From Three Clinics to Forty: A Playbook for Sustainable Growth
In this conversation, Paul Martin sits down with Mike Manzo to explore the mindset, strategies, and leadership development that turned early challenges into a long-term growth playbook.
Full transcript
Generated from the episode audio and lightly edited for readability.
Good morning and welcome to another episode of Paul Martin's Crucial Conversations. Today we're continuing in our new series that is focused on multi-site privately held physical therapy business owners. These are leaders who have successfully grown their practices and continue to drive growth in both their both their businesses, their communities as well. And our goal is to get inside their heads. Let's learn what makes them unique and try to uncover the mindset as well as some of the strategies behind their success. Today, I cannot tell you how excited I am to have Mike Manzo, co-founder of Atlantic Physical Therapy Centers, which is headquartered in Sea Girt, New Jersey.
Mike and his partners have grown Atlantic into a thriving network of 40 centers across New Jersey. I feel like I snap my fingers and you guys were three clinics. Feels like that. Mike is a longtime friend and a client. And Mike, we are so excited to have you here today. Thanks, Paul. I'm very excited to speak with you and you've been along for pretty much all of our journey and happy to have this conversation. Yeah. No, real exciting. Real exciting. So, let's jump in. In this current industry, many owners are simply content to stay small.
What was the different about your mindset that kind of pushed you to pursue growth when others stopped? I'd say you know we have a running joke. My my partner that you know co-founder is my brother Dave who you know well and the joke inside our company and our family is that if it was just me Atlantic Physical Therapy Center we'd still be sitting in Freehold where we first met. If it was just Dave Atlantic Physical Therapy Center, we'd probably be in all 50 states and maybe Dubai at this point.
But there have been points along the way where I have kind of dragged him along for growth and certainly points where he's dragged me along. But I think that dynamic has kind of forced a controlled growth. But what we've what we found initially growth was kind of by accident and then and then maybe more deliberate but we've found that growth though challenging at points provides opportunities and not only not opportunities for us as owners but really for our team. And so once we really kind of got online that there you know the valued people on our team would have a chance to do better for themselves then you know we kind of aligned on growth and got more deliberate about it.
So what I hear you saying there is that opposites attract. So if you are seeking a partner, don't think that partner has to think exactly the way you do because obviously you and Dave, you know, think somewhat differently, but always seem to come to an agreement. And you can't do it alone. No. And I heard team, I think you said team two or three times. When you when you think back to the early days of this business, how did you approach planning for growth and how has that planning continued to evolve as you guys have continued to grow?
Yeah, I think that truthfully in those early days we didn't really plan for growth. It was kind of like it happened. You know, we had a therapist that came on or maybe two. They worked alongside myself on the treatment floor. The culture was not deliberate. It was just work really hard and treat everybody the way you want to be treated. And and then, you know, those therapists were aligned with that. And then maybe a physician group locally said, "Hey, we don't have a good place to send people in this town." And so we just kind of jumped, you know, all right, let's do it.
Let's figure it out and you can go and run it. And and you know once we got to about three centers we started to realize we had no idea. I was 26 when we started the business. My brother Dave was 23. So we had no idea what we didn't know. And and we ended up there with about three centers and no clue how to run a business. And that's when we first engaged. And you helped us kind of start to wrap our arms around, you know, how to how to really analyze your business and understand what's happening within your business.
And and then from there, you know, we started to be a little bit more deliberate about a process. And and now we certainly it's it couldn't be any more different now than how it was back then. But but hard work and dedication to doing the right thing was the early formula for growth. And then now, you know, so many opportunities come across our desk. And we say no to more than we say yes. But really through the guidance that we've gotten working with you and your team over the years, we know how to look at the potential opportunity and say, you know, is it worth the effort that it's going to take and is it is it something that we want to, you know, divert resources away from where we think we may within our existing footprint have a better opportunity.
So much more process driven now, but you know, in the beginning just really hard work and dedication to the right things. Absolutely. And Mike, I forgot to mention this at the start, but you are a Gettysburg College graduate as am I. And you're also a physical therapist that as I understand you continue to treat at some level in various clinics as of today. Is that correct? Yes. Probably at times treat more than I probably should given my other role as CEO, but a p it's a passion of mine.
It's part of who I am and I think that it does it helps align with our team, you know, that they know that I'm on the treatment floor alongside them and I can appreciate the daily struggle of the physical therapist of trying to provide the right level of care, document that care and you know, attend to all the things that they have to attend to and you know, and then that's not only me. It's our COO is on the treatment floor. Our chief clinical officer is on the treatment floor.
So we're deliberate about it and I think it's a unique advantage that we have. Absolutely. Absolutely. So every successful growth story has something unique. What do you think makes Atlantic Physical Therapy Centers really stand out and how has those qualities fueled your ability to continue to grow? I think that the you know my brother Dave is not a clinician and he brings a great business mind to the business and you know and then I think that we serve very different roles. So, so that divergence of our strengths like you talked about in the beginning, the opposites attracting, but still coming from the same values.
That was a starting point and then and then comes back to the team. We've gotten very good over the years. Initially not good, then became very good at letting others take on responsibility and as they've taken on more responsibilities, the whole look of the company changed. It was not the two of us with our limited strengths. It was, you know, the great members of our team who many of them have been with us for 20 years plus. Their voice is elevating and their strengths and their talents, you know, really kind of emerging.
So, I think that's when we become a more unique company and a much stronger company. For sure. For sure. And, you know, knowing your partners, you've chosen phenomenal partners. I can remember a conversation, I think it was 10 years ago at the private practice section. We were trying to get you guys to do something. We talked to Mundrey. Is like I'm going to convince them that we need to do that. Couple later you guys call and say, "Yeah, let's move forward with this. I think that's a good idea." So, yeah.
No, you guys have you guys have real partners and I think it's one of your assets. What were some of the biggest roadblocks? Some of the greatest challenges that you guys had to overcome and how did you overcome them? I think that initially it was that we had no structure to the business. You know, we just knew how to do the we knew how to do physical therapy. We knew how to build physical therapy, but we did not have any sense of how to run a business.
And and I think you know for an early stage business doing what we do to engage with somebody like yourself to you know you know you've been there individually running a company and then for a big corporation and now running your business for all these years. Of a level of expertise that you know I still don't have you know 24 years into running our business and so certainly leaning on resources like that when you have no structure or any idea how to don't fumble your way through it just you know in make an investment in that so that was certainly an early roadblock later on I think we continued to try to do thing you know and then we grew and we changed and we were operating pretty well.
And and then there's these stages along the way where we tried to continue to do things the way that we had done them to get to whatever that point was and we hung on to doing things the same old way and it just became unwieldy. And so we had to kind of like reorganize and so like there's different challenges at different points. But we went through a process last year and we did a whole organizational chart reorganization and redefined some responsibilities and reporting and the cadence of reporting.
And you know things were kind of we were getting too big to do things the way that we used to do them. And one of our company values is to embrace and drive change. And we had to check back to our company values and say listen change is hard but we need to change. And It was a year's worth of work, but you know, we're now feeling like we are in a better place again, ready to grow again. Yeah. No, when you guys hit obstacles, what I see is that you take a little bit of a step back, you look around at exactly what's going on, and then you come together to overcome that obstacle.
I would tell you that many of the large groups that we've worked with over the years, you guys do that probably as well, if not better than anyone. And I really commend you guys for that. I appreciate that, Paul. So one of the biggest and we've we started talking about this when we talked about some of your partners, but you know, one of the biggest obstacles for multi-site physical therapy business owners is creating leaders beyond the founders. How have you guys developed such strong clinical leaders?
I know you have them, but now I'm asking you, how did you develop them? How did you get them to where they are today? Yeah, I think we have a couple groups. One is our leadership group which comes together a couple times a year including clinical directors and leaders of all you know groups within the company and we're pretty strategic about what we talk about there you know just so that everybody's aligned throughout the company and we do some leadership training in those meetings and we have an emerging leaders group where we're kind of handpicking those younger people on the team who we see leadership ship qualities within them and you know they're people that we could identify that down the line they're probably going to be someone that we might lean upon.
And so in the emerging leaders group, we're doing work on leadership training and exposing them to some of the things that you might encounter in an expanded role. We brought on a health mental health coach onto our team and she engages with the entire team twice a month and she's working on programming, you know, whatever programming she wants to work on just goal setting and sleep habits and, you know, all kinds of different things. And, I do a monthly email, I call it the mindful moment, just talking about mindset and how you might want to approach things in your life and certainly with your clients or your co-workers.
And so we're trying to just develop an overall approach to how you want to engage with others and and then do, you know, those leadership groups, you know, along the way, too. I need that coach's number. She's awesome. I I've worked with her and, you know, pulled her aside and said, you know, I need some help from you, too. Wow. I mean, talk about thinking outside of the box, right? With your emerging leaders program and you know sometimes when you do something years ago with companies you wonder if they're still doing it.
That's that came from Dennis Bush and he's now in California but that is just gold because how can you expect to take folks that are in your clinics and you know kind of just stick them into a leadership role if you haven't trained and groomed them to be that? And so, and again, I commend you for that, too. Yeah. And we've arrived, you know, Dave and I always talk about we've arrived where we are by making mistakes. And we've certainly made a lot of mistakes along the way, but we tend to learn from them and not repeat them.
And I'd say in those early stages, we probably did just take somebody and stick them into that role and really set them up for failure. And so that's a where a lot of these things over you know 24 years now we feel like we're getting that ship in a pretty good direction and we're going to make more mistakes but hopefully not the same ones you know and we'll learn from them and you know re-plot the course. Absolutely. So speak directly to our audience today. Those that are out there they're a one clinic or a two clinic business and they really want to grow.
What do you think are some of the first practical steps or tips that you might give them? I think that as long as those one or two clinics are thriving, don't I wouldn't pursue that growth until you have a really stable footing in whatever your existing footprint of clinics is. So if you have if you have a thriving clinic and again a technique that you've taught us years ago and it's certainly been a way that we've grown organically is kind of like the pilfering from the thriving clinic.
So we have a location in Freehold, New Jersey that we've stolen from multiple times and that location always rebuilds back to its you know the level where it should be. But we look at the zip code of where are the patients coming from who are coming to that clinic and they're not all coming from that town. They're coming from some towns that are adjacent. And and then you know if it makes sense in that adjacent town, pop up the location there. You have kind of an existing referral source that might serve that location and making it more convenient for the clients in that location.
Providing an opportunity for maybe that second therapist to emerge into, you know, a leadership role and become a clinical director. That model has been our most successful model for growth. Yeah. No, great advice. Great advice. So Mike, you know, on somewhat of a personal level and again as a physical therapist, what have you learned as now a longtime business owner during your, let's call it your rehab business growth journey and how has it shaped the way you think about your role and now the future of Atlantic Physical Therapy Centers?
Yeah, it's been it's been an incredible time of growth for me in my life and it's paralleled with a time of you know the greatest time of my life and getting married and then having a family. So so started the business single and you know all of the wonderful changes in my personal life have come along during the growth of the business. So that also provides challenges and I think that we I've had some conversations with some of my peers who are running their own companies where I think the company that you're that you're running is going to be enabled to grow or to stifle based on where you are as an individual.
So, if you stifle yourself as an individual and you're not growing, you're probably gonna inadvertently stifle your company, if you continue to grow and expand and see possibilities as an individual, your company's going to probably come along with you. I think another important thing that I've learned through again mistake and struggle is that because you live in the home with whomever is significant to you be that family or you know a loved one or whatever sometimes it's easy to assume well I sleep there you know they're getting a lot of me you really have to put guard rails around yourself and be present and I worked hard on strategies to be where my feet are.
So, if I'm at home, I'm going to be at home. All of me is going to be there. Not stressing about the stuff that I'm not attending to at the office. And when I'm at the office, I'm going to be there. I'm not stressing about the time I'm not having with my family. But you know, I've had to schedule time for my loved ones the way I would if I was going to go have a dinner with a referral source, you know, and protect that time.
Also, you know, we've had discussions recently within our leadership group about like when you're on vacation as a leader of the company, you got to try to check out a little bit so that you're not setting the example for your team that hey, when you're on vacation, you should be checking in and managing that. Go away, we'll handle it, you know. So, you know, it's been quite a journey. I wouldn't trade it for anything. And the growth on the business side. You know what I've learned is that surround yourself with people that are running businesses and it doesn't matter if it's a car business or a manufacturing business or an insurance business.
Business is business. Everyone's dealing with the same kind of struggles and you can benefit from their knowledge. And certainly in our industry, be a part of the professional association. Go to the meetings, have conversations. People want to, you know, if you're somebody who's been out there for two years or five years or eight and you want advice, I could not wait to like reach down and grab your hand and pull you up along and maybe help you avert, you know, avoid some of the mistakes that we've made.
People want to help people, you know, so use the resources that are around you. Absolutely. Yeah. Mike, I love the way you coin that in order for your business to grow, you have to grow personally. And if as you grow personally with your business, you shut off what's going on in your home life, it's going to come back and it's going to bite you bad. And so that balance, I think, is just amazing. And you, one would think that how could somebody grow a business to 40 clinics and have that balance.
But Mike Manzo, you do. You can. Yeah, absolutely. Absolutely. So, Mike, I cannot tell you how much we appreciate this and I can guarantee you our audience has gotten an enormous amount of value from our talk today. I really appreciate it, Mike. Thank you. Thank you, Paul, and thanks for everything that you've done for us along the way. Absolutely. And for all of you out there who listened in today, if you want to talk to myself or you'd like to have a conversation with Mike, just click below and let's talk. Have a great rest of your day and a great weekend. Thank you for joining us today.
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