Signs You are Ready to Open a Brick and Mortar Practice

Welcome to Pelly biz podcast. I'm Dr. Kelly Alkui. I have grown and established brick and mortar practice in Northern Virginia called Ortho Pelvic Physical Therapy and also founded Pelvibiz, which is an online business consulting company that helps healthcare providers make more money and be healthy while doing it, especially in the pelvic health realm. Today I'm going to talk about when is there the sign that you need to start your brick and mortar practice? What are the signs? And I think it's a very interesting question. I saw someone today post on Instagram and it was like, starting a practice is so hard, you really have to make sure you, you want to do it or something like that. And I actually, some of you guys are probably going to disagree with this, but I actually disagree with that. I think starting a brick and mortar practice is actually very easy. I think most of us tend to overcomplicate it. What's actually very hard is actually being able to stay in the game and stay and continue to grow your brick and mortar practice. That to me, is hard. And hear me out on it. The reason why I say that is because you have more at stake now. Most of you guys are like, kelly, no, I have everything at stake. When I'm trying to, you know, pay down my $230,000 of student loan debt, that's what I had and I don't have any income and I don't know how to make it like everything's at stake. Yes. However, when you do get into owning a brick and mortar practice and Your payroll is $70,000 or $80,000, whatever it may be, and that's every single month, there's also lots at stake there because you're like, crap, I gotta pay my people. And to continue to uphold that month after month after month, I feel like that's actually more challenging than to starting a business. Because the reason why I say that is because if it doesn't work out, guess what? Tomorrow someone will take you back in. They will. They're gonna be like, oh, you need a PT job, you need an OT job, you need a therapist job. Oh, you need a chiropractor job, no problem, I'll hire you tomorrow. So to me, and I say that now looking from a different lens, when I first started, I really thought that, you know, I was doing something insanely crazy, which it still was, I do believe that. But looking now back at it and now being at this game for six years now, I actually think it's harder to stay in the game than it is to start the game. Yes. I'm not denying you have to have lots of energy to start the game and lots of consistency and lots of boringness and all that kind of stuff. I'm not denying that. But what I am saying is I don't believe it's as big of a risk as it was meant to be, at least for me. And, and, or it's perceived to be. I believe that if you try and it doesn't work out, then you can go back to getting a PT job and you don't have much invested, especially at the start. I believe if you have something that's established and you have, you know, a building to pay for and you have staff to pay for and all this other stuff, you have a lot at risk because you gotta figure out how are you going to make that payroll, how are you going to keep the numbers up to keep everyone's family afloat. It's a big, big deal. It's not just about you anymore and your family. It's about you and the 10 other employees potentially that you have, or maybe even two other employees, whatever it may be. So I say that. Okay, to give a little reference here on, you know, everyone's different, really. Everyone's this, this is a hard one. Signs, you know, that it's time to start a brick and mortar practice. I mean, I can speak from my own personal experience is I realized I traveled to five different states. I thought each state is going to be different. It's going to get me a different outcome. It was the exact same model. And by the way, it was all insurance except for my last one when I was in Southern California working for Julie Sartin at Pelvic Healing. Okay, Sartin Physical Therapy. And by the way, she's amazing. She's one of my mentors. I give her a lot of credit. I was the clinical director and I helped run her clinic. And in doing that, it gave me a glimpse into what it was like. Now, it wasn't the best, but at least it gave me a glimpse at trying to run a big clinic. She had lots of clinicians and, you know, I, I was going to be, I always felt that I was going to be like second in line to her. I, if I would have stayed in California, I would have been her right hand, 100% because I didn't see the vision to go beyond that. I felt comfortable in my position. I liked my position. I didn't want to be the boss because I saw the boss being stressed out. So I Was like, no, I don't want to do that. And I was comfortable with being second in line. However, when my circumstances changed, I had to move to Virginia. I worked at an in network place and it murdered me going back in to an in network place, seeing 14, 15, 16 patients a day where they were yelling at me and saying, kelly, the notes are more important because now I get it. That's how they got paid. I didn't get it at the time, but I was just like, oh my God, like, why do you care so much about these notes? I care about the patient. Let me just see the patient. And it irked me so badly. That to me was my first sign that to me when I was like, you don't care about these patients. For me personally, that was my sign that I was like, I have to do this differently now. At that point, I worked in five different states, I worked for eight different companies and it was all the same. It was literally all the same except for my last experience in the cash based model. And so I was like, I have to get out of this insurance based model. I just can't do this. It didn't sit well with me. So if you were thinking right now that something doesn't sit well with you in the position that you're in, potentially, you may want to start your own practice now. There's more to it. So that was the first kind of thing. The second thing was I then my dad came down with metastatic cancer. He had testicular cancer, prostate cancer, and then he was diagnosed with stage four metastatic cancer. Christmas came around. He was just diagnosed and they told me, because I was new to the company, because I just moved from California, they told me, no, you cannot go home for Christmas. And I was like, what? I can't go home. My dad just got diagnosed and I don't know how much longer he has to live. And they're like, no, you can't, and you have to stay here because you're like the last person that got hired on. Which now I get, I get the reasoning behind it. But I was just like, this is stupid. I need to go see my dad. And that kind of was the next straw that I was like, why are these people people? I'm in a grown ass adult and I, you know, have this medical health thing happening with my family and I can't go and be there with them. And that was a moment where I was just like, what? What the heck? You know? And that was the next straw that I was just like, I have to do this differently. And so that was another like nudge to go and be like, no, I'm going to do it differently. I have to do it. At this point. I didn't want to because I knew how stressful it was because I worked very closely with someone that did own their own practice. And so I never wanted to be an entrepreneur. I didn't know anything about it. I didn't want to do it. I thought it looked stressful from the outside. I just thought it wasn't for me. But I would say those are the two biggest factors, at least for me personally, that pushed me to the edge of being like, you know what, maybe I do do this differently. The other factors I would say that I think along the way helped build up my confidence was each state that I was in, remember no one knew me. I would start over again. New York, Atlanta, Portland, Oregon, Southern California, Virginia. Like each. These are on different sides of the freaking us. So it wasn't like I was just moving next door, it was like, no, I was literally making massive cross country moves so no one knew me. And then plus he got married, he got a name change, like all that stuff, right? And so I had to start over. Like I had to, every single place I had to like start over and be like, build up my clientele. And I started to realize like people were requesting me a lot and I was getting them better and I was, you know, getting them the results. And that to me gave me lots of confidence to say, well, if I can continue to help them. And this place that I'm at just wants me to focus on my notes and I can't help them in the way that I know I can help them. Like, why don't I just do my own thing? And that to me again was a driving factor because I knew I could do better than what I was doing. And that frustrated the crap out of me. And I'm one of those people, my COO knows this. I'm one of those people that I give a hundred and freakin 10% in every single thing I do. So does she. And if I can't do that, I get very annoyed, I get very frustrated and I have to make a change and I want to always give my best, no matter what. I'm 110 percenter all the way. And that really bothered me. It really did. Because I would have a patient come in, I just did a quick internal exam on them. I had like 20 minutes with each patient. Basically by the time they came in, they were, you know, either Never on time or were never on time or whatever. By the time they got their pants down, me walk back in the room, me come back in the room, I basically just did a quick internal exam on them. That's all I could do. And then send them off to my aide that had no pelvic floor experience, let alone any exercise training. And then she would just, like, murder them with exercises. And I was just like. Like, it was horrible. And then they're like, patients weren't getting better. And I'm like, I know I can get you better. I just treated thousands of them everywhere across the US and this isn't how I operate. And so I just knew I could do it better and the systems had to be better. And if you are feeling that, then I think that is your cue to be like, well, let me just try to set it up the best way I know how and do it in a way that. Like, that you want to do it like. I built Orthopubelvic to have, Max, seven patients a day because I am a therapist. I didn't want to see more than seven patients a day because I know what that feels like. So I said, max, we're going to see seven patients a day. I built in wellness breaks because I know it takes a lot of energy to talk to clients, and you're on all day long. I get that. So I built in breaks for that. I, you know, so, Max, my clinicians see 35 patients a week. That's insane. I've never worked at a place like that. Okay. I don't heavily put emphasis on the documentation and. Because I know that burns people out. Like, and yes, we do good documentation, but. But I already have a system that's built around it that makes it so easy to do. What else did I change that? I was like, no, I'm going to make a change that, like, I created bank shifts, which bank shifts mean, yes, we have a certain PTO days, but I also allow you to see a patient before or after, you know, your normal scheduled hours so that you can bank hours so that if you need more pto, you can take it when you want. Because, again, I didn't like that. I was limited in pto, so I tried to solve the problems. Still able to run a business, but tried to solve the problems that I faced that I personally didn't like in business. From the business side and then from treating the patient side. All of our, you know, we treat 55 minutes. So all of our appointment times are 55 minutes. Again, I solved the problem with the time that we actually are able to solve their problem. So if you're someone that's like me ish that you want these things, then that potentially is a reason why you should open up a brick and mortar practice again. Yes, there's risk to it, but there's not as big as a risk that people think there is. And it's very easy to get started. I can tell you literally in five minutes how to get started, and you can go see your first client tomorrow. I'm not kidding. Okay. I'm really not. If you have questions about it, please just DM me on Pelby Biz on Instagram, because I really can just walk you through very simply in five minutes. Not kidding. I've probably done it to over 400 people so far. How to actually start your practice. That's it. So what else would I say about this? I would say, you know, to start your own brick and mortar or even, you know, something online. If you feel that you've outgrown it. If you feel that, you know, there's no ascension in Orthopelvic. I always say there's always ascension because I have visions for every single person that is in the company. Higher visions than they have always, because I can see it. And if they want to stay along that vision, great. Let's keep ascending. If they don't want to stay along the vision, then it's time to go. You know, if you don't want to keep people that I bring on, I always want to push to be better all aspects. Learning confidence, going outside the box, thinking, like, I'm just a big, big, like, let's progress kind of person. And so I get it. It's not for everyone, and that makes people very uncomfortable. I get it. But then it's probably not a good fit for us at Orthopelvic. But I like to do that because I see the potential in so many people, and I want them to see the potential in themselves. Because there's just a lot that you can do that you potentially don't believe you can do. And it's cool when you're able to do it. So if you feel like you outgrown your place, then it's time to move on. What's the next thing I would say if you don't feel ready, then it's probably for you too. That's, like, not the obvious thing to say, but I feel like if you don't feel ready because you're never gonna feel ready, like, ever, no matter if you're, like, the best therapist or not. We should probably just give it a shot and see if it feels right for you. It's gonna feel horrible. It's gonna feel awful. It's gonna have the longest days of your life. But the alternative is, at least for me, it was not going to see my dad that just got diagnosed. It was. Notes were more important than the patients. It was not getting the outcomes I wanted for patients when I knew I could get better outcomes. It was not dealing with a nice work environment. It was seeing way too many patients a day and just feeling overwhelmed and just done. There's a difference between seeing all these patients a day and then just doing something that you want to build. It's crazy. Like when you give up a nine to five, what, you work eight hours, technically, right? Okay. When you start your own company, guess what? You're gonna have to work more than eight hours a day. I hate to break the news to you, but you are. But it's weird because you're just like, I actually like doing this. I actually love doing this. And you'll just be like, okay, I just got to do what I got to do. If it's the right fit, if you're just like, literally, I just want to clock in, clock out. I don't want to think about it, then it's probably not for you. Then it's probably not for you. Because it's like a child. It really is a child. If you are getting and nurturing this thing off the ground, you have to nurture the crap out of it. You really do. And if it doesn't work out, guess what? Tomorrow someone will hire you. They really will. So I don't know. I always say, why not try? If you guys need a starter kit to get started, please DM us on Pelvibiz, on Instagram Elvibiz. P E L V I B I Z Elvibiz. Just say starter kit. And we will get that over to you if you want to get started. Literally, I can tell you in that starter kit 5 minutes how you are going to get started and get patients right away. And we have proof on top of proof on top of proof of it. So if that's something you want, let me know. But that is, I would say, the signs that it's time to sign. Signs that it's time to get a potential brick and mortar practice going. So hope you guys enjoyed this. We'll talk soon. Guys. Thank you guys so much for listening to the podcast. This podcast is sponsored by Jane, there are the people that are going to have amazing scheduling system for your patients. They're going to provide you with a super bill. They're going to make templates for you. They're going to provide you with the best customer service. And because of that, they allowed us to have a code for one free month. For those that are wanting to try Jane for their scheduling, checking out super bills, telehealth, all the different options. That code is healthy biz1mo we'll put in the show notes. But Pelby biz1mo that is the code for Jane. And thank you so much Jane for sponsoring this podcast. If you guys want more information and want to learn how that you can keep bettering yourselves, go ahead, click the link down below and make sure that you book a call and would love to provide any clarity questions on any follow ups. Bye guys.