Stop Being The Bottleneck

We break down why a therapy practice can feel stuck even when leads and demand are strong, and how the real bottleneck often traces back to the owner. We walk through three common constraints and the practical moves that free up time, improve profitability, and make growth sustainable.

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Hey Physical Therapists! I'm currently writing the book Profit First for Physical Therapists and I'm looking for advanced readers. Go to www.pf4pt.com to join the waitlist and get early access. 

*Intro/outro song credit:
King Around Here by Alex Grohl

Transcript

The Bottleneck Behind The Plateau

SPEAKER_00 0:49

Is your practice at a place where it just feels like it's it's plateaued? Maybe you are growing and then all of a sudden it's just you've hit this ceiling that you're really trying to push through but can't. There's a bottleneck somewhere. Well, what if that bottleneck is you? My name is Craig, and I'm the owner of Daisy Financial Coaching. Our team is on a mission to make your therapy practice permanently profitable. If you own a solo or group practice, we're here to help you build a business that creates more time, makes more money, and serves more people. This is the Therapy Business Podcast. In order to run your practice efficiently, you have to look for bottlenecks. This is a term that you've probably heard before. Uh it genuinely and literally comes from a bottle itself. So if you take a bottle, it doesn't matter how big the base of that bottle is. It could be a Coke bottle, uh, it could be a three-gallon jug. If that opening, the neck of the bottle, is skinnier than the body. That's just typically how it goes. So you could tip it upside down, and it only so much can get through that small opening. Again, regardless of how big the base of that bottle is, it's all got to go through that small, that small opening in the neck. And in a business, this the term bottleneck is often used when you have your business at a place where everything's humming along, but then there just only so much can happen because you've just kind of hit this wall. Uh, maybe you have so many leads coming in, but you don't have enough people to support them. And so that creates a bottleneck where you've got people on a wait list or you're turning people away because you cannot you don't have the capacity to take them on, or uh maybe your your clinic doesn't have enough tables to to work with uh patients or whatever that is. So bottlenecks can happen. Now, what happens a lot of times, and in many cases, is we, the business owners, become our own bottleneck. And it can happen without us even realizing it. We can be frustrated. Why are we not growing? What happened? Why did we hit this ceiling? And truth be told, it's it's us. And so I want to walk through a few ways this happens. And maybe you already know it, maybe you're feeling it, and we'll go through some ways that you can fix this or begin to take steps to take action. Or maybe this is just a chance to self-diagnose, listen to the different ways it can happen and see if they ring true for you. It might be that light bulb moment of oh, this is why we're running into issues right now. So, one way this happens, the first way is trying to do everything. You, the business owner, are trying to do everything. When you first start this, your practice, uh and you're solo, and it's just you, you are doing everything. You are wearing every hat because you financially cannot afford to hire people, probably. So you are the therapist or the PT, you are the admin, you're the biller, you're the marketer, you're the salesperson, you are the business owner, you are everything. Then as you grow and you hire people and you your team starts to develop, you might run into an issue where you're sitting here and you're like, why do I still feel like I am doing everything? Why do I still have a full patient load? And why am I still

Doing Everything And Burning Out

SPEAKER_00 4:24

dealing with this billing? Why am I the one who's still doing the sales and consultations and I'm still doing the marketing? And you realize I've grown, the revenue has increased, our team has increased, and yet here I am still trying to juggle it all. This can happen because we we feel this need to control. Sometimes it happens just because it's easier just to do it ourselves than to pass it off. I've caught myself that in that in that mindset many times where uh with when I had a VA uh helping a virtual assistant helping me out, I would be going through a test and like, oh, this is probably something I could pass off to them. I'm like, well, or I could just I'm just gonna go ahead and do it because it's faster for me just to go ahead and knock it out instead of creating a video or trying to teach them how to do it. And then of course next week I'm doing the same task again. It's faster for me just to do it myself than teach them how to do it, and so on and so on. So the problem here is we just continue to try and do everything. Whether we are realizing it or not, we become the bottleneck there. And all of a sudden, we are so strapped so thin that we can't give enough of ourselves to the marketing, and we can't give enough of ourselves to our patients, and we can't give enough to of ourselves to our team. Everybody everybody's getting scraps, and it just creates this bottleneck, this this it just constrains, and we can't grow from there. So the way to fix this is to delegate. Uh, go through your well, I I like to say start by looking at what's your ideal week. Uh, what do you want to be doing? What is your ideal role? Uh, is it to be focusing on big picture visionary stuff? Is it to uh be managing the team? Is it to do you still want to work with patients and clients? What does that look like to you? Then look at your week. And as you're going through this week, you know, I would say create a list right now of tasks that you have to do or that you are in charge of doing that really you do you really need to be doing it? Maybe you don't enjoy it, maybe it's not important, maybe it's just something like, yeah, I could easily pass this off to somebody else, and just start generating that list. And then over the next couple weeks, just be really aware of tasks you're doing that you could pass off to somebody else. And then delegate these to your admin team. If you don't have an admin, uh if you have the funds to, you can look at getting somebody part-time to come in or a virtual assistant. There could be a lot of things you could do. If billing is on your plate and it's taking up a lot of your time, look into companies that can take over your billing for you. A lot of different ways to delegate those. Look at your if you're working with patients and clients, could you delegate some of them to your clinicians? What else can you take off of your plate so you can focus on something else? If you enjoy, uh for me, I enjoy content creation and marketing. So because I enjoy that, I created more space in my work week to do that. I was finding I wasn't able to keep up with it all because I was so busy doing all the other things when I was trying to do everything that I couldn't keep up with the content. But I want to do that. If you don't enjoy doing that, then maybe you outsource that. You you partner up with a marketing company. If you're doing your own bookkeeping, then you know, find a bookkeeper. All these things that you are just make a list, see what you can delegate out. That's gonna free up a lot of time so that you can then focus on the bigger picture, on growing the practice, on taking on more clients. It's gonna help you scale and that can really remove that bottleneck. Number two is you don't have any clear or repeatable systems. You know, when I first hired my first coach uh to work for me, this was um maybe five or six years ago. I brought in Alicia to work with me on, she was gonna take over the personal finance coaching side. And as I'm training her, I'm realizing all of my systems or a majority of my systems were just in my head. I didn't have clear, repeatable systems, something that I can teach or show somebody for them to easily follow. And that became a bottleneck right there. Because how can I scale if everything's just in my head? All of a sudden the business relies too heavily on me and what I know. And if an employee were to run into a question

Systems That Let You Scale

SPEAKER_00 8:40

or into a problem, how are they gonna solve it? They're gonna have to come to me and ask questions. Versus if we have a repeatable system or standard operating procedure for everything we're doing, they can defer to that instead. They can become their own expert in the procedure and they don't need me to figure it out or to solve it. So as we grow, again, if you started as a solo person and then you start hiring, at some point you you realize, okay, yeah, we need a legitimate system. And so some different systems to that I think every practice needs is a money system for sure. Uh, this is gonna be your profit first. So, yes, you need an accounting system. That's another one. That's your bookkeeping and your taxes. Again, I highly recommend, unless you have an accounting background, that you outsource that. I outsource my bookkeeping. I don't even do my own bookkeeping because uh it's it's just not a good use of my time. I want to focus, it's not where my passion lies. I would rather spend my time focusing on growing the business and doing marketing and working with my team. So I outsource that. So an accounting system that you can outsource, a money system, which is one you're gonna manage, but something that's simple, like profit first, something that's easy to follow. So if down the road you end up hiring an internal accounting team, they know what to do. They know how to allocate funds, they know how to do X, Y, and Z. Profit First takes care of that very simply and easily. An onboarding system, what does that look like when you bring in a patient? Do you have an evaluation process? What does that look like? When how do you get somebody to sign up for their first session? How do you uh collect their information? How do you schedule out their follow-up appointments? All of those elements. Do you have a sales uh system or marketing system? When, and this can be for a variety of different ways, but I'll start with inbound leads. If somebody comes to your website and fills out a form or somebody picks up the phone and calls your clinic, what's this what's the process? You collect their information. What are you what's the goal? Are you trying to get them into um again an evaluation? Are you trying to get them to schedule their very first session? What are you collecting from them? Do you need billing information? Do you need insurance information? What does that look like? Is there a follow-up process, a system there? So after they've called, or they filled out the form. If they don't, maybe they left a voicemail or they filled out a form on the website and you reach out to them and they don't answer. What's the process after that? This is an area where a lot of times we lose people because we're not following up with them anymore. It's just we've tried once or twice and they vanish into the into the into the outer space. I don't know wherever they go. So follow-up systems. All of these are really crucial. And so I'm I know if you don't have any of these, this can be incredibly overwhelming as I'm throwing them out. Take these as examples. I'm not saying run out and you need to do all of these things immediately, just things to start thinking about as you grow your team. And if you have a team and you don't have these systems, pick one. What's the biggest pain point and see if you can start implementing something? If you haven't hired a team yet, or even if you do have one, but this is for anybody, start now by just simply recording yourself doing tasks, doing what you think the system should be. This is hitting screen record on your computer, pull up a microphone, just speak into the microphone, talking through how you're doing something. So somebody fills in the form on your website, screen record. All right, I'm gonna take their information, we're gonna automatically plug it into their CRM. I'm gonna go ahead and reach out to them now. Okay, they did not answer. So here's what I'm gonna do: I'm gonna schedule a reminder for tomorrow to try to call them back again to do a follow-up. So you see, you just screen record it, and then you can upload it to a library of different tutorials and operating procedures so that people can defer to that. You have a process that, again, if they get stuck or they're not sure what to do, they can go look at that instead of tapping you on the shoulder and asking you to show them or remind them what to do. Uh, there's once you've recorded those, you can even upload them into AI and say, can you convert this into a SOP document, a standard operating procedure document? So something that somebody could read. Uh, there's great softwares out there like Scribe, which will screen record as you're doing something. And as you click, it's gonna screen capture it and then it's gonna put little descriptions of what to do. And then you can go through there and it's something that people can read and then they can see the image of what to click on, what to do. So there's different resources out there that are that make this really easy and simple. So I just say start now as you're doing any task, even if you don't have somebody to delegate it to yet, just record it and upload it somewhere so that one day, if you do, if you don't have an admin now and you do hire somebody, you now have a library of tasks. Number one, that you want to offload to them, and number two, how to do them. And so you can give them access to that. They can then train themselves on how to do these things, and bada bang, you passed it off. So that is a great fix to the no-clear repeatable systems. And the final bottleneck, I there I say final, there's probably endless bottlenecks, but the the third most common one that I see is you're treating too many patients or working with too many clients. This happens so easily, uh, again, because you probably started just you by yourself, and you treated and worked with everybody until you reached a point where your calendar was so full and demand was high enough that you brought somebody in to help you, and then you built up their caseload, and then maybe you had to hire again, and then maybe you built up theirs and had to hire again, and so on, but at no point stopped to reduce yours, right? You just kept treating the same number of patients, started working with the same number of clients, and you never stopped to reduce it. You just kept hiring because demand increased, and it felt like you couldn't turn them away because your the demand was

Reduce Your Caseload On Purpose

SPEAKER_00 14:44

too much. And then your time is is thin. Uh my calendar got so full a few years ago before I finally started hiring coaches between sales calls and client calls, and then my own calls with my coaches and um different things where it's it's accountability groups, my mastermind groups. So I had so many things on my calendar that I was barely able to squeeze in time to do anything else. My calendar became not my own, and I realized okay, I have to reduce what I'm seeing. Um, so a good rule of thumb here as you're growing is if you hire somebody, let's say, uh let's say you're a physical therapist and you hire a PT and you have a caseload, well, you're gonna start giving them the new clients. So if they get a client and that client pays a hundred dollars for simplicity's sake, and you see a client and they pay a hundred dollars, it's not a one-to-one. So let's say you're working with them and they pay a hundred dollars, you get to keep that hundred dollars, right? You don't have to pay anybody to to treat that patient. You it's yours, it goes into the business. You don't have to pay anybody. If they treat that patient for a hundred dollars, you have to pay them to do that. So maybe they take forty dollars of that. So really all you're making is sixty after you've paid them, sixty dollars gets paid to the practice. So if you're trying to grow and reduce your caseload, then a good rule of thumb is for every two patients your employee gets, your PT gets, you can let go of one. And so you can reduce one. So if you have 20 patients visits per week, if they add two, then you can drop yours to 19. If they get to four, you can drop yours to 18, so on and so forth. So this is a good rule of thumb reducing your patient load, but find a proactive way to bring that down so you can then refocus your energy on other things. If you're finding bottlenecks, our coaches are really good at helping strategize through these things. So, yes, the money system profit first is something we specialize in, but we use that as a foundation so that then we can help you grow your practice in a healthy way, avoid bottlenecks, create a practice that really does give you that freedom of time and money that you've been seeking. If you want some help with that, there's always a link in the show notes to get connected with one of our coaches. It's a free consultation just to get to know us and see if it's a good fit and see how we can best help you. So we would love to talk to you. Otherwise, find that bottleneck, get to working on it, and grow your practice as big as you can. Thanks for joining us on the Therapy Business Podcast. Be sure to subscribe, leave a review, and share it with a practice owner that you may know.

Get Help And Take Action

SPEAKER_00 17:34

If your practice needs help getting organized with finances or just growing your practice, head to therapybusinesspod.com to learn how we can help you.