If your clinic looks busy but the bank balance says otherwise, this episode is for you. Nathan Shields and Adam Robin get raw about the slow bleed that almost sunk a practice — and the exact moves they used to stop the leak and re-build profitability. They cover the blind spots owners accept (too much compassion, not enough accountability), the culture cracks that ripple into revenue, and the concrete fixes that actually move margins back into healthy territory.

In this episode you’ll hear:

• How a six-month, slow-burn decline (tiny losses here, a few underperformers there) turned into a culture issue — and the moment Adam realized things had to change.
• The playbook they used: hit the numbers first, reset breakeven & productivity expectations, co-design the rollout with leadership, and run a company-wide reset.
• Why “production is the basis of morale” isn’t just a slogan — it’s how high-performing clinics protect culture and profit.
• Real, tactical targets: how to calculate required visits per provider from revenue-per-visit and salary, reasonable ramp plans (4–6 week steps), and what to do if training doesn’t move the needle.
• The hard truth: you can be compassionate and still demand profitability — but the owner must lead with clarity and conviction.

What you’ll walk away with:

• A checklist to spot the slow bleed (what to watch monthly so the problem never becomes a crisis).
• A step-by-step reset playbook you can run with your leadership team (numbers → expectations → rollout → accountability).
• Language and scripts for the tough conversations (owner to team, peer-to-peer leadership, and ramp plans).
• How to turn underperformers into contributors — or transition them out without wrecking morale.

Quick production note: If margins are slipping, don’t wait 6 months. Start with revenue-per-visit × target visits = required productivity. If numbers don’t line up, recruit and retrain now — don’t romanticize comfort over solvency.

🎯 Want help running your own strategic planning session? Join Nathan & the team Jan 9–10, 2026 in New Orleans — or book a one-on-one with Nathan: https://calendly.com/ptoclub/discoverycall

💬 Learn more & find event details at: 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

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99.5% of successful owners interviewed on this podcast have at one time or another leveraged a business coach to improve their business. Private Practice Owners Club is coach you need - ppoclub.com