How To Scale An Allied Health Clinic - Case Study

We had have just stood at the front of the team and said we're all going to start systemizing. We want you to use the word systemology and this is how we do it. Coming alongside with the program has, has allowed that culture to change and it has changed quickly. Really quickly.

Hello, I'm here with Renee Kelly, she's from Lime Therapy and we're going to talk a little bit about her journey to systemizing their business and where they're up to now. What are some challenges, what are things they've overcome and what are some of the wins to try and inspire some business owners. So maybe as a way to start. Renee, I don't know if you can just introduce yourself, talk a little bit about what you guys do at Lime and we can go from there.

Sounds good. Thank you. Thanks for having me. David, the wind has just picked up here. Can you hear me all right?

Yes, you're coming through loud and clear. It looks like a gale force wind.

Over there, but I can hear you.

It was perfect when I came outside. Yeah. So as David said, I'm the business owner from Life therapy. So we started off as Renee Kelly Occupational Therapy, working out of our farm way back, you know, 15 years ago and gradually we have built a service around the gaps in our community and working with like minded people who have the same values and passions as me. So we now have a, a business called Lyme Therapy. So changed our name very quickly because we outgrew Renee Kelly Occupational Therapy and we have an allied health service that comprises physiotherapy, occupational therapy, speech pathology, exercise physiology, allied health assistants, disability support workers and an incredible administration team. So we provide services within the clinic. We also provide community based intervention and work with some of our key stakeholders in the community. Community with private hospitals, community health centers, aged care facilities. Yeah, and in people's homes I guess. So we, yeah, we're a private service but we, we often refer to ourselves as a private service that offers and delivers. Government. Yeah, government scheme. You know we provide government schemes within that service.

Yes. And how long have you been in the business for?

So 15 years and my milestone is my 16 year old son. So I was going to be a stay home mum, finished up at the local community health centre and had my first child and I was out on our property where I am now. So we've got 10 acres out here of wheat and sheep farming and I thought I'd be a stay home mum and that lasted about a month and I realized that that wasn't for me and yeah. Then we launched into working privately and I could see the gaps and the need in was primarily disability and aged care back then. So seamus is now 16, so he's my yardstick. So it's been about 15 years.

Yeah. And size of the team. Like, obviously you've got some different therapists that you work with and you mentioned the admin team. What sort of size team are we talking about?

Yeah. So it's close to 40 now. Yeah. So. And we have a range of FTE in in that team, so that's not full time. We have people that work from full time to school hours to two to three days to, you know, one or two mornings a week. So we have a really. What do you say? As you can see where I am today at school holidays, I'm working from home. We have a really good culture of trying to, you know, strike that balance between our family, private life and work. So people work a whole lot of combinations of hours.

Yes. Yeah. And I'm curious to know if you class yourself as a systems person or if you've ever thought of yourself as a systems person.

No, ask anyone who knows me. No, I'm a really big picture. Let's do this. This is amazing. I've got an idea and someone will say, but how do we do that? And what are the steps? Don't worry about that. That's okay. We'll let we' to that. So. No, but my husband, who is an accountant, is very methodical, very black and white, so he's picked up pieces along the way. But that's probably more from a finance perspective and even that in itself. I used to do that before the service got to a point that it was not manageable for me to be managing that side of things. So he was working as an accountant and I was, you know, starting what I was doing. Never expected the growth that we've had. So, no, I'm not a systems person, not a details person at all.

How did you come across the idea of systemization then? Was it through systemology or did you hear it in other books? Like, it's a topic that's talked about in. In business communities. How did you discover the idea?

Yeah, yeah, good. Nice question. It's honestly, it is the missing piece of our puzzle and I've been looking for what this is for. Probably the last. Gosh, yeah, I would say six or seven years we've been looking for this. I didn't know what it was. We've had external coaches come in and work with us. We've Paid a lot of money to have people help us and we've know we've done some incredible work that never quite hit the mark in quality, sustainability, consistency. And I was still having to pour out everything in my brain and have that same, you know, level of, what's the word? Engagement for things that didn't really need me to, to be involved. So I was in, I did this online course. I was super experienced. I've been a therapist now for, gosh, it's only 25 years and there was some real new graduates that were there that are doing some startup work and I probably wasn't overly respectful. I was like, ho hum, you know, yeah, been there, done that. And then one of the young girls talked about systemology and she was reading this book and this light bulb went off in my head and I went, oh my gosh, if only. I read that book when I was that therapist age. And yeah, she understood the value of having systems in place obviously and how that was going to allow her to get the best out of the service that she was going to provide. So I, as I'm on this online course, I'm ordering your book. One for me, one for Matt, my husband, and yeah, the, the rest is history. I couldn't put the book down. I was like, this is the answer. And I guess I've had those feelings along the journey of Lyme therapy where I've known we need to engage physio and it's like, that's the next best, best thing. And you know what we've done just now, we've built a hydro pool and a, and a gym and you have that passion of, oh, this is the next thing and we need to do this. Systemology was one of those moments. Systemology was one of those, this is it, this is, this is what's missing. So it was, yeah, it was exciting.

Was it anything in particular that really stood out for you in the book? Like, was it, what was the moment? Or maybe it was something that younger therapist had said. Like I'm wondering what, what were those bits that you felt were missing or that this helped to really clarify for you.

Yeah, I, I think we had spent a lot of time investing in policy and process because we're registered with government funding bodies.

Yeah.

And I couldn't work out why that wasn't transferring into consistency, quality and sustainability. And we spent a lot of money on, you know, like, we're all about investing to make the service and the, and the culture better for our, for our team and then for our, you know the clients and patients. But it wasn't working. So Systemology changed that. That thinking of I thought we had the answers in our policies. I've got policies. Why aren't they working? To tell you the truth, I wouldn't even know how to get into those policies. Someone else wrote them within the team. No one looks at them. They're just sitting in a little folder somewhere. And Systemology was that was the I could see was the answer to why we are doing things so differently and not getting the same result at the end. Even though I'm saying the same things and directing people to where I thought the information was. Systemology was the first time I'd heard how we could like ourselves, not someone external that we had the resources and the knowledge to change the way we did things and yeah. Put some control back over what we were delivering.

Yeah. And did you started with the book. You also went through a program with James, is that right?

It. Yes. Yes. So Systemology kind of the book sat around for about 6 months, 12 months. We pick it back up. I've had the audiobook. I've listened to that a few times. I have about an 80k drive into Mudura. So I listened to that a few times. I took notes. I was like when you want to train for a marathon. I had my shoes, I had my AirPods. I had my hat, had my sneakers. I just did the running. Um, so then I launched him because we with I must have signed up for like system hubby through the book. You can do some really cool online stuff. That is part of the book. Yeah. So then I finally reached out and said what is this? What is the next step? And this program was running and I, I guess because I'm, I was like I'm really busy. Can someone just come in and do it for me? And they're like great, like great people in this in your team as well. Really talked me through what I needed and why and to start with this program. And I'm so glad I did because we have got the answers within our team. This isn't don't. Yeah. Don't need to externalize this. Which is temptation when you've got no time or you think you haven't got the time. So.

It'S funny with the time one because I I when we hear that a bit now, the more I'm starting to realize with business busy business owners, they're always busy. And oftentimes we've come to the conclusion that sometimes being busy is one of the best times to do it, because if you can get it done when you're busy, then that means it's easier. Otherwise what happens is you might start something and then you get busy and then you stop part way, which is actually even worse. It's like if you partway into something because then you abandon it and then you go, oh, I tried that and it didn't work. And it's really important to see it all the way through. So I think like, I, like I'm biased, but I think the Catalyst program is the best value for money as far as like impact and permanent change. Because like you said, you're building that capability internally.

Yes. Yeah. And, and sorry, Matt's just arrived. As you want to see Matt's face.

Matt, howdy.

David.

David, Matt. Good to meet you.

We have a, we have a dog at our feet as well. Yeah. And that culture is so important and this is what's changed. So you know, we, we want our team to be happy, we want our team to be supportive, we want our team to stay with us as well. I didn't realize that systemology would actually become part of our culture. And you can't change that externally. So. And as you said, you can't just tools down and change culture. You've got to keep working, you've got to stay in that pace and you have to prioritize it.

Have you identified a systems champion on the team?

Yeah, we have. And that was again like had we not had the Catalyst program, I think we would have could have gone wrong there because we were really looking to Matt and I being that person and then we looked to someone in our leadership group and the temptation was to go to the person that's written all our policies and the work that we did through that program and how, you know, it was incredible how many different businesses were in that program and yet it applied to all of us regardless. There was plumbing, accounting, you know, Ally Health and we, yeah, we came up with, with Caleb who's, you know, a couple of years out, new therapist and it is just, honestly it's been phenomenal. The buy in and the change in our culture at work around systems. And that's come from having the right systems champion and following through with what we're doing. We did through the program and Caleb hitting that up.

What a great experience for Caleb also like planting that seed seed at just the right time for him. It's that classic thing where you look back and go, I wish I knew this when I was his age.

Yes. And I was saying to James in our Last session, last group session. We've now got people saying like, there's curiosity around systems, which, you know, there's never been curiosity around policies. People saying, I want to do what Caleb's doing. I don't know what he's doing, but it looks fun. I want to do that, I want to be part of that. How do I, how do I get involved? Yeah. And the systemology has become part of our, our language and our. Yeah. It's been thrown around now as the solution, which is. Yeah. Every problem, every opportunity we now see as a system, which I would not have believed, you know. Yeah. Six months ago, especially when you asked me, are you a detail systems type person? No. Yes. Matt is. No, not so. Yeah. It's got us to this point.

I know there's probably a range of things that have kind of contributed to the change. Is there anything that's obvious to you going through the group program, that was the leverage point. Like was it getting Caleb, was it committing and keeping it front and center every two weeks, was it, was there something else that you just go. Putting these two or three things in place made all the difference.

I think identifying the systems champion as not being us was probably the biggest driver. Knowing that we were outsourcing that or, you know, sharing that load of developing systems. Yeah. And, and knowing it was also, it felt like a fresh, fresh start to. In the fact we had now had someone that wasn't the voice of letting people know how we're doing things. And you know, not coming from our policy standpoint so much, it was a fresh voice, fresh start. And then that just sort of reactivated everyone to okay, this is something new and fresh. So I think that was probably one of the biggest drivers. Knowing that we will then we really want to invest our time and effort further into the systemology because we could actually really see that it was going to benefit not only us and taking a bit of a load off us by us putting energy in there, but also the whole team then embracing the concept and the ideology of it.

Just one step in front of the other type thing too. Like, I wished I'd trusted the process of the course from the, from the get go because that's probably not been my experience. We've done things, but they've. Yeah. The expectation is we'll just give you this piece, but the expectation is you'll just work it out. Whereas if I had have just gone along, you know, we caught up, we. We worked it out pretty quickly. But yeah, putting that time aside, valuing it and then Doing what is asked is. It is so reasonable, what's expected, it is achievable. And you look back now like it's. Yeah, we could have invested that time, you know, 10 times over, like for how valuable it was. But you sit there going, I don't think I can spare two hours a week.

You know, like, I think what Renee's trying to say is she wanted to go to the last question first.

Yes, that's me.

She just wanted the answer.

Can I just get to the.

And that's it. She didn't want any. Yeah, no, no, no basis for. For why or how you do it. But she just wants. Yeah, she wanted. Which is that. That's. I'm sure it's a common thing that people. Okay, we'll just give us the. Give us what? Give us the answer. But yeah, what I love about what.

You guys did, especially with the business owner goes through the program, it's something Michael Gerber had said to me when I got him to read the System ology book. The one bit of advice he said to me was don't let the business owner off the hook. He said, be really careful when you read. When you've written Systemology, it makes it sound like the team is going to do everything and they just handball it over. And he said, even though they might not be the ones doing the documentation and they might. You might not be extracting from them, the business owner still needs to lead this and, and like, I can see it from you, Renee, that you see this as important and valuable and then you'll lead the team. That it is important and valuable and that's how you change culture. If you just try and, you know, handball responsibility to someone else, it just doesn't happen. So it's kind of like that mix. And I think having you go through and go through the steps is, is now going to have lasting change that's actually irreversible.

Absolutely. Yep. And people want to be seen and valued in, you know, it's a lot of time and energy and care for the systems champion to be doing what they're doing and the people that are that. That he's working with. So you want to nurture that. There's so much that's gone into it and as you said, this is forever after. So it's not a done and dusted. That's sorted. I'm going to move on. We're looking at everything now. There's, you know, there's opportunities sitting in front of us and we're looking at them with a systems lens and saying, you know, great, how do we do this? And let's get Caleb involved. And I'm sure Caleb's going to have a little team team with him. And we're meeting with James, I think it's tomorrow to talk about what these next steps look like. But you're right, this for us is about sustainability and having everyone with consistency and that same level of information. So we were always going to stay involved. But I couldn't imagine not because it's. Yeah, it's integral to culture and culture starts with your business owners.

Yes. Is there any wins that you've got? I know the more wins will sort of happen as this gets rolled out and deployed. It'll be very hard because systems touches everything. It's going to be hard to really sometimes pinpoint and say, oh, systemizing did this and got me that outcome because it, it touches everything like it is business. It's the building blocks of business. But have there been any wins for you that you can identify as a result?

Yeah.

Yeah. Did you want to talk? Because we have kind of, we have people that are like, they are the expert in that area. So if they don't turn up, we, that person is no longer there. So we've just implemented a new software program. It's incredible. It's, you know, batches and invoices and sends things off very easily. And there's one person that really has her head around that. So she unexpectedly wasn't at work. So we, Caleb had done some work around the invoicing with her. So that was one of our low hanging fruit that Matt said, let's get in and systemize how we batch and send off these invoices because it has to be done daily. And we're doing.

There's 2,000 invoices a month we're having to put out. It's a task if you're having to do it manually.

Manually, which worked. But it's a few, I'm going to make this sound really simple. It's a few clicks of a button and actually idea what I'm talking about and off it goes. But no one else knew how to do it. Caleb did the work and it was our first one and it was actually quite good to be the first one because it is quite black and white what you have to do. And we've now, you know, with that work we've now got the administration team who are efficient when that person isn't here. Like she's still responsible for that as part of her day when she's not here, someone else jumps in, has gone through the system, and it is so beautifully documented. And he's used some really cool tools with that person as the expert, showing and navigating and doing it, all very live and interesting. They can now do that task. And it's not daunting. We haven't got three weeks of batching and invoicing sitting there because this one person's away. So, yeah, that's a great example of where we jumped in and got that happening. It was part of our. It was part of our ccf and then our DRTC was to systemize that because it's part of our invoicing. Sorry, it's part of that big process. But yeah, that was an immediate win.

One thing we find systems for a lot of business owners and one of the reasons we like the Catalyst program, is there's a compounding effect. And you often don't notice the effects of the system when there's just one or two at the start. And that's oftentimes why a lot of business owners might abandon partway through because they don't see the immediate results. Whereas the Catalyst program, you commit to six months, and over that period, then you get to stack a certain number of systems on top of each other. Then that's when you start to see the compound growth kick in. So you're kind of like six months down the line. I don't know. Yeah. If you can kind of speak to that compound growth effect that happens with the systems as you just start, you know, all of this snowballs on itself once you add more and more systems in.

Yeah, yeah, it does. Even that example we thought was one. One particular way that it had to be done, but there's five different ways depending on. So it actually showed why this was difficult for us to upskill everyone else. But we thought that had to be done with a human sitting there explaining it to every single person. In answer to your question, then what would.

Has it translated to the bottom line yet? Like, are you seeing either efficiency or reduction in error? Like, is that starting to show up yet?

Certainly, with going through that, that invoicing example, the time has in conjunction with changing software as well. But with that process, we're now, you know, decreased our time to do that thing, you know, tenfold. Like I say, combination with software and systemizing it. And that'll keep improving as well once that system becomes tighter and tighter, I guess.

And I suppose in the tail end of this. Again, very hard to quantify the ROI on The effort for going through the Catalyst program and the investment and the result that it'll deliver from here until years into business. But I don't know if there's.

Yeah.

Anything that you can either speak to around the program's value and even what you might say to someone if they were thinking about doing it. Because you were a little bit hesitant at first, Renee, obviously you just wanted someone else to do it for you, so.

Yes, I did. Yeah.

I don't know if you've got any insights there.

Trust the process, you know. Yeah. We don't feel experienced in being a business owner. We find. I find those. You know, I find that awkward where, you know.

That.

Yeah. Trusting the process. This really works. And the team that you have around, you understand what we're going through and it's. It's not complicated. And as I said before, I wished I'd just. As Matt said, it's quite interesting. I did just want to get to the end. I wished I just sat and enjoyed it more at the start. I guess I wasn't trusting. I'm like, when's the bomb going to come that you're just going to abandon us and we have to just find that endpoint. But, yeah, and it works. And if you get the right systems champion and get them into the program. We probably didn't get Caleb in early enough too, because I was still thinking this was my thing to manage. Getting Caleb in earlier would have been. Yeah, you know, would have been good for us. But, yeah, you know, there's lots of things we've done in. In business to help, but this, you know, I just wish we'd done this sooner. Like it. I know. I really do. And I talk to you about where we've invested in other areas and that has certainly helped us. But this is fundamental. And as James said, when we worked every opportunity, every problem can be solved with a system. And we look at our business and our service and what we want the outcome to be. Now, with a systems approach, I couldn't have dreamed that that would have happened. I wouldn't have believed you, actually, if you had said that was the case. Because that's what our teams are talking about it, you know, that the team is, you know, we should have a system for that. Let's systemise this. And I'm like, I couldn't have done that on my own. Matt couldn't have done it. We had have just stood at the front of the team and said, we're all going to start systemizing. We want you to use the word systemology and this is how we do it. They would have been like, okay, whatever. So coming alongside with the program has allowed that culture to change and it has changed quickly, really quickly.

I think it's, I find it interesting like I can feel the energy when the business owner gets it and then they talk in terms of systems because historically systems aren't a sexy topic and business owners don't normally gravitate them. But once you see it, it's actually really exciting because it. You can then see how you can start winning the game or improving because it's this constant and improving, like never ending improvement that you go to work on. And I feel that in you guys there's a level of excitement about systems which yeah, I love it when I see that in the business owner because that's, I know you've got it now.

And as I said, that sits with, you know, his skills and sort of personality with an accounting background. But I thought that's kind of systems. Wasn't the answer like having, you know, even using the word now, I didn't even know what the word was. You know, when you say it isn't the sexy, it kind of has become the, yeah, we need a system for this. Excited.

I find too when it's really frustrating and you end up removing yourself a bit back from the well, sorry, I shouldn't say now previously when I've seen something that should be systemized and it should have a flow and you know, you're looking at it from an overview, you know, why isn't this done this way? You know, how come it takes this long to do this same thing? How come it's done differently each time? How come it's, you know, et cetera, et cetera, it's really frustrating. You end up as a business owner removing yourself from probably assisting that because it becomes too frustrating and you're not sure how to solve the frustration or solve that particular issue. So I think then now having the tools with systemology and that talk and that knowledge around, around how we move this forward in a positive way, it has been one of the real engaging things for business owners too. Particularly, you know, to be able to see the growth in the team members as well.

I appreciate you guys sharing your story and insights. Like I said, this will end up inspiring another business owner that will hear something that you've said and go, hey, that's me. And then that's enough that they can then kind of follow in those footsteps or get the confidence to take the step. So if people are in Mildura and they need some allied health services. Where should I send them?

Yes, send them, send them up to our beautiful new premises in on 15th street and yeah we've, we're really excited to be in our new home. It'll be 12 months come January so we've got a fully accessible gym, hydrotherapy pool, state of the art clinic. Yeah we're, we're really excited and a big part of our new building is our team end where it yeah allows us to do our thing and really connect as a team to yeah provide the services that we do in our community. So we're yeah we're really, really happy with where we're at and systemology. We just feel like we're, we're on a, on a really good path to yeah, sustainability, quality and consistency.

Perfect. Well thanks being a, a shining light for other business owners And I'll make sure I put the, the links to your website right near this interview. So thank you again.

Good. No worries. Thanks David, Love your work.