How to Market Pelvic Floor for Men with Amy Stein

A lot of our male patients get to us. It's, they've already been to five, eight physicians and they're still not getting the answer. They're still not getting better. The Flomax, which is for urinary retention and frequency, the overactive bladder meds, they're not helping the UTIs that they think they're having. They're still coming back. It's the physicians that understand what pelvic health and pelvic floor physical therapy is. Then those physicians refer to us or in some cases the men find us on on via Google. They're like at their wits end.

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. 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. Welcome to the Clinic Boss show, everyone. Today we got Amy Stein and she's a DPT owner of Beyond Basic Physical Therapy in New York. She got two, two locations with a team of 12 and they specialize in women's health. Right. So Amy, welcome to the show.

Thank you so much for having me. I'm excited to be here.

Yeah, yeah, we were just talking about it. We got some common like friends in the, in the PT world, like Jessica Drummond, you know, she's the pelvic floor, you know, business coach. And it sounds like she's kind of done some work with you as well, right?

Yeah, yeah.

So I'm so curious, how difficult is it to run like a practice in New York? You know, when I think about New York, I just think about it's expensive and it's competitive. You have to be really good at it, right?

Yes. So I, I feel like I was fortunate in when I started my practice because I was one of few or almost zero. There were a couple of pelvic health pts in the country that were doing pelvic PT and I feel like it was great time to start 21 years ago. I had already been seeing pelvic health patients for a couple years and then I started my practice in 2003 and I was one of the first to even just have a pelvic health practice. So I felt very lucky. Now I have to say there's much more competition and keeping up with it and keeping up with the practices that are the more not sure if this is politically correct, but more of like the mill practices there are certain.

The middle or the mill.

The mill. Like they see like three to four patients an hour type thing.

Run of the mill. Yes, I get it. Okay.

So what I've seen in New York is that some of these practices that have really expanded in like the last five, eight years are implementing pelvic PT into the practice. What's happening is that they don't have the time or the expertise to understand and treat pelvic pain. So I think some are definitely, some patients are getting help and it's fine. I would say the easier cases, the non complex cases, but the complex cases, what I'm finding is they're either thinking that they failed the PT because it didn't work with the, with the practices that are seeing patients like every 20 minutes or, or they just don't think it's right for them. So. And then a lot of those patients come to us still and they're like, oh, this is what pelvic floor PT really, really is.

Interesting. Yeah. I had, I had Nicole on my show, like cozy, and I think we both kind of know her and, and she was talking about that how. We were talking about how a lot of these general orthopedic clinics, you know, the call it run of the mill, you know, you know, they are introducing pelvic floor services within the clinic. Right. But then the clinics aren't built or designed for pelvic floor because it's a very intimate experience. Like the ambiance is like different, like the music even like how you onboard a patient is very different. And we were talking about that. So it's interesting to actually here you kind of talk about that, right?

Yeah. Yeah. And so that's definitely been a challenge, I would say in like the last last 10 years that I've seen like this shift. And you know, I know a lot of them are taking insurance, so great for that. But it is, it is, it is making it more, it is making it harder. For a clinic like mine that's out of network, we do one on one sessions for an hour. So it's just a different treatment plan.

Yeah, yeah. And are your clinics like in like in downtown New York or is it kind of on the lt? Okay, so what has it been like in New York with like, you know, maybe, maybe with like the op? Like, you know, because there's a lot of talks over the years about people not going back into work, you know, or like rent prices going like crazy, like inflation, like, are You. Are you seeing that within, like, the business environment in New York? Running a clinic there?

Yes, definitely seeing it. So one office is in midtown, so a lot of, like, commercial. And I have to say, the commercial, I mean, my. I have a family, two family members that are in commercial real estate here in New York. And you're saying how challenging it is in New York City to get the commercial, to get people occupying space again. So we definitely are feeling it. The other office is in downtown, so they're actually, interestingly, seeing, like, more residential coming from, like, a different borough. Brook. Brooklyn. So it's an interesting shift, and it is, as you asked before, it is challenging. Rents are crazy in New York City. And then just. Just the overhead in general, the even, like, the salaries and just everything is. It's definitely a bit more challenging in New York City.

Can you shock us? Like, how much per square foot are you paying in. In, like, your lease or real estate?

I like per month or trying to think exact. I think it's like, create like a thousand. I'm not exactly sure, but, yeah, rent's like 20,000amonth here. Wow.

And. And how. What's the square footage that for 20,000?

So it's about. Well, so what they do here is they include the hallway, they include the lobby. So I think the actual square feet is about. In each office is about 1500.

Holy smokes. That's crazy. Insane. You know, you're paying 160 bucks a square foot. That is insane. Like, that is a lot of money.

Yes. Sorry I couldn't do the math that quickly, but.

No, no, but like, you're saying it's 20,000amonth. It's 1500 square feet. Yeah. Like, you don't count all the common space, right?

Yeah.

And so you got to be good at your game to pay that type of, like, money. Right. Let's be honest. Like, you can't let too much things leak. You know, it has to have a good patient experience. You know, you got to be. You know, you can't. You can't run this business on Medicare or certain types of insurance plans, right?

Yep.

Wow.

New York is not that supportive. So we do actually. We actually. Interestingly, what. What I've done over the last couple years is I have a couple pts that are taking Medicare. So, like, I. I'm not currently. I only see, you know, six to ten patients a week anyway, as a clinic owner, manager of both offices. But. But yeah, we've slowly had the PTs not take Medicare because it's just. It's A break even for them walking in the door. Even. Even a loss.

Yeah. I was talking to this owner in Jersey and he was talking about how much they get paid in Medicare there. It was disgusting. I'm like, why? How can you run a business where you're making 30 bucks a session?

Yeah, yeah.

Just like.

No, I know. Sad, though, because we want to have. We want to help, but we're also like. But there is a system with Medicare that if you don't take, they can opt out and they can sign.

But it sounds like you're not doing that anyways. You're doing cash or auto network. Right. You know? Right. Which is like, definitely the right way to go. Right. You know, so.

Yeah, especially for this. The. The specialty that we're in. Like, our patients need this time. They. They can't. I did orthopedics for three years while I was congruent. At the same time, I was doing pelvic and I was at one of those run of the mill. Is that what you're calling.

You were calling that. I would have called it cookie cutter physio, but that's different.

Cookie cutter physio. I was seeing six patients an hour, sometimes six.

And an assistant. Did you not have an assistant? You probably had an assistant, Right? Okay.

Like, two aids. And I was like, not even. But I was right out of school, so it was exciting for me. I was seeing knees and shoulders and Broadway dancers and theater and. And Wall street people. So I was seeing the gamut. But.

Yeah, but Amy, I'm going to challenge you on that because, you know, like, think about a dental practice. Right? And if you think about a dental practice, a dental practice is really good at working at teams, Right. You know, you got the hygienist doing certain stuff, you know, like the ratio of hygienist to, you know, assistant to the dentist. Like, like, they work in that team and total. Like they're. Yeah, they're seeing six or they might be seeing like a lot of patients per hour, but, like, you know, the delegation of work we're in this team, the environment is, you know, I. I feel like our profession can do that to serve the amount of people. The question is, like, no one's figured out to do it really well. Right. And, you know, and the dentists have, like, they perfected it so that, you know, in a way is like, you know, the dentist, like, I'm not cleaning your teeth. That's what we got this hygienist to do that, you know, I'm going to do the $200,000 work, not the, you know, not the, not the 20 bucks an hour work. Right.

So interesting. Yeah, good point. Yeah. I did feel like I was pretty good at delegating, so I liked it. Like, I was able to, I got my Medicare patients in the corner, like practicing balance exercises with an aid. And then, you know, my, my, my frozen shoulder patient, I was like, all right, I gotta get in there.

Yeah.

So.

Well, this is, it's a philosophical debate, but, you know, like, you know, like I know that most Americans or most people in this world don't know what PT is. Right. You know, and so, but imagine if people did know what it is.

Right.

How could this profession even serve all these people? They can't because there's not enough therapists, you know. Right, right. And so if you can't work in this collaborative, like, team based model, like what the dentists have perfected, which is like, been really good in terms of a patient experience, then this profession, once again, I, I'm getting philosophy here. I just, I just seen it both ways, you know? Right.

Yeah, yeah, yeah. So a lot of, interestingly you say, like, a lot of people do know what physical therapy is. A lot of people still don't understand what pelvic floor physical therapy is. So when we're just told to just go to anyone, like pick someone on a list. Yeah. It's a, if it's a different experience because there's, there's a huge range of training right now with. There needs to be more set guidelines on, on like what a pattern pelvic floor physical therapist can and can't do. So.

Yeah. Cool. So what would you say is you've been in business for 20 years. What would you say are kind of the biggest, like lessons you've learned with like running a business, growing like a team of 12, having two locations running, you know, running a clinic, you know, like in probably the most expensive and hardest like city in the world, like New York, you know. What would you say are the top lessons, like, you've learned in business over the years?

I've learned a lot. I have learned to really understand what your strengths are and really to rely on other people for what your weaknesses are. Because, I mean, just simple things. And I think I was taught this like in the very beginning, like, you need a lawyer, you need an accountant, you need like a financial advisor, whatever the lists were, you need those and I had those. So that was great. I, I have to say, probably for me personally, the management has been hard. I'm really good with positive feedback. I'm really good with praising people. And like, I hate to say this, but I was a cheerleader, so I'm a good cheerleader. But when it comes to, like, difficult conversation and also recognizing, like, this isn't working out, I have someone in my office that's been with me for like 15 years. She's basically runs the office and she, she is like telling me, she's like, this isn't working. You got to get on this. And I'm like.

So, yeah, difficult conversations are hard, I think, for. Yeah, just. Yeah, it is. It is something that I see very common in the community, you know? Right, right.

Another lesson learned with that. The difficult conversation is definitely something to work on, but also when there is something happening that's not positive in the work environment, like addressing it sooner rather than later and not skirting around the issue, like, those are the things that I've really had to work on in the last couple years.

Yeah, I would agree. You know, it's like, it's. It's like, it's like your kids, right? If your kids are doing something wrong, do you wait like a week or a month or two months to talk about it? No. You deal with it right away, but you do it in a constructive way. Right. You know?

Yes. Yeah.

It's interesting. Like, you know, I have a 9 year old. I was kind of sharing with you. And when I reflect back on, like, leadership and parenting, I feel like there's a lot of similarities. Right. You know, and if we could be leaders, like parenting, where we are coaching our child, you know, to be the best version of themselves, like, that would be amazing to be a coach. You have to push and pull. It's not just like praising. Right. You know, and. And what's interesting is that when I look at my journey of, like, leadership and management over the years, when I started a business, I was like a dictator. I'm the boss. You do this, do that, I'm paying you. Like, it was like this mindset. It has, like, I'm paying people, they should be doing their work, you know?

Right.

And then I. And then I. And then usually we get a reality shot because some we lose people. Right? You know, and then when I lost all these people, like really good people, then I went from a dictator to becoming a people pleaser. I just want to, like, make you happy. Right. Like rah, rah, cheerlead. Just stay, you know, and then. And then these people also left me because they weren't challenged and they weren't that, you Know, because we're not getting results and you know, the business wasn't winning. And when you don't win, you know, and yet got good people, like, they leave. Right. And so then, you know, and over the years I pivoted to this new journey where I like, I'm embracing myself as a coach, you know. Right. So my job as a coach, like, you know, I'm preparing you for the Olympics. Right. You know, in this role. And part of that is we got to train. I'm going to push you, I'm going to celebrate with you. But that is kind of that role that has evolved, like with my leadership, you know, over the years. Right.

Wow. I, I, I need to meet with you more. Oh my gosh. This is like my journey right here.

Yeah, no, but, but don't you agree, like the dictator to the people pleaser, right? And then to becoming a coach where like, I don't want to tell you what to do. Right. You know, and it's like, it's like our kids, you know, like, I don't want to tell my kid. I want my kid, you know, like, the best outcome with you, your kids, is when they make the choice themselves. Right. Y, you know, like, I, I, you know, like, you know, my wife is vegetarian and so early on in my years I had to like, get my, you know, my daughter to eat vegetables. Right. You know, and so part of that process is like, hey, let's go and do together, let's go shopping. Like, like, what vegetables should we buy for, like, thing? Like, but she has to be part of the process, part of the decision making process. Right. What are we going to need today? Option one, which is broccoli or option two, which is kale? Pick one. I don't care which one you pick, just pick one.

So I do the overlap with my, my kids too. And, and guess what my weakness with my kids is also like, I am a people pleaser. And when they say, when they're not, my kids are teenagers. So I'm finding it even more challenging now because they're like, no, I don't want to do that. I'm like, oh, geez.

Yeah, yeah. But, but you know, like, like I said, I think we're, we're, you know, like, you're running a big team here and you know, like, I think getting buy in from your team is really important. You can't just enforce them to do something and to do that, they have to be part of the decision making process so that they feel like they were part of it. You know, and then you using communication and language to make them feel part of it. Even if they fail, at least they own it and they care about it. Right?

Yep.

Yeah. So I'm curious, like, you know, if you think about this again, you know, like, if you were to like start your clinic from scratch, right, you know, like, what would you do differently? Know what you know now?

Oh, that's a good question. What would I do differently?

Yeah. Is there a few things that you point that you're like, I would do, like I would do differently?

Yeah. I mean I always, I do feel like I involved people right away, but I feel the same as you. Like, I don't know if I ever felt like I was like a dictator like you were describing, but I do feel like I would have tried to involve people more in like maybe the management portion or I think the higher decision making that that probably would have been. And, and I think also taking more like coaching and how to have those difficult conversations. So I think those things for sure. I have recently thought about like, I do have pts frequently because it's such a. This is such a niche. So I've been trying to think about like how to get them without leaving or if they do leave, like, how do we expand our practice? Those have been things that I've been trying to. How do we expand the practice without like, like I already feel, you know, as a clinic two clinic owner, like I'm an owner of two clinics and a bit overwhelmed already. But how. What would that look like? So it's just, it is something I've started to like, think about more. But.

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Yeah, that's hard too though because it's such a small. Like there's two offices, so there's only five, six people in each office. So it's also challenging.

What's kind of your, what's kind of your current org structure looking like right now? Like, what does your management team look like? What does it look like at the clinic level? Maybe at the corporate level?

Yeah, so I have like a manager that helps with hr. Everyone. It's small Practice, So everyone does wear different hats. And then this, the manager that I mentioned that's been with me for like 15 years, I, she actually, she talks about how she started with just filing way, way back when we had paper. She started with like, you know, $14 an hour. And now she manages, she helps manage both offices. And she, I was mentioning, is really good with people skills. So that's something I wish I did have from the beginning. Someone at some point at my, like, someone like her from day one that could help with the, with the people skills. Because I have a couple managers that I'm like, oh my gosh, how did I have them as a manager? And it was one of those things like people pleasers. So it took me a while to, to move on from realizing, like, this isn't working out. And six months later, it's still not working out. Okay, maybe, you know, and then they hit rock bottom, which that catching that sooner would have been, would have been a good idea to move on sooner.

Yeah. Wow. Wow. And, and would, and would you still, would you still focus on a niche practice like pelvic floor, or you would go, you know, like, oh, you would do kind of the stuff we talked earlier, which is like a, like adrenal orthopedic with like, you know, like maybe a service of pelvic floor. Would you make any of those changes or no? Or are you happy with that choice you made with going all in on pelvic floor?

That's a great question. Yeah. If I could do it over, I probably would have tried to do more ortho first. But what happened? Like a practice that was ortho first and then add the pelvic. But what happened with me was I was at one of the run of the mills and, or what did you call it before?

The cookie cutter. All the cookie cutter clinics are getting super upset with you. But like, I'm not saying it's cooking. It's just like, you know, like a general orthopedic clinic. Right. You know. Right.

Yeah, I, I, that's where I started. And I started there. I started bringing in pelvic floor patients. Like they didn't have an. And I went from six patient four to six patients an hour to one every 45 minutes. And I book schedule with a wait list. So when I left, they all came with me. So all the patients came with me because they didn't have anywhere to go within that company. So I didn't start with orthopedics because I started with pelvic because it just it landed in my lap, which I'm very lucky for. But yeah.

So if you reflect, if you reflect back, would you like. Is that what I'm hearing? Like, you would do a general orthopedic and like, add the niche service or you would keep the niche?

I. Well, I really. So I love the niche, but I do feel like from a business perspective, having the ortho more prominent in the practice would, would be more helpful and helpful now. Now that there's more pelvic floor competition. Yes, there's more about pelvic health today, more than ever. It's still fairly unknown, but it's better. And now that there's so much more competition, I am like, oh, if we had some, you know, just some more though, it would be, it would help balance. It would help balance.

This is interesting. And, and here's the thing. I'll just be honest with you, Amy. Like, I've, I got the luxury of seeing hundreds of like P and L statements, right. You know, profit, loss statements of like, clinics and chains and, and, and, and, and I'm not single on public floor, but I find that most of the niche practices that I see, the revenue and the profits are like, it's somewhat limited on how big you get. It works if, like, you want to be like a sole preneur with a couple practices, you know. But back to what you said, like, when I think about, you know, does it make sense from a business standpoint where you don't treat and you run it like a business? Like, my favorite clinics, when I look at it, are the ones that have, you know, they're doing like, you know, 2, 3, $4 million of revenue a year. And like they got, you know, I would say, diversified, like revenue streams where they do have like. Yeah, you know, like they might do a half a million of like, you know, like pelvic floor. They're doing the half a million of like maybe like peach, you know. Right. You know, maybe another half of like, of like OT or something else. Right. And the other stuff is like, you know, a million of physio. Right. General orthopedic. Another million of like Cairo. Right. And then, you know, and then even another like, I would say another million of cash based like LMTs, like massage therapy. Right.

Well, maybe I should start doing that.

I'm not saying you do that, but that's a different level complexity. But I'm just telling you, like, those are the type of practice that I've seen. Like, I'm like, oh, man, those, those are really good. Looking P. Ls when I look at. I was like. And it makes enough money where it pays for like really good talent, you know, in your management teams. Right. You know, so, but, but yeah, that's what, that's interesting you brought that up. You know, and so I've always wondered that because on whether people who double down on niche, whether they would do it differently, you know, so. But like you said, competition is getting more and more like fierce. Not just in New York. Everywhere is like this. Right. You know. Right. You know, like I see a lot of, you know, like soulpreneurs or a lot of, you know, cash page therapists, like, they just don't want to go up and open your clinic, have one or two, three therapists, you know, and they're happy, you know. Right. But that's not really running a business. Right. Because you know, like with two, three therapists, it just kind of is like a break even operation. Right. We agree.

Yep.

So it's hard to be like. And you could be more fulfilled if you like. There's nothing wrong with doing that. But just know that like, you know, if your break even point is having two or three therapists work in there, then it's more of like a lifestyle business. Right. Versus because you could, you could choose. I don't want to have a lot of staff. I could choose my own schedule. I could do whatever like that is. Okay. There's nothing wrong with that. But from a business standpoint, from a return on investment is very different. You got to look at it differently. Right. So yeah.

Yeah.

Would you agree or no?

Oh, yeah, yeah, yeah. I agree. I also feel like it's more stable too. I would say in the beginning it was pretty stable because it was, it was just me. I had a smaller office. It was in Times Square, actually. Wow.

I know.

People are like, wow, the rent must have been so crazy. But when I was there, it was when Times Square was transforming and they won commercial in there. So they gave me a decent deal for New York City.

Yeah.

I think then it was like to just to give an example, it was like 30 a square foot. 35 compared to it now.

Yeah, but that was 30 back like years years ago. Right. You know, when the value of the dollar was probably like worth like, you know, way more. Right. So. Right.

21 years ago. So. And now, now Times Square is like tripled and yeah.

So I. I'm checking on your social media account. Like, you guys are rocking it, you know, like, who does it. Who does your social media account within the Business is it you. You pay someone or someone on your team, like who's, who's doing it? You guys are rocking it, right?

Yeah, we do have a strong like marketing. Marketing team because I try, I personally try to get more like into the business end while still seeing a couple patients, blah, blah, blah. I actually love the marketing part. But in the last couple of years and since I opened the second practice, which was just about five years ago, I did realize, like, I have to delegate more. In the beginning it was just more me and the pts. Now I have someone that helps with our social media, an outside source.

Okay, so an agency or like, is it part of like some social media coordinate or like that helps you with that or is it an agency?

I would say it's like it's their own small business and they do this like, and then we give content. So I have a marketing manager here that she works for Beyond B6 physical therapy. And then she helps to organize our social media. She helps to organize our website and our SEO and SEM, and then she obviously also helps to organize when we do the reels and you know, whatever. So I remember I started with Facebook and even then.

Or MySpace. MySpace.

Oh no, MySpace.

I was on MySpace.

I have to say I. I've had like my own, like, I'm into it. I'm not. I have to say I've taken like almost like a three year, two year, three year hiatus of.

Good for you, good for you. Yeah, yeah. So. So. So what I'm hearing is that you outsource your social media content, you know, to like, you know, to another company or another agency. Like they're a small business, right? And then they send each week to you like, hey, like, this is what we need for you. This is what's trending. And then you guys go back and you know, send them like the videos or like the information they need, you know, so that they could cut it up, make you look like rock stars. Right?

Exactly.

Okay. Amazing.

Yeah. And then the pts, like, who wants to do it? Who's interested? So that's one thing that I definitely try to get them involved. Or do you want to write a blog or do a talk? We do quite a bit of talks.

And do you pay them to do it or like they just do it because like, of. Because of like they're part of the team and it's a clinic culture thing.

So the blog blogs are a lot. So we actually about a year ago started paying for the blog because we were like, this is a lot. And it Takes a long time. But the social media part, like the. The videos and stuff, we try to do it during their hours. So that one, you know, we all. We have to be careful about burnout too, right?

100%. Yeah.

We try to do that during their hours. Right now, like, we. For the last. So I opened downtown five years ago here about six years ago. Here's 21 years. We've always had more people in our midtown office than our new office. Right now. It's worse because I did lose a PT, actually, 2 PTS. So then it becomes like a time issue. They just don't have time. So that when I pay extra to do like an hour of social media.

But yeah, yeah, but do you find that, like, the person. It sounds like your manager there, like, you know, when she gets them to do, like, silly stuff, you know, like on social media, like, it actually strengthens the clinic culture and it brings everyone, like everyone has like, a giggle. So using the social media, you know, like, to create the content also helps with your clinic culture. Right? Is that something that you see within your practice or not?

Yeah, yeah. That's interesting. I. I hadn't put that together, but yeah, because we've had some silly ones and everyone's like, oh, my gosh, did you see that?

Yeah. Like, I think. I think it's these subtle things that happen because, like, you know, when you get them to, like, do jumping jacks or do something silly and it's, like, awkward for them. They don't want to do it and then, like, have the biggest kick with, like, filming it, you know, like, it's. It's like. It's like, amazing for culture, you know? Right?

Yeah, yeah.

You know, we even. I even seen this one clinic that they would decorate a special phone, you know, it would have diamonds all over it. And the whole purpose of it was that, like, hey, they would use this to capture. To document, like, live stuff when it happens. And people, like, would, like, you know, they would, like, they would love it, you know, and. And every time they do it, like, it just brings the team together because everyone's just, like, laughing and joking around and stu. Stuff. Right.

So, yeah, I like that as, like, team building.

It is team building, you know. Right. Well, it is, right? You think about it like, you know, because, you know, the stuff you get from your social media agency, like, they tell you to do something like, really, like, like do this trending reel and you gotta look like an idiot. Right? And it's very unprofessional, but, you know, and actually that's the second question. Because when I look at your social media account, you know, is very different from most typical clinics that I see. Right. You know, like, you know, most clinics typically I see is like, it's. There's a very professional medical tone that has no engagement. Right. Versus when I look at yours, it's, like, entertaining. It's, like fun. You know, maybe you could talk about that. Is that. Is that. Is that kind of. Was that kind of part of your strategy?

Like, yeah. I have to say, again, I'm not as savvy about social media, so I do depend quite a bit on our. We use a company called Nailed it, and I depend on them. And then my marketing manager, she's really helpful with that, and she even is like, okay, we need to make this fun. It's also the topic that we treat. So we treat bladder, bowel, sexual dysfunction. And we see. We see all genders and we actually see peds, too. So also making the material lighter. It's hard. It's hard when you're talking about sexual pain or leaking after pregnancy or leaking during workout routines at the gym and in classes. It's a topic that's so taboo that we want to make it untaboo.

Yeah, yeah. But it's working because you got amazing engagement, you know, like, and, you know, you got the followers. And like, I just look at it like, oh, my. Because I had this debate all the time with a lot of clinics in our community, and a lot of them were like, no, I'm not doing that. It's like, it's. It has to be professional medical. Right. You know, but it's not working.

I know.

Like, people don't go to social media to get, like, people go there to get educated, and it has to be, like, fun and light, you know? Right. You know?

Yeah, yeah, yeah. So I. My marketing person's like, amy, you need to get back on social media. And then when we joke, because she's like, so you're like, you're the og of which I didn't even know what OG meant. You're the OG of pelvic health. You need to get on as the OG in pelvic health. I'm like, okay, I'm going to try. Try to get back in.

W new handle. It'll be og, Amy. Right. And I'm curious, does. Does your social media channel. Does your social media actually helps you with getting new patients? Like, can you, like, do you see that or not really? Right?

So that's interesting. And that is. That is one Area that I do, I, I am more interested in. I mentioned earlier like the, some of the management part, not my strength, but this part I like. And interestingly over the years, even when there was no social media, now that there's social media and Internet, there wasn't Internet that much Internet when I even started, it's still the providers that are on referral source the provider.

So then no, like, like you're not getting, you don't feel like you're getting ROI on, on social media or you don't know.

I think we get some, I think we get some and I think what happens is that some people get to know a pt. See with our social media that we try to get all the PTs involved. Those that they get to know the PT and then they actually ask for the PT. But I would say our top is still the providers.

And then what do you mean by providers? Like you're talking about like doctors or like business in the community. Like what do you mean by providers?

Providers like the doctors. So there's number one referral source doctors. We also see, we get patients from like acupuncturists and sexual health practitioners. So.

And who does that? Your marketing manager does that. She goes out and does all the relationships with the docs or the other healthcare providers in the community. Is that kind of her role then?

Yeah, that's part of her role too. I have to say in the beginning I love doing that. So I like when I, so I opened my practice I had, I was again, I felt very fortunate. I had like 60 patients on my schedule. So I was. And, and it was like every 45 minutes to an hour. So you can imagine how many hours I was working.

That's insane. That's insane.

Like that marketing part because I also wanted to get the word out about what we, how we can help these patients. So I would, in my downtime I would just as they say, pound the pavement. I went and tons of doctors in the beginning.

Wow. Geez. So Dr. Marketing still works for pelvic floor clients say geez, that's, that's not what the other business coaches are telling. Like all you have to do is spend money on Google.

That's interesting.

Is Google working for you? Like do like are you converting on, you know, SEO or SEM? Like when people search for a pelvic floor physiotherapist, is that a good channel for you? Like on ads?

Google Ads and yeah, so that's our second. So healthcare providers and then Google SEM, SEO and website.

Yeah. And is it like, is there certain keywords that seem to work really well for you or is it just the same ones like pelvic floor? Or is it more the. The condition? You know, like, I'm like, you know, I'm leaking my, you know, like, you know, I'm peeing my. Like, I don't. I'm gonna be butchering on peeing my pants is. I don't know if that is keyword. Have you find something that works really well for like. Or is it like, I want a pelvic floor physiotherapist in New York Floor physical therapist.

Yeah, we are trying. We're like experimenting with the words and things. So. Yeah, I have to say too any for anyone that's out there. I did also wr two books and I do feel like that helps as well. It also helps for the just, you know, patience kind of. They like, they appreciate respect, basically. They're like, wow, you wrote two books.

What's the name. What's the name of the book that you wrote that is the bestseller?

Oh, you can't see it because of the background.

What is it? Yeah, I wrote Heal Pelvic Pain. Right. Is that what it says?

Faith. Okay, I did that. And, and so what happen.

So what happens, like, when a patient comes on? Like, do you give them that book? Like, is that part of your like, like onboarding of a. Of a. Of. Of a new patient?

Yeah, for some. Some already have it, so some have through my book. So the other book is also beating Endo Endometrier. It does help. It's just. It's just. It's an added. Is it.

How do you. But how do people get your book? How do people know about this book? Is it because you're doing talks? You know, are you doing like certain types of workshops, and then you give them the book? Like, how. How is this book being, like, promoted across, like, what you do?

So I have to say that social media did help with that because my sales have gone down since I am not on social media because when I was on social media, I would say I'm the author of Heal Pelvic Pain and reading Endo. Now that I am not on social media as much, I have to say book sales have gone down. Okay, that. So. Yeah, so I would do giveaways on social media. Giveaways. But I would personally do giveaways. I would. I would take them to conferences. I would reach to certain societies and be like, hey, if you want to do like a book giveaway, happy to. To donate a If a lot of the patients already have the book, so they've searched it on Amazon or their physician. When I told you I was pounding the pavement, I literally came out. It was like my.

I love that. I love that. So. So it's like, here's a referral form, by the way. Here's my book. I'm a famous author for this specific topic. I am an expert. Right.

Yeah. Pound the pavement as much. We do more snail. And obviously there's a time and a place for that too. But what I do is I try to send the book with, like, if we have a new provider, I send the book with it. So then it. So then the. The letter and the material doesn't go right into the trash. So, like, oh, there's a book here.

Yeah, yeah, yeah, yeah. No, I love it. And the book is what, like four bucks, right? You know, like, it's. It's. It's. Is that the price?

Yeah, yeah. One book is right now. It's its lowest it's ever been nine bucks. The Heal Public paper.

Is that your cost or is that the price of the book? What, you're selling it for Amazon?

Yeah.

Okay. Yeah. So what do you think the co. What do you think the cost is to make like, your. Your cost to. So to create that book?

Oh, that's a good question. Because I don't do that part. I actually.

Okay.

I had two different publishers help with the book. I'm sure it's not a lot of money, but I. I get the royalties from the book. They own the book, so McGraw Hill and HarperCollins.

Interesting.

And I get the royalties. We still have not gotten the.

What.

What they'll do is they will. A lot of the publishers will give you an advance.

Yeah.

Towards your. Towards writing the book. And so for heal pelvic pain, it was only like 7,000, $8,000. So I made that back quick. Or I made that quickly.

Yeah.

Raw Hill obviously took that money, and then within two years, I was making royalties. Granted, it's like a thousand dollars, $2,000 a year. It was more in the beginning. It was.

But I just think, I. I just think it's a brilliant. Like, you know, I think it's a brilliant approach when you do doctor and call it like, provider marketing. Right. You know, where, you know, like, you're, you know, you got your manager, you're a marketing going out there, and they're like, hey, by the way, like, hey, here's this book and this book, like, if it cost you 2, 3 bucks to make like, whatever. Like, that's cheaper than making a freaking postcard, you know, And. And it's more impactful. And then, you know, your authority just goes up now, right?

Yeah, exactly. Yeah. It's genius that I'm trying. That I try to use to like, differentiate us from other practices too. Like, we've written books.

Wow, that's amazing. So you talked about health care providers. What are the top, like pelvic floor referral health providers. You mentioned acupuncture. Was there anything else that seems to like, work well for you guys?

Acupuncture is a small provider.

Okay.

But just because also like, not a lot of acupuncture specialize in pelvic health. So they wouldn't even know to refer. Probably. Still, the interesting thing about pelvic health is from the physician perspective, we do get some from primary care and even orthopedics because you has a tailbone, they have a sacrum and they have a pelvis. So there's definitely angle to it. Plus hip. There's a lot of new finding. Well, not. They're not new anymore, but there's a lot of findings that hip dysfunction contributes to pelvic pain. Pelvic health issues. So we get. But we also get the gyns, which probably more people are like, oh, yeah, that makes sense. But we see also we get referrals from urologists, gi. Yeah, GI doctors. You see a lot of bowel issues. So actually the subtitle of my heel pelvic pain book is Proven Stretching Strengthening Nutrition program for Pain, Incontinence, IBS and Other Symptoms. So we do see quite a bit of ibs, which is more a general term for just bowel issues. And then colorectal too. We get some docs from colorectal, like rectal pain and okay, so.

So most of the providers are within. Still like the medical community, not like the allied health. Right.

Within the medical. But then we still have like physical therapists that like ortho that are like, oh, people do pelvic. Yeah, I gotta refer you somewhere. So.

Yeah, yeah. And do you guys actively market that or not really. We.

We do, but I have to say we haven't in a while.

So just throw that book in there, you know? Right. You know, I love that. And I'm curious about this topic because actually someone in our community asked about this is how is there a market for public floor for men?

Oh, yeah, of course. Yeah, yeah.

As equally as big as the women? Or is it like, you know, like from. Or is it a small, like much.

Smaller Percentage, it's not much smaller for sure. I say the only, the biggest difference is that for women they do have not all obviously, but some have the childbirth. So that contributes to the patients with female anatomy, the issues that could arise with that and then also menopause for women. So those both can contribute to pelvic health issues. But all the other ones like the urinary urgency, frequency, the bowel urgency frequency retention, so causing those are all. I would say that's almost equal between.

Wow. So. So your practice, like is it 50, 50 people coming in or is it, is it 90, like women still, right?

Oh no, it, no, it's like 60, 65.

Really? Wow. I'm actually fascinated by this and, and the. And once again, I don't know, like this is. I'll probably need to come to your clinic in five years. But like do the. And.

My book explained.

All right, I'll get the book and I'll do it. I'll do my key goals. Right.

You're welcome though.

Do they, are they okay with like, do men want to see like a men therapist or like do they typically prefer like they're okay seeing a female because it's a very sensitive issue for like, for, for all people, you know. But like, I think especially with like men like me who have like maybe high ego and they can't talk about these difficult conversations.

Yeah, it's definitely a challenge. But what we find, and it's a great question, what we find is by the. Unfortunately, by the time a lot of our male patients get to us, they've already been to like five, eight physicians and they're still not getting the answer. They're still not getting better. The Flomax, which is for urinary retention and frequency, the overactive bladder meds, they're not helping the UTIs that they think they're having. They're still coming back. So that's when the, the and again, it's the physicians that understand what pelvic health and pelvic floor physical therapy is. Then those physicians refer to us or in some cases the men find us on. On via Google. They're like at their wits end. Yes. They're like probably, I would say probably one in probably a hundred to ask for a male therapist. But most, most prefer female. Some religions that they actually prefer male.

Interesting. Interesting. You're right. I could see that.

Yeah.

It's like I have a, I have a therapist. I prefer to talk to like, like a female just because I could, you know, I feel more comfortable. I don't know if it's like the male versus male thing, but I personally just. I'm like, why, why is it that my preference is talking to a female therapist? You know, so.

Yeah, but we're doing this so long that it's like we make them feel comfortable if they don't feel comfortable. We. We work around certain things.

But wow, this is fascinating. This is way higher than I thought. 40, eh.

You know, and we like pediatrics.

Yeah. But what I'm hearing is that like, the key to this still seems like it's the doctors. Right. You know? Right, the doctors. And maybe Google for pelvic floor for men. Right. Is that what I'm hearing? Do you get a lot of word of mouth from men or no. Or do they. Do they share with like, because I can't see like me, like, if I like, I just think about some of the health issues I have. Like, maybe, you know, I don't think I share that with everyone. I might share with like the ones really close, like one out of like 10 people. Like, it's not like, hey, guys, like, you know, like.

Yeah, I would say the referrals from other, other patients is more. When it's like a family member.

Okay.

Female, we find it's like friends, like the female population, we find like, oh, I'm friends of so and so. The male population is like, oh, my wife sent me here or. Or my niece or nephew or whoever told me that they came here and they had great results and they suggested I try this because I'm peeing every, you know, every 10, 15 minutes.

You know what? Yeah. And what you're saying is I could totally relate. You know, I'm just thinking like, so what you're saying is like word of mouth for females typically are like friends and family. Like, they just want to share with everyone if it works. Right. You know? Right.

Not all, though. Not all.

Okay.

More. I would say more.

More. Whereas males typically, if you're getting word a month is usually from a family member. You know? Right. That's an interesting distinction. That's cool that you could see that. You know, that's very. How do I say this is interesting from a psychology, like, and behavior standpoint. Right. You know, why you. When, why you wouldn't do it, why wouldn't be the same, you know, so.

And if you see also I just thought of this. There are a couple documentaries now on like endometriosis. So that is more female anatomy condition. They talk more openly about it on these documentaries. I'm trying to think of Yeah, I guess. I guess there are another. A lot of other documentaries that would, like, talk about. So.

So when it comes to your marketing, do you do a lot of marketing, focus on, like, the males or, like, is it balance or is it mostly females?

Then I would say it's pretty balanced.

Okay.

They, you know, they see some neurologists see primarily female. Some do see primarily male, but we try to talk to both. Both groups.

Okay.

Rectal doctors, they obviously see. So they would both. Both. Both genders. So. Yeah.

Wow. Maybe you could do a photo of me, like, in my pants and I have wet pants on. Right. You know, I. I see. I see a lot of those, like, images, like, on a lot of Instagram, you know, like, you know, they. They're trying to, you know, but I usually see females, but I never see the males. I'm like, oh, my gosh. Like, I feel like you could, you know, really open something up if you could crack this, right?

Yeah. And I. I feel like they're, you know, when I think about the. How long it takes the female and the male to get to us, I'm like, oh, this is. I feel like it's a disservice for them because I'm like, so when you have. I. Whenever I do a talk, I try to use this analogy. When you go in for shoulder surgery, when you go in for knee surgery, the number. The one thing they say a lot of times prehab, like, before the surgery, but also post op, they say, you need to start pt, you need to start scar tissue mobilization. You need to start range of motion. It's the same for the abdominal pelvic region. No matter what surgery, what gender, like, you need to PT right away. And even for, like, a condition like endometriosis, they were even saying. I just spoke at a conference recently for that, and they were saying, like, oh, you got to wait to six to eight weeks. Now they're saying, no, no, because you get. You need to start that mobilization to make sure that scarring doesn't start to adhese.

Yeah. Wow. I love it.

Similar to shoulder, like, you don't want to wait. You know what happens as an orthopedic, you know that if you wait too long, that shoulder is going to be frozen and not want to move. So you got to get in there right away. So now they're saying, it used to. When I started, it was like six to eight weeks. You need to get the doctor's approval. Now they're saying, like, pretty much right away, you got to go. You got to go for pt and then so for some male, the prostatectomy surgery, like. Yeah, we should be seeing them. So they have good behavioral habits. Prior.

Yeah, yeah, yeah.

And then after. So just. Just an example.

This is so cool, man. I really enjoyed our chat today. And, Amy, I'm curious. How do people find out more about you, you know, and where. Where can they buy your book?

So book painting, beating. And they're both on Amazon. Barnes. Is Barnes and Noble still? I don't even know.

Yeah, it depends on the cities. Some of them are bankrupt, some of them are not. Right.

So primarily Amazon.

Okay.

On our website, Beyond Basics Physical Therapy, we also have links to it and then social media. At Beyond BasicsPT, we're pretty active. We do a lot of educational stuff. So we do free, like, in services, too. We have a Pelvic Health 101 that we do yearly and that.

Love it.

Just community outreach. Just telling everyone, like, this is what pelvic health is. It's actually coming up in a. In a. In a month, so.

Wow. Sounds good. Amy, the og. Thanks for coming to the show, Amy. This is, like, amazing. I'm glad we finally connected. Right.

So, yeah. Thank you so much for having me. And I appreciate you doing this. This talk because getting the word out about pelvic health is for everyone is really important.

Yeah. Love it. Cool. 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.