Paul draws from four episodes to show what championship-level thinking looks like inside a physical therapy practice.
Generated from the episode audio and lightly edited for readability.
Look, Coach Cignetti is special because he can repeat success. Repeatability only comes from systems, standards, and disciplines. And he brought all of those to that program and it will be really interesting to see how he's able to repeat this now that they've won a first national championship. And for our businesses, our businesses, we can look at being repeatable as we open our first clinic and we put all the systems and the disciplines into that first clinic. Second, it's just a repeat. Third, it's a repeat. Fourth, it's a repeat.
15, 20, it's a repeat. Talk about recruiting. Very interesting. He recruits production over potential. He literally stress tests coachability of a player early in his discussions. What he wants to see is how people and players will respond to hard coaching, not how they talk about leadership in interviews and use fancy words. He wants to see them under pressure. You know, at Indiana University in Pennsylvania, he partnered with ROC, the ROC, to put players through real stress situations. This was not punishment. It was a way to ident identify who are our true leaders and that was based on what do they do in terms of their behavior under pressure.
This is one of the most interesting things about him and I really enjoyed watching him on the sideline. His sideline demeanor. He is calm and the word I love, he's diagnostic and he's corrective and the players trust him because emotion never overrides evaluation. What are we going to do on the next play? I heard him say many times,"Wh should I be a cheerleader on the sidelines when we score a touchdown? I'm expecting that we're going to score a touchdown." And I think that calm, diagnostic, and corrective behavior kept his players also focused as well.
So, why do these turnarounds stick? And I really truly believe now you know I'm not a direct fan of Indiana but I think what he is installing which is standards before talent that is a discipline that shows up before the winds and again leaders are not revealed okay and not simply just appointed leadership shows up in those moments of stress. Cignetti identified leaders by behavior, not title or tenure. He didn't care what high school talent that he brought in, whether they were captains or not in high school.
He wanted to see how they would be under pressure in his system. The people who stay calm, take ownership, and stabilize the group. They will earn influence. In a physical therapy business, those people often exist before the title does. Your job is to recognize them and develop them intentionally. They will typically show up rather early in their careers with you. And that clarity makes recruiting far more effective because you can now build a criteria by which you're going to evaluate the therapists and the professionals and the support staff that you hire.
I know there is a real difficulty right now hiring professional staff. There is a shortage. But many owners hire because someone is simply available or they're credentialed in their state. The high-erforming organizations that we see, they hire because expectations are clear for the professionals they're hiring and they're non-negotiable. Depth matters at every size, but depth with the right professionals will always win over depth with just bodies and positions that are filled. If one person leaves and performance drops, the system is fragile. And that naturally leads to testing the system under pressure.
When you've been tested under pressure and someone leaves, you are far better built for those difficult times. All right, so let's talk about the coach, Dusty May. This man was a student manager for Bob Bobby Knight at Indiana. Coach Bob Knight at Indiana. He did coach Knight's yard work. He got him coffee. He would get him a donut. Whatever Coach Knight asked. What did he learn? Well, he said the greatest lesson that Coach Knight taught him was this. That the will to prepare is much more important than the will to win.
This is also a quote turned around a little bit from Vince Lombardi, the old Green Bay Packers coach. And as a high school wrestling coach, it was painted on the wall in our wrestling room. It said, "The will to prepare to win is not nearly as important as the I'm sorry, the will to win is not nearly as important as the will to prepare to win." I think you get the idea. Coach May took that very old school preparation and he paired it with new school approach that players truly felt.
You cannot coach and you cannot manage young people today the way in my practice back in the early 90s the way we managed young people. That you have to bring it up a level and you have to understand what they want. Players described Dusty May as a cool uncle. Someone who believes in you deeply, but is absolutely going to hold you accountable. He scouts opponents personally. He even sat courtside at UConn's semifinal game and it was only hours before his own game. That folks is preparation.
That is coaching. So let's go back to the lesson for business owners. You have to believe in your team. They need to actually feel it. But belief without accountability is just what we would call cheerleading. The best leaders, just like the best coaches, they blend trust with super high expectations. They set the bar high and then give your people the tools and support to clear that bar, then hold them to us. Every single one of them came through the transfer portal as of the year of their national championship win.
You had Elliot Cado came from the University of North Carolina. Morz Johnson that big power forward came from Michigan State. Yakenborg the virtual superstar of the whole team came from Satan Hall in New Jersey. Imara, the seven foot plus giant from a program in Spain. The the idea here though is they were from different programs with different cultures, different systems, and coach Dusty May had to turn that into a cohesive unit. And he had to do it fast. All right, folks. Does this sound familiar to you?
If you're a growing physical therapy practice, you are hiring new therapists, new front desk staff, new techs, people from different clinics, different training backgrounds, different philosophies, the challenge is the same. So, how do you get them aligned? Because you got to get them working in the same direction and you have to do that quickly. Well, let me tell you how Coach May did that. He did it by establishing a clear culture from day one. And it wasn't they weren't just signs on the walls. This was something that came from him, from his heart, and from his gut.
And he called it a covenant. Your primary allegiance is to your brothers in the locker room, not to your old school, not to your ego. It's the team. And he used he literally did one on-one film sessions with his players. How many coaches do that? He would text players 7se secondond video clips just to reinforce all of the culture lessons in what he described and what the players described it as. It's a collaborative environment. All right. What are the lessons for your business here on boarding?
Look, it's not just paperwork. It is a culture installation. You have to have a very clear mission and you have to communicate it relentlessly. Now, this is the part that really literally gives me chills. Yakel Lindenborg was Big 10 player of the year. He was absolutely Michigan's best player. And in the final four semi-final game against Arizona, he sprained his MCL and he rolled his ankle. He said he felt awful and super weak at halftime of the title game. But two things happened. First, Lendorg said after he got, "I'm playing Monday night regardless." and he ended up gutting out 36 minutes which was more than any of his teammates and he dropped 13 points on a bad very good on defense.
Secondly, the rest of the team rallied. Elliot Cado went off for 19 points and he ended up becoming the most outstanding player in the championship game. Morz Johnson was incredible. Posted a double. He is a lethal weapon and he has those second effort putins over and over. Will Shedder said it best, that dude brought us so far this year. They weren't going to let him down. And the lesson here is this. In your business, your top performer is going to have a bad week. He or she is going to take a vacation or a leave.
And if your business falls apart when one person is out, you don't have a business. You have a dependency. So you want to really try to build that depth. A lot of crossraining. Create a culture where people step up when someone else is struggling. And that is what a championship roster does. And that's what you want to have. This guy won four major championships. Check this out. Before he turned 25. Four. That puts him in the very same room with Jack Nicklaus and Tiger Woods as the only players to ever do that.
And then nothing. For over a decade. He went from 2014 to 2025 without winning a single major. That's 11 years. Can you imagine that? Being that talented, that dominant, and having the one thing you want most just keep slipping away. And here's where it gets really interesting for us because everything Rory went through, you knew you were c, you knew I was coming with us. Every setback, every lesson, every adjustment that he made maps directly into the challenges that you and I deal with every single day in my business and you in your physical therapy businesses.
Have you ever had a quarter where everything just fell apart? Where your best therapist quit, your referrals seem to just go away, and your collections tanked all at the same time. I've talked to practice owners who have had exactly that kind of month or quarter, and it can feel like literally the end of the world. But here's the thing. Two months after that Masters collapse, Rory won the US Open by eight strokes. Talk about a comeback. Eight strokes. It's still one of the most dominant major performances in history.
He was so young. He took that failure and let it fuel him. He didn't let it define him. So the lesson for your practice, your worst quarter, your biggest failure, your most embarrassing stumble, that can become the found I'll slow down. That can become the foundation for your greatest run, but only if you study it, if you learn from it, and you refuse to let it break you. And then there's the mental side of all this. Rory works with Dr. Bob Rotella, one of the most respected sports psychologists in the world.
He brought in Brad Faxton to help with his putting and his mental approach on the greens. As you know, you know, T- shots, second shots, it's all one on the greens for these big-time golfers. He built a team around him that covered every angle, technical, physical, and mental. Here's what I want you to take from this. In your PT practices, in your PT business, I should say, do you have a team you trust? And I'm not just talking about your therapists. I'm talking about your advisors, your accountant, your attorney, your marketing outsource or insourced person, your consultant.
Are they people who you know who understand your vision and who have been with you through the ups and the downs? Or are you just constantly cycling through vendors and hoping to find the next one is going to be the answer? Rory's lesson is clear. Find great people, build deep relationships, and stay loyal. The payoff comes. It might take eight years, but it comes for your practice. This is the final lesson. The first win is not the goal. The goal is to build on that. When you finally crack the code on referral growth or you finally hire the rockstar clinical director or you finally get your margins where you need to be, that is not time to sit back.
That is the time to double down on what you've already been doing well because momentum is real. Rory did not just win one masters and go home. He came back and proved it was no fluke. Your business should do the same. When something works, systematize it, replicate it, and build on it immediately.