Scaling Smart: How Leaders Grow Without Losing What Matters
As Elliott Physical Therapy grew from one clinic to a thriving regional network, founders Daryl and Patti Elliott kept one principle front and center: never lose what matters. In this episode, Paul Martin explores the mindset and structure behind that kind of sustainable growth.
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, so excited we are continuing our new series focused on multi-site privately held physical therapy business owners. These are leaders who in their communities have successfully grown their practices and continued to drive growth around their current market. And our goal is to get inside their heads and really try to learn what makes them unique and uncover the mindset and some of the strategies behind their success. Today's guests, we are real excited to have Daryl and Patti Elliott.
They are the co-founders of Elliott Physical Therapy. Patti and Daryl, welcome. Thanks so much, Paul. Thanks for thanks for having us today and look forward to being part of this and I've watched many episodes of your show and excited to be part. Awesome. Awesome. Well, it's great to have you guys. And Patti and Daryl are the co-founders of Elliott Physical Therapy. And they have grown Elliott Physical Therapy into a thriving network of nine clinics, four satellite locations somewhat south of Boston and Massachusetts. So if you guys are ready, let's jump in.
Let's do it. Sounds great. All right. So, let's start with, you know, a lot of owners are just content to stay small. And we don't knock them, right? If you're out there and you want to stay small, we're not knocking you. But what was different about your mindset that pushed you to pursue growth when others around you stopped? You want to start in with that one, Sure. Daryl, you know, we came before we founded Elliott Physical Therapy, Daryl was a partner in a large physical therapy company.
And so we knew, you know, we had come from a system where Daryl was in charge of four clinics. So we knew how to do that and that was essentially our goal when we started. How could we do that ourselves? How could we do that differently? So I don't think we ever set out when we founded Elliot to just have it be a single clinic location. It's kind of what we knew and you know and ultimately I think you know the answer to that is that there was a need you know I think the communities you know community we lived in you know wanted a some more options and then as you work with different therapists you know they live in different communities and you know the need and want was out there and you wonder if that is kind of a prefix you know a before for companies like yours that have you've managed multiple clinics in your kind of your previous life, right?
And so you never saw anything different than you know multiple clinics and managing those multiple clinics. So it' be interesting to see how often that transpires. Because many physical therapy business owners, they work for a single practice and they see how that's done and then they go off and they do their own single practice and maybe are not thinking outside that box, which you guys were able to do for sure. So when you think back to some of those early days, how did you approach planning for growth and how has that planning over the years, how has that evolved over the years?
I can start with that one, too. I think people underestimate how powerful planning is. Daryl and I before we got started, we planned so many things and thought about so many things and thought about how we wanted to leave our mark on what existed in outpatient orthopedic physical therapy. And so we definitely tried to think first about like our core values and our mission statement and how that applied. We opened two clinics the first year. So how that applied to the first two clinics and how that would impact the communi communities that we served and our team members.
So you know every we spend a ton of time with quarterly meetings and annual meetings planning out and changing and adjusting our plan to how we want to operate. And I think sometimes people think, oh, you just like hang your shingle and then like people are just gonna come to you because you know where I worked previously had a wait list, but we really thought about like what are we going to do and what are we going to do differently and how is that going to impact the communities that we enter into?
Yeah. And then you know my thoughts on it too is you know I think most practice owners they think about okay you know you're just going to pick a number of locations and this is what my goal is you set forward say I'm going to have five locations 10 you know whatever the number is and you just go from there and I think what you evolve into see it's way more than just that it's a matter of like Patti said planning and figuring out everything else that goes into it and you know and the and the teams the teams you have to build you know to you know create success.
So all well-laid plans have issues have problems and every growth story has something that's unique. And so what you guys what I heard you say Patti is that we wanted to be different. We wanted to stand out. What do you think makes your company stand out and how has that uniqueness kind of fueled your ability to continue to grow? You know, because we are still local and we are familyowned. I think that really is our superpower. We are in communities where we're able to really care for the community and know the community members.
That's harder to do the bigger you get, right? So, I think that really is important and Daryl, we talk about this all the time. We listen to patients and we listen to, you know, what their, you know, sticking points are in healthcare and then we actually have the power to make changes because we only answer to ourselves, you know. So, if there is something that people are unhappy about, we can, you know, adjust and make changes that I think as organizations get bigger, that gets harder to do.
And that goes for our team members too. You know, we've had retreats where, you know, we read people first and then we made changes and then, you know, we just listen to we have annual engagement surveys that we send out and we spend hours going over those surveys, answering the questions, you know, going over the points that people have and making changes. You know, sometimes Daryl and I sometimes will read the answers and we come out and we're like, "Oh my gosh, like this, you know, there's like a lot to change." But I think it's powerful to be able to get that feedback and make those changes.
Yeah, we kind of go by this by this process, you know, and typically with the planning, I'm the process systems, you know, part of this. And, you know, we go by this concept of be, do, have. And I think that that's part of our uniqueness is that we really, you know, have a being about us and what we believe is true in the industry of physical therapy and, you know, being researchbased and, you know, good patient experience and, you know, just the values and culture we have developed.
And then the do is the next part of it. And and I think it's that that's not as easy as it sounds. You know, it's like the execution part of it is really carrying it through and getting it to a closing point. You know, that you've actually accomplished what you set out to do. And you know, that's where the halves come in. The have is really the last bit of it. Have is just the result, you know, where it where a lot of people think of it, you know, the other way around.
They they want this, right? So, so then they're going to do that and then you know the being is the last thing. So I kind of think that's a lot of what we do is we just stay true to our kind of you know our values and what we're trying to do and then carry it out. So Daryl and Patti here's a test. If we lined up your clinical managers, clinical directors and I said, "Explain the be do have, you think they'd be able to explain it?
Are they are they?" I think so. I think so. It's in our onboarding and almost everything that we do. So, there you I would be I mean, at the manager level, I would be very surprised if that you know, if they weren't able to clearly define that. Yeah, that's awesome. And that's something, you know, we talk about things all the time about how many times people need to hear things. And I mean, that's something we talk about at annual meeting every year just because we have new team members.
That's something that's part of our onboarding. We're not afraid to repeat the concepts that we think are really important. It goes back to the zig ziggler, right? You know, ba bathing every day. Yeah. And you know, professional football teams, you know, you guys living near one of the greatest of all times, they practice. Do they practice different things every single day? Of course not. Right. Right. That's the way they really learn that playbook. And so it sounds like, you know, your playbook continues to be followed.
What were one of the you know biggest roadblocks that you faced as you were growing and how did you overcome kind of that biggest roadblock or roadblocks? There were a couple of things that when I was reading this question, the first year that we were open, every Sunday night, we got like 20 ines of snow and I just, you know, we were growing. We had two clinics open. We had people, you know, team members employed and I was just like, Daryl, how are we going to do this?
Like, how are we going to And it is funny. I, you know, we always talk about not having a plan B. And so I would call people on Sunday night and I'd be like, "When can we get you in later in the week?" And just we would extend days. We had people parking and like crossing Morsy Boulevard, which if you knew where that was, I mean it was just craziness. And then I think co honestly we had never done a tellahalth visit until CO happened. And we got word from the governor of Massachusetts at the time, Charlie Baker, on a Sunday night that he was going to make sure that we were re reimbursed for teleahalth visits.
I googled free teleaalth, you know, you know, we started using a platform and you know we said we never closed for not one day. So the next we sent out messages to everyone that Monday whoever whichever patient would be willing to try a tellahalth visit. You know they logged on and they did it and some people said oh I'm going to take the two weeks off and then I'll see you after two weeks when you're back in the clinic. I don't want to do tellahalth and then after the two weeks they were like actually I'd like to get started again.
So I mean those were huge obstacles that you just can't foresee. No one thought like could that's impressive. Yeah, that's impressive. Yeah. Think thinking back to those days and that was a big do, right? Was you didn't lay off one person during co Yeah, that that's absolutely amazing. Yeah, absolutely awesome. So you know I can't wait to for you to answer this question because I think this is the biggest hurdle for single site companies to become multi-site companies and it's the ability to create leaders beyond the founders you guys.
How have you developed strong clinical leaders and somewhat of a leadership pipeline to support your continued growth? Yeah, you know, it's definitely a key part and it's part of the process is you have to have even you know after this we have a session with a lead a development program you know that we're involved with you know so we have one of our managers that that's super successful and you know he runs a leadership development program you know kind of training And then from the from the outside, we bring in we hire mental strength coaches.
And you know, we have a bunch of other people that come on to help with this type of training because it is it's something you know I think mostly what happens is good PTs become you know good clinical PTs you know kind of become managers and without the right skill set you know a training behind them you know it really challenges them to be successful in that position and you know so I think that's key and e even as stepping stones I think We create different leadership responsibilities.
You know we almost create like a rock wall in the company and we have you know that you can be head of an APA leaison a university leaison that you can be an assistant manager and all these are stepping stones to you know kind of go we don't look at it like a just a straight corporate ladder you know you can kind of climb around I guess and test it out yeah and I do think in those founding days like those people who you know were there with us when I when we started really worked alongside of us and so we sort of saw who the leaders were you know at Elliot from day one we have what we call community ambassadors so they're expected to work different community events and work alongside a senior either therapist a manager or ourselves you know Daryl and I the last two weekends have been really busy South Boston is our newest clinic and so getting out into the community, but having someone there who shows you know, Daryl talks about execution and closing the deal and a pet peeve of ours and maybe it's just the way we're wired, but I hate when I get a I've tried this, I've tried this, I've tried this.
It's like actually what have you closed? Like we could try everything but unless we actually accomplish something and actually close the deal that we're you know working toward the trying doesn't really do it you know so I think seeing that approach and seeing people who know how to do that you know I always kid about Daryl like there's no accident that he's successful in a group of people he will walk over as uncomfortable as that may be for him and I think sometimes younger therapists feel like oh I I'm not ready yet to speak to that doctor or they wouldn't want to hear what I say or last night we went to a benefit for a senator that's an advocate for physical therapy and so they are they do care about every voice and just having the strength and seeing other people do that like being able to shadow just in your professional career I think is so important.
So, kind of thinking outside the box with, you know, a mental strength coach, how has that gone and what changes have you seen from your leaders after going through that kind of training because that's absolutely outside of the box and probably not a skill set that either of you had, you know, for your business, but apparently you saw this need. How has that gone? Yeah, it's been unbelievable, I'll tell you. You know, we connected with this gentleman and you know, and this was kind of his first introduction into healthcare.
You know, he really his clients were from the NHL, from the NFL. He works with our military and you know so for us to talk with him and bring this concept into healthcare he was extremely excited about it and he really latched on to our managers and taught them a lot of skills and techniques you know to help with their teams. And again like he's successful on other levels in other industries. And so we just kind of took that concept but we try to utilize a lot of things outside of you know healthcare is a very tough system right to be involved with and you know I think we can learn from other industries and bring that out.
So it's been immensely successful and the changes you see is that we feel we have some of the strongest leaders in the industry. Yeah. Yeah. Yeah. And guys, that's making a commitment to your leaders and to your people. It's it's showing commitment to your people. And I applaud you for that. And I am sure that your staff is talking about that a lot to their to their peers and to their friends. So for those single clinic business owners, two clinic business owners, and they really want to grow, what practical first steps or tips would you give them?
I would hope they were a boy scout, you know, is kind of be prepared, right, is the motto. You know, is it's not for the faint of heart. You know, I think roll up your sleeves if you think it's going to be easy, you know, it's a great rewarding experience, but, you know, one plus one, you know, clinics doesn't equal two. It's probably in the three to five range. Great point, you know, and so I think it's to me it's about systems, processes, you know, there's a ton of information out there now with books like scaling up and you know, but it's about processes and systems and you know is carry through on your vision and dream and know what that's about.
Yeah. And I think you're never going to be completely ready. It's never going to be a perfect jump from one to two. I, you know, I equate it to almost like having children, right? So, you have one child, you're like, "Oh, I've got this down." And then you have two and you're like, "Oh, I'm outnumbered." You know? So, I think it's you're going to have bumps along the way, but you're never going to be perfectly ready. So you have to make a leap if that's something that you really want to do.
And it's okay to have one clinic, but if that's part of your vision and you want to have growth, I think another thing that really helped us too is we had team members who wanted opportunities. And if we stayed at one clinic, then we have one manager and we h, you know, one clinical manager and one office manager. If we open a new clinic, we open up new opportunities and we retain that talent. So it's it can have a lot of positives and you just have to you know be you know be comfortable with feeling uncomfortable.
Yeah. Let them lead. Right. They they want new opportunities. So okay if you want that opportunity we have we have the means and we have the systems to set you up and get you going and yeah I think that that's a great strategy. Great strategy. So is there something in the future that for you guys and independent companies something unique to grow over the next three to five years? What are some of those opportunities that you guys are kind of keeping your eye on for the future?
Yeah, I think it is exciting times and you know we see different things happening you know in the physical therapy world. You know, I think the use of technology has been unbelievable and you know, some of the platforms, you know, that are out there and we work with prompt an awful lot and you know, hopefully as a as a kind of partner help develop some of this you know, technology and so I think utilizing that and then even the delivery you know and seeing and using these platforms is with tellaalth you know all the portals that are being developed in healthcare in general.
I think these are all opportunities. And I think we're at a tipping point with reimbursement. You know, you see a lot of things going on and I that's going to be what's going to substantially change our industry is really getting, you know, paid fairly, you know, for our service. I think we're at a time now where everybody's understanding, you know, what reimbursement means, you know, to keeping this industry alive and healthy. Absolutely. Yeah, I have to agree with the technology. We now have our therapists miked up and that's generating part of their subjective avail.
And I mean there's just so much amazing technology that's coming that's reducing the administrative burden and allowing for more patient care. And so it's, you know, I think you have to stay flexible and we demo more products and are just open to the thought process of being able to incorporate anything that can assist our you know our team members and you know providing a better patient experience and maintaining their work life balance. So, if they're not bringing notes home because it's basically been generated by the actual session, I mean, it's amazing.
Yeah. And and one other thing I'd add in there, too, is, you know, I think there's going to be plenty of opportunity to stay independent and kind of create and keep these, you know, family-owned practices alive and going, you know, but I'd be remiss to say if the opportunity is not out there for consolidation as well and merger and acquisition market, as you know, is strong and alive and you know, I think we're thankful that it is in the industry, you Sure. Yeah. Sure. Yeah. No, and you know, again, this show is really for six to eight weeks is focused on without capital behind you and without that kind of private equity or big company push, there are still businesses out there that are growing to 2, 4, 6, 8, 9, 12, 15, 20, 50, you know.
So, it it's very unique and I think that's why we're trying to capture, you know, kind of the mindset here. So, yeah. No, and I I applaud you guys on what it sounds like you're doing with innovation because innovation can also become a burden when you know we're just jumping on every single thing that comes our way. It sounds like you guys are really trying to focus on what makes our therapy staff more efficient and improves that patient experience. Because if innovation doesn't do those two things, you know, we don't, as you guys know, it's not just the next cool thing that comes out.
Right. Right. And we're lucky in the fact like even with remote therapeutic monitoring, like it is better care. It isn't just because those codes get reimbursed. If you're tracking somebody and you're following Mrs. Jones and seeing if she's walking or maybe there's a day she's not walking and you pick up the phone and call, that is amazing care. And so I think having the innovation just align with our values and the care we want to provide. It's it's easy to incorporate it then. Yeah, Patti, you said it way better than I did.
Aligning it with your values, right? You can't go wrong there. And and we're seeing the outcomes, right? Right. The research, the studies are showing this is better care and it's creating not only, you know, it's creating a better quality of life, you know, for people. Yeah. And when Daryl and I go out into the community, it's so validating when people will come up to us and say, "We've been to therapy before and you're a level above." And I'm like, gosh, I can't even. It's just we have created what we wanted to provide and what we would like to receive and like our family members to receive and our neighbors to receive and it was it's really that simple, you know, and just holding true to that.
Makes that hard work worth it when people say that, right? That's true. Correct. Yeah, for sure. So, personally, what have you guys learned as business owners during this, let's call it the rehab business journey, and how has it shaped the way you think about your role and now for the future of your company? We touched on that a little bit, but give us a great ending here, guys. Yeah. Yeah you know to me I think really the shift you know I think back you know now w with this company you know it's going on 12 years and you know that we were in the planning stages and you know at the start of our journey even you know coming from being a partner in a large company is I think the direction went from you know a lot you got to focus on yourself in the beginning and just kind of getting things going and kind of going but then you quickly realize how important it is.
You know, obviously the focus is on patient care and the patient experience, but then it's the people that you work with and you know, building your teams and surrounding yourself with good people and thinking about the bigger picture and how you know that mission statement is not a plaque on the wall. You know, when we set out to build healthier communities, you know, like Patti was saying is, you know, we live and breathe that and, you know, we kind of think of that. So, it it's really a shift from self to kind of the bigger picture and, you know, involving more teams and, you know, we really feel PT is the answer, you know, and that's what we're trying to do.
Yeah. And I think learning from the new the young professionals that are coming into the field. I think as therapists for so long we didn't want to talk about the money side of things and we didn't want to advocate and fight for our value. And I see the younger generation coming into the field. Obviously they've invested a ton of time and energy. They're bright and energetic and they're not going to take it. I always think of that song. You know they're not going to take it.
If we want these beautiful people like young, energetic, like empowered therapists in the field of physical therapy, we have to change the payment structure. And I just think it's really I applaud them. I don't think Daryl and I ever thought about boundaries. Like when people asked us like to stay late or see more visits or do whatever we did, we were like, well, hey, that's just part of it. But it's true. There should be some sense of like work life balance and there should be, you know, appropriate payment for the work and the services we're providing.
We have to feel like strong enough to say that. And I think it's I'm really like I give them a lot of credit for just, you know, really having the guts to be like, yes, I'm a caring professional, but also people have you have to care for me, too. And I think that's something that's really new or it just Yeah, absolutely. Yeah. Look, Patti and Daryl, I cannot tell you how much value you have given our listeners today. You can see and hear your passion in every single thing that you talk about and describe.
And this has been so warming for me to hear you guys because I've known you for a long time. But we've probably never gotten into some of the questions that we asked you today. It's units, it's visits, it's all the other things around it. And this has been so refreshing. And so Patti and Daryl, I really appreciate your time today. Thank you so much for having us. Yeah, re really appreciate the time. Hopefully the viewing audience gets a you know, we just want to kind of do our part and you know, all your other podcasts have been so helpful to us.
So, so we're happy that you invited us on. So, thank you so much. Appreciate I appreciate it. And for all you out there, if you have any questions for myself or Patti or Daryl, just click below and let's talk. Have a great rest of your day. Have a great weekend and look forward to seeing you when you tune in again next week. Thank you. Thank you so much.
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