From An 8x8 Room To A Thriving Clinic: How Jeffrey Smith Built A Multi-PT Practice In Under 2 Years

From An 8x8 Room To A Thriving Clinic: How Jeffrey Smith Built A Multi-PT Practice In Under 2 Years

Welcome to the Private Practice Owners Club. I'm your host, Adam Robin. I got a good friend, good buddy, and coaching client, Jeff Smith, the owner and CEO of Alpenglow Physical Therapy in Billings, Montana. Jeff started his company in June 2023 and started coaching in the PPO club coaching program in October 2023. That's when I went full-time business owner. I'm not going to bring clients on here who aren't doing good.

Jeff's one of the guys. He's doing really good. He's one of the top ten percent in the program. He's made transformative progress in his business. He's a hard worker. He's like a really great business owner. I wanted to bring him on, introduce him to the audience, and learn a little bit about his story and glean some of the lessons that he's learned along the way.

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What's up, Jeff?

Good to see you. Thanks for having me on. I'm excited to be here and just talk about my journey a little bit, and the journey has been. A long journey in just two years.

As I'm thinking back, like when we first started this journey together, you were like renting a space, I believe.

Yeah, I was in the back of the gym and had an 8-foot by 8-foot space to myself.

I remember that you got on a couple of calls with me, and you were in your house, like upstairs in an extra room or something, and you looked physically exhausted, because you were working full-time and trying to get your practice off the ground, and you were trying to figure it out. I remember like you were hustling big time. Man, I'd love it if you could just like introduce yourself to the people, to the audience. Tell them a little bit about you, a little bit about your backstory. Why'd you get into practice? How did you find physical therapy? Just take it away. Tell us about yourself.

The Entrepreneurial Spark: Towards Physical Therapy & Business Ownership 

I'm originally from Vermont. I'm an East Coaster transferred to Montana. A lot of us East Coasters make it out here. I got on the path of physical therapy as an undergraduate. I like spending time with people. I like anatomy. I was like, “This seems like a pretty good gig.” I just pushed through and got my PT degree. Even in undergrad, I knew I wanted to be a practice owner.

I've always had that entrepreneurial spirit, even in high school, which was always like coming up with businesses and schemes to create a business. It's always been like a passion of mine, even in PT school, I was like, “I'm opening a clinic.” When I got into PT school, I started working for a couple of private practices around, really got a good feel of what the atmosphere looked like, what was lacking. I remember I started listening to the podcast right when I got out of school. I found it. I was listening to Nathan, and I was like, “This is amazing.”

This guy is smart.

I know. The keynote is everything. He's saying in my businesses that I'm working in, and I would talk about it, and I was like, “This guy seems like he's got it figured out. We need to be doing what he's doing.” I jumped around a little bit, and just with where COVID brought things like finances, everything was just tough, being a PT with student loans and everything. It's like, “I think now's the best time to just start my own business.”

Actually, after listening to the podcast a bunch, I actually called Nathan, emailed him, got hold of him, and talked to him for a little bit in January of 2023. He's going to give me the rundown like, “Here's what you got to do.” He's like, “Check back with me in June.” I went all in, opened the clinic in my little 8 by 8 room. It was pretty tiny. I had to collapse my little massage table every time somebody came, and then put it back up, and we had to shuffle around it. I got the clinic and I called Nathan and I started working like a dog right away.

The Visionary Mindset: Cultivating A "Scary" Vision And Saying It Out Loud 

I was like, “I'm treating two hours before my job. I’m going to my other job. I'm leaving at lunch to treat a patient, and then I'm going back, and then I'm going back in the evening to my clinic to treat patients again.” I was like, “This is tough.” He's like, “I got somebody they should reach out to.” It took us a little while for me to get in touch with you. Come October, I was like, “I think I'm ready to jump into this coaching because I'm overwhelmed.”

Number one, you said, “I'm opening a clinic.” You were telling yourself that the NPT school. Where did that come from? Who planted that seed inside of you?

I don't know where it came from. As I said, since high school, I've always just been like being a business owner. I think it's in my blood. It was things that are part of me, and I just love the idea of building a business. I was like, “PT seems like a good gig.” I was like, “A PT clinic seems pretty darn cool. Put two and two together. Here we go.” It's just something in me. I don’t know exactly, but I just love it.

It gives me chills to hear you say that. From my perspective, I've been able to talk to so many entrepreneurs and just ambitious people. What I love about it is just learning the way that they think and how they view the world. After you talk to a ton of them, a ton of you crazy entrepreneurs, you could start to pick out some of the common characteristics that separate the ones that are going to be great and the ones that aren't.

Two things really stand out when I get on calls with people. Number one is that they have a vision for themselves that's scary. If you're in PT school, you're a little whippersnapper in PT school. You're walking around telling all your buddies in PT school, “I'm going to open up my own clinic.” What were they telling? They were probably like, “Come on, just pass the anatomy test.”

I remember you specifically telling me, I remember this all the time, it’s like, “That’s too much work.”

You have this big, stupid, crazy vision. That vision continues to grow. The second thing is you're willing to say it out loud. You're willing to say it out loud and know that people around you might not even believe, like they might like to shoot you down. When people do that, I notice that those are the people who always make it.

They always perform, and they're willing to, which goes into my second point, work like a dog. You said, “I was working like a dog” because you were called. You were called to do this. You were willing to sacrifice and hustle and do whatever because you were called, and you had already said it out loud to so many people. It's like you had to do it now. That gives me chills, man.

Scaling Up: From An 8x8 Room To A Thriving Multi-PT Practice 

I tell people all the time, for those who are tuning in, if you sound anything like that, that is why I know you're going to be great. That's why, whether you work with us, whether you work with any other coach or whatever, you're going to be great because you're bitten by that thing. That's why you're on this podcast. I'm proud of you, man. That's awesome. Let's fast forward to today because it just started in the 8 by 8 room. Where are you at now?

Now we have a 3,200 square foot space. I have four PTs working for me right now, five, including me, but now I'm stepping back in treatment, working more on the business side of things, focusing on growth and building leaders. That's the big thing that I'm really focusing on right now, and helping people take control of their own things. It's cool. It's a big change up. When we first talked, I remember you telling me, “We'll get you far.” I was like, “If I have 1 or 2 PTs working for me in two years, I'll be psyched. That'll be cool.” Now I'm double where I could have expected I was going to be at that time.

It's awesome, man.

It's honestly an incredible change.

It wasn't easy, was it?

No, it was hard, and different things are hard each time. The beginning was just man-hours of hard work and not much sleep, but now, like we've been talking about, it's mentally hard now that we're figuring things out that aren't so intuitive. In the beginning, it's like, “I need even more patience.” That was hard. I didn’t know what to do, but now I'm building a business and building leaders. It's not just like getting more people in the door. It's figuring out and learning people and really dialing that in.

I love to hear, maybe this is a big question, but I asked you to do some thinking about this, so maybe you'll be prepared to answer it. I'd love to hear as you reflect on your journey, because you've had tremendous growth, and I'd love to hear what you think about. What were some of the hardest challenges that you faced along the way? What do you feel like were some of the big breakthroughs for you along your journey? Can you answer that?

Leaning Into Discomfort: Overcoming Challenges And Pivotal Breakthroughs 

Yeah. The hardest challenges were always taking risks and stepping out of my comfort zone, because when I was in that 8 by 8 room, it was comfortable. It was cheap rent. I was working hard, but it was just flowing and happening. To get to the next step, I knew I needed a space, and I remember I was looking at a 1200 square foot space or a 3200 square foot space. The price difference was a lot, and I was kind of like, “I don't know if I can swing the 3200 square foot space.”

It was my own doing. I would have gotten the 1200 square foot space because it was safe. I was like, “I can make that rent payment easy.” I talked to you about it, and you helped me understand, like, “You're going to help grow that 1200 square foot space faster than you think.” I would have thought it was fast. I had to push into that discomfort, and you helped guide me through that, which was a huge breakthrough.

Preaching out, I remember my second PT, that one was an uncomfortable hire because it was just very stressful bringing another person on board, especially one that I had to work a lot harder to get. I had to dig a little bit deeper, find some new tactics to show her why Alpenglow was such a great place to be. That was a lot of discomfort because there were conversations I wasn't used to having. Those were two really pivotal ones. It kept getting easier and easier to have those conversations after you helped me push leaning into that discomfort, and it helped a lot having you just talk through me.

Ground me a little bit and show me that, like, “These are doable things. Trust yourself.” That's a big thing too. You always help motivate me by being like, “You're a good worker, a strong worker. You've got these dreams and you've got these goals.” You help me take the right steps. That support is huge because my spouse is amazing. She supports me, but when it comes to like the business side, it's harder for her to see that, where you can really see it from that business perspective and be like, “I can see the road you're going on, and let's keep driving it.”

Those who are tuning in, Jeff is the perfect client to work with. He's one who's like, we don't have to motivate you. It was just like getting you out of the way, which is so fun because it's like all you got to do is stop trying to do it all yourself, get out of the way, and lean into a little discomfort, and like you always figure it out. That's the fun part. We give you a few tools and a little bit of clarity, and that makes our job super easy. It’s really cool, man. I'm wondering if the next question is a step like leaning into some of the discomfort. How do you do that? What do you feel that motivates you to do hard things? Why are you so motivated to suffer?

I know. That's a lot of suffering. I think two big things. I really want it badly. I know what I want, and I want it bad. I'm willing to sacrifice a lot of stuff to get there. Actually, a big change for me now is that I think I'm so motivated because once I started getting employees that I really like and care about, I also wanted to give them an opportunity. It's more than just motivating for me, wanting it, but I want what they want. That's a huge drive for me now, not being able to create a future for everyone involved because a lot of people took a big risk joining me early on. It's scary. We're the first or second PT higher to this.

The answer is no.

It's like they took a big risk on me. I want to lean into that discomfort, do uncomfortable things so that they can grow and have opportunities to do uncomfortable things themselves too, and grow as well with the business. That's a huge motivator for me now.

I can see that. It goes back to that thing. Sometimes you need reminding that it's not all about you. There are people who are counting on you to be uncomfortable and to do the hard thing. When you do the hard thing, you do the hard thing, you learn the skill, whatever it is, bet on yourself, you elevate yourself. That's the thing that gives everyone the room to follow you. If you stay small, they stay small.

Learning From Setbacks: Navigating Mistakes In Hiring And Leadership 

You don't grow. You don't give them an opportunity to grow. That's awesome. Tell me about the mistakes you've made. What are some of the biggest mistakes? Failures are always our biggest teachers. When you look back and you're like, “I really screwed that up,” or “Maybe I didn't do that as well as I could have.” When you think back, where do you feel like some of those mistakes are?

There are so many, from small to big. The small ones are small business mistakes, such as not filing my unemployment insurance soon enough. That's small, but those are bound to happen when it's your first time in business. Bigger mistakes, luckily, I haven't lost any employees yet, but I've lost opportunities with employees because I wasn't confident enough in myself and what I was offering to instill confidence in them for what they could have here.

Those are some of my bigger mistakes I've made. It's all a learning period. I've had interviews where I haven't really nailed it, and they can sense that I get really nervous in the interview process. It's stressful for me. I was interviewing that one individual, and I kept calling you because I was like, “I think I'm losing it.” We pull it in, but I just got myself in too deep in the beginning, on just the wrong path, where it just wasn't recoverable, which is unfortunate because I think they would have been an excellent fit.

That's how it goes. I learned from it. Now I feel much more confident in my interviews. My last hire was smooth. I definitely showed her how great it is here. I learned a ton from that. As well as I've made mistakes with interactions with my employees, just not being the answer guy is one of my big mistakes too, which we talk about a lot. I think that I have to be the answer guy all the time. That's created difficulty with personal growth for my employees, as well as understanding the clarity of where they're going.

If I'm answering all the questions and they're not having that self-realization, then it's hard for them to understand for themself where they fit. That's one of my big mistakes as well, which I'm learning from. I've learned a lot from you, and we've actually been working on that. I think it's getting better. As well as micromanaging. That's another mistake I made for a long time, and it really deterred people. Luckily, with you guys and having problems, like something really blows up in my face, where you're able to objectively look at it, be like, “Why don't we try approaching it in a different light, a different manner, and we can reorient the course?”

Mastering The Interview: Building Trust And Finding The Right Team 

For those who are tuning in, we're talking about the enrollment interview process. I think I shared with you a script for the enrollment interview. For those that are tuning in, tell me what the enrollment interview process looks like? When you're conducting interviews now with candidates, what does that look like for you? What's that process like for you?

Now I've pretty refined it down for physical therapists specifically, the first interview is really just getting to understand the individual that I'm talking to. Genuinely being interested in what they have to say and learning in depth about them, who they are, what their goals are, which is crucial because then it gives me the basis where I can rule out either for them or however our goals and their goals align. Once we get that, we set a second interview. In that interview, they are told to come to the meeting with the team and spend an hour with the clinical director.

They spend about two hours shadowing, and we have lunch somewhere during that time. They spend an hour with me where we really dive a little bit deeper into the details, where we talk a little bit more in depth about their professional goals, where they can fit into it, and where they can grow within the business. That's really helped just by gaining that genuine interest right off the bat in them. That's really, I think, the biggest change that came for me.

I love how the first step of the interview is not to ask questions. It's not to talk, it's to listen. When candidates come to you or when they're having a conversation, people build trust through their story, not through your story. When people get to tell their story, they naturally grow fonder of you. They grow more comfortable with you because they're actually open and vulnerable with you.

A lot of times, and I've made the mistake of missing that, of treating my interviews like an interrogation and being like, “Tell me about this. Talk to me about this. What's the first time you did this?” It's rigid and structured, and you don't really build trust, especially in today's profession, where a lot of therapists are burned out and overwhelmed, and they do feel frustrated in the industry. Just being really intentional and showing up and allowing people to, like, give them that space to tell their story is like such a powerful way to start the interview off.

It's incredible how powerful it really is.

There's a new practice owner starting a practice, and they're thinking about it, but they're not really sure. What is some of the advice that you'd give them?

You just got to do it. You've got to trust yourself and bet on yourself. There's no better guarantee than yourself. You're the best guarantee out there. Invest everything in yourself and go for it because when you get to be the deciding factor, you're not going to let it not happen if you get to make the decision of it happening. It's worth it. In every way, working for yourself is unbeatable. I'm a million times happier than I ever was in my profession at any other point.

That's awesome. What's next for you? What's the future look like?

The Future Is Bright: Expanding Alpenglow And Empowering The Team 

We're still trying to grow. We've got something amazing going. We're really focused on growth right now. We're talking about clinic number two. Hopefully, we're looking for a couple more staff members to help get the clinic along, move along. We're not sure where clinic number two is going to go. Is it going to be a pelvic clinic?

Is it just going to be another outpatient clinic, or are we getting dialed in on this clinic right now so that the second clinic can be happening hopefully early next year, is the goal on that. Get that rock and rolling, building our leaders so they can take over, and I can just focus on building the business. We're super excited about that. I know everyone's excited, too, about continuing to get opportunities.

I think that builds a lot of excitement for people as well. We talked about this, where it builds that excitement for people to be a part of that growth. A lot of businesses don't see themselves in the future where they're like, “We're thinking of opening another clinic. Maybe I'll be able to manage that one. Maybe I'll be able to go over here and have a clinic owner go back to my hometown and open a clinic there.”

I really want to support people to take those leaps, too, and be there for them, so that's something they aspire to do. They can open it. Once we get clinic number two going, hopefully, we'll see if it just keeps flourishing and keep changing the way PT is in the area, and just really offer high-quality services that are trying to shine. I think we do a job.

I love how your vision expands. It's like as your vision expands, once your vision grows, now you're talking about opening up another clinic or expanding, now it gives people underneath your room to have their own vision within yours. That's super cool. That gives you something to be excited about.

A ton of excitement. We've worked really hard in our meetings. Alignment is a really big thing we work on. We do a lot of stuff to show people that work is work, but work's also fun. I think that really helps with our growth and getting people involved to do quarterly outings, where we'll take a half day once a quarter, and we go out and have a good time and hang out as a team. That's a ton of fun, but they say, I think it's like, “Spend 75% of your thirties with your coworkers.”

I'm like, might as well have a good time with them, too. Trying to build more fun with everything, too. That's a big thing that we're really focused on, and keeping it fun because I love work. I'm maybe a little different where I really do like work, but a lot of people would probably rather be out in the woods doing something fun, but I like to make work as good a place to be as any. That's a big goal for us.

There are probably 1 or 2 people who would benefit from reaching out to you and just getting some advice. If somebody wanted to reach out to you, how would they get in touch with you?

They can email me. My email is Jeffrey@Alpenglow-PT.com.

Awesome, man. I'm going to send them your way. If people reach out to me, I'll send them your way. Jeff, man, I really appreciate your time.

Thank you.

Important Links

• Jeffrey Smith on LinkedIn
• Alpenglow Physical Therapy
• Alpenglow Physical Therapy on Facebook
• Alpenglow Physical Therapy on Instagram
• Jeffrey@AlpenGlow-PT.com

About Jeffrey Smith