Growing a $1.5M Cash-Based Practice with 30%+ Profits with Ben Bagge

How do you convert them from insurance to cash? You know, because like they're already coming in like not wanting to pay. Right. You know, or pay very little. Right.

So there's always going to be people that tell you no. We convert around 65 to 70% of leads that we get on the phone with.

How to get smarter in business and in life. This is the question and I'm on a journey get you that answer. I'm going to interview the world's top entrepreneurs and deconstruct their winning secrets. Going to talk about everything from marketing money and living a bucket list life. I'm Rick Lau, healthcare entrepreneur. I grew and exited my 127 locations in my 30s. Welcome to the Clinic Boss show. So welcome everyone to the Clinic Boss show. Today we got Ben, you know Ben Baggy. They get this, right? Ben Baggy, right? Boggy. Ben Boggy, PT. He's a PT's owner of Pro Kentex of Physical Therapy. Three clinics in California. And he also coaches different like owners who want to start a cash based practice. Right. You know, so yeah. Welcome to the show, Ben.

Yeah, thanks, thanks for having me. It's fun to be on this.

Sorry for butchering your name.

Oh, you're good. Everybody does. There's. I get to the point where I didn't correct like it doesn't bother me. So I don't like, most of the time I don't correct people. So you're good.

How do most people like pronounce it? Like the way I do or like.

Like that's probably the most common way. People also get it real, like real fancy with it and they're like b, like I'm French or something. So I do kind of like that one.

But yeah, I'm gonna have, I'm gonna have an excuse. English is my like second language. Right. So that's why I butchered it. Hey, I'm. I'm curious. So you're inside the clinic cell community and I'm curious, how did, how did, like how did you hear about it or how did we first meet, you know?

Yeah, I think it was actually when I was in physical therapy school, Rick. I was, I was think. I think it was second year and I just got done with an outpatient clinical rotation and it was super high volume, super high volume. I was like, I don't know if I want, if I can do this. I don't know if was like thinking, honestly thinking about dropping out of PT school and go a different route. But I was like, I worked so hard to get into PT school. I need to see this through. Let's see if there's something like another route that I can go. And I stumbled across like cash based PT and then I started just listening and consuming a lot of content and different podcasts and that's kind of where I stumbled across you, Rick, on the private practice side of things. So I you for. For a while and, and yeah, I think I just followed you on Instagram and yeah, I'm not really sure but randomly interacting here and there over the last like five years I think and, and then call hero as well and a lot of just random things.

Wow. Total random. Oh, maybe, maybe you listen to one of the podcasts years ago I did with like Aaron. I used to be on Aaron Labour's like podcast all the time, you know, used to. I, I think we did a live 1@pps 1 year in Vegas or something. Right.

So yeah, yeah, could have been that. So but yeah, I just kind of immersed myself in the private practice, the kind of practice in PT school and then upon graduation and I know you were, you were a part of that for sure.

So cool. So tell me about your practice. Like how big is your team and is it 100% cash or you do a bit of out of network as well?

Yeah, good question. Yeah, we're 100% cash. We don't take insurance or anything like that. We don't build out a network completely cash based with people super bill that they can submit to their insurance if they decide to. Um, we have we in Oakland, California. That's the first location we open that I opened. We have five full time PTs and personal trainer and then two front desk staff. Des Moines we have two physical therapists and then in San Diego we have two physical therapists as well. So Oakland's by and large our largest boys at ATT 210 to 15 employees somewhere around there.

And it sounds like it was very intentional when you started your practice. It was cash. It wasn't. It's not like you transitioned from in a network to out of network work to cash or was it?

No, it's very deliberate. I knew I wanted to do cash. I knew I didn't want to deal with deal with insurance and just wanted to go that, that route. So yeah, it's very deliberate. I knew right from the get go that I wanted to want to do the cash route.

Yeah. And what would you say is like kind of the biggest, the biggest changes like that are happening like in the US with like you know, insurance that's making you like make this, these big moves, right?

Yeah. I just saw, look at the trend, like year over year, reimbursement rates are going lower and lower and you've got inflation that's not well, so you've got, you've got two, two big issues. You're going one in the wrong direction on both ends, right? Yes.

It's like it's converging. Exactly. It's converging to zero.

Yeah. So, yeah, so that's, I just kind of saw that right on the wall. I'm like, this isn't going in the right trend. And you know, since I opened my practice five years ago, that trend is exactly continued on that same trajectory as it had the five years. So who knows when it's going to stop. And I just didn't want to be more at the mercy of insurance companies.

And yeah, this insurance re. This insurance reimbursement or these insurance reimbursement, like threats is happening right across the world, you know. Right. We're seeing this like, you know, up north, like in Australia as well, with certain fee codes not be able to build now as well. Right. So you can't, you know, like, anyways, I'm not going to get into it because it's a whole can of worms. But it's, it is something that like, it is like a global trend that's happening. Right. You know, which kind of sucks. Right.

Yeah. I'm really interested to see when, like what's the breaking point when it, when it comes to it. There's a lot of clinics in the US or that are becoming hybrid. I don't know very many except almost all insurances anymore. There's more clinics are dropping different insurance companies. UnitedHealthcare is the main one that a lot of people are dropping. So yeah, a lot. There's more and more clinics becoming hybrid. They might not be 100 cash, but we're seeing the US a lot more becoming hybrid if nothing else.

Yeah. So hybrid is a combination of auto, network and cash, right?

Yeah, yeah. They might take like a handful of insurances, but they don't take like lower reimbursing ones or the ones that are dying, dying care and stuff like that. And then they charge those patients cash if they want to be seen by them.

So maybe help me dumb this down. How would you explain cash out of network in network, you know, and all the different like buckets would make it. What makes it very complicated for someone who doesn't understand the industry. Like.

Yeah, that's one thing that's been very awesome to see is, especially in the state of California is people are becoming more and more aware of what cash based is and out of network. But I guess the way that I would dumb it down is if you're in network, you are contracted with. And you can correct me on this too, Rick, you know, probably more better than I do. So. But in network, you know, you're contracted with insurance companies, you have to abide by their rules and you're in network with them. Out of network, you may be able to. You don't directly take their insurance, but you can bill on behalf of the patient to that insurance company and they can tap into their out of network benefits cash based. They pay at the time of service and then what we do is we give them a special receipt, it's called a super bill that has all the information like our tax ID number, CPT codes, all the information that they need to submit to their insurance and then the insurance company based on their benefits will reimburse them a certain amount based on their benefits and their how I.

Can explain it, but what would you say the benefits of each are? You know.

Yep. Benefits from. Well, I guess from a patient perspective or a clinic, clinician or clinic.

Maybe both. Actually. No, let's do it from a clinic's standpoint. Forget the patient.

Clinic standpoint. The case for in network is you are going to be able to treat vast majority of patient populations and be able to essentially help everyone. When you are cash based or out of network, you aren't. You're going to be unable to maybe help more of the underserved population directly. However, I will talk about how you can also do that in a cash based setting as well. And what we do, but across the board you're just going to have a higher pool of people that you're actually going to be able to help by taking in the insurance. Their insurance.

Yeah. And the prices are fixed too, right? You know, like, you know the, the in network like there's a set amount of price and those prices, you know, depending on what state is either going lower, lower every single month or is just staying flat.

Right, right, exactly. So those are fixed perfects and it's more affordable. I'll use that locations or on paper it seems more affordable for patients. But I guess we're not talking about the patient per second. But from clinician standpoint you're marking, I feel like you're marking. Your sales do not have to be as air. You still need to have good marketing and sales in network clinic. But in a cash Based setting, it has to be even a higher level because people are paying out of pocket. You have to be able to communicate on the phone when somebody's inquiring, like what is the difference? Why would I go using my insurance to work with you guys? So you have to be able to position, communicate that.

Yeah, yeah. And correct me if I'm wrong, but out on network you could charge, you could charge whatever prices you want too.

No, yeah, we charge, we charge between 225 to 275 per visit. So you can set a race. I could next week I could change. Hey, I want to change it to 155 to deal. I can really take whatever we want.

But you could also do that for out of network as well, right?

I believe so. Yep. You can do it, do that for out of work as well. And then it's mainly the difference between out of network and cash based is out of network you're kind of doing the billing on behalf. You're still submitting those claims on behalf of the patient for them to get reimbursement. We, we don't.

So the only extra layer is the admin side of like them doing it, you know? Right.

More or less. From my understanding, I've never done out of network. I've just always been on base side. So there maybe there's more nuances than, than just that. But from my understanding, that's kind of the main difference between network and cash based.

Yeah. Yeah. And so, and so if you were to like from what you like, why not do, why not do the hybrid where you do a bit of both so you could open up your, your marketing funnel and actually see more patients. Right.

And that's the benefit too of being in network is you do have a wider net that you can cast. But in my opinion for it, it's going to be a little bit less profitable. So in my opinion you have to have a very strong. If you accept insurance that reimburses really low even you pretty much, you need to have a great back end product. Maybe that's enrolling them into massage therapy services or, or having them do personal training on the back end, chiropractic care, you have to have some of these other services on the back end to make up for that. But that's what is initially getting those people in the door that they otherwise wouldn't come in through the door.

Yeah, yeah. Interesting. And so, you know, like, what would you say is like the average, the average revenue like per year of a typical cash practice, you know? Right.

It's very, very. You're gonna get all over the place.

You got some hundred thousand, right?

Yeah, I would say, I would say probably especially because cash based hasn't been around. It's a newer, it's a newer thing. Like in the last 10 years it's really taken off. We do about $2 million per year that I would say that probably the average clinic is mainly like, I would say most of them are like just mom and pop shops where they're solo practitioners. Like they started the business and they don't really have anybody else working for them. So they might be around that like 100, 150,000 mark with it. But then obviously you can grow and scale like any can any business and bring on employees and stuff like that and increase that. But I would buy around 100, 150,000.

Yeah. So in essence they're really just find a job for themselves, are they not?

Yep, exactly. Yeah. They just pretty much. Pretty much, yeah. Just created a job for themselves and, and yeah, it's a tough. I, I don't know about you, but I think it's a tough spot to be. You know, people like, oh, I just want to have a lifestyle business. I don't want to have employees. I want to, you know, see patients three days per week and treat, you know, patients a week. And like, and they think, oh, I'm just going to have to work 20 hours because I'm just seeing 20 hours patients. No, you got to call patients, got to reschedule patients, you got to do the marketing, you got to do the sales, you got to do taxes. Yeah, you're not 20 hours of patient care, you're going to be still working way more than.

Because this thing I struggle with is like, you know, I speak up with all these different like cash based practices and like it's credible that your, your clinic is like doing like 2 million. But most of them are small. Right. Most of them do a couple hundred thousand. Right. You know, they might rent a space like you know, like here, you know, and, and yes, like there's the main work but at the end of the day is that you're right, it's a bit of a lifestyle practice but they're not pulling a lot of cash in, you know.

Right. I think it's.

And they're still sitting on mountains of student loans like you know, like, you know, their inflation wages and all the other stuff. But yeah. What's kind of your thoughts about that?

I think it's, I think it's funny when I hear this all the time, like, oh, I just want a lifestyle. Well, a lifestyle business. I'm like, well, I remember when I was at that stage, it was not much of a lifestyle. I was working 60 hours a week. There's nothing lifestyle about it, you know, And I just, I really preach that if you do want to really start a business, you need to actually have a business and not just create a job for yourself because it's a tough, tough spot to be when you're doing everything on your own. So.

Yeah. And would you, would you say that 80 or 90% of the people who have cash based practices are in that category?

I would say so. There's more that are scaling and whatnot. But because cash base is a newer thing, there just takes time to scale and, but we are seeing more and more people wanting and actually growing cash based practices. But because it's in the newer stages, you're just gonna have a little bit more people at that, at that earlier stage. But there's a lot, I would say there's a much higher percentage of people that in the cash based world that start a practice, that stick with just being themselves and somebody that starts an insurance based clinic. Usually if you start insurance, you're actually more apt to grow and scale and have that mentality. To grow and scale.

Yeah. And what would you say is the biggest, like, you know, cash practice that you've seen, like in a single location?

You know, a single location. Mine. Yeah, but, but Oakland, our Oakland location, that does almost one, that does 1.5 mil. That's the largest I've seen, I've come across from my knowledge. There could be maybe other clinics out there that, that are doing more, but I haven't come across across that.

So that's, that's interesting. And so, you know, is there any chains, right, like the ones that own like maybe five, 10 or 20, 30 clinics that have something like that. You're like, you know, they got 20 of these clinics or 30 clinics and each of them are doing like a million and a half. Does that even exist?

It doesn't.

Why is that?

I'm not sure. I think it's, I'm not really sure why it doesn't exist. I think one again, kind of goes back to just being newer. And also I think the mentality of the average person that starts the cash based practice doesn't have that mentality to do it and to franchise. But yeah, for my knowledge, there's nobody out there that's done it. Rick.

Yeah, it's, it's interesting. Man. Because you know, when every time I go to like, you know, PPS or I go to these like big, you know, big events in the US and I'm meeting, I'm talking to all these owners that own like 20, 30 locations or you even, even the CEOs of some of these, like, you know, the ones that own like, you know, like five, 600 locations. Right. When I talk about cash, what do you think the reaction is?

I mean they're, they're probably thinking it's one thinking too small on it and there's like.

Yes. Yeah. Like is, they're like what makes up like that, that 2% or that 3%, you know.

Right. Yeah.

You know, and, but I'm just like, I'm just like, you know, anyways. But, but then when I hear about like what you're doing, I was like, why hasn't everyone figured out how to scale, you know, you know, these, you know, to a dozen or a couple dozen of these type of clinics, you know, if it is, you know, because, you know, like we talked about profit margins at your clinic, it's insane. You know, your profit margins are not normal of a typical PT practice. Right, right, right.

And it's because, because of what we charge and whatnot. Yeah. Our profit margin around between 30 to 35%. And I think a big reason that a lot of clinics haven't scaled is because. No, there's not. We're, we're kind of, from my knowledge, we're the largest cash practice in the US and so we're trying to figure out, we're trying to kind of lead the charge on like, hey, how do you, how do you actually grow and scale a practice? A cash based tracker? Because up until, up until now, the, the whole coaching model has been like, oh, go do workshops at gyms, go network with in your community. That can only go so far. You have to be able to tap into SEO. You've got to be able to tap into paid advertising and tracking that code. And there's just not a whole lot of that's being taught and coached in my opinion to really grow and scale. It's more so just kind of how to create a lifestyle business.

Yeah, yeah. I think you're bang on with the lifestyle businesses. Right. You know. Right. You know, I met some of these, I've met some of these cash based business coaches and when I look at the clinics that they own, they don't, they're not very big.

And that's the thing too is like I, there's like we coach people and I tell like when they're hesitant, like they're considering like whether they should join our program or join somebody else's, I tell them, hey, I don't know if ours is right for you have to figure out what your goal is. And my big thing is like, hey, are they coaching? Because they're actually making more in their coaching program than they are in their practice. You know me, I do it more for just fun. It's kind of my, I do the coaching not for the money. I do it because it's fun and it's a change pace. But I still, my full, full focus is still on my practice and growing. So I think it's important to make sure that you're in investing in somebody that's still kind of in, in the ground, on the, on the ground work with that.

So yeah, that's, that's super interesting, you know. And so, and what are your thoughts? Do you think there's a model around like you know, having you know, these, these multimillion dollar cash practices which is, you know, a combination of, let's just say cash and I'm going to say out of network too because, you know, out of network, you know, you could bill like, let's just assume you could bill and like it's just like a min work, you know, like pay for the mint, do that. Right. And also cash based, like massage, you know, LMT's. Right. And then, and then even adding that Cairo arm. And the reason I say this is like, you know, I've had the luxury of seeing you know, like thousands of like P Ls like over the year profit loss statements and my favorite P L's right. That I've seen that are, are the ones that do like about, you know, I'm talking about single practice now, right. Like one location doing about like 3 million of revenue a year. Right. And it's pretty diversified. You got a million of pt, you got a million of Cairo, you got a million in massage. Right. You know, but when I look at California or Texas and I look at what's happening with a lot of the states, I'm not seeing that everyone's like still in their own little silos. You're going after their own little category. And you talked about SEO, but there's a whole new category of SEO just on massage. And there's equally just as much like new patients, like searching for Cairo. Right?

Right. Yep. And not only that, but it's also keeping people in your world and you get those cross referrals with as well. Like, that's why we added personal training into our location is we want people feeling better. They want. Now they want to make sure they stay pain free. And so like, hey, I need to do strength training to be able to do that. I don't have no idea how to do that. So they enroll a personal training. Maybe they fall off their bike. Well, then they come in, see your personal trainer and like, yeah, you need to go see a PT right now. They're back and reactivate. So you just get this. This cycle of keeping patients in your world. I think it's important.

Yeah. Why don't you think more clinics do this, Ben? Like the massage. The Cairo, like, you know, the, the. The personal training, you know, like, even, like, even some of. Some of the other stuff like, as well. Right. With like lifestyle.

Yeah. I think it's just unfamiliarity with. They think that, oh, I'm PT so I can only hire PTs. Maybe that's some of the mindset around. I'm not really sure. I think one thing that is definitely a mindset of physical therapists in the US is we don't get taught a whole lot about a business in PT school. And we did a kind of interesting exercise. It's like one of the first classes we took in PT school, and it was about personality and what motivates people. And one thing that was across the board, and I've seen it continue to see it with pts is they just want to help people and they just want to serve and they think they need to do all the serving.

They.

And they don't have that. They haven't wrapped their minds around the business aspect of it. I just find that PTs don't have as much business acumen and. And motivation and background to. To do it. I think that's contributing to it. But yeah, I'm not really sure why it's not happening more, but if I had to say that, I think it's more personality of most pts and why they get people.

Everyone likes to kind of, you know. Yeah, it's. Everyone's still kind of like in their, like, silos, you know, like, it's time to break down these silos because, you know, like, the trend that I'm seeing is I see like when I look at all the bigger clinics, I see that are, you know, building three. Like, like I said, the 3 million bucks, you know, you know, $3 million. A lot of them are actually. A good chunk of them are actually owned by Cairos that have pts billing it. Right.

And guess what? Cairos get tons of business background in PT and their schooling. I think Kairos just also have that mentality and whatnot. So yeah, I'm not surprised that it's mainly Cairo's that year.

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Right, Right. Yeah. Why do you think it is? Why do you think it's that way?

I think it's the old mindset of you know, pts versus Cairo. You know like, you know, I hear that. Yeah. Versus like building a business based on what patients or clients want.

Right, right, right.

Like you know, like, you know if you look at like Google like people like you look at the search volumes and what, what's trending. Like people are searching these categories already. You know it's either you offer that service to them or they're going to go somewhere else, you know and, and you know I look in, in our communities that you know I clinic celebrate that. Like I look at the, the top clinics are doing really well with cross referrals. Like they're getting like 67% cross referrals. Right. So every single PT patient that's coming in, if you can convert 60, 70% of that to include a plan of care that includes Cairo. Right. Or massage cash based LMT massage. That's an extra like plan of care.

Right.

And that's a fast way to jump start and that has nothing to do with you even just like you know, doing a lot of the online or you know like online or, or, or offline marketing to promote that category.

Right.

Of chiropractic or massage therapy. Right? Yeah.

Right, yeah. And it just, it goes to your lifetime value. It just skyrockets the amount of amount that somebody's spending with you when you can offer another service on the back end. That's been, been a great piece of us adding in personal training. We have more, we have some of our clients that are coming in for physical therapy that are spending more on personal training on the back end of things.

Wow. Wow. What's your. What's your lifetime value right now for a typical PT patient?

Typical PT patients, right around 2200.

Okay, that's insane. That's a lot. That's like twice as much as normal, right?

Yeah, yeah.

And then, and then, and then how much does that include the. Does that include the personal training or the personal trains on top?

The person that's excluding the personal training. Yeah.

Okay. And then what's. And then. And then how much more is the. The personal training? Like, you know, on your. Call it. Your upsell, right.

Yeah, our upsell. Most people do. We have a couple different packages. We have like a 12 pack, 16 pack and a 20 pack. Most people opt in for 20 pack, which is 1, 3 per session. So that's 2,600 bucks for personal again. Well, the. This is something new that we've added Rick in the last. Just this last year. So our ascension rate isn't where I want it to be. It's what we're working on. But yeah, when people do ascend, it's great. Our lifetime value for personal training is. Yeah, 2600 and then our at 22.

That's crazy, right? You know, and then what type of conversion rates are you seeing from PT to personal training? Is it like 10, 20% or is it like, you know.

Yeah, we're close to like 5 to 10. We should on that. It's something new that we're really trying to perfect. It's also getting on boards like teaching old dog new tricks. Like they've been setting their ways about things and.

Yeah.

Incentivize them and whatnot. So it is turning direction, but it is lower than I'd like it to be, but I would love for it to get close to that. 15, 20%.

Yeah.

Wow.

Yeah. And have you. Have you considered like massage and Cairo at your practices?

Yep, I've considered it. I've considered for sure. Yeah. I really want to crack this personal training code. Maybe that's.

Maybe.

Hey, why don't we try both at the same time and.

Yeah. So what would you say is like the. The top three ways to market to get these cash patients right that you've seen that's worked for your practice.

Yeah. From strictly a lead generation standpoint.

Right.

So our. Our biggest one, by and large, is our website. We. We do a really good job of collecting Google reviews and Yelp reviews in California. Yelp is really big across the other parts of the US Yelp is not we ranked top five on both Google and Yelp in the entire Bay Area. Not just Oakland, but the entire Bay Area. So we show our search engine optimization is great. We get live traffic and our website does a job of converting people as well. We get about 10% opt ins. If you have 100 people visit our website, we have 10 of them opt in on average.

And so that's an opt in is someone that fills out like a form or that calls your clinic. Is that we're calling an opt in? Yep.

They, they. Yep. Either call or form.

Yeah. And I think we were talking about that, you know, like just maybe in Slack that like I think your form, you know, when someone submit one of those like web forms like you know, like that want to talk to someone in your clinic, you're converting at 65% right. Which is insane. And your phones are only doing like maybe half or so. Right. Which is a completely flipped, you know, because you know most clinics typically are converting on the phones at these 70, 80%, I call it 70%. And then these, these web forms typically like are 10 because like they get like. And these are the ones that don't get back and they get ghosted. Right?

Yeah. And I, I thought about more about our conversation Rick and I think I know a better insight. This is the entire reason but it's my thoughts on it is in a cash based setting. People that are going to choose to invest in a cash service want the best. They want, they want premium care, they want to be working with them and they are going to do a little bit more research on who they work with. And so they're going to take the time to go through the website, look at the meet the team page and they're gonna, and then this submit the form. What we find is people that click on the call button. They're not, I've been looking at like our interactions. We started, we installed something on our website. So I can actually see people's behaviors on our website. And the people that are just calling, they're just going to the website, barely scrolling, just clicking. So they're coming a lot less warm than the people that are going take the time going through the meet the page, meet the team page, our about page, learning more about our review page, stuff like that. So when people submit, they're much more warm because they've actually taken the time because they care about their health and they want the best versus somebody that's just visiting like oh, I saw that they were top of the rankings. I'm just going to call them and that's it.

Yeah. That's crazy. Yeah. That doesn't make sense. Yeah, it just boggles my mind because typically, like, you look at any anywhere else, you know, like, typically it's, you know, it's. It's because of the phone calls is what converts, you know, like, it's not these, like, web form options. It's just. Yeah. It's insane. Whatever you're doing is totally working. Yeah.

Yeah. Get the phone calls up. If we get the phone calls up where you guys are at, we would be. We would be really. So that's. That's the next thing. But yeah.

All right, so Google reviews and Yelp, you know, it sounds like you got this process, you know, that really gets that going. So what else. What else is. What else is working? Like.

Yeah, referrals. Referrals is probably our second second most. Where we get new patients referrals and then Facebook ads and what's.

What's. What's referrals like? Referrals not from docs. Right.

You know, we don't get a whole lot. Yeah, we don't get a whole lot of referrals. We do, actually. We do get more referrals from physicians than you would think, but not nearly as.

Okay. Because. Because doctors don't want to talk about money with their patients. You know, it's just awkward. Right?

They don't. It's actually more out of network or cash based docs that are referring to us.

Cash based doc. So. So cash based pts or cash based docs?

Cost based physicians.

Okay. Okay. So is that where the most of your referrals are coming from? Cash based referrals or cash based physicians?

Yeah. From referrals from other practitioners. Yes, that was our highest. But what we get way more is of patients just referring their friends and family.

Okay. Yeah. Word of mouth, like, blah, blah, blah. Right. You know, so. Okay, cool, cool, cool. And then you say Facebook ads. Right? You know, Right. Like, what do you mean by that? Are these, Are these like retargeting? Like, like people who. Were you familiar with your brand or is this going after cold leads?

You know, yeah, these are going well. It's mixed. We. We've been running Facebook ads to cold traffic for about the last three and a half years, almost four years. And it's for a discounted assessment. We runners of. Of San Diego tired of. Tired of knee pain when you run. Um, we are offering, we're offering an assessment that includes X, Y and z for only $49. It's typically 225 Claim your voucher now have 10 left expires at that month. So you get that scarcity urgency they opt in. We call them the lead quality there's much lower than our website for sure. But filling in the gaps. Rather have that an opportunity to fill in those gaps on our schedule than have them leave blank as well. So it's a good, good filler.

Yeah. And what. And then what's the best campaigns that have you seen? Is it. Is it the running ones with these like $49 like you know, teasers. Like what's. What seems to work or is checklists or like some of your ebooks or like the webinars. Like what. What seems to be working.

It's. It's a direct offer to an assessment is what we seem we see work best avatars that work best. We've tested low back pain, we've tested hip, we've tested knee, we've tested shoulder. We've tested runners, golfers, crossfitters. The two things that perform the best is as runners and people gym goers with shoulder pain. So we always run the campaigns. The lead quality on shoulders tends to be a little bit lower run rate, better lead quality, but your cost per lead goes up. So the ROI across the two is very similar.

What's your cost per lead?

Our cost per lead is around 95. 95 bucks.

Who cares if you're getting 2200, just keep on spending. Right. Especially with your 2600 like upsell at the end. Right?

Exactly. Exactly.

Yeah. Wow. Okay. And then. And then what about one traffic does do you spend? Has that been effective? Like so this is retargeting patients who's already like, you know, went like the 90 who go to your website that actually don't do anything or maybe like they looked at some of your stuff like on Instagram and Facebook, but they haven't done anything as well.

Right. Yeah. That's something we just started doing the last six months with Facebook ads is targeting warm traffic. Okay. Working on getting the. The. We ran it and realized our tracking is not set up where it needs to be. So working out the kinks with the, with the tech on the back end with like UTM's unique tracking wasn't unique something. But anyways, long story short, our track needs to be better, but we haven't. We haven't been able to track as well as we want with it. But we're working on. On that. But that's something new that we just started. We started working on. Rick.

Yeah. My thoughts is like that's low hanging for like that should perform way better than your cold traffic because they're familiar with your band. This is like that 90% of the people who've been on your website who didn't do anything, you know, they didn't opt in.

Right, Exactly. What do you what for when you do retargeting like that? What are some of the things that you're retargeting them with? Like what we're doing right now is we're like, we are like giving them social proof like reviews. We're also directing them to like blogs like, of like oh, I just want to rest it and see what happens. Yeah, like common objections, but I don't know if that's the right, right, right mode to go about things. What are some retarding that you guys do?

I think the data will tell you what that is. But typically what we've been telling what works for us and what the clients that do really well is you know like taking, taking some of like your best organic like posts that did well on Instagram. Right. Because it's validated that it's working like you know, like the engagement. And typically it's going to be Instagram reel.

Right.

You know, it's not going to be something that is like a photo stock and it's like very static and corporate, but it's actually an Instagram reel of something. Right. You know, you know, and then when you retarget that, you know, and you make it an ad and then you just change the copy so that it's about like booking your appointment with your 49 like runner offer. Like you know now like you imagine someone scrolling their, their phones now like they actually think they're watching Instagram reel, not some type of advertisement.

I like that.

So, so they, so, so the impressions and the click through rates are insane. You know.

Right.

Does that kind of make sense, Ben? Yeah, that, that's like a wicked hack that we've been doing, you know.

All right, gonna, gonna go and do that after this podcast and see if we can get something else launched with it. So.

All right. And then the second one is for the people who are thinking of doing like, you know, that struggle with recruitment, which is the same thing too. Right. Is that like you could use the exact same formula to retarget your best clinic culture. Instagram reel.

Right. I like that.

And then Target, you know, once again the warm traffic who's already been to your website and these are like, you know, the people that maybe thought of applying, working with you or you could go cold and go after like that. But, but the whole formula and the secret at the end of the day is like use something that has performed well organically and then dump money. Don't test it with like, you know, paid ads without having some type of validation with some of your free.

You know, I like that. I think, yeah. Released something about recruitment and how a big key piece that is these, these applicants for people that are interested in you and applying are going to go check out your Instagram page and if you can show, stop having a good time and being happy. They want to be part of that culture. And so I thought that was.

Yeah, yeah, it's, it's like, you know, it's just who. It's like the whole Gen Z millennial. Like this is, this is how they, this is how they purchase, like make like important decisions. Right. You know, so why stop that?

Right? We got it.

What's that? Yeah, well, it's only adapting for recruitment, but also like, you know, like you're young, you're still going to be owning your, your business for the next 10, 20 years. You're also nurturing the next generation of like these Gen Z, like patients. Then the next five, six years, right, they may not be using Google Reviews and Yelp and go to your website. They're going to be making all their interactions through like Instagram and Tick Tock, right? Like, you know, like a good example is like when, you know, I'm in Spain right now, you know, I've been here for the last like two months. Like, so when me and my wife go travel and we go to a new destination, like I'm searching for like restaurants. Yeah. I'm looking at Google reviews. Like I'm very like, I'm looking at all the ones at the highest amount of reviews. Like, you know, like I'm part of your typical customer event. You know, I'm looking at the highest reviews and I just skimmed through, you know what, that's enough social proof for me to click the call, right? My wife acts like a Gen Z. She goes on Instagram and she starts looking at what other like influencers are doing and like, you know, searching the hashtags like, you know, on like best restaurants in Seville, you know, and then she's just watching reels and she's making her decision this way.

Yeah, that's interesting.

Which is like, which I'm like, this is insane. Like, this is so not effective. But this is like the world they live in now, right?

You know, at least you balance each Other out. Right.

So, yeah. Hey, last question. These, you know, like when someone calls your clinic. Okay. And you know, and they're calling your clinic and you know, how do you convert them from insurance to cash? Is that even possible? You know, because like, they're already coming in, like not wanting to pay. Right. Or pay very little. Right.

Yep. So there's always going to be people that tell you, no, we convert around 65 to 70% of leads that we get on the phone with.

Really? Wow.

Yep. And so the, the big thing is they come in so warm because they see so many of our reviews and whatnot.

Okay.

So if clinic. The big thing is like patients, when they. A lot of patients, like, we'll call back. Hey, do you take my insurance? Right.

Yeah.

Yes. They somewhat maybe care about. They take their. Your insurance to a certain extent. But the big thing is they also want to just know mainly, am I going to have to pay it completely out of pocket for this? And the thing is, is not everybody pays 100 out of pocket. We see some, some insurance get good reimbursement on the back end. So we say, hey, we're all of our patients do have insurance and see some reimbursement. We want to make sure that we can absolutely help. And before getting you scheduled or anything like that, tell me about what's going on. So we really get to call a lot of other clinics that take insurance in the Bay Area. It's. They call, hey, what's your name? Date of birth insurance. Like, that's all they care. Not like, hey, can I actually help you? So we really spend at least 15, 20 minutes with each prospective lead to learn more about what's going on. Hey, how long has this been going on for? What have you tried what's worked, what hasn't worked, what are your goals? Right. So because anybody can get physical therapy anywhere, we're not selling physical therapy, we're selling an outcome. So we really trying to do that, reveal what is the outcome that they want to get and then sell them on the outcome, not on physical therapy. Because that's exactly what the other clinic is doing is selling on physical therapy. That clinic's not asking enough questions to learn about what their actually actual why is and what they're doing. Hey, my goal is to be able to get back to playing with my kid in the backyard and play catch, because that's something that's really valuable to me because I didn't get to do that with my, my dad when I was growing up. And I don't Want my son to miss out on that as well. I've got a, you know, wedding coming up in six months and I need to lose weight and I've gained 20 pounds because my knee injury. I want to be able to injury so I can fit my wedding dress. The clinics asking in depth enough questions to get to that point. Now we offer that as a solution, those bigger solutions than just physical therapy. Then it switches a flip. Flips a switch and they're in their head. And we're now offering something that no other clinic is.

Yeah. Then you talk about pricing and you.

Build as much as you possibly can, and then you talk about price.

So it takes you on average 15 minutes to convert a call then. Right. Whereas in a typical transactional, you know, I call it transactional PT clinic is probably like a, like five minutes. Right.

You know, Exactly. We have higher admin. We have higher administrative costs because I have. I've hired a doctor of physical therapy to do those phone calls. He's remote. He doesn't treat patients. He just does these phone calls throughout the entire week and.

Oh, wow. Okay. Oh, but these. But they're not live calls or schedule calls, Right?

Calls and scheduled calls. Any lead. He's taken care of, he's taken care of.

Okay. Okay. Oh, wow. So like he's just at home and it rings and he starts like. It's like he's like a little call center.

Yep, exactly. It's like a call center. And we. We used to have a front desk, a general administrative. Front desk staff do it. And they can do it as well, but. And they would follow the script and do everything to a T. But. Because this other physical therapist has. He can say, hey, this is Dr. John with Prokinetics. He has an authority behind that. And when they come in, they're going to more likely come in than they're talking to, you know, somebody that doesn't have their doctor in physical therapy or is just kind of more administrative staff. There's more weight behind.

Dude, this is amazing. How many, how many cash practices do this? I don't think so. I think most people just hire like some like front desk admin, you know, and try to educate them. And their conversions probably show for that.

Right? Exactly. From my knowledge, we're the only one that, that, that does. There are some clinics that obviously that are the lifestyle ones where they are doing the phone calls, they're doing, treating patients, they're doing the phone calls at scale. From my knowledge, everybody just does more administrative, general administrative. But that's why we scale, in my opinion, if I pick one, why we scaled to where we have, where nobody else has, it's because of that, of our sales process and because we have a doctor of physical therapy doing those phone calls and doing a very sales aspect of it.

Yeah. Wow, cool. And what's next for Ben? Like, how many are you looking to scale? Like your. The amount of clinics you have right now, Ben, like, what's next for Ben?

Love your question. I'm gonna stick with these three locations and really just maximize them. There's so much growth potential within these three locations that we haven't tapped into. I'm really going to focus on. I've still also really focused on getting my time back even further. Yeah, I don't treat anymore. I haven't traded for two and a half, three years. But there's still things I have to do from managing employees and stuff that I'm trying to work. What you've been helping me out with, which has been great and, and changing that mindset. So my main, my main goal is to work myself even further out of the, the practice. I've been investing in real estate on the side and really want to get my money to start working for me from the profits that are coming in from the business. So started kind of turning on that as well. And then also the business coaching, too.

Yeah. I actually like this mindset that you have, and I wish, like more business owners do that is that they use their business as a vehicle. Right. To help them generate cash, like passive cash flow.

Right. You know. Right.

And to do the things that they love, you know, and to buy back their time.

Exactly, exactly.

You know, and so you do in real estate and maybe some of this other, like, stuff that kind of lights your bubble. Like, it's amazing, you know. Right. And. But using the, the cash off your business, you know, to reinvest, you know.

Yeah. And I think that's something that doesn't get talked enough about in the coaching space is like, hey, yeah, we've helped you, you know, scale and grow a business, but now what do you do? Profits and whatnot. So I think that's important that we need to start doing in the industry. Talk more about how, like, hey, yeah, you've got a successful business now. What do you do with the profits and how to make that money work.

Yeah, but, yeah, and I just want to say, like, you know, your clinic, making these type of margins, like, you know, like, whatever you're doing, you're crushing it. Like, I don't think a lot of clinics are kind of in your spot right now. And so that's where you have these conversations. That's where we can have these conversations about reinvesting. Like, you're. Here you go. You got to start making, like, cash of your business first. Right, so.

Exactly. I think that's. I think that's a big too. Sometimes people turn to, I need to invest or start in real estate. They get into it too soon. So you have more capital to invest, in my opinion.

Yeah. What's your thoughts about owning the real estate in the clinics that you. That you have?

I think it's a great. I think it's great. We haven't done it yet, but it's something that I'm thinking about. Thinking about doing, actually. So.

Yeah, like, yeah, you know, and, like, why not, like, if you're gonna be there for. If you're gonna get a lease for the next 10 years or 15 years. Right. Or that space. Right.

Well, right.

Just makes sense. Right? You know, so cool. Awesome. Ben, thanks for coming on the show. And how do people find out more about you?

Yeah, you can follow me on Instagram, Dr. Ben Boggy. You can also check out or check our website, prokinetics rehab.com as well. So those are two. Two best places to. To find me, but probably Instagram. Dr. Ben B. Is probably the best place.

All right, thanks r. Thanks for coming on the show, Ben.

Absolutely. No, it's been. It's. It's an honor to be on here, Rick. You know, I've been following your stuff for. For a long time and listening to your podcast, so it's an honor to. To be on here and I appreciate everything you've been. Been doing for the physical therapy industry, and I know I wouldn't be where I'm at with. Without some of your help, too, so I appreciate you.

That's awesome. If you found this helpful and want some free resources to help you be an even better clinic owner, head over to clinicbosstools.com we've got tons of free stuff on getting new patients, bone strips, selling your clinic, managing clinical teams, and much more. Head over to clinicbosstools.com.