to get that human and take care of them. Once we started doing this, we discovered that it’s now the opposite and it started growing very quickly. We started with one clinic within our four walls in one room and that’s probably how everybody starts.

At least, they should because I think a lot of people have this idea, “I need to find a 1,500-square-foot space.” They think they need to start big and have it fully delineated instead of trying the product first in a room and see if it flies first and then go from there.

Simple scales, fancy fails. What’s the least you can do to see if this stuff works for you in your town because this doesn’t work everywhere? You have to have an audience who values what you’re doing and who’s willing to pay for it. This is a cash-based service so people are opening up their wallets. I like it. It’s different from physical therapy. In fact, many things about this are the exact opposite of what you’re used to as a PT owner. It wakes up new parts of your brain. Within about 4 or maybe 5 months, we had four of these separate studios.

This leads us to how we were dumb in part one. I’m a classic visionary. I’ve never met an idea that I didn’t like. If you talk about squirrel, “Squirrel, there’s a great spot. Let’s put one there.” I could justify it. I could talk you into anything. All of a sudden, we went from maybe 600 square feet to probably 4,000 square feet in total in these four studios, which comes with staffing, expenses, and rent, and everything was upside down.

Growing too fast in this business is a real problem. You have to guard yourself against that. That’s how we were dumb part one and it’s taken us quite a while to recover from that because it opened up some other dumb things that we discovered that we did and didn’t do which I’m happy to be vulnerable to your audience and let them know. It’s because if they go down this path, they can create their own wounds or an unforced error if they don’t think things through.

Growing too fast in this business is a real problem. You have to guard yourself against that.
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Here’s the next one and now, it’s funny because as you listen to me, see if it also applies to your PT business. It’s very interesting. Here’s the next big mistake that will make you kind of wince a little bit when you hear it. We didn’t have systems and procedures in place. We thought we did, but we didn’t. I think it’s a mark of being an adult when the idea of policies and procedures to some degree maybe excites you a little bit because there’s safety in, “How do we do this?”

Here’s how we do it. We have a do a document that says, “This is how we do it.” This is what we do and this is how we do it. That’s the operations manual and the employee handbook. It’s simple. If you want to keep it simple, but if you don’t have it, trouble happens and you’re not ready for it. We didn’t have systems and procedures in place and it’s taken us a long time to have the right person develop those to make things run the way they should.

Can I ask you about that a little bit?

Please do.

You thought you had some policies and procedures in place. Was it that you just hadn’t detailed them enough or what was missing that didn’t allow you to follow the system? Where was the disconnect there? You thought you had it, but what were you missing?

Here’s one of the secrets that I tell other owners that they should use because I think that I may be the laziest person on the planet. What I did as a PT owner is I said, “I got policies and procedures. It’s called Performance Physical Therapy Policies and Procedures. I’ll just use that.” I just moved it right over.

You change the title from Performance Physical Therapy to StretchPlex and keep everything the same, right?

Exactly.

I see what you’re doing.

Who looks at those things? However, you then see how it’s different and then you go, “Yeah, that’s a problem.” The other beauty of that is it also makes you look at your PT business differently because you discover, “There’s no strong accountability chart here. We better do that.” If you venture into a cash-based business, it’s going to make your PT business better because you are going to take some of that. Why make the donuts over again if you can help it, but then you have to look at it and you see where you probably need to tighten up operations over on your PT business side, which is a good thing, isn’t it?

Yeah. I think you’re going to get to this point, but it’s at a point where it’s at the top of my mind, and I have to ask because we had the same thing. We started a separate venture in our physical therapy clinic. We got into diagnostics and it was great for us, but it didn’t survive well until we made it its own organization. We tried to stuff it into the physical therapy and make it work within the physical therapy organization and it didn’t go well or it wasn’t gaining any traction.

It didn’t gain any traction until we made it a separate LLC with its own organizational chart, its own policy, and procedures. Sure, we could steal from the other one. It has its own KPIs, reports, and chart of accounts in QuickBooks. We didn’t co-mingle funds between the two anymore. We were tracking them separately. It has different billing and collections accounts even though we use the same people.

Nathan, that’s a golden nugget the one you just said.

I didn’t know if you were going to go down that route, but that’s what we noticed is that it has to be that it has to be separated and treated as a separate business.

It makes total sense and it should be that way in the beginning but it’s like your child coming back home after they graduate from college. It’s like, “It’s not working here. Now, we got too many adults in this house.” That’s what you find to happen. The staff is fighting for literal physical space. Your customers are confused. Here’s a tiny little story, which as a physical therapist, is embarrassing.

We had somebody who wouldn’t come to the stretching because it was in a PT clinic, and they had been to a PT clinic in the past and had a bad experience. That hurts me and my heart because you like to think as a PT that everybody does great work and everybody has great experience but there’s something that you never thought that people do have some preconceived ideas of our profession that can be a barrier to unrestricted flow of service.

If you’re not careful, those same employees, if they are pulling double duty for both organizations, can get distracted especially if they’ve caught the vision of this newfangled thing. Also, maybe they’re similar to you, and they get distracted by the shiny new object, which is the new cash-based program and they’re sitting at the front desk.

Maybe they’re letting their authorizations slack a little bit. Maybe they’re not making the calls to canceled patients or no-show patients like they used to because they like this new thing over here. “I thought you wanted me to get that up and going and help you out with that.” They could get distracted from their true KPIs, which are in the physical therapy organization.

There’s a lot to unpack for what you just said. You go in a lot of different directions there and one that I do want to touch base on because I’m sure that there are some people out there who are pulling their hair thinking you’re just waiting to be sued and that is I’m very clear that this is not physical therapy. They’re customers. They come to a studio. They’re not patients. They don’t come to a clinic. There’s no physical therapist touching somebody. They’re separate people.

You have to be very clear about that, which is another huge tick in the column for, “Get it out of your clinic as soon as you can and make it separate.” I get it. That’s a big leap of faith. I’m talking about step five. Think about step one, which is fine, but step one may not last very long. It might only be months before you’re like, “That’s nice. We’ve had enough. We’re leaving now.”

The other part of your statement that is worth noting and I’m talking right now, hopefully to PT owners or PTs at least that is you have to make a decision about what role you’re going to play in that new entity because it can be a full-time job. If you think, “I’m just going to do this as a side gig for a couple of hours a week. We got this one room and it’s just going to be fine. We’ll not spend a lot on it. Joe is good. He is a PT aid and people seem to like him. We’ll just have him stretch out Nancy after she’s been discharged.”

You have to be very, very clear in what your role is and what you’re going to play in it because it’s a new baby and you’ll be as successful to the degree that you devote some of your bandwidth to make it go. Some guys and gals want to be operators. Some want to be owners. Be clear on which one you want to do because if you’re going to be an operator, I get it. I don’t have to do notes anymore. I don’t have to worry about insurance. “I’m leaving it all behind.”

Be clear on which one you want to do.
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It’s still going to take up a significant portion of your time if you’re going to operate these services and it doesn’t matter. Just because I offer personal training, stretching, and compression. I’m talking about anything. It could be chanting, burning incense, and tarot card reading. It’s what your people or your customers want and if they ask for it and you provide it, then you have to be clear on what your role is going to play and stick to it.

You want to be clear, “Are you going to be the technician? Are you going to be the person that’s doing all the hands-on work? Are you going to be the owner who hires the technician to do all that work and you’re just going to oversee?” Eventually, you want to work your way out of that technician position to the owner/administrative position, which is the same thing you should be doing in your physical therapy clinics, by the way.

If any of these new projects you think are only going to take a few hours a week, then I think you’re kidding yourself because you should be going into it developing a marketing strategy and building out policies and procedures. This is how we get a customer. This is how we treat them. This is what we say when they first make the phone call. This is how we approach them when they come for the first time. This is how we collect. This is how we say goodbye. This is how we keep them as a customer.

It’s a marketing strategy and customer service strategy. How are you going to provide the product that they’re creating? Also, that all takes time, and speaking of that, I like to say that your business’ love language is quality time. If you are having a hard enough time giving that quality time to your physical therapy clinic, and now you think you can just shove in a couple more hours for this new venture, if you want to make it work, it’s going to be hard if you don’t have the time to carve out and provide the time that it needs.

Every time you speak, there’s so much within that one little soliloquy that can be pulled out that I’m like, “You’re right.” One thing that stands out to me, Nathan, is that I think it resonates with about everybody who’s reading this. Nobody thinks they’re average as a physical therapist. You think you’re great and we all have our groupies. Believe it or not, there’s a cohort of people out there who think that I’m great. You start believing that after a while, and you’re like, “Once I start seeing this patient, they’re mine forever. There’s a steel cage around them. They love me,” etc.

It takes humility, which is a core attribute of a leader, to say, “Whatever the Steve magic is or the Nathan magic, I can probably operationalize that. If I thought about it long enough, I could make a checklist of how on my initial evaluation, I create people who will come back the next time and 100% they will not cancel.”

Also, you wind up identifying these soft skills. I look people in the eye. I call them by their name. I shake their hand. I say hello, goodbye, and thank you. I explain what I’ve done. I make sure that they can anticipate that something’s going to happen the next time. I tell them how they’re going to feel so that when they do feel it, they’re going to be like, “That guy’s brilliant. He knew that I was going to be so after this.” Those little things all have to go into how you teach physical therapists, support staff, and then your cash base providers on how to speak to people.

It’s because in this world of AI and in this world of Amazon, you will win every time because of your people skills and your soft skills. That can never be reproduced. You spend your time teaching everybody below you how those little differences, those little turn-in phrases make all the difference in the world to people. We train a lot on that and then we revisit it.

In this world of AI, you will win every time when you have people skills and soft skills. That can never be reproduced.
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You grew too fast and then you also took on what sounds like a lot of expenses too quickly instead of keeping it slim.

Do you know how easy it is to spend money?

Yeah.

You don’t like those tables. Let’s get new ones. You don’t like that color. Let’s get a different color.

You didn’t have policies and procedures in place and you had to work on that.

Here’s the next one. Are you ready?

What’s that?

Lack of accountability and follow-up.

I think that the studio should look, sound, and smell a certain way. I’ve told you how it should be. I’ve shown you pictures of it. I then go about my business of being a physical therapist and running a physical therapy practice. I let you handle it and then I come back and this is the actual thing that happened. I walked into one of those studios and they were playing Ozzy Osbourne. The body coaches were wearing baseball caps. They looked like thugs and the lights were off. You think, “This guy’s got to be exaggerating.” I was not.

I walked in. I looked around and I walked out. I said, “I can’t believe what I just saw.” The lack of follow-up and accountability is critical when you start to branch out and you start to let others into your sandbox. Just because I’ve written it down as a checklist, you got to follow up on it and make sure that it’s always like that because you get to have it whatever way you want it to be, but you have to make sure that it still is.

I’m like, “How come that studio isn’t doing well? How come visits are dropping in that studio?” We walked in and we found out. “That’s not welcoming to people.” Seventy-year-old Betty is not going to like listening to Ozzy Osbourne and AC/DC even though the people who work there liked it. You have to ensure accountability, and that means you have to follow up. You have to make sure that everything is just the way you want it or the people that you delegate that follow up on it. It’s the same thing with PT, isn’t it?

It is. I like that the first thing you did was observe. In my training in the past, it was if you see an issue in a certain area as it is being reported to you by the KPIs. You’re seeing something go down in the wrong direction on a graph according to the KPI, I think one of those first things is to observe the situation. If KPIs are getting low at the front desk, if KPIs are low for someone for a provider and their cancel rate is high compared to the other providers in your clinic, I think one of the first things you need to do is simply observe.

I like using analogies and the analogy is true. I call it a dashboard. Just like the dashboard of your car, when the check engine light comes on all that means is you better go check your engine. It doesn’t tell you that your spark plug is bad, your distributors are all messed up, or you left your coat under the hood or something. It doesn’t tell you any of that stuff. It just says that something’s not right. Just like in your PT business, you should get to a degree of intimacy with your KPIs that you may not know at first blush what’s wrong, but you know something’s not right.

I know that if the claim is submitted a certain amount two weeks later, revenue’s going to be a certain amount based on visits that were a certain amount. If one is crazy, everybody in the leadership team goes, “Something’s going on there that in the beginning we didn’t.” Also, the same thing will happen when you have a cash-based business. Only you won’t have any history to know.

Right now we’re at the level we can predict and we have it all out, leads, conversion rate, booking rate, and follow-up plan of care booked. We can see it the whole way but you won’t know initially. On the cash-based side, it’s really simple. In the beginning, it’s “Do I have more money at the end of the month than I did at the beginning of the month?” That’s okay for a couple of months to think that way. We all did that. I did that for probably the first ten years.

My KPI was my checking account balance and now you’re like, “That revenue per visit dropped a little bit,” You look at the charges and the units. If your 26-year-old self heard you now, they wouldn’t even know what you were talking about. It happens over time and you develop a new nomenclature for this side business. The next dumb move is letting the wrong people in.

Now, if anybody has the key to unlock the ability to know 100% of the time who the wrong people are, I would like to know who you are. We could probably spend the balance of this show talking about funny stories of the person who was all that in a bag of chips and the first day they were late because their car was booted and those kinds of people. You’re like, “I didn’t see that coming.”

However, letting the wrong people in and then adding insult to injury, using time, energy, and resources to train them when they’re the wrong person is a huge mistake particularly when you’re growing fast because you need people. I need people. If I don’t have enough openings, I can’t do the business. We all get that. It’s the same as PT but if you let the wrong person in, and if you don’t have a framework and a procedure to try to at least weed out the obvious bad ones, this is going to go bad fast.

You’re not going to give up some control to be able to do the things that you need to do. Finding the right person is critical. You’ve had many guests on your previous episodes on some cool ways to evaluate that. I think that there’s good advice in some of your previous shows on how to do that and lots of books to read. I think that there may not be one that’s the absolute best, but something is better than your gut.

That’s a hard part for most physical therapy owners because we weren’t trained to weed those people out. We’re trained to be physical therapists. We weren’t trained to even be business owners. As you said, Adam and I talked about how to interview people well and that’s a big part of the weed-out process to ensure that there’s value alignment to begin with.

The shadowing process, I’m a huge believer, in job shadows for at least a couple of hours at a time. It helps weed people out. References are huge, of course. That is something that just has to be learned because otherwise, our interviews devolve into, “Tell me a little bit about yourself. What makes you great? Why are you excited about physical therapy,” without getting to the nuts and bolts of are they aligned with you or not?

One data point can have a slope in any direction. Having people other than yourself be part of that sourcing process is helpful and then compare notes. “Did you see that? Did you see women’s written? Did you get the same thing?” “Now, I didn’t,” or, “Yes, I did.” Having somebody else is helpful and different platforms. We use it online. We use the phone. We use in-person and we use hands-on. Those are four different data points that help you come to the conclusion of whether the person gets it, wants it, and has the capacity for it.

I love the stuff that you’re bringing up because it’s fully applicable to the physical therapy clinic. All the stuff that we’re talking about is the exact same thing when it comes to opening up a PT clinic. You have to recognize that you’ve got to do all that over again for a cash-based business. You can’t think that you’re past it now and I can open up this cash-based business because it’s a great idea.

The Laws of Gravity still apply. If you step off the balcony, you will drop. There’s no doubt about it. You can’t forget that. I’m not going to call it a dumb mistake because we didn’t commit this, but I’m going to reverse it. It’s the best thing that we did, there is no doubt about it, is coaching. Tiger Woods has a coach. Why the heck would that guy need a coach? It’s Tiger Woods. I need a coach. You need a coach. Everybody needs a coach.

What you want to do, and I’ll quote my buddy Alex Hormozi, who I love. “Get a coach from the person who’s two or three steps above you who’s done it.” He said, “I can’t coach you on a billion-dollar business because I don’t have a billion-dollar company. I can coach you on $100 million business because I have a $100 million dollar company but that’s who you go to. You go to somebody who’s done it and has experience doing it so that you get the lessons without the scars.

That’s been my mantra since I started. There are three steps. It’s to reach out, step out, and network. Reach out is it but you got to find some kind of support.

You don’t do it, but I’m telling you, most people are like, “I don’t need that,” but yes, you do. Where are we now? We’re probably going to go past a million in the cash-based services. I don’t consider it a secret and that’s four studios. That’s with systems in place and exceptional people. My COO is probably one of the most extraordinary young men I’ve ever met. He is everything that I’m not. I couldn’t do it without him. He’s the horsepower. It’s good to find those kind of people. I’m saying that simply because we’re not talking about a $1,000 difference. It’s getting to be, at least to me, it’s that significant amount of revenue. It’s nothing to sneeze at and where’s the limit? I don’t see one.

I know you have a model to get StretchPlex throughout the country. Are you in other states at this point?

Pennsylvania and Delaware but I’m saying this because you can do this as a PT. You should be doing this as a PT. Again, if you decide to offer infrared, cold plunges, and CBD oil, I know. I get it. There are people who are like, “That is an affront to my professional sensibilities. It’s totally unethical.” You can say that all you want but I’m going to still be here. I went to get my car wash, and I’m looking at the display inside the car wash. They’re selling CBD oil.

Why do they do that? If somebody is not appropriate to sell CBD oil, it should be a car wash for God’s sake and I’m worried that I shouldn’t be selling TheraBand or I shouldn’t be selling a pillow. There might still be people like that but again, I’m also going to offer the services that my people want me to sell to them. I want to try to make it as valuable as possible to solve a problem that they have. Part of the problem that we have as physical therapists is there are a lot of obstacles to get to us.

A lot of obstacles to getting to us, whether it’s insurance, the doctor, the paperwork, and son on. Again, I’m a PT so I can say it but the business that solves the problem with as little friction as possible to the customer wins. That lady who looks good in a bathing suit on Facebook. She is selling her exercise regimen for $800 and she doesn’t know what an iliopsoas versus tensor fasciae latae is. She doesn’t care.

Neither are the new buyers.

She wins. Again, I want everybody to think about opening up their mind. Think about saying, “I got a built-in advantage here as a physical therapist.” “Are you kidding me?” I see people coming into these studios. I overheard one guy say, “I’m getting a double hip replacement in a month so I came here before I was getting my hips replaced and then I’m going to come back afterward.” I’m like, “That’s great that you’re here before. I think if you get your double hip replacement, you should probably see a physical therapist, by the way. I happen to have a great one.” I just won. You are the first person that they get and you have a good experience with them. You have a relationship with them. They’re not going to go anywhere else but your PT place. Why would you do that?

What are some other cash-based services that you’ve seen that you’ve been impressed with? There are some out there that I’m like, “I don’t know about that.” As you’ve looked at it, are there some that you’re like, that could fly, or that’s cool?”

Not to be crude, but there’s a butt for every seat. You see it on your Facebook feed or your social media feed that there are people who love infrared. They love saunas. They love cold. Personally, I don’t want anybody taking their clothes off. I don’t want anybody getting wet. I don’t want any of that. None of that. In fact, that’s what one of our customers said.

They said, “When I get stretched out, it’s like a massage but I can come in during the day because I’m not going to get all messed up and I have to change and shower. If I leave my clothes on, you just stretch me around. It’s just like a massage.” I went, “You just gave me a tagline. Thank you so much.” I listen to the customers. I think that there’s great potential in those kinds of things because there are people who like that now. It’s probably not going to work in the hills of remote Kentucky somewhere just because you have to be where the people are ready, willing, and able to pay for that kind of service.

StretchPlex for a time got some traction and I still see it. Do you see it continuing to grow or do you see branches of it forming?

To me, it’s absolutely a blue ocean. It is so underserved in all my travels that any physical therapist should be able to do this and dominate their local market because you just add 1 or 2 elements. Here’s how I advocate for small businesses. We add 1 or 2 combinations to our offer and then we have a unique offer that no one else provides. We do personal training and compression. StretchLab doesn’t do that. Stretch Zone doesn’t do that. We are totally unique and it’s good to be the only person that does that in your area because then it’s not about price. It’s about the valuable service.

Also, when you have that, you don’t have competition. It’s then a matter of you getting the word out. As I like to say, if I have a bowl of ice cream, all I need to do is take that little scoop and say, “Would you like the taste of this ice cream,” and then it’s that simple. When they go, “I like that ice cream,” you go, “Do you want a bowl?” That’s it. It’s like in physical therapy. You say, “Do you want to get off the toilet?” I’m going to stretch that knee out after it’s replaced. They’re like, “I see it.” It comes with some pain and all, but it’s not quite like ice cream but they get the solution.

It’s not as fun as ice cream.

We have great stories to tell as physical therapists. Do you want to talk about great stories? Look in your clinics. There are people who are miracles and we need to be better storytellers. That’s why I started with a story at the beginning of our show to try to also illustrate that to tell a good story, you have it, and then you can tell it more with your cash-based services. Why wouldn’t they do it? It’s like selling a hamburger and not selling the French fries. I’m okay selling the French fries and if you want to tell somebody to go down the street to get French fries separately, you keep doing that and I’ll keep selling the French fries. How about that?

Do you want to talk about great stories? Look in your clinics. Some people are miracles, and we need to be better storytellers.
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Thanks so much for your time.

Absolutely. It’s fun to talk about this. I’m more than happy to talk about all my mistakes. If anybody wants to reach out to me, they can certainly email me. It’s simple to remember my name. It’s Steve Rapposelli. Wrap it up and sell it. Google search it and you’ll find me sooner or later. A lot of people reach out and ask questions. I’m happy to do that. I even have some checklist that I could email them to evaluate whether their business is good for this or not because not all businesses are meant to do this, and not all owners should do it. You have to have the right framework. You have to be the right person. You got to be ready to go. I’m happy to help people. Sometimes I tell people, “Don’t do it,” and some people I’m like, “This is going to be a ride for you.”

I imagine that it’s not a good fit for our relatively new owners who are still trying to build their first clinic. Don’t get distracted. Focus on your clinic. I know you want to increase your average reimbursement rate, but focus on getting solid policies and procedures in one clinic first and then we can talk about some other things.

That’s valuable to come to that realization and that’s where your coach comes in. Put the brakes on. Nathan, thank you so much for having me on. It’s a pleasure. Again, nothing but respect for the quality of your show.

I always appreciate having you on. I appreciate you sharing and being a little bit vulnerable. Everyone else takes a lesson from it as well.

Sometimes I’m an example. Sometimes I’m a warning.

Thanks, Stephen.

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