The Cash-Based Practice Podcast

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...

Drop-offs happen. Even if you run a tight ship… even if outcomes are strong… even if you've trained your team well… People still drift. They hit 70% better, and justify to themselves that they feel "good enough". They get busy. They tell themselves, "I'll just stay consistent with my home program." And suddenly you've got gaps in the schedule that didn't need to be there. This episode is about wha...

A lot of practice owners don't lose revenue because of ineffective marketing… They lose revenue due to slow lead follow-up and weak conversions. And sometimes I even come across those that don't follow up with every lead because they/they're staff think "we're too busy" … THE HORROR!  In this week's episode, you'll hear a slightly different flavor of my coaching, and it applies to both fully Cash-...

Most Cash-Based practice owners don't struggle to get interest. They struggle to turn interest into commitment. You run or participate in an event that is filled with your ideal prospective patient... You offer free screens or discounted consults. People seem excited, but then they say things like, "I'm going to try this on my own," or "I want to see how I do with the exercises," or "Let me think...

Most Cash-Based practice owners don't fail because they lack effort. They fail because their effort is scattered. They're busy all year. They're solving problems constantly. They're reacting instead of directing. And when December rolls around, they realize they worked hard… but didn't intentionally build the business they actually want. This episode is about fixing that. Not with a complicated pl...

As a new year begins, most practice owners feel like they should  "plan better" than they did last year. But here's the problem: Most annual reviews are so complex that they never actually get finished and often focus on things that don't really move the needle for a cash-based or mostly OON practice. In this episode, I walk through a practical, real-world approach to reviewing your year and desig...

As the year winds down, most practice owners feel the pull to "look back" and "plan ahead." But too often, that process turns into either a surface-level glance at revenue—or an overwhelming spiral of things you should have done better. That's not helpful. And it's not how you build a practice that actually supports the life you want. In this week's episode, I walk through a more grounded, intenti...

A lot of Cash-Pay practices are doing something very smart right now. They're using entry-point services to get new customers in the door… things like specialty services and modalities (like shockwave therapy, red light sauna, etc), performance-based training, etc. And it works… Ads convert. Promotions fill schedules. New Patients and Revenue comes in. But here's the problem I keep seeing in most...