The Cash-Based Practice Podcast

Ever finish a discovery visit or evaluation feeling confident you can help someone, only to hear, "I need to think about it"? You might assume you need a better closing script or a stronger way to explain why your care is worth the investment. But here's what I tell the practice owners I coach: The close happens long before you ask someone to book. In this episode, I walk through a real coaching c...

If you ever offer free consultations or "discovery visits" in your practice, you'd be crazy not to listen to this episode.   Have you ever offered a free consultation, only to realize the person was really just looking for a few free exercises or stretches, with zero intention of becoming a patient? If you have enough of those experiences, you might start wondering whether free consultations are e...

If you've been in practice long enough, you've heard some version of this: "I already tried physical therapy… It didn't work." Sometimes you hear it during a consultation. Sometimes it even comes up on the phone. And it can be especially challenging when that person is contacting you specifically for something else, like Shockwave or Laser therapy, because the last thing you want to do is create f...

Getting a patient to say yes to treatment isn't the end of the sale. Every time they decide whether to book another visit, follow your recommended frequency, finish their plan of care, or continue beyond a package, they're making another decision about the value of their care. That's why one of the themes that came up in a recent Cash-Based Practice Mastermind coaching call was something that can...

We routinely poll Cash-Based practice owners and ask what they think is holding their business back… what's their "biggest problem/challenge"?.. And in all our surveys over the years, 60-75% of them answer "lead generation" / "I need the phone to ring more." But after more than 15 years of tracking the patient lifecycle across hundreds of practices, and identifying all the profit leaks and missed...

One of my Mastermind members recently attended a local racket-sports tournament with a booth alongside several competing healthcare businesses. The other providers waited behind their tables, hoping people would stop by. Meanwhile, she had a steady crowd at her booth and booked 8 new patients! That difference wasn't luck. She used a clear pain-focused offer, promoted it throughout the venue, creat...

We've all experienced it… You're at a party, attending a networking event, or watching your kid's game, when someone discovers what you do for a living. Before long they ask, "Can I ask you something about my shoulder?" Most providers either start giving free advice or try to politely end the conversation. In this episode, I explain how to quickly and naturally guide these conversations toward a b...

After more than 15 years of coaching practice owners, I've seen the same misconception over and over… When schedules aren't full, most owners assume they need more leads. They start trying different marketing or chasing more referral sources.  But when we track the entire patient lifecycle, the real issue is often conversions… dare I say, "sales." Calls aren't converting, evaluations aren't creati...

If you want your patients to get the best possible outcomes, your clinicians to thrive, and your practice to get maximum value from every new hire, your onboarding process matters far more than most owners realize. In the Cash-Based model, clinical skill alone isn't enough. Via your onboarding and ongoing training, yourYour clinicians need to understand your mission, your values, your ideal patien...

If your Cash-Based practice isn't growing as quickly as you'd like, it's natural to assume you may have a marketing, or sales, or retention  problem. Maybe you need more referrals, better Facebook ads, or a stronger sales process. Sometimes that's true. But after coaching hundreds of practice owners over the years, I've found that many growth problems have little to do with those things… Quite oft...

One of the most common things I hear from practice owners is some version of this: "I tried Facebook ads before, and they didn't work." Sometimes they hired an agency. Sometimes they boosted a few posts. Sometimes they spent a few hundred or even multiple thousand dollars, but never saw a patient walk through the door. The problem is that most practice owners never set up the campaigns in the uniq...

Here's a harsh truth that is vital for you to understand if you don't already: You are already losing patients to AI. Patients are already using ChatGPT, Gemini, Claude, and other tools to get diagnoses, treatment suggestions, exercise programs, and answers to health questions rather than going to (or returning) to your clinic. And those answers are getting better every month. So what can you do t...

Most practice owners assume that if they want to grow, they need more leads. More referrals. More website traffic. More ads. More people calling the clinic. Sometimes that's true.  But after coaching more than 1,000 Cash-Based practice owners over the years, I've found that most practices actually have a much bigger and more costly problem with conversion and retention, than they do with lead gene...

One of the most common patterns I see among clinicians turned practice owners is that they struggle to pull the trigger, uncertain key things necessary to build a successful business…  For many that "thing" is hiring … whether their first employee, or even their fifth. It's a process that makes them cringe, and therefore, is often put off way too long. The schedule is getting fuller. Their respons...

If you are hiring in your practice right now, or know you eventually will be, this is an incredibly important conversation. Because the hiring landscape has changed dramatically over the last few years. Gone are the days where most private practice owners could simply post a job on Indeed and get flooded with great clinician applicants. In most markets now, that just is not happening consistently...

Most practice owners dramatically underperform at local events. They show up with a table, maybe do a few injury screens, collect some emails, hand out some flyers… and then wonder why almost nobody actually becomes a patient afterward. But the problem usually is not the event itself. It is the strategy used by the practice owner and their team. Because when you have a concentrated group of your t...

Most practice owners think hiring problems begin after the employee starts. Usually, they begin during the interview. Because the wrong admin can sound amazing in a conversation. They can be friendly, confident, experienced, and still end up becoming one of the biggest operational headaches in your business. That's especially true in a Cash-Based practice. This model requires a very different type...

Most practice owners who start their practice as a side hustle, don't struggle because it's not a good model/approach. They struggle because it when it really starts working, and they don't know when they can safely stop splitting their time, cast away the employment safety net, and do a cannonball into full-time practice ownership. (I used to be a springboard diver so I'm always pumped when I can...

If you don't have at least a 6-12 month follow-up system for patients after discharge, you're leaving a lot of money on the table. Most practices either don't follow up at all, or they send one message a few weeks later that says something like, "Just checking in to see how you're doing." The intention is good, but the message is too easy to ignore. It doesn't remind the patient what they accompli...

If you use social media in your practice and it takes a lot of time and/or doesn't generate many actual patients, then this episode is for you. The appeal of AI is obvious for this delima: it can save time, speed up content creation, and help you get more mileage out of what you already produce.  But there is also a real risk here, and it is one a lot of practice owners are starting to run into. W...

Most practice owners don't just struggle with hiring these days...   They struggle with what happens after hiring. Because once someone is in the role, a new tension shows up if you're not a seasoned manager/CEO: Am I asking too much? Am I not being clear enough? Am I giving too much constructive criticism… or not enough? And underneath all of that is a bigger fear: "If I push too hard, I might lo...

If the word sales makes you—or your staff—feel uncomfortable… You are not alone. It's one of the most common mental barriers in cash-based practice. Clinicians feel it. Admins feel it. Receptionists feel it. And unfortunately, that discomfort quietly crushes growth. Because if you don't feel good about selling, you won't do it well. And if you don't do it well, fewer people say yes. Fewer people s...

When the schedule softens, most practice owners do the same thing. They panic. They think, "I need more leads." They start chasing brand-new people. But that's usually not the fastest move. Because when you need results quickly, the smartest question isn't: "How do I get more strangers to find me?" It's: What's the lowest-hanging fruit to get the result I want? That's what this episode is about. Y...

Episode 300 feels like a good time to zoom out. I started this podcast back in 2014. It was the first podcast on this topic of Cash-Based practice. Since then, I've had a front-row seat to startup clinics, multi-location operators, practice owners who were barely hanging on, and practice owners who were absolutely crushing it. And when you watch enough practices long enough, patterns become imposs...

Most Cash-Based practice owners approach referral source networking the same way… They imply they'll "send patients" to the prospective new referral source, and they hint at a partnership that (if we're being honest) they can't actually sustain. Because if you're trying to build 10–20 referral relationships, you cannot send everyone patients. It's not realistic. And the physician/clinician knows i...