How Tariffs Will Impact Your Practice and How to Prepare For It

Trump is really, he is laser focused on getting interest rates down. With the tariffs, there's sort of a competing effect where if inflation is high, the Federal Reserve are kind of forced to keep interest rates high. So we're going to see who wins out on that tug of war.

How to get smarter in business and in life. This is the question, and I'm on a journey to get you that answer. I'm going to interview the world's top entrepreneurs and deconstruct their winning secrets. Go 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.

Okay, so we are going to talk about tariffs today. And before we start, obviously we just have to say this is not financial advice. All of this is just experience share. You know, if you guys have any questions after this, we can try to help you out. Maybe just come on our office hours. Also know participation is going to be key for the, for today. We do want people to get on mics. And before we start, Karen, did you want to just, I know the last three weeks we've been talking a lot about leadership. Do you want to just talk about leadership and how it applies today?

Yeah, I think, although we're talking about the impact of tariffs, I think keep in mind, like, how are you going to show up as a leader in your business when we're dealing with such uncertainty? Because everyone, most everyone here is an owner. You have it, but not only do you have it, but your team is also feeling the uncertainty and the fear. So how are you going to navigate those conversations and those decisions that you're going to make in your organization? And I think that comes down to leadership, having really good leadership and how, how transparent do you need to be? How much do you need to, say, secure, you know, security and making reassuring people that they have jobs, Things like that are going to be probably at the forefront of a lot of people's minds.

Yeah. 100.

Ask yourself that question. And if you can, at the end, just reflect. How are you going to handle this as a leader and with your leadership team?

Yeah, yeah, I think that's, that's critical because it is sort of on the back of everybody's minds. But I also think that a lot of people, like a lot of our staff, maybe they're not really sort of understanding the full impact of what could possibly happen. So. Yeah, and, you know, this week was, you know, part of the leadership series was supposed to be about handling crises and you know, what you do in difficult situations or having difficult conversations. So I think this actually, this tariff discussion sort of ties in nicely with the last three weeks of what we've done in terms of leadership. So.

Yeah, and I'm curious, like this is the big elephant in the room for most, like I think practice and business right now. And how many people actually has had a conversation about this with like with their staff and their team, maybe type staff in the chat. I'm curious how many people's actually had this crisis Very similar to what we had during COVID where we're over commuting. Was everyone or has everyone just been silent, you know?

Yeah, type. Okay. Yeah, type in yes or no if you have a chat with your staff or if anybody's come and ask you. Yeah, yeah. So this is really interesting. Right.

I'm curious as to why.

I'm not sure what to say. Yeah, yeah, it's interesting. It's true. It's a hard subject because we're not like economists, not, you know, a lot of people don't follow what's happening with the tariffs. There's so much noise with what's happening, especially with Trump. There's a news cycle that literally is happening every 24 hours instead of, you know, quarterly like it used to be. And so, and so there's a lot of uncertainty for sure. Go ahead, Karen.

And I think it's okay to, and I've done this, you know, it's okay to even just say, you know, we're all aware what's happening. I don't know as a leader, just even say, I don't know what to say. I don't know what's going to happen as much as you, but I want you to know that I'm going to communicate that with you and that when I find things out that I will do that. So it's okay to say I don't know right now. It's better than actually burying your head and trying to avoid it, in my opinion.

Yeah, 100%.

Yeah.

Andrew Grant has a really interesting comment. You know, possibly it's because we're a service based business rather than an export import. Right. And so we're going to talk a little bit about that. Like, you know, obviously we're not going to be directly impacted. Impacted. But you know, after doing a little bit of research and talking to our leaders at clinic accelerator, there may be like some second order effects that will, will be impacted by. Right, yeah. And I think so.

Yeah, Paul. And I think Two things that I would add. And I think, to go to Karen's point, I think most of us wait to say something when we have an answer. Right. But on the leadership side, it. The Karen's right. Like, we don't know, but there is interesting things because some people won't know what we're doing, so then they ass doing nothing. The other thing I'm picking up too is, is what Elizabeth had written there. Like, there's actually quite a few people around me, especially in my inner circle, are very passionate about sourcing Canadian. Right. And supporting local businesses, again, like we did during COVID So. So again, that actually could be an interesting initiative that you guys are thinking about. Even though we don't really know what's going to happen, is there anything we could do to support individuals around us that could be more affected? And again, not to make this always about sort of the business side of things too, but maybe there's some relationships we can have with certain employers around. Well, but remember too, is there's people that we treat or our staff that really may be affected. While we're still kind of questioning that, how is it really going to impact us, thinking about us as the bigger team dynamic? It's actually could be quite impactful.

Yeah. Okay. Awesome. All right, so I want to actually get into, like, this sort of initial question, right, which is, do we actually think tariffs are coming March 4th? And it's kind of scary because March 4th is literally next week. Right. So, Sarosh, I know you had a little bit of opinion on that. Type in the chat box. Do we think that tariffs are coming March 4th? Type in yes or no.

Canadian terrorists, Right. Or just terrorists as a whole.

Yeah. Okay, so just type it right into the chat box. Okay. Suresh, what were you. What were you finding?

Yeah, I mean, like, he had a video saying April 2nd. He's like, I don't want to do April 1st because he doesn't want people to think it's a joke. But I. I also think, like, personally, I think this is what I do with, like, Internet companies where I play chicken with them until they give me a better deal. I think this is a big. Just a big strategy. At the end of the day, he wants people to feel pain, to get what he wants. This is like, kind of just aggressive negotiation tactics. So hopefully that's what it is. And it doesn't actually land, but we'll see. He might have to, like, push the agenda for a month or two or the pain to come so that he can have more leverage I could be.

That I don't know. Yeah. Daryl, Karen, Rick, do you guys have any other opinions? Like, do you think they're coming? Do you think they're not?

I tend to think yes. I just don't know what and how and where. I think there's something that's, I don't know right now. It's just the game of chaos is what the agenda is.

Yeah, yeah, I know, I know, I know it's tough. It's hard to answer that question because the communication is a little bit confusing. So I'm not 100% sure either, but I'm going to play a video of, of a CBC reporting that was just put out yesterday. So let me just make sure I can play the sound too. Can you guys hear.

No. You guys share on your zoom. Paul, there's an audio setting that you have to click on. It goes share.

Yeah. Okay, I'm just going to share the audio then.

On the question of whether terrorists are coming next week, more confusion from the White House.

I was going to do it on.

April 1, but I'm a little bit superstit. I made it April 2.

At his first cabinet meeting, U.S. president Donald Trump appeared to announce he's delaying the 25% levy on all Canadian goods scheduled for March 4.

When does it go into effect? April 2, April 2 and for everything.

But his secretary of Commerce suggested that March 4th is still a deadline.

Big transaction is April 2nd. But the fentanyl related things, they're working hard on the border. At the end of that 30 days, they had to prove to the president that they've satisfied him to that regard. If they have, and he'll give them a pause or he won't.

On Parliament Hill, Cabinet ministers struggle to make sense of it all.

We'll see.

You know, one thing we have learned.

Is to take it step by step.

I don't think tariffs are a foregone conclusion.

There seems to be a blistering amount of new policy, but policy is not.

Policy until it's enacted.

The federal government says as far as it's concerned, nothing has changed. Work continues to shore up security at the border to prevent 25% tariffs from taking effect next week.

We actively and aggressively enforce against fentanyl.

And we will continue to do so.

But Trump's comments are moving markets and alarming premiers.

This guy's classic.

Every single day he's changing his mind.

There are multiple tariff threats against Canada. They're changing days.

It's not even totally clear from his.

Statement what he meant.

And that may be intentional.

Do not react to whatever Trump says. Because he says one thing today, another thing tomorrow, reacting to it actually gives in to exactly what he wants, which is creating chaos and confusion.

According to a senior federal government source, Trump's comments left officials confused. Were the March 4 tariffs on or off? They reviewed all the tape from the White House with Prime Minister Justin Trudeau and realized they were, in fact, still on.

So, Olivia, what do we know for sure, if anything, about what's happening next?

Well, that's a big question. I mean, federal cabinet ministers say they have to take their lead from Trump's signed executive orders, which have the fine details. Aside from March 4, they're bracing for steel and aluminum tariffs March 12 and imported vehicle levies on April 2, both set at 25%.

Okay, we'll be watching the calendar. Olivia Stanovich, thank you.

You're welcome.

All right, so what did you guys get out of that? Is it still happening March 4th? What do you guys think in the chat? A little bit of chaos. That's right.

Yeah.

So I think what I got out of it was that likely March 4, like, we just have to go with the executive order. And then the executive order says March 4th. Trump said, we'll go through this timeline. You know, Trump on February 1st signed the executive order. It was the tariffs were supposed to start February 4th. Then Trudeau on February 3rd called Trump. We got it delayed to March 4th. And then yesterday, Trump had a cabinet meeting, and he basically said not all of them, but some of them would start April 2nd. During that cabinet meeting, Howard Lutnick basically said the tariffs are still on, especially related to any sort of, any, any of the fentanyl related tariffs. And that would still happen on March 4th. And then obviously we may get some more tariffs on April 2nd. Okay. And so, so I think what we have to do is just assume the worst and hope for the best. Right. And March 4th, likely we will start to see tariffs on Canadian goods. Hopefully something happens where Trump says, hey, it was a negotiation tactic. And we're, you know, hopefully not going to be experiencing these tariffs, but this is sort of a blanket tariff on all Canadian, Canadian goods. Okay. There's another one coming March 12, which is on steel and aluminum. How many of you guys think that tariffs on steel and aluminum will affect your province? Type in maybe your province, like ab, Ontario, whatever. Type in your province into the chat if you think that'll affect your. Your province. Okay. And then on April 2, there will be an imported vehicle levy. But something that I found during My research is that there may be reciprocal tariffs as well coming down the line. Okay, does anybody know what reciprocal tariffs are? Okay, so an example of a reciprocal tariff is, let's say, Canadian banks. So I don't know if you noticed, but when you go to the US you see TD Ameritrade, you see bank of Montreal, you see all these Canadian banks in the US and they're free to open up their banks there, no problem. But Canada has restrictions for US Banks coming into Canada. And so what Trump is basically saying is that there's a ton of these sort of, you know, unequal sort of restrictions around US Businesses being able to go in, in Canada. And so there may be extra tariffs related to those types of industries. So a good example is banking, but another good example is telecom. Telecommunications. Right. We don't get a lot of American, you know, mobile services here in Canada because of the restrictions. Right. And so if that starts to happen, then, yes, we will start to see a lot of impact that way. Okay. And then this is just a chart of, you know, I asked ChatGPT, like, which provinces would be impacted the most, and it looks like Alberta, Ontario for sure. But I think every province will be impacted pretty. I mean, we start at medium to high, so it's, it's not like every province won't get impacted.

Well, I think that's the thing. It's going to affect every single province.

Like, yeah, it may affect either directly.

Or indirectly, every province will be affected.

Yes. Yeah, the. And Evan brings up a good point. You know, if you look at what happened yesterday when Trump accidentally said April 2, what happened to the Canadian dollar? The value of the Canadian dollar spiked up. Okay. So the opposite may be true. Right. Where if these tariffs go into play, then the dollar, the Canadian dollar might actually go down. Right. And what does that mean? Exports get more expensive. Not just because of tariffs, because of the value of our dollar, you know, everything becomes a lot more expensive. And so again, as you know, it's very rare that us in healthcare, we actually have to think about these macro events. Right. But this is, this is start to impact us if the tariffs actually get applied.

The other, it affects everybody's purchasing decisions. That includes your patients and your clients.

100%. 100%. Right.

And job losses across all the different sectors.

Right.

You know, sectors, industries, all that sort.

Of stuff as benefits.

Yeah. Now there is. So some, some like, to Sarusha's earlier point, right? Is this a, is this a negotiation strategy or do they have a bigger strategy behind what they're doing right. And I'm not sure, but one of the, one of the theories that I saw was that Trump is really serious about tariffs because he wants to actually reduce income taxes for the citizens of the U.S. but if he reduces income taxes, he needs income coming from somewhere else. Right. And tariffs is potentially where he's going to get that income. Right. And so if you look at sort of underneath what the bigger strategy might be, maybe he really is serious about this and we have to take it seriously.

Okay.

Okay. So does that all make sense? Give me a score of 72. If that sort of all makes sense. I try to, you know, put it as coherently as possible. And so I'm going to ask the question again. Give me a score of 100. Do you think tariffs will impact our clinics now? Give me a score of 100. I should have taken one before, but just type in the score that you think there's a lot of high scores, 80, 190. And so I kind of want to pause here and have a little bit of a discussion so that we can maybe just see what other people's thoughts are. And to the, to the panel, if you guys can find people to put on mic, that would be great. But maybe I'll start with you. So, Roosh, what do you think the most immediate impact of tariffs will be on our clinics? And type into the chat, guys, what do you guys think the most immediate, the most immediate impact will be to tariffs on our clinics? Type it right into the chat.

I think that the two probably fastest impactful things is going to be the jobs, which relates to the benefits and the inflation. Just because so the jobs. So there's already actually companies I'm seeing, they're doing these mass layoffs in preparation for possibly something like this happening. But they may recall those people if obviously everything's good. But this is what happened kind of the last round there was some quote, unquote, recession like risk or that was the sentiment in the market. There's a lot of these layoffs that happen in the tech industry that's kind of, you see that happen pretty quickly. So and the more of those people that again, don't have the jobs, less benefits, less spending at the clinic level. And I think what you'll see in your scoreboard is PVA is dropping. Like that's kind of an easy metric to kind of look at. And the inflation piece is just doing the same thing. It's just any copay, it's going to be harder for people to pay for. So what I Think if people do a. I think if you look at, if you actually break your scoreboard down between your different payer mixes. So if you have ecb, wsib, mv, et cetera, you might actually see a shift in percentage of your total like revenue starting to shift towards some of those funded people versus the private or third party people. I think that's what you could start to see. So that could be a leading indicator for you to start to make some quick decisions.

Yeah, that's interesting. So just to sum it up, you think jobs will be impacted with the industries that are immediately affected and that you may see a drop in those people with benefits from those jobs.

Yeah. And inflation is going to just make everybody make everything more expensive again. We saw that happen before too.

All right, yeah, those are good insights. Michael, you're on mute right now. You're from Windsor. What are you, how are you thinking about this?

So I mean Serious gave a great overview. I think that's kind of the, the general themes across all locations. No matter where you are in Windsor, we are, you know, kind of beaten up and used to this a little bit. You know, anything that's trade wise, anything that's trade wars with the US any, it's auto manufacturing, steel, aluminum, it all comes through Windsor or not all, but we're the busiest border crossing for that reason. We just built the new Gordie Howe Bridge which is set to open up in a few months to enhance the trade with the US and then everything kind just everyone's a little nervous to say the least. So our largest employers are manufacturing. So those if they get put on, you know, layoff or whichever, that'll take a hit for sure. We do have other things happening economically in Windsor which is diversifying us a little bit. Agriculture is there, but depends where are you sending those tomatoes. There's some new development in the EV stuff. We have a big battery plant that's being built. So there's a little bit of prep work that was going in ahead of this for trying to diversify the economy in Windsor. And that's been good. So I think the major thing is again what we're all kind of concerned about is getting benefit reduction, people losing their jobs, people unable to pay for the services. So if they, if everyone tightens up their spending then you know, we are essentially kind of discretionary spending to a lot of people. It's a lot of reason why people don't come to physio is the cost and our costs have not gotten, have gone down. They're Only going up. And unfortunately because of the cost of recruitment, they're only getting higher. So we're kind of might be in a crux of okay, where do we price ourselves? Do we price ourselves out? Do we look at different arrangements for keeping our costs lower so that way we can afford the staff to treat the people? Because people aren't going to go away. I mean they'll, they'll reduce. There's a chance they reduce, the benefits reduce. I think PBA is the right thing. Soroo said so they'll show up, but they might come three times instead of 13 times. And they still need some help. The doctor's still telling them to come. But how often do they attend? How frequently they attend? So might be a thinning happening. But that's essentially what we're expecting here in Windsor is, you know, a slowdown in jobs, people becoming more, you know, money conscious. There is inverse of that I thought of which was use it before you lose it. Do we get this sort of strange spike in people purging their benefits before they lose jobs and before they lose other things? I'd be curious if we get this inverse bump here for, for a short period of time. But yeah, we're gonna get hit. I think we're expecting it, but it's honestly not. This is like a four or five year cycle in Windsor. I think we're kind of used to it. Roberta on the chats also, she's in Kingsville, she's, she's seen a little bit more than me maybe, so she might have some insight as well.

Hey Michael, just a quick question. Thank you very much for that. That was awesome. Did you have you heard anything from some of the industries in your neck of the woods? Like in terms of their plans if tariffs actually get deployed?

Yeah, so we have, I mean we have large, large employers and they usually have. What ends up happening here is. Okay, well we got a plant in Texas, we got a plant in Arizona, we got a plant here. Like if you have a plant in Windsor, you're not a solo. There's only so many small shops. They all feed bigger shops. So it's not auto manufacturing like a GM plant which we already lost, you know, 20 years ago. It's, it's all the filler, it's all the people who fill those plants, the tool and mold, the ones who are doing the work for. There's a large seatbelt company here in Windsor.

Right.

And you have a larger conglomerates like Magna, but they're all over the place essentially. What kind of Happens is I think they built some resiliency too, but they pivot. So they might send stuff to the U.S. they might move their operations to the U.S. more so, which I think the, that hurts us in the longer term. Right. Because once they step away from us, the likelihood of them coming back is going to be very rare. So the immediate might actually be a little muddled for us where I'm a little bit more concerned about if someone just says, okay, well Windsor might be a small, small satellite now as opposed to running a lot of our major operations through there. It's going to have a bigger long term impact for us that way.

Yeah, that's, that's really interesting. Kind of what I'm thinking about too is like, how much are the tariffs? But if our, the cost of our Canadian dollar goes down and the cost of our labor goes down, would it be more attractive to have some manufacturing here? Who knows? You know, on the other hand, Trump wants to bring a lot of manufacturing back into the states, so maybe there won't be.

Sorry, sorry.

Is Michigan, is Michigan is promoting Ontario like nothing else. They're stepping up to say, hey, we need Windsor, we need Ontario. So the, the governor of Michigan has been pretty, I mean, I think it sets up her politically to be anti Trump. But the idea is, you know, you don't realize the pain this is going to cause Americans.

Right.

Not just Canadians, because again, we do supply a lot of what they need down there and their costs are going to, are going to rise just as ours do. I think everyone hurts from this. There's no benefit. We ourselves, we used to get a lot of our supplies, our tens pads, we order from the states. There's, you know, I just, I haven't crossed in like a month just from a general distaste and I just, now I just choose not to. So there's a lot of that going on. There's those stories of the Americans coming over buying Canadians and Windsor lunch and dinner and, you know, apologizing. And so there is this, we have this great relationship with Michigan and I think we're trying to try and maintain as much as we can around these tariffs.

Yeah. Did you, when Trump was first in his first term, did you. I mean, I don't think he had such vast and sweeping like executive orders. But was there any sort of impact on the industries when Trump came into power in the first term?

Yeah, I think I've, I've probably lost a little bit about, you know, the details of that, but at the time I think it was there was definitely issues with the Canadian dollar and manufacturing again, because we have multiple but like sort of multiple businesses that run U.S. canadian. Right. There are a lot of U.S. canadian companies. Was it a major impact economically, negatively for Windsor? I can't remember to say it was. I mean, to be honest, we had Covid, like a year and a half.

That's true. Yeah.

I think, I think my memories are a little bit faded to Covid, but if I look at Covid and I look at tariffs, I feel like if we survive Covid, we'll survive tariffs. I think we're just, I'm thinking four years ahead now in some of my planning.

Okay. Yeah. Thank you everybody. Let's give Michael a high five for, for coming on. Mike, that was awesome. Let's put, let's put Evan on. Mike. Evan, like what are you, how are you thinking about this? Especially Alberta being like oil and gas, heavy into oil and gas. Like what sort of your thoughts around this?

Yeah, I think we'll be a little bit more indirectly affected, but definitely affected. Like I'm, I'm sensitive to Michael's situation there of direct industry that'll be affected immediately by tariffs. But in general, hungry, sorry. Strong economies are hungry for oil and we're very energy dependent out here, as everybody knows. So I think that will affect us on kind of the direct level. Semi direct level. But in general, the way I think about this is a significant amount of my net worth is tied up in my business and my shares are, are going to be liquidated in Canadian dollars. And if the Forex is affected by 10%, I think you can, you can kind of look at it that way. Like something a weak country and investors lack of confidence in Canada hits us to the tune of 10 to 15% on the forex alone, let alone the impact that it may have on jobs and the micro economy.

Yeah, yeah, that's a good.

That's so that, that's what stresses me out. And I'm like, I'm starting to look forward. Like I'm in my 40s now. I'm starting to retirement. I'm looking to liquidate my business in the next decade. And what is it even going to be worth compared to what it would be worth at a par dollar? You just feel like you're behind the eight ball a little bit.

Yeah, 100%. How many of you guys feel that way? Like you know the value of your business, especially related to the Canadian dollar, Your purchasing power is going down because of inflation and whatnot.

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You know, is that something you think about Sarosh? I don't know if you like, you deal with a lot of M and A stuff. Like what are your comments around that?

Yeah, I mean there's like. And I don't want to be doom and gloom all the time, but there's definitely like, if obviously something like this does actually go forward and it does impact the economy, then it also not only again is the value of the dollar the one of the questions that's going to have to be, you know, in front of us all the time just when you go out of Canada. You know, I know when I go to the US it feels way more expensive now than when it was before. But the other, the flip side is just people are just not going to be as aggressive with valuating the businesses in those environments because they're not going to have as much leverage. Credit environments are going to be different. Interest rates are going to be higher to obviously push down the inflation. So in those scenarios, obviously, like, you know, the, the multiples are going to be obviously a little bit different too. It's not going to be as, as premium as they were. And like, I don't know how long it's going to take for it to turn around. It will at some point in the future for sure, like turn around. But I don't know. Is that three years, five years, 10 years, 15 years? I'm not like, I, I'm not an economist and I can't predict that future. But, but yeah, those are going to be very real impacts is just the willingness for people to even buy the business and the dollar also just not having as much strength to. Once you actually sell the business.

Yeah. 100.

Well, that kind of happened during COVID Right. You know, when that was the time when everyone wanted to like get ripped out of the business. Right. And then the, you know, the big consolidators were just picking like clinics up where it was like lower.

Right.

Just the leverage was there and people just gave up.

And money, sorry. And money was so cheap then too, Rick. So it was also che.

Cheap.

It was also cheap for them to get. So then they're out there paying higher multiples for assets that aren't worth it. And then I think a lot of us Sat back and kind of got a false sense of value. We're like, you know, ABC crappy clinic down the street just sold for 8x. I'm probably worth 12. Yeah, it's like that's, that's actually not the case.

Right.

And then when interest rates come back to reality now we're, we're seeing those things kind of settle into place a little bit more.

Yeah. One thing I will say is Trump is really, I've been following this like he is laser focused on getting interest rates down. But with the tariffs there's sort of a competing effect where if inflation is high then the Federal Reserve are kind of forced to keep interest rates high. So we're going to see who wins out on that sort of tug of war. But you know, if interest rates do lower then that hopefully will bring valuations back. But it is sort of a guessing game at this point. I kind of want to shift gears a little bit. Gaetan, you mentioned something around insurance like MBA and that sort of thing. Do you want to just to give some of your thoughts there?

Yeah, I was you know, thinking from a micro perspective. I completely agree with Sarosh said in terms of like families and finances will be affected. People might be on a tighter budget but on a macro level those of us who have clinics using, you know, third payer insurance companies through MVA or wsib, you know, these are much larger corporations, sometimes national international companies that own these insurance companies, you know darn right well that if they're budgets are squeezed and their profit margins are reduced, that that is going to be handed down by either increasing insurance rates through, you know, insurance policies or reducing their expenses. And I'm wondering potentially their approval or their funding for rehabilitation costs.

Like you think the funding sources will diminish or decrease?

Yeah.

And I know that we've been in the MVA market for a long time now. There certainly seems to be some months of the year that there are more denials than approvals. Seem to see a spike in September of more denials. We seem to see a spike in January and February and I don't know if that's in line with their fiscal years or their budgetary timelines. I don't know. But there does seem to be an influence between what is denied from an auto insurance perspective and paying for rehab expenses.

Daryl, do you have any thoughts around that?

No, I think. Well, there's certainly two pieces to that. Right. Like I look at it on gaten side of like what we have now and how will that that get impacted and, you know, it will likely require more documentation and paperwork and justification and follow up. So even this, like our admin time and costs now are going to go up on the expense side just to get approvals. So that'll make that part harder, which none of us like to do. And I do think, though, on the flip side of that, though, I do look at it too. There's a lot of clinics that don't see those patients. So, you know, is this something that we're going to now have to start to think about? Is this now going to be a potential consideration if we're going to see, you know, PVAs drop and private payers go down and people lose their jobs and their benefits? So it is kind of an interesting piece. And I know there's a ton of issues with ICBC right now for our colleagues in British Columbia. Right. So again, it kind of is two big things happening at the same time, both unpredictable. Right. So I think, I think sort of looking at those trends, Gaetan, I think knowing your data, like, as well as you do is so critical. And again, being proactive with this. And again, lots of people have legal representations. So again, this is where I know legal has an icky feel to it. But again, this is, we're now, you know, partnering with strong legal firms to support this, knowing that we see denials so they can actually fight for the advocacy of the patient. On the flip side is something that we have to do.

Yeah, just on, I think. I know it was. I just want to cover this topic and then we'll get into solutions. But, you know, Sarosh, you, you were wanting to comment on, like, splits coming from, you know, our clinicians and whatnot. Do you want to just expand on that?

Yeah, I think, like, you know, you were talking a lot about, I think, the negatives that come up, but I think one of the big positives that could come out of all this is, of course, if, you know, let's talk about, like, the funding. If funding does get less, obviously there's less patients coming into the business, there's less capacity for clinics to hire clinicians, and obviously retention will be an important conversation. But the leverage that I think that we've seen might start to fade away a little bit from a clinician perspective. Meaning that we may actually start coming to a more reasonable conversation when it comes to splits. Right. Because what's one of the issues with obviously a really good economy and very little physios is we get all these patients that want care, but we don't have the people to staff the clinics. And so then everybody starts to get, you know, competitive and okay, I'll give you 65. I'll give you 70, I'll give you 75. Like there was even, I've heard 80, like out there, like, which is insane. So I think that conversation actually is going to start shifting gears. And I've already actually had, I've talked to some owners in different markets that's already actually had a bit of an impact just over the last year where, you know, I had somebody ask like, do you feel like the splits are actually like a little bit more reasonable? Because people aren't coming in asking for these crazy numbers as much. So I think we're kind of seeing that shift, which is good. Again, of course, pros and cons for any economic change. But that's one of those things that maybe we have a little bit more control of over the next, next little bit. So something.

I agree.

I think, I think this is the opportunity, right, where like recruitment is going to get a lot better for the clinics that's like, that are strong and so around and running a really good business, Right?

Yeah. This is what we saw in Covid, right? Where a lot of clinics that were not running, you know, up to snuff, not running their systems, their process, their culture, like doing the things that, you know, hopefully our, most of our clinic accelerator clinics are doing, right? Those clinics that were not doing those things started losing clinicians like crazy. Right. And there wasn't a lot of jobs out there. And so the clinics that were doing really well, a lot of our clinics in ca, they're the ones that picked up all those extra clinicians, right? And so just like Covid, this is a little bit of a slow, slow moving or maybe even fast moving crisis where Covid was just immediate like that. But this is a little bit of a slow moving crisis. We can do things that are within our control. We can double down on our business, we can double down on our people. We can do things to help prepare for this potential crisis. Okay? And this is why clinic accelerators here, like, we need this community to bounce ideas off of each other to come up with the best solutions, the best tactics and strategies, and that's what's going to help us survive. Right? So if that makes sense. Type in hive in the chat. We're a hive mind. We're going to share ideas, we're going to do things to help, you know, everybody in the community. Okay? And this is really important. This is why it's important. Not for us to not, you know, keep our solutions to ourselves. We got to share that because realistically speaking, we're still a small portion of the entire community. Like when you look at the industry in Canada itself. And so it's okay to share these sorts of things. Okay, so awesome. Let's, let's actually shift gears and talk about solutions. All right, so we talked a lot about the risks, right? Higher cost of equipment, supply chain issues, reduced patient spending, power, energy cost spikes, staffing, people asking for raises, retention, recruitment, clinic clinic evaluations. Okay. These are all risks that we've spoken about. I want you guys to type in the chat, which one are you most concerned about? And then we'll get you on mic. So panel, I want you guys to choose someone to put on mic and let's actually talk through some of the solutions that we can have to each of these five potential risks. Okay, so type in the chat, which ones concerns you the most? Right. Type in the chat and then panel. If you guys can choose a couple people, that would be great.

This is interesting.

Okay, so let's start with you, Daryl. Who do you want to put on Mike?

Yeah, let's put Amber on Mike. She's sort of looking at the reduced spending power.

All right. So bad at this. All right, Right, let's go with Amber. So reduce spending power. Let's go ahead, Daryl.

Yeah, go ahead, Amber. What are you thinking? Because you're, you're around the corner for me in Ontario.

Yeah. So, I mean, we're steel town, right. Big manufacturing section sector. And I'm concerned that people are going to lose their benefits or just be. They're going to be worried about losing their benefits. And so they're not going to want to use them, they're going to save them, they're not going to want to pay out of pocket. So I feel like we might see reduced, reduced PVA for sure, and maybe even reduced assessments. And to be honest, we had a situation like I bought my clinic from the previous owner. So I didn't start up the clinic. The previous owner retired. And I bought it in 2007. And in 2008 there was a huge market crash and I had to like, refinance because I was, you know, expecting to pay off my business loan in a few years and, and couldn't do it because at that time there was also reduced patients coming in because of the economy.

Yeah. And I think if you look at what you're. You've kind of identified, right. Is drop in assessments and obviously PBA being a challenge I think this is sort of where we have sort of this collective strength now is, you know, what, what would be your first sort of approach now as a potential solution with your prediction? Because they both may be very well accurate.

Yeah. So I'm, you know, I'm all ears to hear what other people want to suggest best. But I know we really have to keep our reputation and let people know that we're here for them through this crisis, that their health is still important, that, you know, they're going to get, they're going to get better with if, if they follow their treatment plan and don't, you know, cut out visits, etc and also, you know, marketing our other services more as well so that people are willing to try out osteopathy or massage therapy where, you know, they. We were just 100 coming for physio before. Those are some of my ideas just off the top of my head.

Yeah, everybody type in the chat box, like, what would you do if there was reduced spending power of clients? What would you do in your business to try to offset this reduced spending power? Type in the chat.

Yeah, and I think, and on that note too, Amber, like, this is sort of the part too where I think we all kind of foresee. Right. So right now most of you guys, and I know you're typing something else in the chat, I was going to ask, like, you already know, you have clinicians who struggle with people from a financial perspective. So now if we know that our clinicians may already be worried about things from their own financial impact, you know, it's going to come down the, the kind of the pathway. So one of the things that I'm thinking about right off the top of my head is like, get right into our regulatory standards and find out like, what are we allowed to do when it does potentially come to thinking about can we offer programs, can people pay in advance, can we allow discounts? And again, it's going to be very dependent on which jurisdiction you're in, what regulator you're responsible for. So again, you have to think about that because they're obviously going to still protect the public as their main priority. But I think the other thing too though is this is twofold for me. We talk about we have multidisciplinary clinics, but we all know we're not interdisciplinary well enough. This to me now is a great opportunity to really start thinking about how are we educating, mentoring and coaching to really utilize the full spectrum of the team that we have. And it's not going to be just with a sign On a door. Right. And then again, what is our marketing strategy in anticipation of assessments dropping because utilization goes down? What's our strategy there? Right. We also know too, as, as people get a little bit more concerned, our cancellation rate may go up. Have we done the appropriate training with our front desk? So they actually know how to respond to a cancellation call? Do we have the ability to reschedule them still? So again, I think there's a lot of operational pieces that we can look into, but I. The other question I had, there's lots of good stuff in there, but how many of you gu are on Sanjeev's monthly Sprint? Just type Sprint in the chat. Because this is a piece of support that we now offer in order to make sure that we can help you guys with whatever that strategy is you're looking for in that month. Okay. So just keep an eye on that and if you want to know about the Sprint, put a question mark and then I'll follow up with you guys afterwards.

Yeah, awesome. I love what I'm seeing in the chat. Double down on marketing, double down on Google Ads, workshops, process, working on clinician efficiency, the cross referring. Right. Like we have control over all of that shit, right? And so we just make that better, you know, 1 or 2%, like as Karen says, 1% every day or 1 or 2% in each of those processes. That's going to add up to 10, 15, 20% of increased revenue. Right. So it's critical that you guys start thinking about this stuff.

And one thing I just want to add is that you don't need to wait for whatever happens with Trump to actually execute, implement every one of you right now. You guys should like be doing this like now and like just doubling down, running a good business, which means double down on the operations, double down on the marketing, double down on the recruitment, double down on all these things that you should be working on every single day right now. So whether it happens or not, your business will be flying, right? And then whatever opportunities come up where, hey, you know, you could scoop up that recruitment or maybe you could buy out out that clinic that is going to shut down or that sole preneur and roll up within your bit, there's going to be opportunities available. But you have to like position yourself today as a really strong business and a surviving survival. The fittest.

Yeah.

100 put. Put fittest in the chat box, if that makes sense. I'm gonna, it's just for the interest of time. I want to get through all of these because we still have to do the, The. You know, the. The prize at the end. So, Karen, what would you do for a higher cost for equipment and supply chain disruptions? What would you do to help alleviate that?

I mean, I would probably just do an inventory, look at the suppliers and the costs. And what do we actually really need? What does it need? What does it want? Where can we cut those expenses? If we want to buy Canadian, then maybe switching to a different supplier. I think to me that's. I mean, that's one thing. Certainly. I think I'll just add this. The biggest thing I feel that, that you need to do is invest in your people. Double down on what we talked about at the very beginning. Get everybody back aligned. What is our North Star? What are we about? Who are we? How do we behave? Create trust, transparency through communication and coaching with your team so that people feel stable, safe and secure when they're coming to a place. They spend more time than they do at home, because outside of there, it's scary. Nobody trusts anybody. So I would work on trust. I would work on your rally cry. I would work on role playing and having those conversations when this comes up in the room and providing people hope. We're still about providing people hope with a solution for patient care. And patients don't want to come and be afraid in your business either.

Type in lead. Type in lead. Be a leader. Right.

Time to really step up your leadership, invest in your people, take care of your people, and that will grow your business along with the other processes. I think that's crucial. Trust is everything right now.

Okay. And just a couple other things. Type in the chat. What would you do with higher cost of equipment and supplies? Negotiate with your suppliers right now. Get bulk deals. Order stuff you know you'll use for the rest of the year now, right?

Yeah, I would do that now and get in on it before.

So that's right.

Proactive.

Type in bulk order you don't need. Yes, 100% sense. Type in bulk, if that makes sense. Right. Order stuff that you know you're gonna need for the rest of the year. You know how we did during COVID Right? Like we ordered all that PPE equipment. Right. I know Sarosh was meeting with all the pharmacies in the area. All right. Okay. What's the next one? The next one is energy cost spikes. What can we do with energy cost spikes? Type it in the chat box. What can we do with energy cost spikes? Like, what are some simple things that you could do in our clinic? Right in the dark?

That's close.

We could get. We can change all our halogen light bulbs to LED light bulbs. Right. We can try to negotiate with the energy, you know, companies to lock in certain rates. Right. You know, you could, yeah. Don't wash your hands. Right. There's a lot of things turn down.

That's a small stuff.

Let's be honest.

Let's work on the big stuff. The big stuff is like you gotta grow your business, keep that patient like staying, you know.

Right.

Like you might make some incremental like, like big like cost reductions here.

Yeah, yeah, yeah. Well it's, it's everything okay. Let's, let's work on staffing, asking for raises, retention, recruitment. Type in the chat. What are HR related things that you're going to do now to prevent, you know, all the, that we might have to deal with with the tariffs. Type it in the chat box.

Well, from leaving to find a job that's going to pay them more, especially our, our front of the house people, like I would pay close attention to those people that may take, oh somebody's gonna give me six figure salary to go work at their insurance company. I'm out.

See ya.

Yeah, I think the other piece though we have to, I agree like with Karen, your ears got to be to the ground very, very tightly because I think we already have a love part timers or we have people who are full time but then they're like I don't have enough volume. So they're going to start looking for part time jobs and you're only going to find out about it when they ask you do if they can change their hours. And now it's too late. Yeah. Right. So really getting into conversations. Yeah. Like don't wait for the quarterly review. Start doing your touch bases now.

Yeah. I like, I like Lee's comment. Discuss upcoming increased costs. So clinics need to be lean. Get everybody on the same mindset of being lean. Right. Gay 10 like exactly what Karen said. Culture. Right. Like focus on your culture and it doesn't mean necessarily processing like, like creating systems and process around your culture. Maybe as simple as like hey have everybody over for dinner like and have those discussions. Right. Take people out, spend a little bit of money now when it's cheap, cheaper to spend on your people. Right. So yeah, so really important the communication is critical as Daryl was talking about.

I think Sarosh made a good point too around stability for people. I think we underestimate that people are seeking financial stability. So again, it's just again don't do this necessarily. Think about it. But this is a chance for you to level set some of your P and L ratios and move people into a stable hourly rate versus these high splits. So again, I'm telling you to change it, but start to think about potential options.

Yeah, 100%. Okay. And the last thing that we had on there was clinic valuations. For those of you that want to keep your clinic for 10 years, don't worry about it. You'll make it past the cycle. If you guys are even thinking of selling in two to three years, you may want to bump that up a little bit. Right? Just. You may, right? And if you do, we help with M and A and all that sort of stuff so you can reach out to us through our dms. All right, guys, thank you guys very much for coming to the call today. It was great discussion. Thank you to the panel. Thank you to everybody who, you know, contributed. Appreciate all your, your comments. Have a great weekend, everybody. We'll talk to you soon.

Thanks.

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