The 3 Stages of Business Growth with Jamey Schrier

So there's three stages of business for the small business owner. Stage one is someone just starting out to about 400,000 in revenue. Stage two is 400,000 to a million. Stage three is like a million to three million, three and a half million.

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 everyone to the Clinic Boss show. My name is Rick Lau and I am your host. I grew and exited 127 locations and now I'm on this journey to meet the coolest and healthcare entrepreneurs in the world on how to get smarter in business and in life. And so if you, if this sounds like you, you found the right place and you'll love the show. And today we got an amazing guest, my good friend Jamie Squire. He is a practice owner for the last 15 years and now he helps hundreds or thousands of practice owners on how to not get overwhelmed. Right. Burn out, you know, and tree less, earn more. Did I, did I say it right, Jamie? Rick.

I think he did. Shrier is the last name. Okay. I don't care what you say, I'm showing up. I mean, if you got free food, yes, I'm showing up. If you got free food, I'm showing up. I don't care what you call me, but yes, yes, I am in the coaching space helping these practice owners overcome the overwhelm, create a path, create a plan and help guide them to, to making more money without working more. Actually, you have to work less in order to create a successful business. So that's what we're doing here at Practice Freedom U. So great to be on with you, man.

Been too long and, and one thing I kind of respect over you over the many years that I've chatted with you is you're not your typical business coach. You actually do a lot of executive coaching, some of the higher level thinking, which I have a lot of respect for that Right. And just, just I'm curious, like, you know, do you remember how we met, jb?

We met at a, we met first of all through a mutual friend of ours.

Yes.

Right.

All right. From Australia.

All right. From Australia. The one minute, I think it's the one minute thing. One minute. Manager. One minute something.

One minute practice.

One minute practice. I knew it was a minute. And then you and I met in person. I'm picturing the hallway. Was it in Denver? It was somewhere at a conference.

Denver, Colorado, at pps, I believe.

Right. And I'm picturing the room. We were at the cool hotel there, Broadmoor or something. And I. And I. And I met you, and I went, dude, I thought you'd be taller. No, I'm just kidding. You're actually pretty tall.

It was interesting.

So.

So I've been. I've been. I've known Paul Wright for a long time, and he's always told me about this guy named Jamie. Got me Jamie. Jamie, like, amazing. And, like, Jamie actually reminds me of me. And, like, he did say that.

And after talking to him, I'm like, he is me.

You're gonna love him. He's such an amazing guy. I'm like, yeah.

Well, you're too kind, man. And, like, the respect is. It flows both ways and what you're doing and what you're passionate about.

Yeah, yeah. And so just to kick off on the show, I want to start off with something maybe like, quite juicy and controversial is, you know, Jamie, what is one of the most insane stories that you've heard or worked with a clinic owner on with, like, an employee quitting at a clinic? You know, like, what's. What's this a situation or scenario that you've seen that has just been, like, insane on how someone quit? Like an employee?

Right? Yeah, yeah. I mean, it's. It's bigger than that. I mean, I've worked with hundreds and hundreds of practice owners, so someone quitting isn't a story. I had a practice owner that came on, and she was buying out her partner. Her partner and her just did not see the same way. She had a clinic of her own, and then she was buying out her partner, who was partners in this other separate clinic that was actually in another state. So they had several staff there, and we negotiated. I helped her negotiate, like, buying her out. They wanted to do a slow buyout. I said, no, pay her the money, get her out of there, because I had a feeling it was not going to go well initially. So she bought the clinic, and within 30 days, every single person of the staff quit, except for the one person that was just being hired. That this woman actually was the one that interviewed everyone else quits. She was just down to one. We're talking, I don't know, seven or eight people. All. Everyone therapists, because they were all so Allegiant to this other person who was just not a great person. Like, she was not the kind of person that you wanted. She. She didn't have the morals and the ethics and the values that you and I do.

This is the person that bought the clinic.

The person that bought the clinic, okay. The entire staff left when they realized she was the owner, and the other person left because the other person, you know, people attract to people like them.

Yes.

I don't care what your values are. Whatever they are, people are going to attract to those values. If your values are a little shaky, if you're. If you're. If you're, you know, scruple, you know, your ethics are a little shit, you're going to surround yourself. If you like drama and angst, if that's just who you are.

Yeah.

You're going to hire people similar to that. So, you know, my client, you know, she's just the top of the top. Her integrity is just high, and that's why her partner and her weren't getting along. So when she sold, she would talk to the staff saying, hey, we're going to go in a great direction. I'm here to support you guys and all that. They said, we're out of here. And I told her, and I held her hand. I go, it's okay that this was going to happen. That's crazy. Hired all these people.

They all left. They all left. And then where did they go? They just, like. Did they all, like, band up and start by clinic across the street?

They just all started. No, no, they just started leaving, going other places. And I. And I asked her this question, Rick. I said, honestly speaking, do you actually wish any of the people that left stayed? She said, without even hesitating, she's. Nope. I said, okay, so what we're dealing with here is. Yes. We're dealing with a situation where we have to make sure we have to stay connected with the patients that we do have, and we have to rebuild the team. Rick, in less than a year, she not only rebuilt her team, she quadrupled the business from where it was when she initially bought it.

Okay, wow.

400%. She quadrupled the business.

Wow. So we went from like, what, like half a million to like 2 million? Is that we're.

Yeah, something like that. I don't know if it was quite a half a million, but it was something around four or five hundred thousand. Like six, seven, eight employees. Couple of them part time. They left. She came in, started to hire people the right way in her values and her vision started to onboard them better and then the company just started to take off.

Yeah, it's like a cleansing, you know, it's.

But it's hard for her to do that. And this is kind of a plug for coaching. Like you said, for her to go through those emotions by herself and to be able to have to make decisions, I mean that is like impossible because of the emotions and everything you're going with having someone on the outside that's able to guide you that, I mean it, that was so darn powerful. And I give her all the respect in the world because that was not easy because there wasn't a ton of money coming in. But she had this vision. So that right there is, you know, the most recent. So I mean, there's other stories there.

But that one, that's pretty insane.

That's pretty powerful.

Yeah. Actually that reminds me of a very similar story. You know, maybe, maybe 10 years ago, I knew a clinic owner who bought another practice, right. You know, and it was, it was a million dollar practice. There was like, you know, six, seven, you know, therapists working there. And when she bought the practice within 90 days, all the other staff quit. Right. But the difference is that they all actually, when they quit, they actually started up a clinic across the street and they took the entire practice over. Right. And the outcome was not the same as what you brought up. Jamie is that like, you know, the, the, the she bought this practice, you know, and she took like a mortgage, she had some bank debt and she didn't have that fourth 100% like return. And so. And she ended up just like buying a job herself with a mama debt. And then next thing I know it, you know, like across the street you have all these, you know, all, all your past employees becoming your biggest competitor, you know, and they just took that business away. Right. And that was like heart wrenching to see someone kind of go through after, like buy like, you know, after, after buying that. Right.

So I wish I was there to help her. I wish one of my coaches was there to help her. Because it's, it's about reframing the situations. I'm a big reframer, meaning whatever the situation is, no matter how terrible it may seem, there's always a different way to look at it that you can take something from it. Right. Some people may call it, you know, looking at the glass half full. And I'm not always necessarily a positive person all over the place. But when it definitely comes to this in business, it's. What is the lesson Here, because if not, you will get into a death spiral. But if you can say the lessons here, first of all, no one was here to buy into what you were doing, which is fine. Second of all, none of these people are you. They don't have your drive and your courage and your guts and your smarts. And let's focus on not worry about what they're doing. Let's build the company that you want, attract the people that you want, make it very clear the difference between your business and their business and anyone else's, and let's build your vision. If she had that grit and that and that and that guts to do it, she could have done that. If she didn't, if she was like, not that kind of person.

But it's hard to see it when you're at that moment, like, you know, I think what you're saying, like, the theory kind of makes sense if you. If you're not kind of inside, but at that moment when, you know, you just drop, like, you just drop like, you know, seven, $800,000 to buy a practice. You know, you're in financial pain already, you know, and then. And then. And then literally everyone leaves, you know.

Right.

And they take the entire practice. Right. So.

Well, Rick, that's not that much different with the person that I just shared. This. This person that was. That was a client of ours hired us to help her grow her business, knowing that she was going to buy this personnel. So she did it preemptively. If someone is going to buy a practice, does this person ever own a practice before?

No. No.

Okay, so the assumption that she made. Was she ever in business before?

No. No.

So the assumption she made is, I'm sure she's a very fantastic clinician. The assumption is. Right. I'm a great clinician, Rick. I'm going to drop a half a million on a business. And if I spoke to her beforehand, I'd be like, what do you know about a business? Because your ego is saying, I can do this. Your ego is saying, if I just buy this business, it will just run and grow. That's naive. And I think if she went into this and had some guidance and some mentorship and some coaching, that whole thing would have turned out differently. It doesn't mean the people may have left anyways. They may have, but there would have been a quick pivot and there would have been a. Let's just get a plan in place and start executing. Other than that, she got emotionally crushed, then you're done. Because you don't even know what to do. You're, you're. I get that. But I wouldn't say it's different. It's not. It's what it is that you want. And do you have, do you have the support team to help you get there? We have huge. I mean, you and I were talking about this before we came up. We have huge egos.

Everyone does egos, right? Yeah.

We're some of the smartest people of the planet. We got the biggest hearts in the world because we're healers. And guess what? Having an ego and a good heart ain't the recipe for a great business. Right. It's the recipe for being a great clinician. But you actually need skills and know how to run a business. You need marketing, you need management operations, you need financials, and you need the mindset of how to look at your business differently. We're not taught this, and yet so many people go in the business. And there's no wonder why most people are struggling. According to the surveys, most people do not make really any money. They work a God pristine amount of hours and they don't fulfill their dream of what they wanted. Why? It's not because they're not capable and it's not because they're not smart and it's not because they, they're not hard workers. It's because they don't have the guidance and the path to get there. So then they start making decisions about, oh, I'm gonna hire this person, I'm gonna do this person, I'm gonna, I'm gonna buy this product and this thing thinking that's going to solve the bigger issue. And the bigger issue is how they actually think and approach their business. They don't look at it as that. Most of them are looking at it as a hobby even though they have everything invested. I will get off my, my, my stool or whatever, but it just kills me when people, you know, not just you, but people say that, no, no, there's no way everyone can be successful because there's 350 million people in, in the US and there's another, whatever, 14 million in Canada. There's plenty of people that need our help. So it's not because there's not enough people. It's, we aren't taking this seriously. To invest in what it takes to build a successful business. It takes a lot of work, a lot of effort, and it takes a know how. That's what coaching does. It provides the know how to speed this process up to create success faster.

Yeah. And Jamie, we're talking about the earlier. Why is it every time we go to these events, whether it's PPS or these conferences, like, everyone's, everyone's success is based on them saying, like, I have 50 clinics. I have 10 clinics. I got 100 clinics. Like, we were talking about that earlier, right?

Well, you know, we're human beings. It's a pissing contest, right? We have, like you said, you're like, well, it's ego and status. We can't go with a bunch of loose, loose colleagues, right? You know, there's aren't huge relationships there. It's people we may have seen or people we meet. Rick, how are you doing? I'm doing great. How are you doing? I'm doing fantastic. Behind the scenes. You basically just took out a loan to pay your bills, but you're never going to say that. So how do you really ever solve a problem when you can't look in the mirror and say, you know what, dude? You don't know what you're doing. You. You don't know how to do this. But I want to know and I want to learn. If you're not willing, I'm not saying you just meet someone the first time and you give them your sob story, but I've had, just in this past PPS, I had probably over 100 conversations with people, and people know me. I go deep with people. I don't, I don't just say I'm a superficial because it's. That just bores me. I want to know, hey, Rick, so what's going on? Tell me something good happening right now in your business. Tell me something that you're. You, You're. You're having a struggle with. Like, if you tell me, like, oh, no, no, I'm not having any struggles. I'm doing great. I just know you're full of crap. But if you say, well, you know what, we're having a little struggle here, then I know that you're willing to be open and those people are willing to learn and be coached and, and move forward. The other people, they're just living, Rick, in a quiet desperation. They're just quietly desperate, you know, being. Just withering away, hoping and praying. And we both know hope is never a strategy in their business. So the reason why. And I, and I, and I like going to PPS just as a vendor now, an exhibitor, to meet people and see people like you and me. But the reason why something like PPS has never grown. I've been in it for 13 years. It's the same 1100 people out of I don't know how many business owners after 20,000, maybe just in the US let alone the other staff that comes with it. The reason it hasn't grown because it's not connecting to what people really want.

And, and what is it they want then, Jamie?

Well, you tell me. What do people in business really want? I think what they want is to make more money, to be paid what they're worth from their business, and they want to have more control over their time. Perhaps they want to scale, perhaps they want to focus on a particular, you know, area and clientele. But what they certainly want is to create something of meaning without having to sacrifice their well being, which is money and time and, and all that. They want to be happy in this business. That's what I think they want based on what the people told me about. So the question is if they're going there and they're not getting that because everyone they talk to, it's a little bit of a subtle competition. And if the numbers, because you're a metric person, if I told you, hey, Rick, I got this company, we do workshops and every year we've been averaging for the past 20 years, a thousand people, you would say, well, how many people leave? Oh, about a third. Well, how many people do you get? About a third. Like you would say, well, you have two problems. One, you have a retention problem. Why aren't people coming back? And two, we have a messaging problem. We're not, we're not hitting on the right message for people and then delivering the value on top of it. Because if we did, those numbers would double.

But it's not.

So that's kind of the, the thing that I see when I'm there, there's a certain type of person that's there. And I'm telling you, there's some really successful smart people that are there. And I'm not here to talk about pps, but it just kind of goes in that thing where there's people that are not looking in the mirror. My favorite, you know, song is Michael Jackson, man in the Mirror. Because to me it's Jamie had to look in the mirror. And I have an ego, brother. I got an ego like everyone else.

We all have egos.

I got all.

I have egos, right?

My ego used to be pretty damn big. And what I did, rip, I looked in the mirror and I said, Jamie, you don't know what the f you're doing in this business. Because I was working 60 plus hours a week, I was making Barely anything. And I had no vision of a brighter future. And I had to admit, I didn't know what I was doing. And that's when I started reaching out for help.

Hey, actually, on that point, Jamie, like, you know, I follow you on social media, and you talk a lot about cutting, like, you know, like, you know, like, not treating or cutting treatment hours, right?

Yeah.

So, like, how can you actually do that if you have a small practice and you can't afford it because, you know, like, you still have to pay the bills, you have to still, you know, like, you, like, everything is getting expensive. And so how do you. How do you transition from, like, that small practice owner to actually reducing, you know, patient care time? Is that even possible? Or like, you have to put in those, you know, that 60 to 80 hours a week, you know, and do that transition.

I love that question. Allow me to explain. First, let me ask you a question back. Would you agree that the most important person in your business is the owner? Would you agree that's the case?

Yes. Okay.

So that means whatever the owner focuses on and puts their time and effort, that area will grow. That area will improve. Even if it's something that's not good necessarily for the business, it will still become bigger.

It should in theory. Right?

It should. Because wherever we put our time and effort, that area grows. So when we first start a business, any business, what we need is to add massive effort and massive focus. We can't be all over the place. We have to focus on what the most important thing is. So there's three stages of business for the small business owner. Stage one is someone just starting out to about 400,000 in revenue. Stage two is 400,000 to a million state trees. Like a million to three million, three and a half million.

What do you call those three stages? I think you share that with me. When we were in.

Yeah. So at Practice Freedom U, we have archetypes for each stage. So the first stage is called the committed clinician. Committed stage.

That's the first 400,000. And there's probably like two, maybe two or three, like, therapists working max, right?

No. Yeah, probably not even that. It's usually a single maybe. Maybe two therapists. Assuming a therapist can make a couple hundred thousand in revenue. Two therapists max, most likely.

And then you'll be therapist 400,000 first. 400,000 is your committed clinician, right?

Correct. 400,000 to a million. We refer to that as the overwhelmed operator.

Overwhelmed operator. I do like that name.

Yeah, yeah, the Overwhelmed Operator. It's Named that because I started looking at. Okay, what is making you overwhelmed? Well, you're still doing your job as a clinician, but you also now have hired so many people. So you're not just a clinician, you're also the director and the manager. And as well as you're trying to still be the owner. So you're playing now multiple roles. When you're smaller, you're really only playing the clinical role. Now once you get over a million, million and a half, you start to be evolving into this business owner. We call it the evolving entrepreneur or the CEO. Yes and no. You're becoming the CEO, I guess in that place. But the CEO is when you really establish a management team and a leadership team. Without that, you're not really the CEO. You're still playing the role of manager and director.

Okay.

But that's where you start moving into.

Okay, so, so the third phase, what did you call that name?

I was just, I called, I. We call it the archetype Evolving. Evolve.

Okay. The evolving entrepreneur. Okay.

Or you could say the evolving CEO.

Okay. The evolving entrepreneur. Slash CEO. Okay, cool.

So you have each of those areas. At the beginning, what we tell our people and we help and train our people is you have to focus on two things. One, you take care of your clients, you deliver the greatest care. Because word of mouth marketing is the absolute best in any business, especially with a startup.

You know, in the very beginning.

Yeah, exactly. Number two, you need to build your network. We're a small business. People know you. You need to develop your network and you need to develop the skills of building relationships because they will last for years.

Maybe my network, you talk about like some of the community, like marketing stuff like the relationship building. Not, not like.

Yeah, we call it relationship marketing, but it's network against building relationships with people in the community that have influence over your ideal clients.

Example, like, like the personal trainer, the massage therapist, the doctor.

Yeah, it depends who your, your audience. If your audience is runners. Well, who sees a runner? Well, an orthopedicist is going to see a runner. Podiatrist is going to see a runner. A trainer is going to see a runner. Coaches running coaches running programs. I mean it's, it's, it's endless. It's. It all depends on who you want to see. And then you start writing down all of the people that have influence over that audience and you start reaching out and connecting and seeing what you can do to help and collaborate and see if there's any synergies. Because the important skill and I know I'm preaching to the choir here with you, but the important skill, why this is so important to do, could you start learning how to not just build relationships, you start to learn how to handle rejection and failure, which is critical for success. As great as you are, Rick, I'm just going to guess you've had a few things that haven't worked out quite the way you would hope to and it probably crushed your spirit for a little bit. But you said, you know what, I'll just learn from it and get back in the saddle.

I've had a lot of fail, I had a lot of failed businesses. Let's just say that.

Yes, you know why I know that Is because you're successful. And no person that's ever been successful hasn't had a ton of failures. The difference between me and some of the gurus out there is I just share my failures with people because I want people to relate that, look, I'm not just some magical thing here. I've worked my butt off and made mistakes and learned from it. The question is, are you willing to do the same? So a stage one person, a committed clinician, needs to learn that and needs to learn how to sell their services, especially if you're a cash based service on some level.

But Jamie, I'm not a salesperson.

I went to school.

I went to school to be a healer. I am not a salesperson, Jamie.

And this, this is why people need coaches and guiders. Because that mentality will keep you broke. Yeah, because the reality is you are a salesperson. Because the way I define sales is, is someone that persuades someone else to do something. And here's the kicker, that's in their best interests. See, a slimy salesperson sells someone that's in their best interest, not the person they're selling it to. Like the used car salesman that sells the piece of crap. But if you can learn how to actually persuade someone to do something. And by the way, we do this all day long. When you say someone, I think you need to come in two times a week for six weeks. You just quote, sold them a plan of care.

100. You're selling treatment plannings, care plans. You're selling people, clinicians to work at your clinic. You're selling your vision.

You're selling balls and supplies. Now you look at it as selling, but you're, but it is.

100. You're, you're selling to the landlord to give you like a cheaper rent, to give you like ti. Right? You're selling to the doctors to actually put your friendly list, you know.

Right, right.

And so you're selling.

The orthopedist is selling the, the heart surgery that you need.

Yeah.

So if you understand that you are selling and you believe in what you're selling, what you need are some strategies and communication and tactics to help you as long as you're. If you're not willing to go out and talk to anybody, well, you know what, good luck because what you're going to end up doing is throwing a ton of money to have someone else do it for you. And I've never met anyone in stage one that had a ton of money to do that.

Okay, so. So let's go back to. Let's go back to stage one. Stage one is like relationships. He said. Right. You know what else?

Two things primarily that we teach in stage one. I mean there's other things as well, obviously hiring as you hire. But there's two areas, critical areas. You need to learn how to build your network of people that will generate referrals. And you need to know how to convert those referrals into new clients or new patients, AKA sell them on why they should come to you.

Yeah.

And pay.

Because I want to play pickleball again, Jamie. Is that why?

Well, this is part of what we train them on, right, Rick? You always train them, train people on looking at the benefits of what you do. What we do because we're so damn smart, we think they care about. What did someone say the other day, Jamie, I shouldn't talk about like the neutrophils and all that in my shoulder that gets re upped and all that in a post surgical. I go, nut. What are you talking about? I go, people care about pickleball, lifting their kids, going back to running, feeling like human again, getting back into that social connection. They don't care necessarily about how you help them. They just care about getting jargon, all.

The jargon of the industry that overwhelms the consumer. Right. So yeah.

And this is why learning about your specialty, my specialty, marketing, is so important because it helps you think differently about someone that right now you're training. The way you think about that person will not serve you building your business, it will serve you. Well, maybe it won't, maybe treating them. But if they're not there because they keep canceling because they don't see the value in what you're doing. Yeah. It may not serve you with that either. So we all have to get that training. And then the second one, can we go on to the overwhelmed Operator stage no. What's over Overall Operator Stage 2.

Okay, sure, let's, let's go to that. Yeah.

So imagine this. You now know how to build your network and you've done it. Not perfect, but you got referrals coming in. You also have learned how to just deliver great value and care, connect with people, keep them into your world, and now they're referring other people to you and of course coming back to you when another injury comes up. That's all learned in stage one. In the stage two, the overwhelmed operator, you're now starting to hire people. Right. And you're learning that, okay, not only do I have to handle my own schedule, of course I have to continue some of my marketing efforts. I need to learn how to properly hire onboard and train people. I've never done any of that stuff. So that's another level of skill you have to start learning. The key is in a stage two, the area that we help people focus on are the areas of learning how to let go. Remember we talked about Rick, that ego, our ego says, Rick, you don't need, you don't need help. You're so good. You can do all of this, man. You're the best. Save money, Rick. Don't, don't hire anyone. So what, what happens is we have a mental block that says, I can't let go because nobody can do it as good as I can. So what we do is we hold on to things that suck the energy right out. We call them low energy activities or this. Basically things you hate. For me, bookkeeping was one. I used to do bookkeeping because I didn't want to pay someone to do it. I, I treated everyone in the world. Even when I had other people. I focused on social media.

Right.

Because no one could do it like me. Yeah, I focused on a lot of admin stuff. And nowadays you got social media. So we start to do things that zap our energy. And guess what? When you are exhausted, when you are feeling like, oh my God, I really, I just can't stand this stuff anymore, you tend to make very reactive emotional decisions. Those decisions lead you down even worse worth. Worth worse paths.

Yeah.

So that's what we focus on, how to learn how to let go by delegating things that you don't like to do, giving them the people that do like to do it. And that's a mindset shift. Just because you hate it doesn't mean someone else does. And then creating a process or a way to do it and then monitoring the effectiveness of that thing that Takes a mind shift and it takes a strategy of how to do that. Once you start doing it, you do what Dan Martell says in his book, you start buying back your time. Your time is the most important. Yeah, your time is most important. Now think about the things you could delegate. What's the one thing that you could delegate that someone else can do with your tutelage really well, that will generate money for your clinic treaty? There's lots of talented therapists out there. So if someone else can treat and you can focus on the things that you do well, you're going to actually build the company bigger than if you were staying inside a treaty.

But how do I let go of this mindset, Jamie? Because I understand that and let's just say I'm okay with the ego, but the numbers don't make sense because I still have to pay. The mortgages have to pay like food.

The numbers do make sense, Rick.

Tell me how. Explain to me how it would make make sense, Jamie.

So one of the tools. Got it.

I gotta give up my caseload, right? I gotta stop treating, right?

So reduce treating. It doesn't mean you have to stop treating. In stage two, in stage three, you absolutely want to stop. Unless you want to treat some VIP people. At stage two, it's a decline in treatment hours. Here's the first thing we have to do. We have to get very clear on what's happening. You're a metric guy, right? Every business owner needs to upgrade their financial acumen. So we need to get clear on what the metrics are. Now people have all these fancy EMRs. From my experience, I want to know what you think. From my experience, they're not even looking at the metrics. They don't really understand what the metrics mean, what they do. As Mike Michalowicz says in his book Profit first, they do bank balance accounting. They look at their bank account and if there's money in it, they're in a good mood. If there's not money, they're in a bad mood. If it's a 3 payroll month, they're in a terrible mood. I hate. So what you do is you put your numbers into a dashboard, we call it a simple financial dashboard. And then you look at where are the areas that are killing your profitability. I've never seen a business in 10 years and over 400 plus clients, I've never seen a business that didn't have a significant area where they are losing six figures in income. Six figures. The only time I would see that in a. In A practice is when a practice had a terrible treatment model or business model, which means this. Their heart says, I want to do one an hour. I'm okay with one an hour. But their revenue says I get $85 per insurance company. You and I both know we don't have to be a mathematician to say you can't collect $85 and do one an hour because it's too costly to deliver care. That number has to be at least three times, three times the amount of money it's costing you to deliver care in that hour. The only people I've ever seen, and we've worked with some of them with the hope that they would say, look, you have to change your model or everything we teach you is not going to work. I'm not going to have you move away.

What is that? Two, two an hour, three an hour.

All depends on how much money you make. So I have cash based clients that do one an hour and not one cash flake client doesn't charge less than 150. That model works. You know, they pay someone 50, they get 150. If you're doing, let's say $85 a treatment session, well, you're going to have to do at least two treatment sessions an hour on average. Remember, it's on average. Yeah. You're not going to be busy 100 of the time. So you have to incorporate that. If your utilization is like 70 or 60%, even $85 an hour, twice a two patients an hour, you're going to get crushed. So this is what I mean most. When I, when I've done a lot of talks on what Jamie, what's the number one metric? The number one metric, some people say profitability. I go, no, very important, not the number one. What's the number one metric? The number one metric for me is utilization or productivity. Because most of us are running a.

Like clinic utilization or like schedule utilization.

Well, kind of the same thing. Not clinic as in spacing, but your existing staff that you're already paying for. Okay, not busy enough. Compared to the amount of money you're already investing in them. You're investing 85,000 and you're getting back 150,000. If you're investing 85, I want 250 back.

Yeah.

Every one of my therapists, when I had my practices, every one of my therapists had one initial goal, 252,000. Because that was exactly three times what I paid them on average. And guess what happened? They achieved it. They were clear on the expectations and all of our training was geared to helping them become a great therapist and a busy therapist that somebody wanted to see what I see. And by the way, the most difficult stage Rick is the overwhelmed operator. In my experience and my observation, there are less people that go from stage two overwhelmed operator to stage three than from stage one to stage two.

Less. Sorry, less from stage one to stage two. Right. Is that what you mean?

Stage one to stage two? I've had more people move to stage two than I ever had moved to stage three. Because stage three is where you really get your ego checked. And you have to rethink how you look at your business. And most people never move away enough in their business to, to actually hire the right team to surround you. But saying this idea of, well, if I, if. And that's why I do that contrarian treat less, make more, because it's controlling. I want people to think like, wait a minute, how do you do that? And then when I show them, they're like, I'm losing money by treating all the time. I'm like, yep. Because once you see the numbers, I mean, it's, it's, it's, it's six figures. Some people, it's multiple six figures.

So let's go back to this. You're in stage one, okay? You're, you're, you're in stage one. You're billing 150 to $200,000, okay? And you've been doing that for the last five years. And you're stuck. Like you're hovering, you know, like you're there. How do you, like, you know, how do you transition, you know, from that to stage two?

Are you a stage one insurance or out of net or of cash based?

Let's just say I'm insurance.

Okay? So if you're insurance based, you're actually maximizing your schedule. You have to invest in someone else to help with schedule or a treaty. So your investment is. I'm gonna bring. Let me answer it this way. Everything you do, everything has to benefit you, the owner. That's a mindset shift. Everything you do, every person you hire, every piece of technology do, has to directly benefit the owner. So if I'm maxed out on my schedule making good money, but I have a vision to grow. The only way to do that is to delegate. Now, we can start by delegating admin. So we're delegating some admin. We're getting some help there. Fine, that opens up a few hours. But to really delegate, we need to bring in someone. I have a client Right now, who's making 250,000, 275,000. Stage one business, he's crushing it. And guess what? He became comfortable. Like he was like, I'm making more money than I ever thought I'd make. So I'm like, dude, what do you want to do? Because if you just want to do that, you don't need us. He goes, no, no, I want to build something because I don't, I don't want, I don't want just a, a high paying job. I said, you have to hire someone.

Yeah.

So he started searching for someone. We helped him with his job ad in his position and now he's hired someone. The first thing he's going to do when he hires that person is start to shift all of the new patients that call to his schedule.

He'll fill, have enough new patients. Why is it like, why is it your clinic just.

No, no, they're. Their new patients are coming in because this person has learned how to build the network.

Well, let's just say, let's go back to someone that's not in your program that hasn't learned that, you know, like they have just enough new patients just to keep them busy and they're stuck.

Yeah. So this is when they're going to have to invest in this new person.

So they have to take a loss to buy. To take a loss and take the risk of like, you know, generating.

Well, Rick, Rick, time out. Are we working with entrepreneurs? I mean, I mean if, if someone says that, if someone's. Because I've talked to people like you're, you're being. And I love it.

I just like role playing this because I was talking to a clinical order. Like I was talking about clinical under just.

Rick, if I was talking to this person, Rick, if I was talking to you being this person and we kept going around and around, I would say, hey, Rick, dude, I love you. I think you have a great business. Good luck to you. You're not right for this program because if you're not coachable, if you don't have a vision of what you want, that's meaningful. Dude, do you want to guarantee? I have a guarantee. I guarantee if you don't have a vision and you don't have focus and you're not willing to take some level of risk just like you did to start your business, I guarantee you ain't going to go anywhere.

You're going to be stuck doing this for the next 10 years.

Which is why it kills me when I start talking to people that I've talked to years ago, and I say, what's going on? And they say, well. And I go, didn't you have that same problem? Didn't we talk about this? So for that person, I would never try to fight to convince them. I want people that come with, batteries included, man. I want people that are.

I'm just. I'm just.

I'm just.

I bring this up because I spoke. I spoke with an owner in our community, you know, and she's in this scenario where she's been doing this for the last 10 years. Jamie. Okay.

Yeah.

You start a clinic 10 years ago, and 10 years ago she was at $200,000. And like, last year, she was also at $200,000.

And she.

Is in our. She's a. No, no, she's a. She's. She's someone inside our community that just joined. And.

And, oh, just.

What's interesting is that, like, she's like, I'm. I don't know. I'm at this crossroads. I don't know what I want.

Do I.

Like, maybe it makes sense for me to go work for someone right now. I have less stress.

200,000, right?

Yeah, that's. Well, no, her revenue is 200,000. You still have the expenses.

Well, how much is. She doesn't have anybody working for her. Right. Except maybe a front desk person.

Yeah.

So she's still making, you know, let's say over 100,000, which, you know, she's still controlling her schedule, like, if that's what you want. So if she came to me, if she said, jamie, here's where I am. I've been there, and I've had a couple conversations last week just like this, and they. And I said, well, what is it that you want? Like, I do my magic wand. I go, magic wand. A year from now, two years from now, anything's possible. What is it that you want? And they go, I don't know. And I go, okay, tell me what you don't want. And they go, I don't want to do this anymore. Yeah, I either want to quit or make a run at it. I said, okay, if you're ready to make a run at it, we can help. If you're not sure, don't invest in us because it's a waste of money, because we're not gonna. You're not gonna actually do the stuff because you're still in a state of confusion. So what. What I want to do when I'm talking to somebody talking about sales, I know everyone has their unique sales My conversation with people, I call it discovery call, but it's a sales call, is for people to be able to make a decision. I really don't care if they come on board with us or not. I never have. But what I want them to do is to get enough clarity to make a decision and to know what decision they are making. So if someone's saying no, they know what they're saying no to. And if they're okay with that, I'm okay with that. But if they say yes, Jamie, let's do this, they know what they're saying yes to. They're saying yes to the vision that they want, and they're saying yes to us helping them get there. This person is in a state of confusion. Hopefully, by being a part of your group, she will get more clear and what she wants and she will dive into her. As Simon Sinek says, her why her meaning right now? She does not have that.

It's.

It's very understandable.

There's a lot of people who are confused, you know, and they question why they even became a clinic owner. They just felt like it was the next natural step within their clinical journey. That, like, because, you know, Bob did it or sue did it or Nicole did it, like, it's. I should do it. Right?

Right. So when I'm speaking to those people, one of my jobs is as a. As a. As a coach, even on one of the, you know, kind of a free consultation that I do is helping them get clear about things that's very valuable to have. Whether they say yes or no never matters. And I'm sure you do the same thing. So for this person, what I hope for this person is that she gets clear to make a decision because. Or get clear what.

What she wants and what her vision of, like, what her life and what her business looks like. Right. Here's the beauty, because without that, you're just saying it is. There's complete flux. Is that like, I want a bit of this, I want a bit of that. I don't know. Right.

So, Rick, Rick, you had a vision of the lifestyle you wanted, and you're right now in Italy, that just didn't randomly happen. You had to work towards creating a business, building a team, getting yourself and your mind right to be able to have a company that you can have that lifestyle. Was it easy? I seriously doubt it. Were there good days and bad days? Probably a lot more bad than good.

Look at my Instagram. My life is easy. What are you talking about?

I know it is. And we have to recognize that when you go into business, respect business. Don't treat it like it's some little, you know, thing.

What do you mean by respect business? Respect business, like the rules, the rules of engagement. You mean.

No, respect business, the world of business.

Okay.

You are in the business of physical therapy, the business of pediatrics.

Yes, yes.

The minute you sign a dotted line that you're a business owner, respect it. Which means when you, when you wanted to be a therapist, you respected it. To sacrifice, to study for the hopes of getting into school, to have the opportunity to shell out 100 plus thousand dollars for the opportunity to get a job, for the opportunity to start your own practice. No guarantees. And all of a sudden you get into business and now we want guarantees. There's always a level of risk. But I will tell you this. If you want it and you're willing to work for it, God, the rewards are fantastic, isn't it, Rick?

Yeah. Yeah.

I'm in my house. I'm gonna go take a walk. Later. I'm playing basketball tonight. My wife is shopping. This is the life I created for myself because I was willing to do what it takes to get there. Most people either don't know what their life they want it to be, or they don't want to take the level of risk to get there. That's okay. But you know what? That's not what we're doing and what we're serving.

Can you, can you, can you talk more about the risk? Because I think a lot of owners or like the stage one people don't recognize how important and the mindset around the risk is, you know, because I think they need to understand that to actually go to your stage two and stage three.

Yes. So the level of, the level of risk, the bigger the business, the bigger the risk. So when you have a, when you have a smaller business, a smaller risk. My first shop, so to speak, my clinic, my risk was 15,000. I bought used equipment, I got a lease with a forbearing rent for a few months. You know, grassroots, easy. Started building it. Friends and family would come see me. My level of risk was at the level of my business. Now when I bought another clinic a few years later, higher level of risk. Paid several hundred thousand dollars for a clinic, had more staff, had more overhead, had more payroll, different level of risk. Right. So the level of risk rises in proportion to kind of where you are. There's people now that are buying up clinics. Much level of risk, they're putting millions of dollars, but they also have a bigger team. They Kind of know where they're going. So the level of risk is in proportion to that. But there's always a level of risk. Always. If not the worst level of risk is when you get comfortable, when you think you've arrived, when you think you're okay. I did a video blog yesterday that's coming out at some point next week or two. This word okay is a killer. How you doing, Rick? I'm doing okay. Hanging in there. When the hell did okay become a good thing? How you doing, Rick? I'm doing great.

I'm doing the social norm of what people say because they don't want to. They don't want to engage in a conversation it. Or be vulnerable and maybe. Right, maybe.

But I'm talking about people that. I get past the superficial. I'm not talking about the social, social. I'm talking about people like, seriously, how you doing? I go, I'm doing okay. I go, does that inspire you? Is that. Is that like, makes you want to go to work? And they're like, no, I feel like I'm in just a death zone.

Yeah. So that's the comfortable. That's the comfortable zone you're talking about, which a lot of people maybe, right?

Like, I know myself. When I get comfortable, I have to upgrade myself. I have to upgrade my business, upgrade what I'm doing. Because I love being uncomfortable. As uncomfortable as that is, it makes me work, it makes me excited, it makes me know, like, like, like you and I talked before. I'm in an inflection point in my business right now to my life. Like, where do I want to go with this? I've been doing this now for 10 years. You know, I cross a million dollar, right? I can, I can say, oh, I'm a million dollar coach. Not a lot of million dollar coaches out there, especially in this industry. And now I'm like, what else is the exciting thing I want to do? What moves me? I'm gonna create something that I don't know a ton about, that I'm gonna have to be a student again to learn. But it's going to be exciting. That's what I believe we're on this planet for, is to continue to evolve, impact people, elevate us. That starts whether you're in stage one, stage two, stage three, we get to make that decision. And I realize, Rick, not everyone's going to do that. I know that. But for the people that want that, let's face it, I'm here, my company's here to help. Obviously, Rick, what you do is here to help. There are people out there doing some amazing things out there. That's all I got to say.

Amen. Love it. Yeah. I'm a student. Learn. I'm constantly, like, upping, like, my. My game, and I'm always, like, learning from people like you. I'm learning, like, all the latest marketing trends or the sales trends or industry ends or business trends, you know?

You mean you don't already know all that, Rick? Don't you know all that stuff?

No, no. I'm constantly. I'm. I'm a student of business. I love business. I love marketing. I think I. I think. I think we're talking about that even before the session. Like, I am. I'm so curious about learning, you know, on how to make businesses, like, even better. And I look at what other industries are doing. Like, I have other, you know, like, CEO friends, forums or groups I'm in, and, like, I'm so inspired with what they do. I'm like, oh, my gosh. Like, we could totally do this in our industry.

Right? So, Rick, from a coaching standpoint, because I want to give people an idea of what this means. Let me break down what you just said. You have a value in you of lifelong learning. You never know it all. You're always thriving to learn more. You're always. You said a great word, Jamie. I'm always a student. I never have enough ego where I think I can't learn. I'm always learning. I guarantee selfishly, you're doing these podcasts to learn from the people you have on. And yes, 100.

I am selfishly learning from you right now.

Jamie. Do you realize the mindset to be selfish in a good way?

Yeah.

See, so many people are like, I don't want to be selfish. I don't want to not treat. My staff needs me here in the office. They want me here. I've interviewed a lot of staff. Yeah, they could care less if you're there. In fact, they don't want you there. They just want to be supported to do what they love to do. You there is your own ego.

Yeah.

The other thing you said, which I love this word you said, I'm curious. I think one of the most important things we can do as business owners, as entrepreneurs is to stay curious.

Yes.

Stay curious. I'm curious. I always want to improve as a coach. I always want to understand. I want to suck everything out of Rick's mind of marketing, because that's not my strongest point.

I don't.

I don't know marketing like, you But I love to understand it because not only can it help me in my business, it can help me when I'm coaching someone so I know what I'm talking about. So I always look and I, and every coach I have, if they don't have these values and ideals, I don't hire them. They have to be lifelong learners. They have to have integrity as the way I define it. They have to be curious like you start to surround your people with people just like you and your business flourishes. So many of us aren't clear on what those are. We're not at integrity in doing them. So we don't necessarily have the right people or we have good people, but they need to be led.

Yeah.

That is all about the owner.

Yeah, Love that, Love that. Okay, we're on the hour and we're going to wrap up with just one final question. Okay, Jamie, I do this with all the guests that come to the show. Is, and, and if you had, if you had only 1000$, okay, what would you do? How would you spend it to improve your sales next month? And, and let's keep in mind for that stage, let's, let's, let's, let's use that stage one operator. Okay, you had a thousand dollars to spend this month. What would you do to increase sales, revenue or profit for next month? How would you invest that? And it can't be your coaching program, Jamie. It has to be something else. I would although continue.

Yeah, well, you know, you got me caught there because it seems like it's a leading question to, to have me say some tactical response. And you know me, I'm not going to go there. So the reality is that thousand dollars is not necessarily going to help me market my business. Right. It's me going out there and doing it is going to help me market my business.

Okay.

So the thousand dollars is. How can that thousand dollars help me? Maybe give me more confidence, maybe put me in the right mindset. Right. Maybe help me create a better support structure. So I'll give you some examples. Let's say, you know, I have a staff person working. Do I have a staff person working with me?

Yes, you have, you have one staff. Yeah. You have an office manager.

I have an office manager. So perhaps, you know, if I'm busy right now and I need to carve out more time in my schedule to go out there and market and meet people, but my office manager is already, quote, busy, perhaps I would use the thousand dollars and say, hey, I need to be out there more. I know it's beyond your 40 hours and I know you're already busy, but I can pay you in additional hours if you're willing to stay a little bit longer to give me time. So that would be investing that thousand into something that would help me get out there. The other thing would be because our mindset is so powerful of how we show up to people, how we figure out things. How can I get myself in a really good place? So for me, I love float tank. Right. Float tank is very meditative. You sit on top of 8 inches, highly concentrated salt water. So maybe I would take a hundred bucks of that and I would go into a float tank, get my thoughts right and then get a plan and go after and connect with people, but I'd be in a much better place. So I look at it from, I have the capabilities of building my business again. We're talking stage one, a bigger stage.

Stage one. So you're gonna spend 100 bucks on the float tank and 900 bucks on, on your, on your office manager. So free up time. So you could do relationship building in the community.

Yeah. Generate referrals.

I love that.

Yeah, that's kind of where I'm going with it.

Yeah. Yeah. I, I, I actually if, if you ask me the same question, I would do the exact same thing.

Yeah, I mean, if you didn't, if you didn't know what to do, I would say invested in, you know, learning what to do. I mean there's lots of programs, lots of people, but there's YouTube out there. You can learn anything on YouTube. So I would say, you know, invest it in that. But ultimately what stops people is a couple things. One, they don't have any type of plan in place, they don't have any strategy in place. And two, they have a lot of head trash and self talk that they don't believe they can do this. And action cures that. But having confidence will help you get into action, which will help you cure your kind of imposter and stuff like that. So love it, man. Dude, this has been great. One of the best.

So how do people find out more about you? Or like, if they want business coaching from you, they want to join the community. You know what you can find out more about you.

Yeah, you can go on my website, practicefreedomu.com. you know, you can download, you can take my quiz, which is usually what I like people to do. I have a practice quiz that kind of gets an idea of where you are in your business, what you're doing well, what you're struggling with. Then we set up a call and I talk to you more about your business and see, you know, if what we're doing can help you and if you're a right fit. So you can go on my website, you can reach out to me directly. Jamie, at PracticeFreedom, you then, of course, happy to set up a call. And if you'd like, I put out tons of content, so follow me on social media, Facebook. Just type in my name, Jamie Schreier. I'll come up everywhere.

Facebook is your best channel then.

Yeah, like you could do, you could do. You could do that stuff or you can go on my website. I got lots of, you know, free stuff on there and that's the best way to do it.

Cool. Amazing. Yeah. Thanks for your time, Jamie. And, and Jamie, I think you're gonna come join us at the Clinic Boss Summit in Orlando for January 20th. January 26th, 2024.

Right, absolutely. I look forward to it. Speaking on. I don't know, you haven't. You and I haven't talked about exactly what all speaking, but I'm sure it'll be something. I think something like this would be a blast.

Yeah, yeah, yeah. Well, it's interesting. The, the theme of the Clinic Boss Summit is going to be about mastering recruitment, retention and marketing. Right. And those, the two Rs, Jamie, is your area specialty. And so I'm super excited to get you on stage and kind of share your wisdom again.

And the area that's above all of them is the mindset of how you think about recruitment, retention and marketing.

Yes.

So we're going to have some fun. I'm so looking forward to being there with you.

All right, so we'll see you in Florida. And so, everyone, thank you for joining the show and we will see everyone next week. 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 scripts, selling your clinic, managing clinical teams and much more. Head over to clinicbosstools.com.