Most PT Owners Run Their Clinic on Two Numbers and They're Leaving Six Figures on the Table
Most private practice owners know they should track their numbers.
The problem is they either don't know which numbers matter, don't know what good performance looks like, or don't know what to do when the numbers are off.
In this solo episode, Nathan Shields shares a concern he's seeing across the physical therapy industry: declining reimbursements, rising expenses, shrinking profit margins, and clinic owners making critical business decisions without the data they need.
After conducting operational and financial audits for clinics around the country, Nathan has found a consistent pattern—many practices are unknowingly leaking tens of thousands of dollars each year simply because they aren't measuring and managing the right metrics.
This episode breaks down the three common categories of owners, why understanding your numbers is now a survival skill rather than a luxury, and how better visibility into your business can dramatically improve profitability without increasing patient volume.
In this episode, you'll learn:
✅ The biggest financial blind spots affecting private practice owners
✅ Why many clinics are unknowingly losing $30,000–$100,000+ annually
✅ The three categories of practice owners when it comes to metrics
✅ Why declining reimbursement rates are creating urgency for operational excellence
✅ How executive dashboards help owners make objective decisions faster
✅ The key difference between being busy and being profitable
✅ How identifying operational leaks can improve margins without seeing more patients
✅ Why data-driven leadership is becoming essential for long-term survival
If you've ever wondered whether your practice is performing as well as it could—or if you're concerned about the future of your clinic in an increasingly challenging reimbursement environment—this episode is a must-listen.
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Listen to the Podcast here
Most PT Owners Run Their Clinic on Two Numbers and They're Leaving Six Figures on the Table
This episode is a rare solo episode where I don't have a guest. I'm not interviewing anybody. I haven't done one of these in a long time. I hope you bear with me and you're okay with me talking to you a little bit because I want to talk about something that I'm concerned about in the physical therapy ownership world. I've been concerned about it for a while and I'm sure you're experiencing it yourself if you are in a physical therapy space regarding the viability of the individual private practice owner.
I've been doing audits of operational and financial audits on private practices over the past year, or so. Consistently, I'm seeing opportunities within clinical organizations where they are losing tens, if not hundreds of thousands of dollars a year because they're not clear on their metrics and what moves the needle. I've seen owners who know some of their metrics and some of them have multiple clinics. Some of them are doing pretty well, if you can consider the number of patients and the financials they're seeing.
Most physical therapy clinic owners leak thirty thousand to fifty thousand dollars a year because they don't track clinic metrics.
Yet, I can promise you if I were to review your operations and financials. I would be able to find probably at least $30,000 to $50,000 a year that you could be generating. I call that a leak in revenue. Here's the problem with that. Not just that we're losing money but as I said, the viability of our organizations are at stake because reimbursements are declining and our expenses are increasing. That profit margin is continuously squeezing to the point where if you don't know your numbers, if you're not timing up your operations. If you're not maximizing production on a regular basis by reviewing your systems and doing the training and following the metrics. Your ability to survive what is oncoming in the next 5 to 10 years, is at stake.
Knowing your numbers, knowing these things and how to improve your operations is a survival skill and not just the convenience. It's not, “I can do this and add another $10,000 to $20,000 to my revenue. That would be nice if I could take an extra vacation or buy an extra toy.” These are things that make the difference between profitability and closing your doors. At this point, I'm seeing a lot of owners that are single-digit profit margin owners that are questioning whether or not they'll be able to survive if they have any hiccup and reimbursements or whatsoever.
I never want anyone to be in that space. That's when we make poor decisions based on those emotions. Here's some of the problems that I'm seeing amongst owners. Tell me if you fall into one of these categories because a majority of the owners in the physical therapy space fall into one of these three. Number one, you don't know your metrics much at all. Outside of knowing your total visits and looking at your bank account balance, if our schedule is full and my money's flowing. I know things are pretty good. If they're not, then I need to see more patients or let someone go or something like that.
Declining reimbursements and rising expenses make daily tracking a survival skill. You can't run a practice on gut feelings.
Number two, you know some of your numbers but not the ones that matter or you're not sure if they matter that much. Even if you do know some of the numbers, you don't know if they're good or bad. Is 85% arrival rate good? How does that measure against standard? Is 11 or 12 visits per initial evaluation a good statistic? You don't know the benchmarks. You don't know what's good or bad or how to judge them.
Maybe your number three, where you know your numbers are off and you know where they should be but you're not totally clear as to what to do about it. That level of knowingness and what to do about it paralyzes you into doing like, “Maybe things are okay and I'll talk to my front desk again about doing better at over-the-counter collections but I don't know what else to do.” A majority of owners in the therapy space fall into one of these three categories.
Even if you don't, I know you have to go and dig into your management reports, pull them out, put them on an Excel spreadsheet and then analyze them. You maybe track them over the past 4 to 6 weeks. Whether you're in one of those 3 or 4 categories, you're in trouble. You're doing a little bit more work than is necessary because in a lot of other spaces, they have what's called an executive dashboard and that is what I'm promoting. It’s an executive dashboard specific for the physical therapy space. I call it PulseBoard.
Are you running your clinic based on total visits and your bank balance? You're likely leaving six figures on the table.
PulseBoard is the ability to see all your key metrics and statistics on one page by day, by week and by month. The idea is to put them all in front of you color-coded, red, yellow, and green against acceptable benchmarks and what you expect. You can make good objective decisions and know exactly what metrics to focus on within your organization. You can see the objective data and make the objective decision to increase your profit margins without significantly increasing the amount of work that you're doing in terms of patient visits.
There are plenty of clinics out there that could simply generate $10,000, if not a $100,000 more in their clinic with the same number of visits if they just tightened up operations and focused on key metrics and improved them to an acceptable benchmark range. That's the key behind PulseBoard. It give you the data so you can make decisions. It don't make you go into the EMRs and find the data, dig it out and make your own educated decisions. Put it in front of you to save you time and energy. I'll even take it a step further.
You don't need to see more patients or work longer hours to boost your profits. You just need to stop the operational leaks.
I have plenty of resources through the Private Practice Owners Club to tell you what you can do and try to improve those objective measures. Thus, PulseBoard will also include an educational component with forms and resources episodes that focus on those metrics in how to improve them so you're not left wondering what to do in a paralyzed state. This is what I've seen with owners that have done audits with me.
As I give them the metrics, as they've shown them where they are leaking money in their organizations. They're able to then make objective decisions and improve their profit margins an extra $10,000 or $20,000 or $30,000 plus a year because they now know where money is leaking. Here is the goal with PulseBoard and why I'm presenting it to you. If you want to check it out, go to MyPulseBoard.com. I'm looking for twenty founding members who will put down $197 deposit which will lock in that monthly rate for life.
An executive dashboard turns clinical chaos into clear business decisions. Stop guessing and start leading your practice.
It's fully refundable. There's no risk to you. If it doesn't work for you, you get that $197 back per clinic per month. The people who helped me build this will be able to help me also introduce this to the rest of the industry because I recognize that as I became a bitter business owner, I made better decisions. I made more money and I was able to pay people better and give them bonuses. Again, I invite you to consider being a founding member for PulseBoard, which is at MyPulseBoard.com. If you feel like it's a fit for you, make a deposit of $197 per clinic per month. Thank you for your time.
I love that all of you are reading the Private Practice Owners Club. It's truly a joy for me over years that I've been doing this to provide this kind of value to those who read. I truly wish you the best and I want to say that everything I'm doing in the Private Practice Owners Club and with PulseBoard, frankly, is the help you become better owners. I'm rooting for you. Again, go to MyPulseBoard.com and see if it's a fit for you so you can become a better owner yourself.
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