Interview with Dr. Maddy Roth of Inspire Pelvic Physical Therapy

Welcome to pelvis podcast. I'm Dr. Kelly Alhui. I've grown my pelvic health practice, orthopelvic physical therapy, and now I'm helping pelvic health professionals do the same. Each week I give you the knowledge you need to grow your practice. Let's get into today's episode.

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Today I have a very special guest here. She's one of my mastermind students. Maddie, welcome to the Pelle Biz podcast.

Hi. Thanks so much for having me.

Yeah, go ahead and introduce yourself. Tell us where your practice is at and tell us a little bit about kind of, you know, what population you typically see.

My name's Dr. Maddie. I'm the owner of Inspire Pelvic Physical Therapy. We're located in Saginaw, Michigan. So right now it's me and then I have two admins and then I have a pelvic floor occupational therapist, a mixture of patients. I really like the pelvic pain cases. We see a lot of pregnant and postpartum. We see males, we see pediatric cases. There's not a lot of pelvic pts in our area, so we're willing to take on pretty much anyone that needs help.

That's awesome, Maddie. So can you give us a little. Can we go back a little bit and tell us how you got started? Like, what inspired you to potentially have a practice Were you one of those that always knew you wanted one where you were like, no, I was kind of forced into one. Can you give us a little bit more background?

Yeah, it's always been on my bucket list to start my own business. Even in PT school, I was thinking about doing it, but I wasn't sure how it was going to go because insurance is so complicated. And I was like, how am I going to be able to figure this out? And then I kind of was introduced to the concept of cash pay pt, and I was like, wow, this is so easy. So at the time, I was working at a local outpatient ortho clinic, and I had just gotten done from maternity leave. I was working about 32 hours a week, and I was kind of ready to start working on Fridays again. So I was like, well, maybe this would be a really good chance. On Fridays I could have my own little thing I could cross off my bucket list. And. Yeah, okay.

So. So at that time, you're like, okay, maybe I can start a practice. All right, great. So now what do you do from there? Do you go mobile? Did you get an office space? How did you decide to make the next move?

Yeah, so Saginaw, Michigan, is actually pretty. I don't know. There's good and bad for starting a practice. The good thing was I knew I could find a place to. To lease that would be really cheap. So I found a place, and it was only gonna be 500amonth for a huge kind of waiting room, gym area, and a big treatment room. Well, it wasn't that big of a treatment room, I guess, but. And I was like, okay, cool. And then all I need is a mat table, some lube and gloves, and started doing some calculations and, like, all right, I gotta see four patients a month to be able to cover my overhead. This is very doable. I'll work Fridays. I'll see hopefully more than one patient a week. But that's all I would have to do to kind of check this off my bucket list and make it happen. Yeah.

So you're like, okay, so this is what. So you kind of budgeted it out first off.

That's what you did.

So you budgeted out, created a budget, and said, all right, to make this work, I need this amount of money. So you're becoming very logical, which is great. And then you're like, all right, so now, did you ever have doubt of, like, I don't know if I can get these patients? Did that ever creep in?

Oh, yeah. So at that point, I still was Like, I really don't know if this is going to work. There's not really many cash pay clinics in the area. I started kind of putting my feelers out, started making my website. Still wasn't really sure if it was gonna work. Yeah, I just was hoping and hoping it would. So basically I was still at my current job working 32 hours, and I was starting to make my website and things like that, and I was like, well, if it works, it works. If it doesn't work, then, I don't know, I guess I'm gonna have to use, like, the money from my current job to pay for this rent, and it's gonna be kind of annoying to pay on it for a year, but it won't be the end of the world. So. Yeah.

Okay, so you're still at your current job working 32 hours. You potentially now have this side hustle that you got going on. Okay, so now where. How do you leave this cushiony job that's paying you that your parents probably told you, don't leave a cushiony job. Right. And for those who, I don't know if that's okay, if I can say, Maddie's parents are both dentists guys, and they own their own practice, correct?

Yep. Yeah. Yes.

So Maddie grew up with two entrepreneurs, and we can get into that in a second. She kind of saw her parents, like, do the thing, right. And so she's like, okay, maybe this is why, you know, I'll start my own business. Great. But what switch, Maddie, in your head where you were like, okay, I'm gonna let go of this cushiony job that actually provides me benefits and all this stuff, and I'm just now gon in on this Friday side gig.

Yeah. So this is kind of where it all shifted. So at my current job, there were several other PTs that had their own businesses, little side hustles. And I was like, okay, that's cool. I'm going to do kind of what they're doing too. There's been no issue with that. We don't have non competes. All of a sudden I show up to work and the CEO of the company's there. And he said, maddie, we're firing you for starting your own business. So at that point, I was like, freaking out. I had no patience. This was all just an idea. I had my lease signed.

So let's just pause there. I mean, that's a moment right there. Because you show up, it's a normal day. Okay. You're walking into work like, okay, here. I'm just going to do the thing again. Right. And then all of a sudden you're blindsided, and then you're like, crap. So then that day, I'm assuming you had to leave that day, Is that correct?

Yeah. Yeah, I got walked out.

Oh, you got walked out. Okay, so she got walked out. Okay, then. What are you doing? Are we having a moment to cry? Are we having, like, what's happening?

Yeah, there were some tears. Of course. I could even cry right now, but I'll try not to.

It's okay. It's a moment.

I liked my coworkers a lot, so that was the hardest thing. And I felt really blindsided. So basically at that point, I was like, all right, I gotta find a new job.

We need money.

Our family depends on my income as well. I applied to four other PT jobs in the area on all the applications. The first, maybe not the first, but one of the questions was, have you ever been terminated from a position?

Right.

Yeah. I didn't want to lie. I answered yes. And one of the applications, it was, like, automatically just came back and it was, like, rejected it. I'm the type of person that doesn't fail at things like all students, college sports, and I'm like, I can't even get a job in my profession. This is, like, really free. Right? Wow. Wow.

Because they're not even asking, well, why? Why did this person get fired? Because they don't know the backstory. Yeah.

Yeah. So that was another turning point. So I was thinking then, okay, either I need to switch professions, maybe become a massage therapist, or just do something kind of random personal trainer or keep applying to jobs, or I can make this business work. So my husband and I, we looked at our, like, personal budget, and we're like, okay, we've got, like, a couple months that we can survive without your income before we gotta, like, move in with your parents or something like cloth diapers for the baby. Right. Um. And so I. I was just. I don't know. I was forced to go all in. So that's kind of. Yeah.

Some people at this stage, they either decide to do have a side hustle and still work for someone else, or they're forced. And people could be forced in many different aspects. They can be forced because their current employer forces them. They could be forced because potentially their health.

That was me.

They could be forced because it truly is the only option. Because maybe they can't go and work somewhere else. Like, there. That just isn't an option. Right. So there's many different ways. And you decide, oh, you didn't decide. But you were forced into saying, okay, I have to start my business. This literally is the only option right now that you're seeing, because all the other people potentially could have just denied you because you've gotten let go from another job. So now you're forced. How many patients do you have on your schedule right now from your side hustle?

So I still had zero.

Okay.

I always have this philosophy, like, you can will yourself to win. So I was like, I'm going to have to will yourself to win. I don't know if it's possible, but I do. I was thinking about the baby I had just had and, like, how I could support him. And anyway, getting emotional, but so I thought, all right, I'm gonna march into these doctor's offices, which if I would've had another job, I probably wouldn't have done, like. Cause that's really scary for me. I just marched in, gave him all my stuff. I was starting to set up meetings with doctors, starting to set up workshops. And another thing I started doing was posting really crazy inappropriate reels on Facebook, Instagram, and just like committing social suicide, going all out. Cause I was like, I don't care. I have to do this. Like, my family's gonna go down if I don't. And then finally, a girl from my church, she texted me and was like, hey, can you dry needle my neck? And I was like, yes, with first patient. So I was like, oh, my gosh. And then after that, it just kind of snowballed. Like, I had her, she wrote a nice Google review, and the workshop stuff started to trickle. And yeah, like, slowly but surely, like, by month two, I had a couple patients. I was seeing maybe four a week.

So I wanna pause there because what you're saying is. And I find this a lot with entrepreneurs, the ones that are either forced to go all in or that decide to go all in, those typically are big winners because they just put everything on the line. And they may have had you.

May.

You were forced into it. It wasn't even an option for you. Right. But you just went in and you put everything on the line and you said there was no other freaking option. Like, this is it. And when you have that hyper focus that you had Maddie of I gotta do this for my baby. I gotta do this for my freaking relationship.

Right?

I gotta do this. Like, no matter what, I'm going to make this work kind of mentality rather than. And you were still doubting yourself. It wasn't like you were not doubting yourself.

Right.

But you were like, I don't care what it takes. I'm gonna be so obnoxious online that you're gonna get people's attention. We'll promote your social media at the end. But now, I mean, tell em you got a lot of followers right? On social media.

Yeah, yeah. Social media has been really, really big for the business. I know some people, it's not the case. It has worked really well for me though. Facebook and Instagram, I would be up late every night just like worrying and stressing and like studying other big pelvic pts. You know the big ones. The vaginary.

Yeah, yeah, yeah.

Why do some of these reels take off? Why do some of them not? And so I was trying a bunch of things and experimenting and I think I kind of figured out eventually like what can make things take off and what doesn't. So that's been really big for bringing in patients and ad revenue and things like that too.

Yeah, that's awesome. So basically you just did the thing even though you were terrified. You went all in and you were like, okay, I'm gonna do whatever it takes. And you did some studying. But besides studying, this is the part that most people miss besides you guys studying and taking every, all the information in. Because she could, Maddie could have just stopped right there. But what she did instead was immediately took action and decided that, you know what, I'm gonna try to just do the own, my own versions of these videos and let's see if it takes off. And then it did, and then it didn't probably right away, but like over time actually studying and getting better and refining, now it's taking off. Right? So I think this is a really good lesson to. Even if it doesn't work at first, when you made that first post that you put out, I mean I remember mine. I ordered a bedazzled screen behind me. I was in my 600 square foot apartment. I put pillows on the window so there wasn't like weird light coming to my head. I had full on makeup, I had a ring light, my hair was all done and I had, I couldn't even say my name. And I had one word. Hi, I'm Kelly Alhoi. Pause. And that took me two hours to record. Like, I mean, don't you remember yours, Maddie? Like the first post?

Uh huh.

You're terrified.

I was terrified.

Yeah.

Still every time I'm gonna post a reel, I'm like, okay, I can't do this, I can't do this.

Click.

And then I'm Like, I posted it. Oh, boy. And then I, like, keep looking. I'm like, okay. Like, there's not a lot of negative comments for some, but, yeah, I have to kind of psych myself up every time because I kind of grew up in, like, a very sheltered, conservative, Christian upbringing that, like, these wild posts are just like. People are like, maddie, I can't believe you're posting that. I'm like, I know, y'. All.

I mean, we will again. We're going to promote her Instagram at.

The end of this.

But she was doing handstands on the toilet. Okay. That's how crazy we're getting in these reels.

Okay.

But it was fun. It's really fun. So, okay, let's go back. So now you. You're all in. You're doing your thing. You have zero patients. You're going to visit these doctors. You got that one person to dry needle. And that first person, I have to say, is always the hardest. It is always the hardest one to get because it's the one that's going to actually give you the confidence to then get another person. And it's also really good because they'll refer their friends potentially.

Right.

What was your strategy then, Maddie? And we heard you going to the doctor's offices. Was there anything else besides social media and doctor's offices that you were doing to think about? Like, how could I get more patients in the door?

Yeah, I did a couple workshops. I did a diastasis recti screening in the clinic that was really fruitful. Um, at that time, about 30% of them came on for therapy, which was, like, pretty big at that time for me. Great. Yeah. And. And then I think with Google, it takes time for Google to recognize your profile. Because all of a sudden then Google was slowly. I was getting calls for, like, those first three months. There were no Google calls or anything.

Yeah, it takes about two to three months. This is a good stat for everyone. Takes about two to three months for Google to recognize you as a business. That's pretty typical.

Yeah. And another really scary thing for me was my background was in outpatient ortho. I had taken my Herman and Wallace classes just couple months before opening. I treated about four half days in the pelvic health clinic and the former place of employment, they had a pelvic health clinic. They wanted me more in ortho, but I got to do a couple half days over in their public health clinic. So I was fighting myself with imposter syndrome, too. Like, okay, I have this pelvic health Specialty clinic. And I've literally done maybe 10 internal exams. So when patients were coming in, I was like, okay, like, where do I put my hands? What am I? Can I actually get them better?

Let's pause there. I think that's massive. I mean, so many of you guys right now that are listening to this podcast, struggle with this, that you want to take every course. So, Maddie, what the heck is going through your head of how I'm sure your hands were sweating, but, like, you know, because I've been there too. But what was going your head of like, I just gotta do it? Was the drive of, like, I gotta survive behind that, or was it just, okay, I'm just gonna kind of learn as we go. What was going through your head to make you only have experience with 10 people and then say, now I have a pelvic health practice.

Yeah, it was kind of insane. I knew there was such a need in our area for pelvic health. And, yeah, the practice I was in, they weren't going to let me do pelvic health full time or whatever. And I was like, if I don't do this, there's going to be thousands of people that don't get help. If I wait a couple years, like, thousands of people are going to not get the help they need. But me doing my best with the classes I've taken and my background and outpatient ortho and Google, it's probably better me than no one. So I kept telling myself that over and over again.

I actually love that. And I think more people should embody that. I think more often than not, people in our field believe they have to take 20,000 courses for them to be a legit business or a legit pelvic health therapist. And I just don't believe that's true. I believe if you do have a strong orthopedic background, all you need to know for pelvic health is pressure management and know the pelvic floor muscles. That's literally it. And if you just can add that onto your orthopedic background, we're going to make our pelvic health patients so much better, you know, and you don't have to have all these, you know, certifications to feel like, I mean, maybe you do yourself, but, like, you really don't need that because the patients. Maddie, have you not had good results?

I've had good results, yeah.

Her patients are getting better. So, you know, you really. It's just being able to combine both the orthopedic and pelvic health and not thinking, oh, my gosh, I have to be. What is it? Not OCS or what's the other one? C. CWS or something. Certified before I start my practice. You don't need to do that. You definitely don't need to do that. All right, Maddie, so let's bring it back. So now you are at this point, how many months in? Like, let's say you're three months in. How many patients are we seeing?

Man, I'd have to bring up my numbers.

On average, do you think?

I think probably around seven a week.

Okay, so three months in, you're at seven a week. All right. And at this point, Maddie's probably thinking, man, I got it made. I'm now only working seven hours a week. And you're probably making around. If I had to get a guess around what you were making at your outpatient orthopedic clinic.

Is that correct?

Would you say?

Yeah, it was getting pretty close. Uh, I, of course, didn't have my prices where they should have been at first, so it could have been better to start. But.

Okay, yeah, that's. That's another typical error people make. Yes. Okay. Um, so but around there we're looking at. Okay, so now what about six months in? What's happening at six months in?

So let's see. I'm trying to think. When I started pelviz. Okay, so six months in is when I started pelvi biz with Kelly. So, yeah, I was just kind of hanging out around seven patients a week still. And I was like, oh, man, do I just live in an area that it's just so heavily insurance driven? Which it is. It's a very low income area. Is a cash practice just feasible? Should I contract with insurances? I just was, like, wavering everywhere. I was, like, talking to, like, insurance companies to try to get contracted. And I also didn't feel right about doing that. I just really needed guidance. So then I started the coaching, and that really kind of got me out of that rut pretty quickly. Doubled my patient load to closer to 14 patients. And then a couple months after, I'm at 20, 25 patients a week.

That's awesome. Yeah. So you would say then it would be definitely worth investing in a coach to help provide guidance, right?

Yeah, definitely. And just focus, too. And focus. Yeah, I guess. I don't know. Focus isn't always easy for me. Cause I'm like, I need this to work. I need this to work. And it was two months, which really isn't that long. But I'm like two or three months I've been stuck at seven patients. I need to do something. The insurance route didn't seem right to me. Um, I knew it would totally change how I could provide care. So basically then I thought, I need a coach. And. Right.

And you had your space. And then all of a sudden you're like, okay, now we're getting into this. Oh, wait, this now? At this point. Are you believing now this is a business yet or. No, not yet.

Yeah, at that point I was. I wasn't sure if it was gonna grow or if it'd just be kind of like a nice little part time job thing that I was working and supporting our family and feeling better about things. And I was starting to. I was gonna say, like, some of those first cases that I like, got better, like from leakage. I'm like, oh, my gosh, I got that patient better. Like, mm.

It's crazy.

Like, I know it was all theory until now. Cause I haven't done pelvic health and like, pain with sex. Oh my gosh. I can really help people. In theory, I can help people. But then it was like, wow, I really can help people. And I saw it for myself. So that's awesome.

Yeah. So you build your own self confidence up. That's what you did, you said. And you basically prove to yourself without, you know, you having to read it from a book, you basically prove to yourself, like, I'm going to show myself that indirectly you didn't know you're doing this probably like, oh, wow, I can get these people better. And so that only then builds the confidence.

Yeah.

Yeah. Okay, so now you have your clinic. We're, let's just say, I don't know, eight months now. In how many months are we in now? I. I don't know, I lost track.

Uh, right now I'm about nine or ten months in the business.

Okay, so nine or ten months in the business. So where are we at right now? Did we have a move that happened? Can you tell us about that? Like, where are we at?

Yeah, so I switched out of the space I was in before with the waiting room and the treatment room. And now I'm in a space with three and a half rooms. We're using one as a gym and two treatment rooms and a waiting room. And I've got the pelvic floor. Occupational therapist on board too, and a couple admins helping me out. So that's something too, with having the business coaching and having not only Kelly, but people in our group that have gone through it before I was like, okay, I should get some help around here. Because I always thought I would just do it all on my own, Take my own phone calls, treat my own patients. I realized like, how much bigger impact I could have if I got some help with that stuff.

So, yeah, that's a big mindset. Shift right there is. Most of us think, okay, I'll never have a business. And then we think, okay, I'm the only one going to run this business because it's going to be a lot easier then because that just seems right. If I have employees, it's just going to be way too much to handle.

Right.

Where was that shift, Maddie? Was it because the people in the group you saw like, had employees or was it, oh, I just now being in this, around the group that you're like, hey, I now see the benefit of employees.

I don't really even know how or when it happened. I think at first I just couldn't think or dream big. When I first opened, I was so focused on survival and taking, helping take care of our family. And then as it was going well, I was like, wow, like really? I can see I have a vision. I still have like visions of what I want to do. And it's constantly getting bigger and bigger because I want to impact as many people as I can.

Yeah, no, that's awesome. That's amazing. And that's how most people start. You can't even think that big cuz you didn't even know that even existed.

Yeah, yeah.

It's like, wow. And until you see someone else do it or see you're like, come up with these ideas because someone, I. It's just, it's crazy how it can just like keep going. All right, cool. So now where do you see things going? What's the future hold in the next year to five years? Yeah.

I'd like to have several other pelvic floor therapists on the team. It's hard to even envision until you're to that next step, I guess.

Yeah, that's a good step.

Right now my next hope is to hire another pelvic health therapist and then just go from there, I guess.

Yeah, that's great.

That's awesome.

What would you say to someone that is, you know, was in your position or is in your position currently right now where they are, have a, have a job, they have this potential. They're thinking about a side hustle or maybe they kind of started a side hustle. What would, what advice would you give them to like to bridge that Gap on should they do it, should they not? Like if you were, if you went back and you thought if someone could have just said just go for it or just do this one thing or do something like what would have that been? Like, what advice would you have for someone that's on the fence of thinking maybe should I start my business or.

Maybe should I, should I not? I think it's just, there is just a huge need for pelvic health and pelvic floor therapy. Anywhere you go, anyone you talk to, there's patients everywhere. And I'm starting that more through the coaching too. So it is possible. And the longer you wait, the longer more and more people aren't going to get the help that they deserve and that's going to be life changing for them. So hopefully that's a little kick in the butt to give it a try. And yeah, I just had so many doubts even like pricing and stuff where I thought, okay, I'm in this lower income area, I can't do this, I can't do this. But I just tried it and I don't know, it works. So there's a need. It can work anywhere. I've truly found that.

So it truly can, it can work anywhere. We have people in, I mean the outskirts and outskirts of Texas, Alabama, I mean we have all over the place and then we have very, you know, LA and all these different cities and it works. It works always. And it's just in a cash based model.

Right.

So are you happy, Maddie, now that you went cash based versus hybrid versus insurance?

Yeah, I'm so grateful that you kind of just gave me. The reason I chose you as a coach was because you just tell like it is and I'm kind of more of the fluffy type. So I knew that would help round me out. But you just told me not to do it and I'm so glad I didn't. Yeah, I just, it's a different type of model. It doesn't really serve the patients well. I think those businesses are going to end up going out of business in the years to come. I think this is kind of the new way of pt.

I agree, I a hundred percent, I couldn't agree more. I think you're. As we know, every single year reimbursement's going down anywhere between 3 to 7%. So how could traditionally, you know, these businesses stay in business if you're traditionally taking the insurance model, it's going to be harder and harder and hybrid. If you are a hybrid practice. I know we got some of you guys out there that are hybrid, you're going to have to look at ways to filter in some kind of cash based offer in addition to the what you're getting from the insurance company to really survive and pay the PTs or OTs or PTAs what they need to be paid and make overhead. So I think it's definitely, you know, the wave of the future. So I just want to say, Maddie, thank you so much for coming on. Is there any party words that anyone listening to this podcast that you would like to tell them or give advice on or anything like that before we, before we go?

Yeah, thanks so much for having me. That's mainly what I wanted to say. Hopefully something that I said inspires you to achieve your dreams and goals.

No, I think was, it was so inspiring. I mean, come on, guys. She was forced to leave her job and she had no other option. She had to make it work. And I think that really speaks to Maddie. I know now Maddie very well and we talk every day and you know, I can say Maddie is one of those people that is just going to get the job done and no matter what it takes, no matter how, how much it's scary inside, she may say it's scary, she may say, guys, I'm having a hard day today, but I'm going to do the thing. And she just goes and she does it. And I think that's the big difference between Maddie and some of you guys that are listening this podcast right now is that she actually took in the information and did the thing. She went all in. And I can tell you, the people that literally just go all in, those are the ones that are really going to be hitting seven figures and beyond and get their time back and really understand how to play the game. And I can't wait to see it. I'm thankful that, you know, you've allowed me to be your coach. And it's just been, it's been amazing to see the journey so far, how far you've come and how much progress you made in such a short period of time. And I just, I can't wait to continue the journey and just, you know, everyone keep track of you. So you guys gotta go follow her. Maddie, can you tell us where they can find you on Instagram and Facebook?

Yeah, it's inspire_ pelvic pt on Instagram and then Inspire pelvic physical therapy on Facebook.

Awesome. And then do you want to put out your website as well? You want to give a shout out for that?

Yeah, it's just www.inspirepelvicpt.com awesome guys, and.

We'Ll put it in the show notes as well. But thank you Maddie so much for coming on and we appreciate your story and very inspired by it. Thank you.

Yeah.

I consider myself a business and life coach. Are you ready to live the life of your dreams as an entrepreneur? If so, let's chat. See the episode notes below and go ahead and book a call. See you all next week.