Building a Thriving CashPT Practice in a Small Town with Hollan Oliver | CashPT Lunch Hour #57

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Hello, welcome to Catch PT Lunch Hour. This is Aaron Labourer, your host. And today my special guest is Holland Oliver of Coastline Physical Therapy. Holland has a cash practice in Maine, as well as a couple other online programs and multiple streams of revenue. And so I'm excited to chat with her today about all these opportunities. So, Holland, thanks so much for joining us. Glad to have you on the show.

Thank you. This is great.

Yeah, awesome. Can you just give us a little bit of background about who you are, where's your business, what you specialize in? Just give me that. Nuggets. You don't even have to tell us if you're Sagittarius or Cancer or Capricorn, but just give us those background nuggets to describe you.

Yeah, sure. I grew up on an island off the coast of Maine. Tiny little island near Bar Harbor. It's called Dear Alice Stowington. I played every sport I possibly could growing up and then looking to expand my view of the world. I went to the University of Vermont. I took a slightly different path than most people do for physical therapy school. At the time, most people were trying to take biology or nutrition sciences and that was sort of their segue into the field. But, you know, I knew I wanted to go into PT school right away, so I got creative and I did a human development, family studies, social work undergraduate degree, and then I continued at uvm where, I mean, if you've ever been to Burlington, it is absolutely awesome. So I stayed there for PT school. I played softball for the University of Vermont, and at the very end of my clinical rotations, I took a job down in Rhode island where I stayed for eight years and, you know, kind of pushed the envelope of trying to make changes in the insurance model and then decided I felt like I was at a status quo. And after somebody recommended that I connect with you, I took the leap and moved back to Maine.

Oh, wow, that's awesome. So, I mean, I just want to correct you on something. Isn't it called Ba Haba instead of that's awesome? I've been up to Maine a couple times and the lobster is amazing. And the lobster shacks are awesome. So do you guys have one nearby?

I mean, they're everywhere.

Okay, so that's a yes.

The island that I live in catches more lobster than anywhere else in the world.

Oh, my gosh. I need to come visit.

Yeah, I mean, it's incredible.

That sounds great. So you went to PT school? I've also been to Burlington. I didn't spend more than an afternoon there. It was beautiful. You went to PT school and then you went and got a job. And what was it about the job or what happened or what was going on that you were just like, this isn't working for me long term.

I mean, the job I had out of school, they were great. They were willing to invest in what I was passionate about, you know, at the time. And it's still true. You know, I love sports, whether it's, you know, a Division 1 program or CrossFit. Like, I really enjoyed sports orthopedics, PT, and they were great in allowing me to pursue my passion, which allowed me to learn a lot about business management. I was able to take on a director role as that clinic expanded to really establish two of their locations. So when I started, they had three locations and seven or eight pts. And by the time I left, we had probably close to 50 pts. So this small family practice became a little more corporate as. As I was there throughout my eight or nine years. But I had wonderful opportunities. I was able to establish a sports medicine program and start working with University of Rhode island and Bryant Universities and their Division 1 sports teams. And I always thought that would be where I landed. But I got to a point where, you know, you just can't survive seeing 60 to 80 people a week and do that for a long time and feel good about what you're doing and your body. I mean, it takes a toll. I just felt like there was a better way. There's a better model out there for. For me as a clinician, but also for patients. Somebody, you know, in that model, it's, I want you to see your patients two to three times a week for four to six weeks. Wow, that seems pretty generic.

You know, someone else is deciding on the treatment, not you.

Oh, right.

That's a big difference for me. It's like, you know, I didn't go to PT school to be told how to treat patients.

Exactly right. Director. I was trying to, you know, save face for the organization, but also understand that some of my therapists were able to get people better, you know, quickly. And there was something that didn't feel right about saying, hey, you know, you discharge them after five or six visits, you know, that's an abnormal discharge.

Right.

I'm not so sure about that anymore. I just think there's a better way.

Right, right. That's awesome. Was there, like, one thing that, like, changed in your life or at work or something? You're like, all right, you know, the suggestion that was just made to me to look at a Cash practice model is something I'm going to act on right now.

Yeah. I had a good friend, Brittanis. She had worked with you previously and she owns a practice up in Burlington, Vermont. And something that was really unique to me is my partner at the time. We wanted to figure out where we wanted to be. We had kind of grown out of Rhode island, but we weren't quite sure if we were gonna go back to our homes. They were in different sides of the coast. And so I asked her, I said, do you. Do you think that I could have a cash PT practice in this incredibly seasonal place in Maine? And she told me to go for it. You know, a lot of people are like, you are crazy. Only 1500 people there. There's not gonna be enough to make a living. You only wanna do it six months a year. It's too many, like, X's. It's like, that's never gonna work. But it has. It's totally has.

That's awesome. So tell us, like, so what's the name? What's the name of the island again?

Deer Isle. Stonington.

Okay. And there's 1500 people that live there.

In the summer, it grows to about 10,000.

Okay. And how many lobsters are we talking?

Someone can go out and catch 2,000 pounds of lobster in a day.

Wow. Oh, my gosh. So it's like. Sounds like heaven.

It's great. I mean, it's one of the hardest working communities I've. I've ever seen.

Yeah. So walk us through. So. So people are. People come in like what, like April, May. They start moving in and they stay through like September.

Yep.

Okay.

The fall foliage and then people leave. But then there's this community that live here, you know, year round.

Yeah. So you've got a business there. So tell us a little bit, how did you set up your business with so many people moving in and out? You are only open six months a year or you have a presence there through the winter. You know, how does that, how does that work?

The last year I opened in May and I left at the middle of October, which that worked well for me. I had worked at the insurance practice January through May, so, you know, it felt good. And then I transitioned to California, where I also treat patients. But then I came back in May and I'm still in Maine. And I'll be in Maine for a little while longer.

Okay.

I was expecting, you know, this is my first season, really, doing a winter in Maine, which up here it's pretty quiet, but not, not around the Shore and people are still coming in. I haven't dropped in my volume, so I'm still here and helping people get on their boats every day.

Yeah. So at the time we're recording this, this is beginning of November. And so people are still like, is this still in season or is it like most people have gone already and you're still busy?

Yeah. So I mean the other businesses around town, like the restaurants, those are all pretty closed down. But lobster, I mean that season goes through January.

Okay.

So there, there's a very active part of business that, you know, it really does revolve around the fishing industry. So.

Wow. So how does that, like, how does the whole lobster fishing industry, how is that, is that changed how you've kind of what you're offering for your business or how you're running your business other than like the time that it might be busy? What are, like, how does that, what are the impacts that that's having?

Yeah. So, I mean, I guess it's important to know that I had 13 lobster traps when I was in second or third grade. This is just what people do here. By the time I was in high school, I was fishing 400 lobster traps before I even had a license to drive. I was on the water fishing for lobsters. So I think it's been really helpful for me because I know what these guys are doing on a day to day basis to their bodies and for them to come in and talk to a healthcare provider about, I see a ton of shoulder pain, so they can talk to me about their shoulder pain and I can treat them, but then I can immediately say like, you know, how are you doing? You know, how are you gaffing your buoys and how are you picking your lobsters out of your traps and suddenly their eyes get really big. It's like, I can do everything in the world for you today in this clinic, but if we don't address some of the body mechanics on your boat, you're going to have this forever. And they, they immediately are sponges. They want to know everything because I'm able to speak their language and I know you know what they're doing to their bodies on a day to day basis. And it's been really helpful that way.

Yeah, that's amazing. So it's basically the same as like if you were like, if you're a CrossFit coach, you know the CrossFit lingo. But if you don't do CrossFit, you try to sell to CrossFit that they're not going to Buy in the same way.

Well, right, exactly.

You know, that's awesome. I remember you saying, you know, when you opened, like you were busier than you expected to be. What were some of the things that you did to get to set your business up and set it up right the first time and get busy.

It's a small community. Word of mouth is, can be your best friend or your worst enemy. I really had the luxury. Both my parents are business owners, so my dad is a long time commercial fisherman and lobsterman and my mom owns a retail store here that caters and, you know, does the supplies for fishermen. So thankfully I had a family that's well known in the community. So that was really helpful just from a networking standpoint. And when I got home, I never thought I would come back to Maine, never in my plan. And so when I was, you know, when I got here, people were quite surprised. But with the help of having that network and a strong community, I was able to, you know, offer some services and talk to people about, you know, what they're going through on their day to day basis with loft. But also I was an athlete here, so I had, you know, a clientele of high school kids that were, you had no idea really how to, how to train and how to train year round and not get injured. So I had a few different ways that I could, you know, engage the local community. But you know, from a standpoint of setting up my business, I made a lot of decisions early on to, you know, work with you and get things set up the right way. And so the combination of having mentors that have done it before, making sure I have all the software and the platforms so that I wasn't figuring it out as I go having the community. I mean, I think the second week I was open, I had 20 patients on my schedule. It was unheard of.

Yeah. That's incredible. That's amazing. Yeah, I mean, I know other people who've done similar, but it's not typical, you know, and if you have, if you do things right, it sounds like what you're doing is like you get people and people know about you. And that's, and that's even just something I just, we discussed on one of the other podcasts I've recorded this week is that what's the best thing to do is to get people get in front of people and people know who you are and know you're there. So was there one thing as you were getting things prepared to open that you, that you did and you were like, oh, I wouldn't do that again. Or that kind of didn't work the way I expected it to.

Yeah, you know, everyone you feel inclined to throw a little bit of money at advertising in a paper format? You know, I didn't do the whole mailing out cards, but I did put an advertisement in the local paper. I don't necessarily regret that decision, mostly because the local paper is owned by people who are, you know, working hard and I'm happy to support their business. And so I don't regret that decision, but I don't think it made a huge impact on my success early on.

Yeah, it was more like giving back rather than like, yeah, okay. And was there, was there something like, was there a specific strategy of like how you advertise through word of mouth or what you did that really built things up? Was there something like an offer or just like a, you know, whether you did workshops or just emailing people, was there something you did that like really made a difference?

Yeah, you know, having worked in the insurance based practice, they had a really solid discharge plan. People left the practice. It was, do you know anybody who needs my help? And so it's kind of been ingrained since day one of being a PT to, you know, seek out the network of the people in front of you. And you don't have to do that in a way that's super salesy. But, you know, if you're connecting with people, you suddenly learn about your, your patient's husband who's dealing with this shoulder injury. So just talking to people and like being interested in them, you know, I always used to talk to my juniors at my previous job, like, be interested, not interesting. And it will come to you. It's such a small community now. I go into the grocery store and I've got three or four people that are like, hey, I hear you treat, like, do you also treat this. I'm like, oh, you know, getting my groceries and.

Yeah, you're like a local celebrity.

I mean, sure. And there's nothing around here. You know, closest PT is 45 minutes away.

Is that on a different island? Okay.

Yeah.

So what do people to take a ferry in in the mainland to get there?

No, we have a bridge.

Okay.

Yeah.

I don't know. I've never been there. I mean, North Carolina, we got some bridges and we got some ferries, so.

Yeah, I mean, a lot of the islands around here have ferries.

Yeah. Okay, so just paint this picture. Like there's 1500 people, but like, how many? Like, how big is the island? How dense is it, like, is 20. Squeeze it five miles by five miles, or are we talking, like, big?

It's about 12 miles by six miles. Okay. Yeah.

Okay. And is it. And it's mostly people who fish lobsters and the support you need to, like, have some restaurants, some grocery, some supplies, things like that. But is there hospital, emergency room, or.

Yeah, there's a local medical center.

Okay.

Pretty much people who live on the island are somehow connected to the fishing industry.

Yeah.

Yeah.

And who's coming in the summer? Are these tourists or these other fishermen from other areas coming up?

Mostly they're people who summer here in Maine the entire summer.

Okay.

So that's the people. But I did this summer, you know, once you get out on the boat, I mean, they talk so much. It's kind of. We call them, like the gossipy guys. You know, they're on their radios and they're vhf. But I did have a couple guys from a different island come over to see if I could help them with their back. Oh. If I have people from other islands coming, I really need another pt.

Right, Right. So do you. Have you thought, like, are you in the process of hiring someone or, like, because you got busy. Right.

Yeah. I mean, in the spike of my season, which was about a month ago, it was pretty tough find time to squeeze people in. It was, you know, 38 to 42 people a week.

Wow. Wow. That's intense. That's a lot.

But up until this year, I've been renting out space at the local fitness center, so I don't have room to put another therapist.

Right.

But I recently purchased a building in downtown Deer Isle. Have the space now. And. Yeah, you can bet that finding a. Finding some help is going to be one of my first priorities in the spring, if not sooner.

Yeah. That's awesome. And so does that mean that you've got this location? Are you renting out part of it and you're using part of it, or is it just a location just for your clinic?

Right now, it's just for me. I could rent up some space upstairs. I want to get in there and get settled before I get somebody else in there as well.

Yeah, yeah.

That, you know, rental opportunity is there, which is nice.

Right, right. And is it like a. Like a storefront, or is it just like an office building?

Yeah, you know, it's a storefront. It's literally right on the water.

Really?

Yeah, it's great. I send pictures back to all my friends in Rhode Island.

Yeah.

Like what? That's your clinic. You just huge, like, 10 by 10 window sitting on the water.

Can you send me a picture?

Yeah, absolutely.

Send me a picture. That looks awesome. So what is. These are like two questions. They're basically the same, but the one is last one is looking backwards, one's looking forward. What did you do different between your first year and your second year? You know, so in the winter, last, this past winter, what'd you do different to make this year? Like, I don't want to say better, but like easier, better, more profitable, whatever. Like, what is something you change this year that's enhanced your business? And what are you going to change over the course of this next winter season for next to enhance next year?

Yeah. So last winter I spent a lot of time working on my back end systems. I was out in California for a period of time and to get a license out there takes months and months. So I panicked a little bit and then, you know, was highly encouraged to take this time look at your back end system. So I, you know, I got in with, you know, an email automation system. I really, I wrote out some ebooks for patients to help generate leads. And so that was incredibly helpful just to also just write, just, you know, it's so easy to get writer's blocks. What do I have to say? But just start writing. And so I started doing weekly newsletters for people on my email list. And once you start the process, it becomes so much easier, but in the beginning it can be pretty daunting.

Yeah, that's awesome. And so what are you working on as this season winds down? What's your goal for the next few months before next year starts?

So finding another PT is one of my first priorities. But it's important to me to find somebody who has a similar, you know, approach to therapy, but also, you know, give my body a break. It's pretty intense for six months.

Yeah.

To work on some of my other interests, I teamed up with a couple of my therapists back in Rhode island, some good friends of mine, and we're working on some like, digital education content called athleterx. Hoping to do something, you know, create different revenue streams, but that don't require my hands on manual therapy.

Right, right. Awesome. Tell us more about that. So you've got, you've got, you're a part of two different, like, online kind of platforms. There's athleterx and Heligo. And I'm a little bit more familiar with Heligo. But tell us about each of those and you know, like what, what do they each do and how did you decide to get into more of a, you know, non direct, one on one, hands on care type of business. But using your, using your background and education.

Yeah. So, you know, a couple years ago, my dad had a pretty serious shoulder injury. I would drive home from Rhode island and I would help him out. I'd give him all these exercises and then I would go back to Rhode island and, you know, talking to him at nighttime, I would just learn that just wasn't doing that the protocol I had given him. And, you know, it didn't take me long to figure out that he's not unique. Like, this is the reality that most people come to PT and then they go home and they don't do anything. And it's not because they don't want to, but they don't necessarily have the tools for success. So I got into this habit of calling him on a nightly basis and saying, hey, dad, did you do your exercises? And he's like, nope, but thanks for calling. And then he would do them and I was like, wow, like, we really need a better system for physical therapy to get people compliant with their exercise programs or whatever it is that you're prescribing them. And that's sort of how the birth of Heligo started was how is it possible that we have anti gravity treadmills in clinics but we're still handing out a piece of paper with stick figures? Like, it just didn't make sense to me. So I teamed up with some guys in healthcare technology and we've been in the process of creating a mobile app for patients. You know, stay on track with their recovery, send them reminders, but also collect some clinically meaningful data to help you as a pt. So that's the Heliogo story. It's out there in existence. And for Athleetrx. Yeah, it's two of my very good friends from Rhode Island. They're both heavy into CrossFit. And you know, a couple of our friends own CrossFit gyms and just in conversations with them, they would come to us and say, hey, this person's coming back from an ACL injury. You know, they've gone through pt, but is there something I should be looking for? It's just a way to, you know, bring like minded people together and talk about these particular injuries and how you can, you know, rather than, rather than telling an athlete they can't do a particular, you know, Wade. How they can modify it safely, what to look for safe progressions, how to maximize their mobility. You know, if someone can't get into an overhead press, you know, is it their shoulder or is it their thoracic spine? Trying to give people some tools to, you know, help athletes and coaches be more effective and better performers.

That's awesome. Is athleterx geared towards the athlete, the coach or the therapist?

Not therapists. So it's not athletes and coaches.

Okay. So it's a tool that. A tool that you guys as therapists came up with to help the coaches be more successful in their coaching.

Yeah, Right now we're just, we're putting out content there on a weekly basis of showing people. Oh, like assess this overhead mobility with your athletes and if they are unable to perform, you know, pull ups, you know, look at these particular items. But you know, where our goal for that for AthleterX is to build out an online course for people to learn more about. We're working on shoulders as we speak, but to tackle different areas.

That's awesome. Is it, is it a. Is the end game to get people back in your clinic or is it to sell memberships or sell like the app downloads? Those kinds of things?

Yeah. For athleterx is to sell course memberships. Yeah.

Cool. And what does that look like? What is it? What is a course? Like, what is your idea of what. Like, what do you guys have down? Like, this is what we're kind of building. It's a weekly monthly memberships, you know, one time.

So it'd be a one time course fee. And you know, we're using a lot of Alex and Will's advice on, you know, how to the old online courses. That's been so incredibly helpful to learn the click funnel system. It really is in its infancy at the moment, but we have an outline of the things that we are commonly asked as PTS from CrossFit athletes and coaches. And so we're using basically that material to create little bits for them.

That's really awesome. That's exciting. So, yeah, yeah. Like what's it, what's your role? Are you just recording videos, exercises? Are you doing like, do you guys each have like different roles in this? You know, how does that work out?

The three of us right now have really spread it out. So every day we are someone's posting to our social media platforms and we're just growing this out. But when I transition back to California, really diving into building out the course more, learning how to build out the courses, that's something I'm really interested in. Not just for athlete rx, but helping people maybe with low back pain that can't make it to See me because I'm in California and they want a way to be able to address their issues without having the one on one help.

Right. Like some of the fishermen back home over the winter, if you're not there, what are they going to do? January, February.

Right, Right. Yeah.

That's really, that's brilliant. That's amazing. I love it. So what, what's, so what's next? So you've got this business that's running. You got a, you got a couple online courses or programs, maybe higher pt. Like where do you see yourself in like five, like five years? What, what do you think? Where are you heading? What are you, what are you growing towards?

So I would love to be able to treat, you know, for a portion of the year and have revenue streams so that I can also be hands off for a portion of the year as well. Being a PT is tough on your body, you know.

Yeah.

And also just, I like to have the break.

Yeah, that's awesome.

I like to play multiple sports mostly because I like to change things up and, you know, not get bored. So yeah, placency is a terrible thing. And you know that, that's basically what I was facing at my last job was like, you know, I feel like I've been doing the same thing day in and day out and it just wasn't, it wasn't working for me. And like my, my personality is all right, what's next? I'm always pushing the envelope forward.

That's neat. That's neat. So if, if you were going to go back and do it all over again, you know, whether that was from high school to college, becoming a PT or getting out of school and starting a business somewhere along there, what would you do differently? Is there anything that you would change?

I knew you were going to ask this. Honestly, I can't say I would change it. If I had done it sooner, I probably could have made more money doing the cash pt. I mean, it was pretty eye opening to me to work for a week and make the same as I was making for, you know, in a month at an insurance based practice. So I certainly could have made more money had I made the choice. But I mean, that was such a valuable experience for me to, you know, get the business management side of operating practice, even though it's not entirely how I would do, was incredibly helpful.

Right. If someone's thinking about getting into cash based physical therapy, what would be your best piece of advice for them?

Do it. Take the leap. Find mentors. You know, I think you guys have helped to Generate a network of people that are, you know, speaking positively about how to do this in the beginning, it's kind of scary. And for people who, you know, people want to use their health insurance. Right? Like a mortgage payment for most people and they pay a huge bill every month to use their health insurance. So when you go out there and start telling people you're going to create a model that doesn't necessarily embrace that, what they have known, it can be pretty scary. So, you know, finding people who have done it and have had some success doing it definitely would be my first piece of advice. Find somebody who's done it and take the lead.

Awesome. Was it easy?

I mean, it's hard work. Like, you're gonna put in a lot of time. You're gonna be working at your insurance based model and figuring out how to set up your cash practice probably at the same time. And so it's, it's a ton of hours. And if you can get through the planning process, you know, I know some people have thought about it for years and years and years. You just got to do it.

Right. That's awesome. Yeah, it's, I mean, it's, you know, I think it's, I mean, I think the payoff is worth it, you know. Yeah. What about someone who's been in business for a year or more, you know, and they're not finding like exactly what they want or success or maybe they're not profitable because that might be a little bit different piece of advice or from your experience, you know, doing this for a couple years now. Because there's something that, not just starting your business, but as you've worked through two years of, two seasons of doing this that you've learned that you're like, oh, I should have done this the first season or, or this is what, you know, like this is the thing that's made the big difference for me this year.

Yeah. Get in front of people. You know, I think that's also really scary for people to do, but get out there and like, give a lot of information. We are experts and people still don't know what PTs do, so getting out there and hosting, you know, a free event on back pain for 45 minutes, make it warm and comfortable for people to come and ask questions. Just get in front of people and, you know, go to people's events, also support whatever it is that they're doing. In a small community where I'm from, it's, you know, I go to everything, I go to the country club to support, you know, the. What they're doing up there. There's, you know, local nonprofits that are helping fishermen. And so, you know, I went there and gave a shoulder seminar. But even if it's completely unrelated to healthcare, like supporting the local opera house support, give away as much as you can, and people will start to understand your expertise and how you can help them. And I think supporting others has definitely been one of the biggest things that has helped me along the way.

Wow. That's amazing. That's great. That's really powerful. So, Holland, if someone wants to learn a little bit more about your business or you get in touch with you, how do we find you online?

Yeah, so my PT practice is coastlinetherapy.com and people can always email me. Holland. H O L L A N. There's no-therapy.com. so, yeah, I'm happy to help anybody who is interested in taking this leap. It's. It's totally worth it.

That's awesome. And then what is the other Heligo? Is that if they want to learn about that or just check that out. Is there that and Athlete Rx or does that have a website yet?

No, Heligo for sure does. Healygo.com.

okay.

Yeah.

Awesome. Awesome. Well, thank you so much. This has been great. So you've got 1500 people in town, 10,000 in the summer, which is still not very many, and you're killing it. And you've got great lobster. You probably are sick and tired of the taste.

No, I love lobster. I would consider this. My, like, slow season still seem like 30 to 35 people a week.

Wow.

Yeah.

Wow.

Yeah, it's not sustainable, though. I mean, I need to expand out and grow and. But yeah, you know, if you're. If you think you live in an area that's, you know, it's not big enough to sustain your practice, it's possible you just get out there, get networking.

I love that. I love it. Yeah. I mean, that's one of those things people say, oh, my town isn't big enough. I'm like, what do you mean your town's not big enough? You know, the value is there. There's so many people that need us. I love being able to just have you showcase the fact that not only are you in a small town, but you're doing great and you've got a great niche and you've done a lot of things right. So congratulations. That's pretty awesome. Yeah, definitely. Thanks for being here today. I always love hearing what other people's stories and thank you for sharing and taking the time out of your busy day to come be on the show.

Thank you. Thanks a lot.

You're welcome. This is the Cash PT Lunch Hour with Aaron Labourer and Holland Oliver. And we will catch you guys next time.