The Paul Gough Show

I just spent two days in my office in Orlando with business owners who flew in from around the world for our annual strategic planning event. What you’re about to hear is raw footage from that room. Real questions. Real pressure. Real conversations about leadership, confidence, communication, decision making, and what actually determines whether a clinic grows or stalls. We talk about why great cl...

In this episode, I’m taking you straight inside the opening keynote from PPM LIVE — and I’ve got to warn you, it’s real, it’s raw, and if you’re a clinic owner with a big vision (and maybe a bit of guilt), this one’s for you. I kick things off with a story I’ve never told on stage before — about the night we found out we were having a baby girl after planning for five boys. What followed was chaos...

This episode of  Paul on Fire  is not comfortable. And it’s not meant to be. I’m talking about something I see everywhere right now and most people are pretending not to notice. You cannot be successful in business if your life is unstable. You cannot lead a company if you’re afraid of losing approval. And you cannot raise confident kids if you’re building your identity around being need...

In this episode of Paul Meets, I sit down with Todd Houghton (https://houghtonphysicaltherapy.com), owner of a 22 year old outpatient physical therapy clinic in Massachusetts, and one of the most thoughtful business owners I know. Todd’s story is powerful because it’s real. For over two decades, he ran a successful but stressful insurance based clinic. Thin margins. Constant pressure. Always busy,...

Coffee with Goughy  isn’t a training, a webinar, or a list of quick marketing hacks. It’s a real conversation I have with clinic owners who feel the pressure of responsibility, the expectation to have it all figured out, and the frustration of building a business that still relies too heavily on them. In this episode, I answer live questions from clinic owners around the world and go deep on...

PT Reddit Files dives into the shadowy underworld of Reddit, where anonymous PTs and clinic owners vent, rant, and project their frustrations about business without ever confronting the real problem: a refusal to learn the rules of business ownership. In Case File 3… We’re asking the uncomfortable question that’s lighting up therapist Reddit threads everywhere: Is it immoral to charge $250+ per se...

In this episode of  Paul on Fire , I’m laying out five predictions I’m extremely confident about for 2026 and why the “middle of the road” clinic is about to get crushed. If your practice is sitting in that uncomfortable $20K–$40K per month zone with decent marketing, rising costs, and shrinking margins, this is your warning. The clinic itself is no longer the asset. Location is no longer the...

I loved this conversation with Justin. In this episode of Paul Meets, I sit down with clinic owner and CrossFit lover Justin Vaidyan (https://www.arisephysicaltherapy.com) from New York, who has gone from zero to almost one million in revenue in a cash focused practice that is almost fully out of network. He started his business during Covid, used his house down payment to sign the lease on an old...

In this episode of  Coffee with Goughy , I talk honestly about a stage of growth most clinic owners hit but rarely say out loud. The moment when success starts creating pressure instead of freedom. When everyone needs you. When the business quietly starts owning you. I share: • Why growth often feels worse before it feels better • The identity shift I had to make as a clinic owner • Why doing...

This isn’t a training. It’s not a webinar. And it’s definitely not three tips to fix your marketing. In this episode of  Coffee with Goughy , I go straight to the real reason so many clinic owners feel stuck, overwhelmed, or quietly frustrated, even when the business looks “fine” from the outside. I talk about leadership. Standards. Insecurity. Delegation. Pricing guilt. And the hard truth mo...

In this episode, I’m bringing you something special. I just spent two full days in my Orlando office with clinic owners who flew in from all over the world for our Strategic Annual Planning event, and what you’re about to hear is raw, real footage from inside that room. The energy, the breakthroughs, the uncomfortable questions, the big decisions — it is all here. I walk you through how I challeng...

In this episode of  Paul on Fire , I go all in on a truth most business owners still aren’t ready to face yet the future of business is agents. AI agents. And if you are not adapting right now, you are already falling behind. I break down the biggest misconception I see every day. That growth comes from hiring more people. It doesn’t. Growth comes from improving labor efficiency, controlling...

In this episode of Paul Meets, I sit down with Jennifer Penrose (https://penrosept.com), a clinic owner from Washington State who built a nearly $2 million physical therapy practice and no longer treats patients herself. Jennifer’s journey did not start with a perfect plan or a trendy business model. She opened her clinic in 2007, spent years stuck in an insurance based grind, and hit a turning po...

In this special episode, I'm bringing you straight into my Orlando office where I spent two intense days with business owners from all around the world at our Strategic Annual Planning event. You’re about to hear real, raw footage from the room as we dug into what the future of running a profitable physical therapy business actually looks like. From AI at the front door, to content-driven clinics,...

PT Reddit Files  dives into the shadowy underworld of Reddit, where anonymous PTs and clinic owners vent, rant, and project their frustrations about business without ever confronting the real problem: a refusal to learn the rules of business ownership. In  Case File Two , we dissect a Reddit thread titled  “Surviving the Slow Months.”  What starts as a familiar complaint about...

In this episode I’m breaking down the difference between  dreams  and  ambitions … why one keeps you stuck and the other gets you paid. I get into what every clinic owner is really chasing – security – and why you’ll never find it in money, marriage, muscles, or more followers. You only get security when you learn how to feel secure  before  any of those things arrive. Turn this one up nice and lo...

In this episode of  Paul Meets , I sit down with Keith Roed from South Dakota. Keith and I first met in 2018. Six weeks before he left his job, he called me and told me he was done. No backup plan. No safety net. Just a decision that his values no longer aligned with where he was working. At the time, more than one person told him it wouldn’t work. Seven years later, Keith owns a multi location se...

In this special episode of the show, I’m bringing you straight into the room with me for one of the most important conversations we’ve had all year. I just spent two full days here in my Orlando office with business owners who flew in from all over the world to map out their strategic plan for 2026, and what you’re about to hear is real, unfiltered footage taken directly from that event. Inside th...

In this episode, I go off on one of the most ridiculous things I’ve ever heard in my life:  school photo retake day.  What started as an innocent conversation with Natalie turned into a full scale rant about how parents are unknowingly programming insecurity, perfectionism, and lifelong anxiety into their kids… all because a picture “wasn’t good enough.” I walk you through the horror scene of six...

In this episode of Paul Meets, I sit down with one of the most impressive new clinic owners in the Planet Paul community, Ricky Morgan (https://morgainphysicaltherapy.com). Ricky started his practice just over a year ago and has already built a fully booked, three hundred thousand dollar cash clinic. He flew in from North Dakota to Orlando and we spent the day together going deep into his story, h...

In this episode, I’m bringing you something very special. I’ve just spent two full days here in my Orlando office with a group of business owners who flew in from all over the world for our Strategic Annual Planning event. The conversations were big, the insights were powerful, and the next five years of private practice are going to look nothing like the last five. You’re about to hear real foota...

In this episode I go off on one of the biggest lies clinic owners tell themselves:  I can do it better . Maybe you can. But at what cost? Two weeks of your life for a 15 percent improvement that no one but you will ever notice? I dive into the trap of perfectionism, why it keeps so many of you stuck, and how embracing the  G Spot  (the  good enough spot) is the only way to create momentum. I’ll sh...

In this episode of Paul Meets, I sit down with the incredible Ellen Tomsic from Durango, Colorado — a clinician of 35 years who went from nearly losing her insurance-based clinic… to building one of the strongest cash pay, wellness-driven practices in the country. Ellen’s journey is one of the biggest transformations I’ve ever seen. She went 16 years without tracking a single KPI or cash flow numb...

In this episode, I’m bringing you something special. I just spent two full days in my Orlando office with clinic owners who flew in from all over the world for our Strategic Annual Planning event, and what you’re about to hear is raw, real footage from inside that room. The energy, the breakthroughs, the uncomfortable questions, the big decisions — it is all here. I walk you through how I challeng...

PT Reddit Files dives into the shadowy underworld of Reddit, where anonymous PTs confidently share their loudest opinions without ever having run a clinic, signed payroll, or made a single marketing decision. In Case File One, we explore a post from a young PT who believes selling is beneath them. From there we unpack the real issues: insecurity, inexperience, resentment, and the belief that busin...