Private Practice Owners Club

Most physical therapists know something’s broken. Reimbursements are declining. Administrative burden is rising. And despite delivering massive value, the profession is still treated like an afterthought.

In this episode of the Private Practice Owners Podcast, Nathan Shields sits down with Scott Gardner—clinic owner and leader of the United Physical Therapy Association—to unpack the real reason behind the industry’s struggles.

From the “ancillary provider” label to Medicare policy, Scott breaks down why physical therapists are stuck at the bottom of the healthcare hierarchy—and what it will actually take to change that.

This isn't theory. This is a behind-the-scenes look at the legislative, financial, and systemic forces shaping your clinic’s future.

In this episode, you’ll learn:

• Why physical therapists are still classified as “ancillary” providers—and why it matters
• The real reason reimbursements keep declining
• How Medicare policy directly impacts your clinic revenue
• What MPPPR is (and why it’s quietly costing you thousands)
• The truth about “opting out” of Medicare
• Why most therapists complain—but don’t take action
• How advocacy and legislation shape the future of private practice
• What needs to happen for PTs to gain autonomy and higher pay
• Why unity across clinics may be the only way forward

This episode is not about quick wins. It’s about understanding the system—and how to actually change it.

🎯 If you’re tired of shrinking margins, policy confusion, and feeling stuck, this conversation will give you clarity on what’s really going on.

👉 Join the upcoming workshop: https://ppoclubevents.com/04-17-26-workshop

👉 Learn more about Private Practice Owners Club: https://ptoclub.com/

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Register for the Private Practice Owners Club conference now at https://ppoclubevents.com/home-page-2026

What if the biggest growth moves in your business… was saying no?

In this episode, Nathan Shields sits down with Angie McGelry to unpack how one clinic completely transformed its trajectory—not by doing more, but by getting radically clear on who they serve.

After years of grinding in a traditional model, Angie and her team made a bold shift: they stopped trying to serve everyone and built their entire practice around a specific niche.

What happened next?

A stronger brand.

Better patients.

A team that actually wants to work there.

And a business they genuinely love.

In this episode, you’ll learn:

• Why defining “winning” changes everything in business
• The moment Angie realized her current model wasn’t sustainable
• How niching down can feel risky—but unlock massive growth
• What happens when you stop chasing every patient
• How brand and experience replace insurance dependency
• Why the right vision attracts the right team
• The mindset shift from survival → intentional growth
• How to build a business that aligns with your purpose

You’ll also hear how creating a unique patient experience—through environment, technology, and positioning—can completely separate you from the competition and make your clinic the obvious choice.

This is more than a marketing strategy. It’s a complete identity shift as a business owner.

🎙️ If you’re tired of doing more but feeling stuck… this episode will challenge how you think about growth.

👉 Join the upcoming workshop: https://ppoclubevents.com/04-17-26-workshop

👉 Want help building a niche-driven, high-profit clinic?

Book a call: https://calendly.com/ptoclub/discoverycall

💡 Love the show? Subscribe, rate, review, and share: https://ptoclub.com/

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Register for the Private Practice Owners Club conference now at https://ppoclubevents.com/home-page-2026

Most clinics aren’t failing because they lack patients…

They’re failing because they don’t understand their numbers.

In this episode, Nathan Shields breaks down the real reason clinics feel stuck in the “busy but broke” cycle—and what actually needs to change to fix it.

Despite full schedules and strong demand, many practice owners are seeing shrinking margins, rising costs, and increasing pressure. This conversation unpacks why that’s happening—and more importantly, how to take back control.

From KPIs and patient behavior to revenue leaks and operational inefficiencies, this episode gives a practical, no-BS look at what’s really driving profitability in today’s environment.

In this episode, you’ll learn:

• Why being “busy” is not the same as being profitable

• The key metrics every clinic owner must track (and most don’t)

• How low visit frequency is silently killing your revenue

• The hidden cost of incomplete plans of care

• Why most clinics are leaking thousands in missed collections

• How front desk systems directly impact cash flow

• The role of AI and virtual assistants in reducing admin burden

• Why clinicians must learn to “sell” the plan of care

• How to increase revenue without adding more patients

• The mindset shift from clinician to CEO

You’ll also hear how small operational changes—like improving visit frequency or fixing front desk collections—can unlock tens of thousands in additional revenue without increasing workload.

If you’re tired of working more but keeping less… this episode will show you where the real problem is—and how to fix it.

🎙️ Learn how to turn your clinic into a system that actually produces profit—not just busyness.

👉 Join the upcoming workshop:

https://ppoclubevents.com/04-17-26-workshop

👉 Want help identifying where your clinic is leaking revenue?

Book a call: https://calendly.com/ptoclub/discoverycall

💡 Love the show? Subscribe, rate, review, and share:

https://ptoclub.com/

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Register for the Private Practice Owners Club conference now at https://ppoclubevents.com/home-page-2026

Most physical therapists believe better outcomes come from better hands-on skills. But what if that’s only a small part of the equation? In this episode of the Private Practice Owners Club podcast, Nathan Shields sits down with John Woolf, founder of Patient Success Systems, to break down a powerful (and uncomfortable) truth:

👉 Clinical outcomes are driven less by technique… and more by connection.

Backed by research and real-world experience, John explains why only a fraction of patient results come from the actual treatment—and why the patient experience, communication, and relationship are what truly drive retention, engagement, and outcomes.

This conversation dives deep into what most clinics overlook:

not just how you treat patients—but how patients feel when they’re with you.

💡 In this episode, you’ll learn:

• Why technical skill may only account for a small percentage of patient outcomes
• The real reason patients stay, refer, and complete their plan of care
• How “connectability” and relatability impact retention and satisfaction
• The difference between delivering care vs. creating a patient experience
• How to measure and improve patient relationships inside your clinic
• Why some therapists outperform others—even with weaker technical skills
• Practical ways to train communication and connection across your team
• How small experience upgrades (front desk, environment, tone) drive big results

🚀 If you’re a clinic owner or provider who:

• Struggles with cancellations or drop-offs
• Wants patients to stay longer and refer more
• Feels like outcomes don’t match clinical skill
• Or wants to build a stronger, more scalable clinic culture.. This episode will completely shift how you think about care.

🎯 Key Takeaway:

Patients don’t just come for treatment. They stay for how you make them feel.

🔗 Show Notes & Resources:

👉 Learn more about PPO Club: https://ptoclub.com/

👉 Explore resources: https://linktr.ee/ppoclub

💬 Love the show? Subscribe, rate, and share with another clinic owner who needs to hear this.

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Register for the Private Practice Owners Club conference now at https://ppoclubevents.com/home-page-2026

Most clinic owners don’t struggle because they don’t know what to do…

They struggle because they wait too long to do it.

In this episode of the Private Practice Owners Club podcast, hosts Nathan Shields and Adam Robin break down one of the hardest leadership decisions in business:

When is it time to let someone go?

This isn’t just about performance.

It’s about culture, values, leadership, and the hidden cost of tolerating the wrong people.

Through real stories and firsthand experience, they unpack what happens when a single team member starts draining leadership energy, creating tension, and slowly eroding the foundation of your business — even if they’re producing.

And more importantly… what happens when you finally act.

In this episode, you’ll learn:

• Why high performers can still be the biggest liability in your business
• The real reason most owners wait too long to fire someone
• How toxic behavior spreads and impacts your entire team
• The difference between performance issues vs. cultural misalignment
• Why “exhausting every option” is often a trap
• How leadership avoidance creates bigger problems downstream
• The role of standards, accountability, and clear communication
• Why raising your standards always leads to better outcomes
• How strong culture attracts the right people and repels the wrong ones
• What happens to your team, energy, and performance after you make the hard call

You’ll also hear how one decision shifted an entire organization — improving morale, alignment, and long-term growth.

If you’ve been holding onto someone you know isn’t the right fit…

this episode will give you the clarity (and push) you need.

🎙️ Learn how to protect your culture, lead with conviction, and build a team that actually moves your business forward.

👉 Join our upcoming workshop and learn how to build a stronger, more aligned practice:

https://ppoclubevents.com/04-17-26-workshop

👉 Want help identifying gaps in your team, systems, and profitability?

Book a discovery call: https://calendly.com/ptoclub/discoverycall

💡 Love the show? Subscribe, rate, review, and share!

https://ptoclub.com/

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Register for the Private Practice Owners Club conference now at https://ppoclubevents.com/home-page-2026

Most private practice owners think growth comes from doing more…more marketing, more hiring, more effort.

But what if the real leverage comes from seeing what’s already broken — and fixing it fast?

In this episode of the Private Practice Owners Podcast, host Adam Robin sits down with Nathan for a behind-the-scenes conversation on growth, leadership, and what actually moves the needle inside a practice.

From scaling a clinic to selling it… to building a coaching company and launching new offers like a fractional CFO model — Nathan breaks down the evolution of a business owner and the lessons that come with it.

This episode goes deeper than surface-level strategy. It’s about how your role changes as you grow — and why most owners stay stuck doing the wrong things for too long.

In this episode, you’ll learn:

• Why growth isn’t about doing more — it’s about fixing what’s leaking in your business
• The biggest mindset shift from operator → owner → leader
• How small operational fixes can unlock $100K–$200K+ in profit
• What most clinic owners miss when looking at their numbers
• How audits can quickly identify where time, money, and capacity are being lost
• Why “one or two focused changes” often outperform massive overhauls
• The real role of a CEO as your business scales
• How to think about systems, reporting, and decision-making at a higher level
• What a fractional CFO approach looks like inside a private practice

You’ll also hear how Private Practice Owners Club has evolved — from a podcast into a full ecosystem with coaching, workshops, and live events — and what they’re building next.

If you’re feeling stuck, overwhelmed, or unsure where to focus next — this episode will help you zoom out, get clarity, and identify the moves that actually drive profit and scale.

🎙️ Tune in to learn how to stop guessing in your business — and start fixing the right problems.

👉 Want help identifying where your practice is leaking money and capacity?

Book your free audit call: https://calendly.com/ptoclub/discoverycall

👉 Join upcoming workshops and events:

https://ppoclubevents.com/04-17-26-workshop

💡 Love the show? Subscribe, rate, review, and share!

https://ptoclub.com/

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Register for the 2026 Private Practice Owners Club conference here - https://ppoclubevents.com/home-page-2026

Most private practice owners know they need marketing… but very few understand what’s actually working right now — especially when it comes to getting found online.

In this episode of the Private Practice Owners Podcast, host Adam Robin sits down with Jeremy DuPont, former cash-based clinic owner turned founder of Patch Digital Marketing, to break down what’s driving patient growth in today’s digital-first landscape.

Jeremy shares how he built and scaled a multi-location cash-based clinic in Boston without relying on physician referrals — and why mastering digital marketing became the key to predictable growth. After successfully growing and selling his clinic, he now helps other practice owners do the same through Google Ads, local SEO, and conversion-focused systems.

This conversation dives deep into one of the biggest shifts happening right now: why Google Maps — not your website — is becoming the most important place for your clinic to show up.

Jeremy also walks through a live audit of a real clinic, showing exactly how rankings work, where opportunities are hiding, and what most clinics are doing wrong when it comes to local visibility.

Together, they explore:

• Why 70%+ of patients searching for services are using Google Maps — not traditional search
• How Google’s AI and search changes are reshaping how patients find clinics
• The 3 key drivers of local SEO: Google Business Profile, directories, and website authority
• Why most clinics ignore their Google Business profile — and how that hurts rankings
• How review volume and consistency directly impact your visibility
• The role of local directories and why they build trust with Google and AI tools
• How to identify missed opportunities in nearby areas and services (like dry needling or pelvic health)
• Why ranking for the wrong keywords brings traffic… but not patients
• The difference between “marketing that looks good” vs. marketing that actually converts
• When paid ads make sense — and why most clinics start too early or too small

If you’re a practice owner trying to get more patients without relying on referrals — or you’re frustrated that your marketing isn’t translating into real growth — this episode gives you a clear, practical roadmap to start winning locally.

🎙️ Tune in to learn how to turn Google into your clinic’s most consistent and scalable patient acquisition channel.

👉 Want to learn more about Jeremy and his work?

Follow him on Instagram: @_jeremydupont

Visit: https://thepatchsystem.com

👉 Want help strengthening your operations and growing your practice?

Book a call with Nathan: https://calendly.com/ptoclub/discoverycall

💡 Love the show? Subscribe, rate, review, and share!

https://ptoclub.com/

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Register for the 2026 Private Practice Owners Club conference here - https://ppoclubevents.com/home-page-2026

Building a successful business isn’t just about working harder or having the best ideas. At some point, every owner hits a wall where growth stops being about individual effort and starts being about leadership, systems, and the team around you.

In this episode of the Private Practice Owners Podcast, host Adam Robin sits down with entrepreneur and business leader Spencer Shoemaker to talk about the leadership shift every growing business owner must make. Spencer shares lessons from the last year of building and scaling multiple companies, including the realization that trying to be the most important person in the room eventually becomes the biggest bottleneck to growth. Instead of answering every question and solving every problem himself, he explains how stepping back, developing leaders, and empowering the team creates real momentum inside an organization. They also dive into the practical side of leadership: hiring the right people, holding team members accountable, creating clear standards, and building systems that make it easier for teams to win.

Throughout the conversation, Spencer introduces the Momentum Formula, a simple framework that helps leaders diagnose why a team or business might feel stuck and what to fix first.

Together, they explore:

• Why many business owners unknowingly become the biggest bottleneck in their company
• The leadership shift from “doing everything” to building and developing a strong team
• Why allowing team members to make mistakes is critical for real growth
• How hiring for values and alignment matters more than hiring for experience
• Why accountability and clear standards are essential for scaling a company
• The Momentum Formula: Vision, Motivation, Roadmap, and Capability
• How to diagnose whether a team problem is about clarity, motivation, systems, or skill
• Why simple systems and clear processes reduce overwhelm and improve execution
• The leadership mindset required to grow multiple businesses without burning out

If you’re a private practice owner, entrepreneur, or leader trying to scale your business without becoming the bottleneck, this episode will give you practical frameworks and leadership insights you can apply immediately.

 🎙️ Tune in to learn how strong leaders build strong teams—and how the right systems and clarity can unlock real momentum in your business.

 👉 Want help strengthening your operations, leadership systems, and growth strategy? Book a call with Nathan: https://calendly.com/ptoclub/discoverycall

 👉 Join the Private Practice Owners community and access resources: https://linktr.ee/ppoclub

 💡 Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Register for the 2026 Private Practice Owners Club conference here - https://ppoclubevents.com/home-page-2026

Most therapists are already experimenting with AI. But very few understand the compliance risks that come with it.

In this episode of the Private Practice Owners Podcast, host Adam Robin sits down with compliance expert Daniel Hirsch of Risk and Compliance Analytics to talk about one of the biggest shifts happening in healthcare right now: AI. From documentation automation to billing analysis and scheduling optimization, AI tools are rapidly entering clinical practices. But while these tools can dramatically improve efficiency, they also introduce serious compliance risks if used incorrectly. Daniel breaks down what private practice owners and clinicians need to understand before integrating AI into their workflows.

This conversation is not about hype — it’s about using AI responsibly, ethically, and within regulatory boundaries. If you're curious how AI will impact documentation, compliance, audits, and patient care in the coming years, this episode will give you a practical framework for thinking about it.

In this episode, you’ll learn:

• Why AI is becoming one of the biggest operational shifts in healthcare
• The difference between using AI as a tool vs. letting AI replace clinical judgment
• The compliance risks many therapists overlook when using AI documentation tools
• Why HIPAA, security standards, and vendor agreements still apply to AI platforms
• What a BAA (Business Associate Agreement) is — and why every AI vendor must have one
• Why Medicare doesn’t care if AI wrote your note — they care if it’s medically necessary
• The dangers of repetitive AI-generated documentation and why auditors flag it immediately
• How AI can actually improve compliance by identifying patterns, billing mistakes, and underbilling
• Why AI analytics can help clinic owners detect operational risk earlier
• What a scheduling automation and communication tools improve patient adherence
• Why therapists must still review and verify everything AI generates
• The leadership responsibility owners have when implementing AI tools in their clinic
• Why governance, training, and internal auditing are essential when adopting new technology

AI is not replacing therapists. But therapists who understand how to use AI responsibly will outperform those who ignore it. This episode explains how to adopt AI without putting your practice, license, or compliance at risk.

🎙️ AI is not the risk. Using it incorrectly is.

Show Notes:  

Join the upcoming PPO Club workshop: https://ppoclubevents.com/04-17-26-workshop

Want help building a stronger practice model? Book a call with Nathan: https://calendly.com/ptoclub/discoverycall

💡 Love the show? Subscribe, rate, review, and share! https://ptoclub.com/.

99.5% of successful owners interviewed on this podcast have leveraged a business coach at some point in their journey. Private Practice Owners Club is the coach you need — ppoclub.com

Explore upcoming workshops, free resources, and tools to help you scale revenue without burning out your team: https://linktr.ee/ppoclub

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Register for the 2026 Private Practice Owners Club conference here - https://ppoclubevents.com/home-page-2026

Remote Therapeutic Monitoring (RTM) is no longer “the next big thing” — it’s here, it’s evolving fast, and in 2026, it’s becoming one of the most powerful levers for revenue growth, patient engagement, and long-term practice sustainability.

But with opportunity comes responsibility.

In this episode of the Private Practice Owners Podcast, host Adam Robin sits down with Daniel Hirsch, CEO of Risk & Compliance Analytics and one of the most trusted voices in compliance, to break down what RTM actually looks like in 2026 — and what compliance will demand from practice owners who want to do it right and keep the money they earn.

Daniel pulls back the curtain on why RTM struggled early on, how recent rule changes have made it far more flexible (and forgiving), and why the practices winning with RTM are the ones that treat it as a system — not a billing hack. Together, they reframe RTM as a tool for controlling time, improving outcomes, and increasing touchpoints with patients, not just another CPT code to chase.

They dive into:

• Why RTM adoption stalled early — and what changed heading into 2026
• How new payment rules reduce risk and reward consistency over perfection
• What compliance actually requires when billing RTM (and where practices slip up)
• Why documentation, timing, and patient communication still matter
• How RTM fits into an active plan of care — and where owners get in trouble
• The real financial upside of RTM when enrollment reaches scale
• How to think about staffing, vendors, and workflows without burning out your team
• Why Medicare’s continued investment in RTM signals where the industry is headed

This is a practical, no-hype conversation for practice owners who want to grow smarter — not riskier. If you’ve been sitting on the sidelines with RTM, worried about complexity, compliance, or whether it’s “worth it,” this episode delivers clarity, confidence, and a roadmap forward.

🎯 Takeaway: RTM in 2026 isn’t about being perfect — it’s about being intentional, compliant, and consistent.

Want to talk about how we can help you implement RTM the right way, strengthen compliance, and protect your revenue?

👉 Book a call with Nathan: https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share: https://ptoclub.com/

Register for the 2026 Private Practice Owners Club conference here - https://ppoclubevents.com/home-page-2026