Survival to Success to Significance

This is an interview with Jerry Durham PT, one of the speakers at the 2012 Private Practice Retreat. Jerry owns 5 physical therapy practices and has been a successful physical therapy business owner for over 10 years. He has been a speaker at the annual Private Practice Section meeting, and has continued to grow his practice while others have struggled in an uncertain economy.

What’s unique about Jerry is that he has been an active participant of the entrepreneurs organization for four and a half years. He lives in Oakland, CA with his wife Karin and their two dogs Giada and Gemma, loves music (Beastie Boys), cycling and food.

He is very active with social media, and has a powerful social media presence and fan following. Jerry strives to be a master in building relationships and marketing physical therapy. His energy and enthusiasm is infectious.

I interviewed Jerry this week and asked him six key questions.

  • Why did you get into private practice?
  • How hard has your struggle been?
  • What have been your biggest sacrifices?
  • What are the biggest mistakes you’ve made when building your practice?
  • What is the advice you’d give to someone looking to grow their practice?
  • What is the most important attribute you’ve had to develop to grow your practice?
Here is Jerry’s insight into how he transformed his practice and how you can do the same.

Why did you get into private practice?

Jerry: It’s a funny story.  I got into private practice over 11 years ago.  Actually I started on my own before I partnered up with my current partner, Sturdy McKey. I officially got into private practice after about 3 to 4 years ago after jumping from job, to job to job in physical therapy. After I complained for years, my wife finally looked at me and said “Jerry, it’s not your bosses that are the problem, you are actually the problem, you need to start your own physical therapy practice”. So that was a very enlightening day for me.  I realized that it was not about the other people, it was about me and what I needed to do.

So, I  took a year to work on my physical therapy skills and at the end of that year long training, I actually came out not so much believing that I knew everything but literally, this was an epiphany for me, that I now understood what I don’t know. From a clinical sense, I know what I did not know but I felt comfortable looking at the patient in the eye and say, “I cannot help you but I know of other people in town who can” and after that epiphany, I remember the day almost specifically over 12 years ago actually and from that day, this whole story started. I believed I could deliver physical therapy in a manner that was consistent with what I’ve learned from school. So I went out and started my own clinic and that is how I got into private practice.

I met Sturdy McKey, my partner when I was working somewhere while he was an intern.  After about year in my own private practice, he came to me and said to me that “I have the opportunity to grow my clinic, I would like you to partner-up with me.”  I agreed to partner up with him and that was over 11 years ago and we’ve been growing this thing ever since.

How hard has the struggle been?

Jerry: I started my own practice and when I realized that I could do it better, I honed my clinical skills.  But there was one component missing and that was the business side of it. I had zero business sense. I didn’t have a network of experts.  There was no one saying, “Look, Jerry, you are running a business.  I don’t care if it’s selling toasters or treating patients.  You need these people on board, and here are some people you can talk to,” or even “Here are the kind of people you need to talk to”. I didn’t have that network around me to even tell me that.  So that was definitely a struggle early on.  It was a baptism by fire for lack of a better term. I didn’t even know I needed the experts that I needed.   Another big struggle was my failure to go into my practice with a vision, a mission and core values of my company.  I mean we all see these terms every day.  And we know their importance to a business but, it took me 10 plus years of business to realize how important a vision, a mission and your core values are to the company.  So those are my struggles early on.  And in hindsight, if I could change one or two things going back, those are the two things I’d change.  Find more experts early on, establish my vision, my mission and my core values from day one.

“Find more experts early on, establish your vision and core values from day one.”
Jerry Durham PT
What have been your biggest sacrifices?
Jerry: The early struggle was financial.  You need to have a partner, if you are in a relationship, buys into this with you a 110%.  My wife was very understanding and we sat down and did some work together. This is where we need to be in order to move ourselves to our life goals. So my wife played a big role, in helping me through those struggles.  Another big struggle is to NOT believe in these naysayers.  All these people tell me, “I can’t continue to practice this way.  It’s not financially viable. You can’t do this. No, everybody proposes to doing it this way therefore you can’t do it. Your practice will not survive.  You have to go and network with all these providers. You have to, you have to cut your treatment times.” That has been the biggest struggle, going to bed at night believing that I’m actually doing the right thing because people around me, frequently, are telling me I can’t do it this way.  I did not predict that struggle.  I thought more people would embrace the model that I set up.  And as it was successful, I thought people will step up and say “Jerry, I want to know how you’re doing it.” But instead, they just look at me and go “You’re model is not sustainable” without even understanding where I come from with my model.

What are the biggest mistakes you’ve made when building your practice?
Jerry: One of the biggest mistakes I’d say we did was to farm out or send the billing out of our hands too early, we gave it out to another company too early. We should have kept it in house a little lot longer.  So that was definitely a big mistake and by the way, that almost shut our practice down about 4 years in.  We actually sat down and went through our strategy.  What were we going to do when we close the doors because we had a billing company that was so poorly managing our accounts receivables and we had absolutely no recourse against them. And to be honest, we didn’t fully understand what was going on in their end.  If we understood better then we could have phoned and asked specific questions to find out why is the 90-day AR this much, why is the 60-day this much?  So that was a big mistake and almost closed us down within the first 4 years. It’s pretty frightening, thinking back on it.

“One of the biggest mistakes I’d say we did was to farm out or send the billing out of our hands too early, we gave it out to another company too early.”
Jerry Durham PT

SURVIVAL SUCCESSOver 50% of our referrals were coming from ONLY 2 referral sources. Sturdy and I looked at the numbers and made a conscious decision that we have to reach out to more people.  If we lose these two providers, we will go out of business.  This is no joke.  Within 6 months, and I’m going to tell you, it was pure luck that we actually did something beforehand, within 6 months, one of them died of cancer and the other one went into an internal referral model and could not refer out.

If we would not have made that decision, we would have lost 50% of our business overnight.

So that and the billing component were probably my two biggest mistakes early on.  One could have shut us down and the other one, through a stroke of luck, did not shut us down but would have if we did not pay attention to it.

What is the advice you would give to someone who is looking to grow their practice?

Jerry: Do not compromise your hiring.  Every cliché, every story you’ve ever heard about slow to hire, quick to fire is true.  Every article you’ve ever read about how expensive it is to fire someone versus hire someone is true because I’ve lived it all.  The way to NOT compromise your hiring is to have your vision, your mission, your core value spelled out at all time.  If you have them laid out from day one you will be hiring right people, I guarantee your practice will soar.

Another thing is, I would go back right to having your mission, vision, the core values.  It is important to establish them in your business plan before you open your practice. And the day those doors open, you live those and make your mission, your vision, your core values be…it’s a non-negotiation. You live it every day.  It’s off the table. I cannot NOT think about my mission, my vision, my core values every day.  I could sit here and threw a lot of objective examples of how those 3 things have helped to grow my practice faster probably than anything else.

What is the most important attribute you’ve had to develop to grow your practice?
Jerry:  I believe the one word, the one attribute, to everybody  successful , whether you are starting your own practice today or someone stepping into a practice, maybe they want to buy from an owner and take over as their own, it doesn’t matter they could walk into a business with a hundred employees. The one word is TENACITY and by tenacity, you’re not letting go or giving up.  That is the definition of tenacity and so, by the way, when you start your practice and you’re the only one there and you go knock on that first doctor’s door, and they say,  “Yeah that’s fine, yeah whatever – we don’t use physical therapy”.

Tenacity means that you show up there again next Monday and you have this plan in place, a system in place and you don’t give up. Another definition of tenacity is to not discouraged. If you are discouraged in any way, with someone points out your flaws or your downside, or say I don’t need your service, then  do not start your own business.  Do not be discouraged.  You’re solving problems.  So TENACITY, is the one word that every single private practice owner has to have.

The other word I really love is passion. I believe private practice owners also have to be passionate.  Passion without strategy and without that roadmap on how I’m going to get there is a lot of burnt energy.  And that would probably burn you out at the end of it if you don’t find people, if you don’t come up with the best strategy.  So, to put the two words together, tenacity, with a system, with a physical therapy marketing plan, is going to make you the most successful private practice owner on the face of the earth. I believe it.”

“Tenacity, with a system, with a plan, is going to make you the most successful private practice owner on the face of the earth.”
Jerry Durham PT

He ended the interview with a thoughtful note: “I’m going to celebrate my 11th year in business in June. From January of 2011 until to December 31st of 2012, I guarantee you I learned more about running a business than I probably learned in my life before at that point.  I spent all last year, I learned so much, some of it I seek out, some of it just knocked me in the head but then I learned so much last year so even if I’m 45 years old, ten years in practice, I learned so much last year.  And I’m using it to move my practice forward and am happy to share it.  I guarantee you nothing makes me happier than meeting more people who want to do exactly what I did.  With the right people, you’ll move through the stages of growth far quicker and a few years from now you just might say, “Here’s my 30 clinics and here’s my 300 employees.”

Survival to Success to Significance – Practice Evolution[/text_bar_2]Every practice starts with the intention to get more patients and meet costs (survival). As the practice evolves and goes past the ‘early days’, systems to streamline everything from physical therapy marketing  to physical therapy billing and documentation become a priority (success). Once the practice gains a reputation and becomes an authority, it can expand and grow bigger (multiple clinics), substantially increase profits, recruit additional PTs, improve standards of care and make a positive impact on the community (significance).

The key to all these levels is relationships! Whether growing a provider base or recruiting staff for growth, relationships play a key role.

Therefore, every private practice goes through THREE critical stages – SURVIVAL-SUCCESS-SIGNIFICANCE. As a private practice owner, you should strive not only to identify which stage you are in, but also implement the best tactics to evolve to the next stage as quickly and efficiently as possible.

You’ll learn the “what” is a business and the “why” you are in business (know your core values). You will discover techniques to build relationships with providers to grow the practice to the ‘significance’ level. You will learn to streamline this processes with technology as much as possible (systems and protocols). Finally, you will establish the foundation for expansion and legacy (opening multiple clinics and impact on the community).

Join us for the #1 Rated Physical Therapy Business Conference in the Country.

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