Acquirers Don't Buy Your PT Clinic. They Buy This.

Paul has trained as a physical therapist and is known throughout the industry and as an expert in PT clinic mergers and acquisitions. We're gonna talk about how you can get the highest sale price for your clinic. In 1989, Paul co-founded his own outpatient rehab company, and he grew that to 21 clinics, and then sold that to a larger acquirer.

He founded Martin Healthcare Advisors to help other rehab owners grow and sell their practices. His team have since completed more than 200 deals. So really excited.

So Paul, welcome to the podcast.

Thanks, Neil, and thanks for having me.

So let's talk about this. So you built your own rehab company to 21 clinics and then sold that.

Looking back at that experience, what do you maybe wish you had known about building value before you went through that sale and, or got into that sale?

Yeah, I'd love to say that there was a whole lot that I wished I would have done, but we at that time had a, a consultant and really a mentor. His name was Alan Cox from Cox

And he personally helped us prepare really over a three-year timeframe building the company from three clinics in 1993 to 21 clinics in 1996. And with that, and with his expert advice, we were able to build a very strong table of organization, and then we built the systems so the leaders in the company knew exactly what was expected from them.

And then myself and the two other owners, we went from physical therapists in clinics running clinics, and we became business leaders. And so over a pretty short period of time, we took ourselves out of the clinic and then focused one of our partners on marketing, my other partner on operations, and I was focused on growth.

So I really can't say that there was really anything that we could have done, and a lot of what we do today was based on that success and then building from that success in what Alan Cox brought us.

That's awesome story. I love that. But and I think that really highlights a couple key things here.

We get into practice because we wanna help people, and we wanna do it differently than where we've traditionally worked, right? And then we start to realize "Okay, I have to learn how to run a business here," and you get better and better at running a business. And then there's some point where you have to make that transition to out of patient care into more of sometimes like first of all, like a part-time leader role, right?

And then more of a full-time leader role as, as the demands of the clinic grow and the business grows. And I think those are stepping stones for a lot of business owners, right? And where they need to jump over those thresholds. But I think a couple key things there when we're thinking about selling our clinic in that future, having that mentor, having that advisor is a critical piece of getting the maximum value for your practice and guiding you in this really complex journey of selling your practice, 'cause I've been through that myself, so I know what that's like.

It's very complicated. And then having the the advisors to show you, "Hey, here's what's gonna help you have that outcome," right? That maximum value for your hard-earned work that you put into it. So that's the systems that are in place, the not being the, the person that makes the clinic go.

The clinic can go on its own. And so lots and lots of different types of processes and systems need to be created, and that's where a, an advisor really comes into play So I'm curious too, like when, when we're thinking of some, of selling, do you ever hear of clinic owners that are like, "Hey, I'm thinking of selling my practice in three months' time"?

Do they ever come to you with that? And then what do you tell them if they're coming to you with that in terms of lead time and what they need to do to prepare for a sale?

Yeah. Preparing for a sale all depends at what stage are, is a company. When, we would first meet with them or when they would think, "Huh, I think I wanna sell this business someday."

So many business owners they've been running their business from the very beginning with the intent of preparing for either a sale, And what we find is that, by preparing for a sale, what are you ... you're building strong systems, strong processes, you're building a profitable business.

That same preparation it works for selling the company sometime in the future as well. And so what we always tell business owners is start early, because what it gives you are options. And we talk to many business owners who don't have options because they didn't start the preparation for some kind of an event or sale or just having a profitable, well-run business.

So it's really one and the same. And The time is now. Whether it's three months, five years, or 10 years, the time is now to start preparing that business so that if someone came and took a look at it, it's in great shape.

Yeah. Great advice. I'm curious in your dealings with so many different practice owners over the years, we all like to think that we have

we're gonna have this perfect exit mapped out in our mind. But I'm curious, how many ... if you had to give a ballpark percentage of how many people come to you because of some event, like you just said, there's an event. I don't know, maybe there's a divorce, maybe there's a falling out with a partner, maybe there's a health issue.

So when you say "Hey, I wanna exit my business in 5 or 10 years' time," I'm curious like how many events precipitate that happening sooner?

Yeah. Typically an event is I wake up one morning and I don't really wanna do this anymore. And in many cases, that's too late. You've waited too long because you don't have the time to prepare.

And then most acquirers, if you're gonna do a true partnership with an acquirer, they're gonna want an owner there at least three years, and many business owners don't factor into that equation of how long do I have to prepare for this if I have to then sell the business partner and then go another three, possibly five years So when someone's really thinking through succession planning there's the time to prepare, and then there's the time when get to that closing.

You still wanna look another three years plus after that to be engaged and then you get that second bite of the apple, and that's where it becomes very positive.

Gotcha. Do you see the, a buyout by more, say, like a bigger company, private equity? Or do you see, like a sellout to a partner?

What do you typically see there? I'm curious.

Very rarely do we see internal sales whether it's selling to a partner or selling to your staff. The reality of both of those is that there's very little exchange of risk because partner probably, may have a whole lot of money stored away somewhere that they can, put a lot at a closing on, them actually selling that to you.

And for a partner or yourself, you won't have access to the capital to put a whole lot of money down. And staff, then you bring on a whole, I have a thing that I say that I got this from my Tom Carden, who's done many transactions with us over the years.

But in most cases, as far as staff, no money and no talent They don't have the money to have any meaningful exchange of risk, and they don't really have the talent to build and develop the business because you're gonna be waiting for your money for a long time. It's probably gonna be a note. It's probably gonna be a note paid over many years.

We just talked to a business owner, and it's all gone south, unfortunately. But the person who was buying the business, his, number one employee didn't have the money and ran the business somewhat into the ground, now doesn't have the money to pay him the last five years.

Where is that gonna come from?

Yeah.

There's nowhere for it to come from. That's the reality of sales that some people, "Ooh, I don't wanna sell to one of those big strategic companies that are backed by private equity." And then you don't want an exchange of risk because- when somebody puts, 80%, of your transaction price at closing, that's a huge exchange of risk versus the example I just gave where you're waiting 10 years and it's all a note. Very different things there.

Yeah, absolutely. And it, that's kinda that mental preparedness for it, too, right?

As a practice owner that knowing what are you getting into with this? What's the outcome that you wanna have look like, and what is the transition period gonna look like for you, too? 'Cause that's very variable, right? Depending on who you're selling to, and I think that's just mentally getting prepared as a practice owner what, what's that gonna look like for you.

I'm kinda curious let's talk about when buyers are looking at clinics. So whether you're gonna be a buyer of another clinic or a, a larger entity looks to, to buy your clinic, what is that buyer really paying for? What are they looking for?

Yeah. That's a great question. The hard, cold truth is acquirers are buying cash flow.

And I don't care if that's a private equity group backing a strategic company, it's a large private company, it's family office. They can come in all different shapes and sizes, but in the end, they're buying your cash flow because that's the only way that they can eventually pay for your business.

So without cash flow, there's really no opportunity for a sale for a business. Now, along with that cash flow, certainly they're buying the systems, they're buying the people, they're buying your reputation and what you've built in your community. They're buying your patient list. They're buying all those things.

But in these transactions, typically 80% is what's called goodwill. And so they're buying you, and they're buying your ability to build and grow and develop that cash flow.

And they're not just looking at, what's your cash flow now, but what is your cash flow gonna look like a year from now, three years from now, five years from...

what can they build, right? 'Cause they wanna obviously have the return on investment that they're gonna put in, and how fast can they obviously pay off the cash that, that they're putting up front there. So I think that's something... and the nice thing with selling that you mentioned before is that it's the same, it's the same basic business premise that what you build to make a profitable business is what's gonna make it a, a really good sale, right?

'Cause it's gonna build that cash flow. You're working hard towards systems that build better profitability into your practice, and that profitability is what allows you to then get a higher multiple for what people are gonna want and desire it for.

Yeah, absolutely. And so the build has two great endings to it.

The build can be for a transition with a larger partner, or that build could be another, a number of other options if you wanna stay with your practice longer and longer. Once you have a profitable practice that has systems to, in a sense, replace yourself with somebody who has, been groomed to be able to run the business that is another form of an exit.

And that's what I mean when I say it gives you choices when you have a profitable, well-run business. The alternative gives you no choices.

Yeah. And is that something that you get approached with, is that you... I'm sure there's this kind of spectrum here, right? You've got practice owners that have really worked hard.

They have an incredible business systems. They put a lot of effort into the processes part of it, and then they can have a great multiple from that and great exits. And then there's the, maybe the flip side of that, where people think that their business is very valuable, but they, it's all about them.

The business just runs on them. It's Is that something that you see quite often?

We see very commonly, and the, the one word, two words that you used in there was hard work And what we find is that business owners that have, however they have found it, they have found the way to work hard, build those systems, and generate profitability.

Owners that haven't done that are still working really hard. They're just not working on the right things. I've almost never met a lazy physical therapy business owner. I've just met those that have not been utilizing, some of the skills that need to be from a, a physical therapy business owner versus a physical therapy therapist who happens to own a business.

Yeah. 100% correct there. And something I learned a long time ago was that I got to a point in my practice where I realized that I was not that good at business yet. So I had to learn it, and I went with a business training coach at that time, started to understand the nature of business.

I was a great PT, but that didn't translate into being a good business owner. And so there's that whole skill set of business finances, marketing, administration, managing people. There's a lot to learn there, and constantly learn and improve upon, right? That's something

and Neil, unfortunately, myself included, none of us were taught anything about running a business in physical therapy school.

So that all had to come after physical therapy school, bringing in the resources to learn how to run a business. I did a lot of research, and I didn't have Claude or ChatGPT to help me with research, finding the best consultant in the country. And at that time, in 1993, we absolutely found the best consultant in the country with Alan Cox.

He came on site to our business one week a month for three years, and I literally lived in his back pocket learning everything about, how to take this business and get this business ready for a successful sale.

That's awesome. And so what do we... we're talking about cash flow that translates the phrase EBITDA, right?

That's something that people should know about. But what are you seeing out there as far as multiples of EBITDA in, in practices? And is that a threshold based off of, let's say, the clinic's making less than a half a million a year to a clinic that's making more than a million?

Curious what you see there.

Yeah, there's general rhythms to what the multiples are. Smaller businesses, single site businesses under $500,000 of EBITDA, that's gonna be somewhere in a two to four, maybe five range. And as it gets bigger, it gets up. But literally the span is two to three to 10 And a lot of that, yes is based on the size of the business, number of clinics but most importantly what that profitability is.

Now, where I think that, in terms of, two businesses the exact same size, seeing the exact same number of patients with the exact same EBITDA, those two businesses can transact for significantly less or significantly higher multiple based on the systems that have been put in place running and driving that business, whether an owner wants to stay on into the future, how strong that leadership group is, compliance, how well the financials are laid out.

And companies of the same size and the same EBITDA can sell for fairly significant different multiples.

Yeah. That's interesting. And then, and this is what we were talking about before where I was saying it it's such a complex process. There's so many variables and there's lots of different levers to pull to get the maximum value.

But it takes time, right? You gotta have the time in order to prepare to to use those levers to get that maximum value. And so that's where you ... where I think it's so critical to have a team, your advisors or your team of advisors in helping you build the business towards that, that end goal, and they're gonna help guide you in terms of what levers to pull on and strategies to implement into your practice in order to get that maximum value, which could be millions of dollars, right?

If the, if you're doing it right.

Sure.

Yeah.

Any consultant that anybody who's watching this wants to hire, I think one of the first questions you need to ask that consultant is, "What is the return on investment that you typically get from clients that you work with?" Because then a fee becomes a true investment, and, there are a lot of consultants that are just, bringing in a lot of fees, but they're not really giving that return on investment.

And I think that's what physical therapy business owners deserve, is to make any kind of consulting, advisory work to be a return for that investment.

Absolutely. Yeah. In marketing, that's what we've heavily focused on, right? Is what's the ROI- on your marketing investment? So I'm curious, as you've worked with so many different owners, what are some of the most common mistakes that you see that lower the value of their practice without them necessarily even realizing it?

Yeah. I think there's big risk in the financials because as I said earlier, that's really what an acquirer is buying. And so it doesn't mean after they look at those financials and say, "Wow, these are in good shape, and I think I can see that cash flow, and I understand it, and I see the adjustments that are made," that they don't look at a number of other things.

But it starts with those financials, and I think business owners make the mistake of Having a bookkeeper or somebody put those financials together and run them in a way that is truly running your business into the ground because they're not being done properly, and they will not pass Q of E, quality of earnings, from a large investment bank.

And that's what these companies are using for due diligence in even smaller businesses. So that's, I think, one of the biggest mistakes we see is, "I'll worry about cleaning up my financials when I'm gonna get ready to sell." Those financials need to be clean from day one.

Yeah. It also helps you run the practice so much better when you have the information, the data there, and it's clean and then you have someone that helps you extract the information from the financials, right? And I'm curious, as you work with clinics, do you ever recommend a fractional CFO or a fractional type of finance director to help them instead of just a pure bookkeeper?

Yeah, really depends on size.

Smaller companies will have an outside accountant and potentially that accountant may have a bookkeeper, and that, can do the books and records, and then that accountant needs to monthly show them exactly the cash flow, et cetera, et cetera. As companies grow and you start getting into the 4 to 8 to 10 clinic range, and, we really need somebody that's on this more than just our outside accountant, then a fractional CFO could be a really good option, and we've seen that with a lot of success.

Once you get 10, 15, 20 plus clinics a million plus of EBITDA, it's probably time to bring in a CFO. And, that expense will be well worth it if you bring the right one in and they do the right processes.

Absolutely, 100%. Yeah, and I know from experience, we have a fantastic finance director and bookkeeper for us here at Practice Promotions, but it wasn't until I really got a good finance director in there that I realized what I was missing.

Like just the extrapolation of information, the data, the reporting, like it just allows you to make better financial decisions or even operating decisions for the business. So super critical there. Is there anything else as far as mistakes that you see practice owners do?

Yeah. So let's think. We talked about the early financial. I think many practice owners start looking at their practice and they wanna grow. They really wanna grow. And, but they just cannot get out of the day-to-day issues and problems that come up. And we see this a lot, one, two, three clinics and and I'm just swamped because I got questions coming at me.

And that's at a time that, again, the systems and processes really truly need to be put in place, and a plan needs to be written. We did this starting in 1993. We had a strategic plan that went from 1993 to our goal, but then each year that would be updated so we would know exactly what things we needed to accomplish in the next year.

It also shows an acquirer significant value when you can show them the planning that you did and the execution that you did, and now you're showing an acquirer I don't wanna just grow to this transaction, I wanna grow through this transaction. I wanna get to the next level, and I have a plan to get there with your capital, with your recruiting department, with your..."

And and that's what acquirers want to see. They wanna see a company that has shown the ability to plan, execute, and now can show the ability to not only plan for up to the point of closing, but right through it. And those plans we map those plans out for acquirers, for our clients so that they can see and then that's more like a, a train that's leaving the station and who wants to hop on.

Yeah, I like that. And so you're actually even working on helping plan that transition, like what's it gonna do to keep this growth going for the new owner, and I'm sure that gives a ton of confidence to the new buyer when they see that's the thought process that's already in place.

Yeah, it really does because acquirers, while, yes, they wanna see growth, they don't wanna have to hold the practice owner's hand to make that growth happen. So when a practice owner already has a plan for growth, now they're weighing in on that plan, and now they're weighing in on the support that they can provide to make that plan more achievable than if you just tried to do it this on your own.

And the company that can show the most support around that plan is the company typically that has the culture fit, and that's usually the company that at least our clients will end up partnering with

I love that. What do you think owner dependency factors into multiples in the sale of the practice?

What do you see there as far as the how that affects decision if the practice is so dependent on the owner?

Yeah, very size dependent. Single clinics are usually and typically very dependent on the owner, and depending upon the size of that single clinic, it's sometimes pretty hard to get out of that position of, "I'm here, I'm treating patients."

But as a business starts to grow creating that leadership group, and that leadership group needs to have, absolute, job descriptions and what are they supposed to accomplish and what key decisions can they make without even checking with the owner. And I always say the three-month test.

With multiple clinics, if you truly have a leadership group that is being they're consistently not only being brought to issues that we have in the company, but we're measuring their progress against the goals that we've set for each one of them. It's that measurement. And so when you have that leadership group and a business and acquirer then looks at the business yes, they still probably want you because you're the leader of that leadership group, but the risk goes way down and every single problem and issue that comes up goes straight to the top.

And I was gonna say the three-month test. If you took a three-month vacation and told your clinics and your leadership group that you're leaving, and Friday morning you say, "I'm leaving at the end of the day today, and I'm not gonna be back for three months, and you can't contact me for three months," how would they do?

If that leadership group is aligned and they've been given, all the tasks that they need to to do the, the business should continue to run for three months and not show a blip

That's quite a goal. I love it. I think that's what we should all aspire to in business, right? I like the sound of a three-month vacation.

Yeah. Just kinda curious, this is something that we see in practice promotions in helping market clinics in that sometimes we'll get practice owners come in, and they're thinking about, selling their practice in two or three years. And what we tell them is "Hey, you wanna get to that certain threshold, that certain number of visits, that certain valuation.

Marketing's what's really gonna help you get there, right? You gotta fill the clinic, and you gotta create opportunities for yourself." So I'm kinda curious from your side of it, like, where does marketing fit into the clinic's value and how do buyers view a practice with a steady, predictable, growing flow of new patients compared to one that relies mostly, say, on a couple of key referral sources?

Yeah. I think what we're seeing across the country, and, part of the reality on the marketing side is staffing becomes an issue. And then all of a sudden because companies are not able to staff but they have a waiting list of patients, they stop marketing And then when you stop marketing, then when you are finally able to find...

So it's a start and a stop, a start and a stop. We're low, we need more. So there's absolutely no question that a company that has systems that drive their marketing, and it's like a clock. It just keeps ticking and ticking. And those systems put in place and, then you gotta find those bodies to manage, those patients coming.

They are absolutely going to sell for a higher multiple than a company that, says we don't really do any marketing because we can just barely handle the company the patients we have now." That's a bad sign. And I know it's tough, I know it's tough recruiting right now but you don't you can't turn those marketing systems off.

You it has to keep running.

Yeah, absolutely. And marketing actually helps fuel staffing, right? It's, if your brand is really rock solid and you're everywhere online, you have a greater capability to attract top talent to your practice, so it kinda goes hand in hand there.

And you're right when, we see that all the time like, "Oh I'm too busy. I gotta pull back my marketing." Well, people don't realize that marketing is not instantaneous. It's like a, a flywheel, a big heavy flywheel. You gotta put some effort to get it moving, and then once it's moving, it's got momentum, but then as soon as you stop pushing, it starts to slowly slow down.

But then it takes some time to spin it back up again. So you have a new therapist coming on in one or two weeks. Your marketing might take four to eight weeks to really start to spin up enough, and now that, you're not getting that therapist up and running off the ground as quickly as you thought.

So yeah, it's such a critical thing. And then I would say too like One thing that we help a lot of practices that are growing, especially multi-location practices, we have clinics that are actually 180, 220 location practices. So what we see is that at different levels, you need much more complexity of marketing.

And in order to get to that next threshold, you need the complexity and the data and the the tracking systems. So I think that can bring a lot of value if you say, "Hey yeah, we've got this many new patients coming in, but we don't know how they come here." We just ask the front desk just asks them, "Hi, how did you hear about us?"

Yeah. That's not good enough anymore. You need to say, "Hey, we get this many off of our website. We have this many coming in from calls. We have this many from referral sources. This many are coming off our social media." If you have that data, I think that's very valuable to a a, a buyer because they can have some predictability in terms of new business coming in.

Hey, they could pull a lever on doing some more ads, and they know that's gonna drive in more business for them. So I think the tracking and the clarity and the, the data that you can gather with different systems has to grow with your practice too.

Yeah, for sure. And what you brought up in terms of how some companies will say, "Hey, we gotta turn it off because we have too many referrals and we can't handle them."

Sometimes that becomes just a culture issue. It's, "Hey, group, we're all gonna need to see just a little bit more over these next four to six weeks because we have two new therapists coming, but we cannot, will not, won't stop our marketing efforts

Absolutely. And so you were mentioning too a critical area that we know is a, a, a big challenge for our industry right now, which is staffing, right?

And so how does recruiting, your team stability, retention, like how does that affect what a buyer is willing to pay for your business?

Yeah. It's so critically important and it's hard to find businesses that truly, have what we would call, a recruiting engine. And because again, it, either using, trying to use a third party and what we have found is the success of third party recruiters for physical therapy businesses is not high. Because physical therapists don't need to call a recruiter in order to find a job.

They can go anywhere and get a job. So putting into place that recruiting engine affiliations with schools, going to all the local conferences letters, we advocate putting letter series out and not, email, yes but, actual letters that people open and they see.

We feel it's so important that we've built this recruiting engine. And on the flip side of that, there's a lot of companies that are doing a good job recruiting, but they're not retaining, and that is their onboarding process. That is the communication amongst, et cetera, et cetera.

So a big part of that recruiting engine also needs to be a retention program And with all that in place, you Because what most people don't realize is that the big companies, they have problems recruiting therapists too.

Oh, yeah.

Yeah. And, you always hear the local company, I've talked to many, and, I'm in this part of Texas, and we just got three therapists because they left one of the big companies and, so they're not always fully staffed as well. And so if they see that you have the ability to not only recruit, but also to retain and you're not losing a lot of your therapists, that'll add huge value.

Makes total sense, right? Same thing, like we do come across larger clinics that becomes part of their need, right?

So they have to have those recruiting systems in place. They have sometimes full-time recruiters sourcing within the clinic. But it's one of those things that becomes more and more important the bigger that your clinic becomes and it's another system, right?

Another system that you have to make sure, like what's happening within the clinic to make sure that people see there's mentorship, that there's progression, that there's career growth and this feeling of community and how much is that being celebrated and who's taking the pictures of the staff and getting those all, you know, and who's throwing the parties, so like there's a lot that goes into making that happen. It can't be on the owner's shoulders. It has to be, shared and then, delegated. But yeah I think that in today's market, the ability to, if you have a strong retention, if you have a recruiting kind of pathway and program I imagine that makes a clinic much more valuable.

Yeah. And it does not always have to be for the, the therapists that, that you already have also have the capability to find other therapists out there. And I guess where I was going with that was all this can be done internally. It's just for a, a number of people on your staff, it's a small thing that each of them do.

Maybe it's the mailings that you outsource or some things like that, but a lot of these things can be done internally, and again, with the opportunity of your therapists maybe getting paid for bringing in new therapists and having them get hired.

Yeah, totally. Yeah, it's something that, again, we we're on the marketing side, so we're bringing in the new patients, but when they're we're saying before, they're saying, "Hey we're full.

That's great. We got all these new patients now, but when we need to hire..." We needed to solve that problem for them too. So yeah we created our market to hire program. We're actually putting in recruitment centers within their website, and so now those job postings can be found on Google. We have Google ads go into those select job posts too.

And I, I think last year was fantastic. We got about 350 job positions filled for clinics around the country. Wow. Which is awesome. So it's a need. It's not our primary focus. Our primary focus is getting new patients in the door, but- Sure ... we just saw this need where practices needed this help, and we're able to, create something to go with it.

But again, it's just another system that you're building for your business to give it maximum value. Now Paul, you have a really good pulse on the market here, and tell us what you're seeing out there. Has things slowed down? Is it just the same? Or like what are you kinda seeing in the market?

Yeah. The the market's very unusual right now in that businesses with, call it 10 million or less of EBITDA are still, we can bring a whole number of acquirers to the table for a business like that. It's the businesses with, 25 to 50 million of EBITDA and up that have really stalled when they've gone into the marketplace trying to recap trying to have, one private equity group get bought by another private equity group, for a new sponsor.

And so I think right now, there's really a strong market 'cause those companies have now come back and said, we'll go out at another time. But right now what we have to do is to continue to grow. We can't buy a business with 50 million of EBITDA, but we can certainly buy 10 million and below."

Most of these companies have that kind of cashflow available and capital available, I should say, to be able to do those kinds of transactions. So it's really, it's a very good market, but it is a selective market And when I say selective, it's that, companies will, you know, show up for anything that looks interesting.

But you better be ready because as soon as they look at those financials and, like I said, they're doing Q of E for even smaller companies, lots of, close attention to compliance, lots of close attention to some of the other things we've described today. So it's a very selective market, but for businesses that are prepared, it's a market that, businesses are transacting, and they're getting great structures, and they're, finding great partnerships.

Makes sense to me. Yeah. It was a hot market back in '21 and '22, and companies buying people left and right? But I think across a lot of different industries, private equity has become more selective, right? The... 'Cause I think what you're saying kind of the top market where private equity sells to other private equity, that's slowed down.

So the acquisitions are still happening at the lower levels, but they gotta be good. They gotta be quality. So you gotta have your house in order and that's what they're really gonna buy. So Paul, for the owner out there right now listening, and they're thinking about, "Hey, I'm thinking about exiting here in the next three to five years, growing this business, exiting," what are some of the things that you would advise them to start working on this year?

Yeah, so I think, it's the fundamentals, right? Clean financials, strong operating systems that internal process of recruiting. Also being able to have that system of annual planning and executing on that plan. And just knowing what you want. What do you want? How much do you really need or want to get out of your business at the time that you would sell the business?

And then let's develop a roadmap on how to get there. It's like a, a patient comes in. A patient would never start on a treatment program until they were evaluated. And most companies just need to have that evaluation that assessment to really see where are they today and how do they get to where they need and want to get in the future.

And when you can see, like this is a little cliché-ish, but when you can see it, you believe it.

When you can see how that builds over time new patients and systems, et cetera, and then it gets you to that point where now you have those choices that's when business owners will really start to believe it and will go to work.

100%. Paul, just amazing advice here today. Definitely the the leader and the expert here in the mergers and acquisitions for the PT space. So just curious for our audience out there, what's the best way for them to learn more about Martin Healthcare Advisors and what you guys do there?

Yeah. Best way first of all, we're on NEXTLEVEL Owner on YouTube where I have a number of my videos, probably at some point including this one. And but also our website has a wealth of information. It is under a little bit of construction right now, but it is up just without some videos, but that's www, the name of the company, martinhealthcareadvisors.com.

And on there, you can find answers to lots and lots of things that most business owners are asking about growing your practice as well as, at some point, exiting your practice.

Love it. Yeah, great group. Highly advise you to take a look at them if you're thinking of exiting your business in the future.

And can't speak enough for Paul and Martin and his team there. Great group to be around. Thank you, Paul, for being on the podcast and sharing your advice with us. To all our listeners out there, thank you for listening to this. I hope you get a lot of value out of today's podcast.

And don't forget to like and subscribe to the podcast as well as our YouTube channel.