Adam's '3 Things I Learned in 2024': Delegation, Sales, And Leadership Development

Nathan Shields • February 20, 2025
PTO - Private Practice Owners Club - Nathan Shields | Leadership Development


Join Nathan Shields and Adam Robin as they explore some key ideas that came from Adam's experiences while expanding to his third clinic. Adam, who has a lot of experience as a physical therapy practice owner, talks about both the challenges he faced and the breakthroughs he achieved.

Episode Highlights:

Delegate to Elevate:  Letting go of some of your patient care responsibilities can be tough, but it's crucial for growing your practice. By delegating tasks, you can focus on more important work that helps your practice move forward.

Time is Your Most Valuable Asset:  It’s important to manage your time wisely. Prioritizing how you spend your time can make a big difference in balancing work and personal life while also helping your business grow.

Mastering Sales Skills:  Many practices think they have a marketing issue, but often the real problem is in sales. Adam explains how to train your team to connect with potential clients and keep them coming back.

Leadership Development is Key:  Having a strong leadership team is essential for growth. Adam discusses how you can find and nurture leaders within your practice, helping to create a culture of development and accountability.

Outsourcing Isn’t Always the Solution:  Simply throwing money at problems won’t fix them. Instead, Adam stresses the need to enhance your own mindset and skills to create real change in your practice.

 

Adam’s insights are incredibly valuable for anyone running a Private Practice, whether you're just getting started or managing several locations. This episode is filled with practical tips to help you grow your practice more efficiently and effectively.

Are you ready to elevate your private practice? Visit our Linktree for our Coaching Services, Free KPI Dashboard, Facebook Group, and Annual Strategic Planning Services:https://go.ppoclub.com/linktree-podcasts

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Adam's '3 Things I Learned in 2024': Delegation, Sales, And Leadership Development


How are you doing?

 

I’m ready to go.

 

Excited?

 

Yeah. January has come and gone.

 

It's gone. Is this the first episode that we put out in 2025? This is at least the first time we've done a recording in 2025.

 

You and I.

 

We put out a few others, but this is the first time you and I have gotten together. It's appropriate based on the topic that we're going to look back on what you learned. You're still owning physical therapy practices. I sold mine a few years ago, not learning as I go because I'm not a PT owner at this time, but you're still in it. You're in the thick of it. We want to highlight the three things that you learned from 2024. Even though you've grown a lot, you opened your third clinic in 2024, right?

 

Yes.

 

That was like February or March 2024. Huge growth gains in 2024, getting that ramped up. You've had leadership on board. You're in a developing clinic, but you're in no sense in the new stages.

 

No, the clinic's doing great.

 

That just means that you've got things to learn at a different level. Always learning.

 

Always learning.

 

The challenges are just totally different. Whether it's trying to get out of patient care so you can get this singular clinic up and going and hire your first 1 or 2 providers, that presents its own level of challenges, you might think that things get a little bit easier as you get to 2 or 3 clinics or more, but it's just different challenges even though you're out of patient care.

 

I like that you said that because I talk to a lot of owners and they're all working hard. One of the lies that we tell ourselves is that like, “If I step out of treatment, that means I'm not working hard anymore. I don't know how else to move the needle.” Sometimes I have to remind them that no, we're still going to work hard. It's just we're going to channel that same intensity into a different direction so that you can climb a new mountain.

 

You're already on the top of the mountain you're currently at. Congratulations. There's another peak that we have to keep going on. It's a lot of challenges. It's a journey. Just when you think you've put in enough work, you realize there's so much more work to do. It's like a bummer, but also exciting. It's like it just never stops. You keep growing and evolving. The more you learn, the more you get to pass down to others too. That's always fun.

 

Super fulfilling at that point because I even remember, and we're not getting into the topics of what you learned in 2024, but I remember distinctly, and you had to go through the experience, unfortunately, opening up that third clinic and you were cashflowing that clinic and you're like, “I don't want to ever do this again.” That's an experience that you had to go through in order to learn.

 

Three times again.

 

Do it a different way next time.

 

For sure. It costs a lot of money to grow. I'm being called to that book, Scaling Up, by Verne Harnish. She talks a lot about that component of making sure you've got this scalable financial system in place as you're growing. I was like, “Probably should have double-checked on that deal before I opened the clinic.”

 

I harken back to that book all the time. I think it's within the first few chapters. I don't think I completed the entire book because it's got a little heft to it. You used portions of it to significantly improve the culture in our clinics. In the first part, I remember distinctly talking about those growth stages for small businesses in general, 0 to $1 million is a growth stage. You grow again from $1 million to $4 million. I'm talking about in gross revenues. It’s another growth stage.

 

Learning to prioritize your time means overcoming the challenge of letting go and delegating effectively.

I think $4 million to $10 million is another growth stage. In between those benchmarks, $1 million, $4 million, and $10 million in revenues, you're not necessarily making significantly greater profit margins, but you're working harder, infusing with cash to get to the next level. It's cool to see that just play out. As I've talked to other owners, younger owners, more established owners, and owners that have 20 clinics and 40 clinics, those numbers stay true. It's really interesting to see. Not that that's a part of our conversation, but it's good information.

 

Great information. Keep your finances in check. That’s probably a good idea.

 

Make sure your finances are scalable. Keep that line of credit open. Make sure you have a good relationship with your bankers so you can pull out the business loan when you need it. Understand the SBA process if you're going to go down that route. Just know how to get to the money. Know how to use capital. Talk to us about 2024. Where do you want to start? What did you and your team learn in the past year?

 

I've been thinking about this through the lens of not just my clinics, but what I'm observing in other practices as well.

 

Not just what you experienced but also because you're coaching a number of clients.

 

It's like the same pattern. It's very similar patterns. They are just masked a little differently. I'm going to talk through this. How many episodes have you posted?

 

I've posted over 250, almost 300.

 

Delegation & Letting Go

There is never a shortage of conversations that we have around this idea of stepping out of patient care. What we're really talking about there is the art of delegating, the art of prioritizing your time over direct revenue-generating activity, which is a hard thing to do. The first hard thing to get rid of it just happens to be patient care, but that same monster shows up again and again. It just turns into something a little different.

 

Probably the most transformative book I've read in a long time was Dan Martell's book,Buy Back Your Time. I read that in early 2024 and it just solidified this idea that you will grow your business. You will have everything you want if you prioritize your time. What I have recognized is most people want very similar things. They want to make some money. They want to create a transformative impact in the lives of others via their patients, their team, their community, and their family. They want to be present with the people they love most.

 

They want to travel, learn new skills and go to the kids' soccer games, and be a part of their life at a high level. All of that is found through your ability to manage your time well. It's through your ability to recognize when it's time for you to let go of things. Whenever there are these things that you get good at, like treating patients, that seems like a no-brainer like, “I'm obviously the best person in my company to do this, so I should just continue to do this forever.”

 

We get stuck in that habit and then 6 months goes by and 12 months goes by and we don't realize we're still living the same life as we were last year. My risks have just grown. Everything's gotten more expensive and I'm still doing the same thing. I'm not doing a good deal. This is not a good deal. Stepping out of patient care and recognizing that there are greater opportunities for you when you spend time on new things that you can evolve and grow into is the biggest lesson that I had to relearn again this year and the one that I hope practice owners would learn, too.

 

The same challenges exist again. As you said, there's just a different mask on it. One challenge is to get out of patient care, but maybe you are the best, I don't know, at paying the bills, something stupid like that, and you want to control that when it's probably not worth your time to be doing that. I know one of my friends, that takes energy from him, managing all the accounts and when to pay the bills. He said, “I don't want to do it anymore,” so he found a bookkeeper. Find a bookkeeper and get all that crap together.

 

Mastering Time Management

They tell you, “This is due. Here's the link, go pay it.” He takes all that brain work off of his plate. That's just another part of delegating and buying back your time, as Dan Martell calls it. It goes back to those who prioritize money over time will have less of both, but those who prioritize time over money will have an abundance of each.

As you focus on time-saving and making your time essentially sacred and appropriately working on those things that are most important in your company, that's when you start seeing changes in the organization. You start recognizing, “I need to delegate this so I can focus over here where my company needs me.”

 

I can fill my calendar with these things that I can grow into. Whatever that skill is, maybe it's I got to get tightened up on my finances. Maybe I got to spend more time in the financial department or I got to learn how to market or I got to learn how to lead or I got to learn how to do whatever it is.

 

I've got to work out.

 

I’ve got to take care of myself.

 

That was a funny thing about one of our clients, Christy, when she first came on with me, she's like, “I've had a new baby, I've been unable to work out for months. I'm just in it every day.” Within less than six months, we'd found a way that she could start working out again. She had so much more energy and she was more optimistic about what things she could get done. She had a different perspective as she came to work. It just provided a whole different light to her life because she had the time to work out.

 

I would argue that this is the most important skillset that you can learn as a CEO. It is to be more aware of where you're spending your time and attention. It pops up, again, whenever you're starting to build more leaders in your team because if you're at a place where you've got 2, 3, 4, 5 clinics, whatever it is, congratulations. You've gone through this transition of learning how to prioritize your time and battling that demon of learning how to let go and delegate effectively. Now your leaders are going through that same journey. Where is their time being spent? Are they prioritizing their time so that they can grow into new things for your company? There are layers to it. If you can’t master that thing, you're never going to be able to treat or help others master it.

 

PTO - Private Practice Owners Club - Nathan Shields | Leadership Development

I think that's inevitable, that your leaders are going to come up against that. I think that's a natural thing. I know we experienced it, and I'm sure you've experienced it where one of your directors, maybe as a clinic director, maybe it was a director of operations or marketing doesn't matter, but one of your leaders or future leaders comes up and was like, “I'm overwhelmed doing this.” We would do an audit.

 

Will was really good at sitting down and doing an audit with these leaders and be like, “What are you working on?” “I'm doing this, that, and the other thing.” He's like, “You know that one thing that you're working on right there that's taking up five hours a week? I don't care if that doesn't get done until the end of the year.” They're like, “I thought you wanted that done like next week.” He's like, “No, I'd much rather you focus over here.” Having those conversations. We're saying, “I don't want you working on that thing at all. Underneath you, which one of your reports can do one of these for you?

 

I'm not so sure that that aligns with your goals this year or with our goals this year.

 

Do you remember our priorities?

 

Maybe somebody else on the team can grow into that so that you can step into the big thing. 

 

I'm assuming you had some of those conversations as well.

 

I am not doing that every day. We're always looking at like, “Let's remind ourselves, what's the priority again?” I've got eight hours today. How much of this energy needs to be placed towards X, Y, Z? Be more objective about where you're spending your time. It'll transform your life. I used to make the mistake of thinking, “Whenever I feel good, I'll do the thing. Whenever I feel good, then I'll step out of treatment. Whenever I feel safe and secure about my finances, then I'll step out of treatment.”

 

It's literally the complete opposite. It's whenever you do the thing, then you will feel good. It's literally the exact thing. You have to be the designer of your schedule, not the victim of your schedule. It's coming back to patient care. You guys are treating way too many patients. You're spending your time doing things that just don't deserve your time and attention any longer.

 

We need to find ways to get those things off your plate. Quite frankly, I'm tired of the excuse of like, “Patients just want to see me. I'm the only one who can do it,” or like all those limiting beliefs. We've got to move past this. You guys have been listening to Nathan. You've watched me go through his program and literally transform and expand following these principles. Just trust the process. Just do the thing and your life will change.

 

I remember having a candid conversation with one of the owners. She has a flourishing couple of clinics and she's still treating probably 25 hours a week and was telling me how these patients have to see her. I'm like, “Why is it that they have to see you?” She's like, “Nathan, I can run circles around my providers. I've got skills that are better than theirs. They're doing maybe 80% of what I can do. I just get better results.” I said, “How do you think your team would feel if you told them that?”

 

That sounds like poor leadership.

 

“If you told them God's honest truth about how you feel about your providers like you just told me, how would that go over? Whose fault is it that they're not as good as you?”

 

That's the real question. Are you taking ownership of that?

 

You're saying, “I'm better than you,” but if you do nothing about it, then they will never be as good as you, frankly.

 

Literally, it's like what problem do you want to solve? Here's the perfect example. This person has a full schedule of activity that's no longer challenging her or him to grow and expand into a different version of herself, which is the only thing that helps your business grow. There's this other really great opportunity that she can grow in. It's called empowering my team and help in training them and elevating them to a higher level so that they can do things similar to me, which is a new skillset, which will require time and attention and focus and structure and clarity, and vision.

 

True leadership.

 

You can’t get there unless you let go of the thing first so that you can step into it. If you focus on that, if you just decide like, “I'm going to make this problem my priority,” instead of my team, the stress I'm dealing with and the lack of sleep, that's one problem or you can make the problem like, “I'm going to focus on building my team,” make that the priority. You can grow into that. It's a perfect example.

 

I feel like I've beaten it enough over the years, but I think I need to just say it more often.

 

I don't think we'll ever stop. Patient care is just one thing, but it comes back to, like I said, there are levels like helping your team realize when it's time to start stepping out of treatment or delegating. Delegating marketing, recruiting, policy and procedure management, onboarding, hiring, all of those things are hard to let go of. You need to be the first person to recognize when it's time to let go. If you're the last person, then that's the problem. That's why your company's not growing.

 

I worry that we're beating this subject a little bit too much, but it goes, maybe there's an overarching issue. I wonder if that is people who don't know how to offload that responsibility, delegation, or coaching. Instead of facing the problem and saying, “I know that's the path I need to go down. I know I need to train them, teach them, show them the vision of maybe role-play, and hold them accountable to KPIs. No one's ever done it with me appropriately, so I'm not sure exactly how to do it to them because I'm not sure. I'm just a little bit naive to that. Maybe it's just easier to keep the status quo going.” Do you find that as you're working with clients, you have to coach them on how they work out of one role and into another?

 

Yes. There are a few things. It's going to be hard to step out of something unless you can create a bigger vision for yourself. 



Marketing is about building awareness of who you are and what you do.

You're totally clear about what you're going to go into.

 

You don't even have to be totally clear. You have to have an idea of what might be possible if you had some time. That's where the coach is helpful. Somebody who's already been there, who can describe what it's like over there like, “Actually, the room looks like this. This is like this. Can you see it?” If you can help paint that vision for that owner and they can start to see it and buy into that possibility for themselves, that can be the thing to give them clarity and encouragement to step into it, especially if you can give them a framework and tools. It's like, “Now we're here. Let's pour into your team. Let me tell you how that works.

 

Sometimes, it's as simple as just saying, “What exercises would you need?” If you wanted to coach your providers to be better providers so you could offload these patients off of your schedule and do more things, imagine you were one of those providers. What would you need? What kind of instruction? Give them that space now to be a little bit more creative.

 

I think 9 times out of 10, if they just thought about it, about what they would personally want, if they were being coached, to take on patients and do better, you'd be able to come up with that structure, I think. They wouldn't need a lot of coaching like, “Step one, do this, step two, do that.” You could come up with it yourself if you just allowed yourself to sit in that space and say, “What would I need? What would I imagine that being? How could I get to that best possible scenario of what would need to be in place?” I think it would come together.

 

I would take some cognitive centers of your brain that you haven't used in a while. You have to tap into some creativity.

 

Be okay with the first iteration not being perfect.

 

Of course. Mess it up a little bit.

 

Let's try something. Let's try a few things, see how it goes, and we'll work on it as we go. We talked a lot about that. What was the second thing that you learned in 2024?

 

The second thing is this idea of not having a sales framework or a sales process deployed inside the company.

 

What do you mean by sales?

 

I'm going to try to talk as clearly as I can around this, but there will be a framework for having enrollment conversations in various parts of your company, whether you're having an initial phone call, you're enrolling that person to schedule an appointment and to show up. Whether you are hiring somebody, enrolling that person to join your team, encouraging them, or influencing them to join the team,

 

Whether you're talking to a referral partner, you're enrolling them in the idea of doing business with you. You're enrolling a patient to refer their friend and family member. There's a lack of sales. There's a lack of language that you're using to create these enrollment conversations to position your company in a place where you can serve more people.

 

An evil word in the physical therapy world is sales. We don't want to be too salesman-y. I don't want to be like the car salesman trying to sell something. It's all about your level of reference and perspective, as if you're selling a plan of care after you do the initial evaluation. Now, let's get really good at it to make sure that those people actually show up for the entire plan of care and don't drop out.

 

If you guys are in the Facebook group, you might've seen a post that I posted not too long ago. It’s like, what's the difference between marketing and sales? I don't even know what the correct answer is, or even if there is, but what you'll see is that most owners are quick to raise their hand and say like, “I need more new patients. I need to learn more about marketing. More marketing is going to solve all my problems.”

 

If you just get more patients through my door, that'll solve all the problems.

 

It couldn't be more false, in my opinion. I know there are people who are not going to like that, and we're just going to have to agree or disagree. People who know what physical therapy is, for the most part. Most people know what physical therapy is. Physicians know what physical therapy is. They don't know all of the sophisticated high-level things that we do or what we're fully capable of, but they know the word physical therapy.

 

Sales Vs. Marketing Misconception

The awareness is there. You've got 1,500 to 2,000 people in your cell phone right now, who, if you call them and ask them what physical therapy is, would have some understanding of what that might be. That's what marketing is. Marketing is really about this idea of building awareness around who you are and what you do. You don't have a marketing problem. You have a sales problem, which is, how do I influence them and help them see that what I do is a solution to their problem? How do I help them choose me?

 

It's a valuable product worthy of exchange.

 

How do I convince them that, in an ethical way, in a way that serves them, that their time, money, and energy is worth spending with me because I can help them with their problem? That is a sales conversation. You could literally pick up the phone and start dialing and start enrolling people into your clinic. If you're good at sales, you could probably pick up 10 or 15 new patients now if you were good at it. You don't have a marketing problem. You have a lack of understanding of how to promote and position your business as a solution to problems.

 

That is the key because we want to hide behind a Facebook post and a Facebook ad and call ourselves, “We're not promoting. That's just my Facebook post.” We lack the skills or the desire to get out and be bold and promote our business to people, which I think was the real problem. If you have more sales in your business, you'll never have a new patient problem. Your patients will be retained. You'll be able to enroll people into your organization and you won't have a problem growing your company.

 

I think you can look at almost every step of the patient life cycle and consider a portion of that could be sales-related. If that person's making the first call into your clinic, go back from the prescription pads that you might share with the doctors or the website, specifically making sure it's geared towards sales and not just what you do, but why you're worthy of them coming in. Specifically, that first call, your person at the front desk, they need to be able to convert. They have to be able to convert. That phone call that's just like, “Do you take my insurance?” It better not be a yes or no and, “Here are the hours.”

 

PTO - Private Practice Owners Club - Nathan Shields | Leadership Development

I need more leads. I need more marketing.

 

That's where the salesperson of that front desk kicks in. They need to be able to say, “Tell me more about what you're dealing with,” like, “How can we help you? I've got a provider here who has specific treatments and gets great results with X, Y, Z, and problems. How long have you been dealing with it? Aren't you sick of having to deal with it on your own and trying different things and not getting better?”

 

They should be kicking in the sales gear on those phone calls. The providers need to be kicking in the sales gears when it comes to selling the plan of care. “Listen, this isn't how often you need to come in in order to get results.” “I can’t afford it.” I don't know how you go into it from there. “Come back when you can.” Do you just say, “What is it worth to you to get there?”

 

“I totally understand. Tell me more about your financial situation. What types of outcomes are you looking to invest in right now? Let's start talking about the outcome.”

 

“I'm telling you, you need to come in 3 times a week for 4 weeks. Coming in 1 time a week for 4 weeks isn't going to get you there. You're probably going to continue to have problems. Unfortunately, you might even say, ‘Physical therapy didn't help me.’ I'm telling you, you need to come in at this prescription level.” Sales can be seen there. Sales can be seen in the collections process like, “We want to do what's right for you guys. Let us know how we can help you out, are there payment plans we can figure out,” all that stuff. There's a sales part to all of the processes along the patient life cycle.

 

I can tell you for me personally, things literally transformed for me once I started really deciding that I wanted to be better at sales. I started installing that type of thing in my company. Training my providers on what sales is and what it means. We're not like a sales company with all the answers, but we're better than most.

 

Tell us what you're doing in 2024 to make your providers, your team, better salespeople.

 

Sales As A Crucial Skill

It's the same thing that we've done in 2023, which is installing that into the onboarding framework. There is so much that we can go into that, but sales is really the art of language. You're using language to help people make decisions. If you're not equipped with the right language that you need, you're never going to be able to influence behavior.

 

That language is found in the initial phone call, in the initial evaluation, in the check-in process, in the discharge, in the past patient phone call, and in the interview process. It's all an exchange of language. There are scripting and language frameworks that your team needs to be equipped with and trained on so that they can find the words and find the inspiration to create movement in the company. Number one, they have to understand what the patient life cycle is and where they.

 

It's just like the org board. They understand where the org board is and they understand, “I know exactly where I fit in this org board, I know my role, I know my product. They must understand the life cycle of the patient, where I fit. How I deploy effective strategies inside of it. How I create value inside of it, the language that I use to help people make decisions.” They have to understand the patient life cycle and then they have to be equipped with the language to add value. You have to role-play that stuff.

 

That's what I was going to say. You obviously came up with scripts or at least a template of what those conversations need to look like in order to sell end product. You've been training them on it. Is that about right?

 

Totally. For all new providers, we train, I can’t remember if it's before the 90-day mark when we hire people or right after, but we train them on our sales framework. The language that we use, we call it a Profitable Provider Program. That's what it's called. It's our sales cycle. Everybody's equipped with it. They have the language, and they have the scripts. We start role-playing with them. During those role-playing processes or training sessions, we're going to start asking them to use the tools. How are you going to help your patients see clearly the decisions that they're making? It's an important piece. We retrain everybody every year. Every year, Q1, we go through this entire process.

 

Is that like team meetings or something?

 

We'll block it off. I can’t remember how many steps are, maybe it's like 6 or 8 steps to the sales framework. We block off six weeks. We actually have one person on our team who's in charge of this whole program who deploys that into the company.

 

One hour during lunch, one day a week thing.

 

If you're this owner that is running circles around their team without necessarily recognizing it yet, you have lots of skillsets, strategies and influencing behavior that you are using to create great outcomes for your patients. Now it's time for you to bottle that up, package it and give that to your team so that they can elevate their skillset.

What we want to do is go from one person doing all the work to 30 people doing a little bit of the work. Now, you have 30 people who are all pointing in the right direction and understand the assignment. You can try to out-market me if you want, but you're going to lose every time. It's just hard to beat when you have everybody that clear.

 

You share some of that framework and those scripts with our clients, the coaching clients in The CEO Accelerator.

 

All clients that are in our CEO Accelerator get our clinical sales mastery protocol and it's all outlined. It’s an exact process that I use in my clinic, the video training, the scripts, how to install it. We give you access to that so you can share that with your teams, too.

 

I'll tell you the power of this one in particular, like a case, if you will, before we move on to number three, what you learned. I had an episode, it was a few years ago, and they set aside a half hour every week to role-play asking patients for referrals. You might think that's excessive, 30 minutes every week, everybody on the team sets aside, like, “Take your lunch for an hour, then we have another half hour working on this, getting a referral.”

 

I think he realized, 10% of his new patients are physician referrals, some crazy number. I'm not exaggerating. He's like, “I think our physician referral number that we relied on for new patients was like in the 10% to 15% range.” Guess what? When COVID came around, it hardly bothered him at all. All those physician's offices that were closed or scaled back or anything, they kept coming.

 

You have 30 salesmen on your team. It's like, “How are you going to beat them?”


No one is a natural-born leader without first going through challenges to become a great one.

He's like, “We just crushed. My team knows how to get a referral and sell our product.”

 

It's such a powerful thing. I do want to hit on one more thing before we move on because I know that you're not a fan of sales. I know it's not your natural thing that you enjoy doing.

 

It's a weak spot.

 

We all have weak spots, but we all are familiar with that uncomfortable feeling whenever we have to overcome an objection or challenge a patient or somebody. There's that uncomfortableness of like, “I don't know where to go from here. Can you just listen to what I say? I don't know, I'm not equipped with the language that I need.”

 

“Can you just say yes so that I can get done with this?”

 

“Can you just say yes and save both of us right now?” If somebody's trying to cancel their appointment or if they don't want to show up for their, whatever, when you decide that you no longer want to deal with that uncomfortable emotion anymore, you will learn sales, you will learn the scripts, and you will never experience that again. You will just be super empowered and excited about it and it won't be this foreign weird thing. You'll win way more often.

 

I need to go through your training process.

 

Come on, let's do it.

 

What's number three?

 

You Can't Outsource Growth

Number three. Here is what I learned in 2024. There are really owners, including myself, all looking for this outsourced solution to solve all of our problems. Marketing is a prime example. We think that if I just hire an agency to do some Facebook ads, I just outsource that situation, I never have to deal with sales instead of deciding to learn sales and do the thing. We're always, inadvertently, seeking an outsourced solution.

 

We're trying to throw money at our problems. However, things will not move into your business until you elevate yourself, as the owner, which will elevate your mindset, your skillset, and your ability to execute. When you elevate your mindset, skillset, and execution, your company will grow. That's it. Nobody's coming to save you for that. Owners usually get better at the mindset. They can read books, they can learn the language. My mindset will improve. Skillset will improve. Where I see owners getting stuck is this ability of execution, especially executing through their team.

 

As an example, you just hit on it, again, I'm going to use this owner who had all the mindset and skillset but didn't know how to drive execution through her team or his team. It's this idea of, “I know how to do all the hard stuff, but I don't have anybody on my team who knows how to do all the hard stuff. I don't know how to equip them with the tools, resources and strategies that they need to do some of the hard stuff.” A lack of leadership. You can develop yourself as a leader, but you're having a hard time developing other leaders. That is the big bottleneck that I'm seeing practice owners and business owners, in general, bump into over and over. They're not having a hard time getting through that hump.

 

That seems to be one of the more popular topics on the episodes that I've done. When I've gone to PPS, some of the more popular presentations or breakout sessions are those around leadership development. I think as owners, we have a certain level of leadership, whether that's simply because we stepped out into that role without significant training, simply by opening the practice or we have some experience with leadership in the past, whether it's in youth groups or through college or high school. Maybe we're president of the so-and-so club or maybe we're in student councils.

 

We have some level of leadership and then we might have some natural qualities about us, but no one is a naturally born leader who hasn't gone through the rough stuff to become a really good leader. What I'm trying to say is that it's hard to then turn around and develop other leaders because that's not something that you've been trained to do. That's what I like to tell people. It’s like, “What got you to where you are? What influenced some of your decisions? What are influential people, podcasts, books? You name i.

 

Maybe if you just expose your team to some of those same things, they'll start taking on some of the same leadership characteristics that you have and start leading your company the same way you do, which is ultimately what you want. You want your influence to be spread through the company. To go back to where we started the episode, no longer is your influence one-on-one with a patient, me affecting one life as a provider to a patient, but rather now, I'm affecting thousands of lives through multiple providers. That's where your influence and power in your leadership really grows.

 

Building out that kind of leadership development program can also come if you just open up your mind a little bit and say, “What influenced me? What are some of the things that have been influential in my growth and development to this point?” If you don't have those things, then that's probably where you need a coach or you need to start reading some books and listening to podcasts.

 

If you do have some of those things, maybe you can just say, “Here's a library of books that you can read. Let's sit down every so often and tell me about a problem that came up and how you would solve it. I'll share with you how I would solve it. Maybe we can brainstorm on how to better solve it together.”

 

Give them the space to think like a leader and give your feedback based on your experience. I think there's a huge desire for owners to have some instructional and leadership development. You can get part of the way there, but building that out is what's really going to drive your growth from a 1-to-2 clinic operation to a 3, 4, 5, 10-clinic operation. It's just really getting clear on this leadership development program.

 

Developing Leaders For Growth

I'm a mindset guy. I love working with owners who've got the operations figured out, but they're all in on the leadership. That's my, “I love working with those people.” It's my favorite thing to talk about, but the challenge that I've recognized, and I'm not saying this as a blanket statement, it's just been what I've seen, is level one of leadership is leading yourself, transforming yourself into a leader. That is level one.

 

Level two is like, how do I build other leaders? Level three is how do I help others build other leaders. There are levels of leadership. I think most people, especially PTs, OTs, and speech therapists, are really smart and capable humans. As you said, they're doing hard things and elevating their leadership skills. I think what stops most people is what you hinted at. I think that they don't fully recognize that they have much to offer other people.

 

It's like, “Why would Nathan ever want to listen to me? I'm just a regular old speech therapist.” It's not until you help them recognize this, “Look how far you've come. You've read all these books and you've done all these hard things that's inspiring. You have a lot to offer people.” There's this framework you've got to recognize that you've got something of value that some people at least would find valuable. You have to believe in yourself.

 

That's the first thing that we have to help them recognize. Second, this is an industry thing, but we are very hesitant to allow other people to be uncomfortable. We don't want people to be uncomfortable. Unfortunately, there's no path to leadership without doing hard things and letting other people become uncomfortable. The problem is most owners have gone through traumatic experiences and really hard things.

 

PTO - Private Practice Owners Club - Nathan Shields | Leadership Development

It's just like working 80 hours a week, they are killing themselves for years. They don't want that for their team. Unfortunately, there's no path to leadership without hard things. What we want to do is create a controlled environment where it's like, “It's hard, but not too fricking hard.” Once we give our team permission to struggle a little, but then also win, then you can start to see your team growing as leaders as well.

 

There's a huge opportunity there for us to really increase our effect and really get a lot of fulfillment as you see other people grow into leadership. You experienced it more recently than me, but once I really got clear that the leadership team that I had in place, cumulatively, it was significantly better than what I could do by myself.

 

The team, like the rest of the team that reported to them, was happier because they didn't rely on me, the singular person, to answer all the questions. Now, they have a trained leadership team that they could go to. Frankly, I think that gives the team much more respect for those people who they know have worked up through the system to become leaders. Now they can say, “Here's a peer who is now a leader.”

 

They’ve done a lot of cool things.

 

“They’ve done a lot of cool things and has learned a lot from Nathan and Will. Now they're telling me something that I thought Nathan and Will were telling me, but now you're telling me that, too? Maybe there's something behind it.” It's that idea that when it comes from a leader, from the owners, they might take it with a grain of salt. When it comes from a peer who's saying the same thing, then they think, “You're serious.”

 

There's a real culture here now.

 

We've got a second and a third witness of what we need to do, maybe there's some truth behind it. A lot of power and a great opportunity there as you develop your leadership team.

 

For sure. It takes some intentionality to recognize some of your limiting beliefs and to step into that place of boldness. If you do, you can help transform people's lives.

 

Definitely. We've taken a lot of time in this episode.

 

We did. It was fun.

 

The good thing I think we need to really share here as we're talking about leadership development is we have developed a program, the Aligned Leader Program in which owners can offer some leadership development training to their leaders. A lot of what we've done the past few years is coaching our owners one-on-one. We have the one-on-one visits, group calls, a dedicated Slack channel, and you have the vault, a resource that owners can use full of templates and tools, etc., and videos.

 

That's where the sales program you alluded to in your problem number two is fully accessible to those clients. At this point, now in 2025, we're offering the Aligned Leader Program. That is not all on the owners to do all the leadership development. We have some of that structuring in place. You've put a vault together specifically for resources and tools that leaders can use either as potential leaders or current leaders to go through and learn some things like time management strategies.

 

The sales process and how to hold somebody accountable, all these things are in that vault for clinic leaders and they will also be available to have group calls with you. We can start developing some of those leadership or some of those leaders and potential leaders to support those owners that have those out there. We recognize that as these owners are going through, this is a tough stage to develop that leadership team. It can be tough, and we are able to provide some support to our clients now.

 

My vision is to help you transition your team from tadpoles to sharks. That's the analogy that I've been using. We want to help you. You're ambitious, you're hungry, you want to grow, you want to make an impact in your life and in other people's lives. We want to help you build a team that can match that ambition, who's hungry with you, who wants to get on board with you, who wants to do some heavy lifting, who wants to work hard, who's open to sacrificing to grow in your company. We want to help you develop the culture of those types of people so that they can do some of the heavy lifting for you.

 

It’s so nice when you have that team. I've met your leaders and they are equally invested.

 

They're amazing. They're incredible. They inspire me.

 

It's not hard to say they care about as much as you do about that. Catherine might care about it more than you. She's doing awesome. It's cool when you have that kind of support underneath you. Anyways, thanks for your time. If people wanted to get in touch with you and ask about the Aligned Leader Program, how do they do that?

 

Shoot me an email, Adam@PPOClub.com. Join the Facebook group, and find me, Dr. Adam Robin. You can shoot me a DM. That's probably the best two ways.

 

We'll catch you around on the flip side.

 

Sounds good, brother.

 

See you.

 

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