Standing Still Is Losing Ground
This week Paul returns to an old series as he revives the "New Friday Morning Moment" with a clear message: staying the same may be the fastest way to fall behind.
Full transcript
Generated from the episode audio and lightly edited for readability.
Good afternoon. This is Paul Martin, founder and president of Martin Healthcare Advisors, and I would like to welcome all of you back to a series that we had done a few years ago called Paul Martin's New Friday morning moment. So, what we will be doing over the next many months is be we will be mixing in some content from this show every few weeks. And this is a series that is for physical therapy business owners who want to grow intentionally, not accidentally. And so I want you to talk and I'm going to talk to you about real decisions that impact your business, your income, so your profit and loss statement, your team, as well as your future.
So each time we do this, I want you to walk away with at minimum one clear idea that you can act on. And today we are going to start something that I believe is foundational to this entire series as well as our work helping physical therapy businesses grow. We're going to talk about growth because whether you realize it or not, growth is driving almost every outcome in your business. So let's start and let me say this really clearly. Standing still does not mean you are neutral.
In the outpatient rehabilitation industry, standing still means you are slowly losing ground. Think about that. If you're standing still and the others are coming at you, you're going to lose ground. You're not going to hold your position. And we continue to have pressures that are real. We got reimbursement pressures. We have labor market shifts. Your competitors are expanding and they are coming right into your market. So growth is not about ego or how many clinics I can put up. It's not about bragging rights in your market.
Growth is about protecting your future so that you still have options three to five years from now. We see growth as growth in the value of your business, the overall value of your business. And what will that do for you in the future? It will give you choices. You know, there's an old business saying, if you're not growing, you are dying. And I know that sounds dramatic, but in outpatient rehabilitation, it is absolutely accurate. Growth strengthens your position. It gives you leverage. It gives you choices.
And without growth, your margins get squeezed and your options shrink. So what is the biggest myth about growth? A lot of business owners believe growth creates chaos. They think it means losing control or lowering your quality. But in reality, chaos comes from poor systems, not from growth. If growth exposes problems, that is not growth's fault. That just means that the foundation was not strong enough yet. We always talk about growth stabilize. Growth stabilize. When you do that, you do it right and with a plan, growth can be amazing.
Now, growth does not always mean opening another clinic tomorrow or next month or even next year. Growth starts inside your current walls. Internal growth means better systems, better scheduling practices, better utilization, unit utilization, charge capture, clear accountability for your leaders as well as for your rank and staff. If one clinic cannot run with discipline, adding a second clinic will just multiply the problem. And that's why we cause for ourselves that chaos. I know I was there. I grew a business from one clinic to three clinics.
And I said basically all we had was I had one problem. Now I have three problems. Okay. Then we put in the systems and grew from three clinics to 21 systems. And I can tell you that was a memorable something that was so memorable was the way in which we built those systems to achieve that growth. So you know build it once repeat it well. Once something works document it refine it make it repeatable. Many of these ideas will become yours. Yes, you can use outside consultants, you can use accountants, you can use growth consultants, you can use a variety of different people, but in the end, you're going to make it you.
So, the goal is not constant reinvention. The goal is predictable performance. So, you don't have to continue to reinvent. And when you can repeat success consistently, growth becomes less risky and far more controlled. And don't we all like to feel like we are in control? Growth is also defensive. If you do not expand in your key markets, I promise you with the demand in this industry right now, someone else will. And once competitors lock up referral relationships and employer contracts, it becomes very expensive to take that ground back.
So sometimes growth is simply about protecting what you already have built. Now on the flip side, offensive growth is about positioning. Entering the right market at the right time creates leverage. And when I say right market, that could be, as our managing director of M&A, Tom Carden over the years could say, that may be the next town over. But it is about positioning and that becomes offensive. When you move early and strategically, you control your options. When you hesitate too long, someone else shapes the market around you.
In my own growth story, we grew from three clinics to 21 clinics in just over three years. That did not happen by luck. That was a combination of planning and our plan included startups as well as acquisitions but most importantly discipline disciplines and the systems that we put in order to grow stabilize grow stabilize. We didn't chase everything. We followed the criteria that we built for those new startups and for those acquisitions. And I can tell you we turned down way more than we ended up closing.
We also had a very clear defined plan, very clear filters, very clear financial targets, very clear cultural standards. And that disciplined allowed us to say no when something did not fit. And saying no, I will tell you, prevented a lot of regret. It prevented a lot of stress. You'll always find a reason why you should do something when if you created a criteria beforehand and you look at each one of those opportunities with that criteria by your side, that will always guide you to making the best decisions.
You know when you operate from a plan you stop guessing. You stop reacting emotionally. Confidence comes from clarity. And clarity comes from disciplined thinking about where you are going and why. Growth is a mindset. And as you recall, we've done many series where we talk to multicl clinic business owners about how they think differently than single clinic practices and business owners. We're not putting single clinic practices and business owners down in any way. We just want to help guide you on how these owners think as they grow and what their mindset is.
Because growth starts in your head before it shows up in your numbers. Our findings have been that growth owner, growth oriented owners, they stay curious. They ask more and better questions. They pay attention to the trends. They are not complacent. And again, I'm not saying that a single clinic business owner is complacent. All I am saying is that one of the key one of the key criteria for these folks who are growth oriented they are not complacent. They always seem to be moving and that movement always tends to be forward.
You know, most growth opportunities begin with conversations, not sales pitches, conversations. But the owners who grow consistently stay visible. They build relationships. They go to conferences, local conferences, regional conferences, national conferences. They listen with intent. Over time, these relationships then come back to them in creating options. I have found that business owners that grow right in their own markets tend to be out talking to other business owners, talking to folks in town council, wanting to know how the area around them is going to grow and then how can they fit into that.
So as the slide said, network relentlessly. You know why does this matter? Now folks, the rehab industry is changing rapidly. Consolidation continues. Private equity is still extremely active and new models are emerging. We are seeing this every single day with unique physical therapy practices with the unique service offerings some out of network practices. These models are growing and are emerging. I was at a pro a pediatric conference, the growth code conference, phenomenal conference. I cannot tell you how impressed I was with the number of 20 plus clinic business owners that attended this conference.
Remember, prepared owners win in these environments. Unprepared owners feel pressure. Growth done intentionally will position you on the right side of that equation. You know, growth is the lifeblood of a rehab practice, hence the name of this episode. But it has to be intentional. It has to be disciplined. So, in the coming episodes, we're going to break down how to evaluate your growth potential and where the real opportunities are in your business. For now, I want you this week to think about one question that I have for you.
Are you growing purposely or are you drifting and waiting for growth to come to you? That is the question I have for you. And if any of you have questions about what we discussed today, about growth as a mindset, about growth and how intentional you can make it, and how you can plan out your growth strategy and see clearly one, three, five years out what your business will look at look like. If you want to have that discussion, just click below and let's talk. Thank you again for joining us.
Excuse the little bit of scratchy throat here and I look forward to talking to all of you in the very near future. Thank you and have a great day and a great weekend.
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