Growing from 1 Clinic to 20: What No One Tells You About Healthcare Leadership | David Harris

[0:00]  Are you more valuable seeing 15 patients a day, or are you more valuable in getting 10 people, 20 people, 30 people to realize the value of that? Really, how it's not about working people to death. It's actually about getting people better, which is why we're called to this field and why we're doing what we're doing. If you're not growing, you're dying. If you don't have people following the mission, the vision, the values of an organization, you don't really have the success that you should have.

Email is very antiquated at this point. Yes, there's a purpose. There are some things you can do, but for me, it's about developing tools where people can see how they're performing and what they're doing. It doesn't require an email. It requires, you know, "Hey, you log into your system and you see how you're doing."

If you really want something, you've got to stick with it for the long haul. And you've got to be able to demonstrate wins over and over and over. It can't be just this one clinic. We, as leaders, have to be able to take that constructive feedback and say, "Well, where could I have done better?"

Welcome back to another episode here on the Heart and Hustle Podcast. Our next guest, before we even get started, actually, I got to say your journey into physical therapy didn't just start with an injury. It started with watching your mother struggle through years of pain, surgeries, and medication because of poor care. What did that experience actually do to the way you see healthcare today?

You know, I think that was back in the early 90s. Just watching my mother encounter a work injury, and after the work injury, she kind of went through the system, so to speak, at the time. She ended up going to multiple physicians, having multiple tests and different imaging and things of that nature. They diagnosed her with a herniated disc. At that time, her employer sent her to their physical therapy, but it ended up not being a physical therapist; it ended up being an athletic trainer.

Athletic trainers do great things; they're wonderful people, but just not physical therapy. At the end of the day, within a few months, she ended up with several herniated discs in her low back as well as her cervical spine. A lot of that tied back to the activities that this group was having her do.

Fast forward, she ended up with, I think, three or four surgeries to try to repair it, multiple rounds of physical therapy, and ultimately ended up on permanent disability because she could no longer work. But what that really taught me was that the healthcare system was broken. And I think we all know that. We look at it today, and it's still not the greatest that you see out there, but there are things in the healthcare system that are wonderful.

Seeing her go through the multiple rounds of physical therapy seemed to be the thing that helped her. It seemed to be the thing that really brought her along. But she had a rough 10 to 15 years of her life there to the point where she was on 19 different medications. She couldn't hold a coherent conversation. You know, she would be in the middle of a conversation and just go to sleep.

But earlier than that, I had been introduced to physical therapy through some athletic injuries and things of that nature. So, I just kind of started thinking through that, and it really drew me to this profession. You know, people whose goal in life is to get people back to their full function, to get people back on their feet, whether it be back to work, playing with grandkids, or doing whatever. It seemed to cover all of those areas, and so that kind of drew me in.

My first love was teaching and coaching. You know, I was an athlete, three sports, all that stuff. So, I was going to be a teacher and a coach. I had an injury, played some college sports, and had an injury in my sophomore year and decided just to really kind of come back to Chattanooga, start over, and jump into the physical therapy world.

And I tell you, it's been such a rewarding career. But back to my mom, I look at her today; she's 72 years old, she's on zero pain medication, and she is functioning at a higher level than she did 20 years ago. She does a couple of rounds of physical therapy every year just to get back in control. And that's taken her from being what I would call a zombie to a fully functioning mom.

So, she's able to play with her grandkids and do things that she wouldn't have been able to do otherwise. I'm confident without physical therapy, my mother would not be here. So, that's enough for me. Ultimately, you know, still today, she's probably one of my biggest fans.

Which, you know, she probably has to be. She's mom, right? Might be a little biased on that, but you know, really, I think she kind of went through that process, and everything happens for a reason. I think we all know that, but that really kind of started my journey in physical therapy, and here we are almost 27 years later.

Man, Dave, what is your title today? What is the organization you represent, and what is the role that you're playing today in that organization?

So, I am the CEO for Prop PT out of California. We have 20 clinics in the Central Valley, California. So, we go from Modesto down to about Bakersfield. I say Modesto to Bakersfield. Those aren't there yet, but the leases are signed. Our goal is to take physical therapy to the public, to as many people as we can because we know it's effective. We know it works.

And here I'll go on my bias: I think it's probably one of the most cost-effective things that you can do in the medical field that takes you away from surgical interventions, imaging, hospital stays. It just kind of gets you back into that activity mode.

And you just mentioned it. Why do you believe physical therapy might be the best value in healthcare? Why do you believe it's actually so underutilized in healthcare today?

You know, part of it is going to be education. I think the education's so much better today. The public knows more about physical therapy and how it actually helps bring people back to their full function. But I think it's still underutilized. I mean, I think I read a white paper here a couple of years ago, and probably 10 to 12% of those that need physical therapy are actually utilizing it.

So a lot of our jobs these days, outside of providing the service, is educating the public, educating our physicians, and really ultimately, physical therapy takes a lot of the burden off of the medical community. Because, you know, if you take a person that hurts their back, in the old days they would go to the physician, they would end up probably getting some type of medication for pain control or something like that, some imaging to determine what's going on, and then they would still end up getting sent to physical therapy.

Where I see us as being cost-effective is now in the United States, all 50 states have some form of direct access, which means a patient can come directly to a physical therapist without going through the other items to get there. So, if you go to the physician and end up going through all the testing and different things, that could take two, three, four weeks. There's further damage that goes on during that time.

So, the quicker you get into physical therapy, the more likely you are to gain 100% of your function back.

I'm still kind of in shock, man, how you said, and it's so true, life does happen for reasons, right? And because your mom's situation kind of really got you into that space, and now you've grown so many clinics. What did that level of growth teach you about the need for this service?

I think that's also something that we could talk about as well. The reason that you grew so well is because people really needed this.

They did. They did. But I would even take it probably a step further. My path has been amazing to me. It's been great. You know, when I started school for physical therapy, I started as a technician. I worked at a nursing home, working with people and just basically getting to get my feet wet, so to speak.

And then really through the years, being able to accept mentorship and guidance from so many that had done that before me was probably the biggest catapult in my career. It wasn't just one person. I mean, it started with coaches, teachers, parents, went into colleagues, you know, people that saw something that I probably didn't see at the time and said, "Hey, have you thought about this? Would you like to try this?"

So me not really knowing much at the time, opening myself up to be vulnerable to mentorship and not knowing everything. That was really the biggest help for me going through the years.

And you know, I've just had amazing experiences. I spent 20 years with one company here in the Chattanooga area, a wonderful company. They're still around, Benchmark Physical Therapy. But you know, seeing that progression of that organization, when I joined, I think we were 15 or 16 clinics. When I left to take on another opportunity, I think we were close to 1300 clinics.

So just seeing that growth and seeing the need because you open a clinic and it's full. People need these services, so that goes back to we're just scratching the surface here. We can be and we are a valuable part of the healthcare team.

And that's something that I'll stand on a soapbox all day long and talk about how valuable this part of the healthcare team is.

Hey, if you're getting value from this conversation, do us a favor and hit that subscribe button. We drop episodes like this regularly, and we don't want you to miss a single one. Now, let's get back to it.

That mentorship, man, is a huge play in everyone's life. You've got to find that person that could really pour into you. I think sometimes we're always pouring into others, and we forget, as you mentioned, to just allow people to mentor us.

What is that one thing that comes to mind when you think about a leader? Maybe a saying or a phrase or analogy that still sticks with you today that just pops up like this?

If you're not growing, you're dying.

Okay.

You know, that's something one could go so many ways right there.

Absolutely. So, one of my mentors for many years used to say that all the time in meetings, and it really stuck with me. It's not just if you're not growing your business. Growing your business is important because if you grow your business and you're successful, you can pour back into the business, right?

You know, successful businesses seem to always have the latest and greatest. They're pouring more into their team. They're doing more for the communities they serve. So, I think that one really stuck with me.

I had a mentor for many years, Dave Meyers, who I still communicate with pretty frequently. When I first stepped into leadership, he was very hard on me. It was interesting. The first probably year and a half or so that I was in a multi-site director position, he was like, "I need you to call me every day. Let me know what's going on."

Those 15 to 30-minute conversations every evening, as much as I didn't care for them at the time, he was teaching me every moment. He was micromanaging a little bit at the time, or at least I thought he was, because I didn't understand what he was trying to do.

It goes back to he saw something that I didn't see. I'd always been successful in my career, but I'd always been successful through just hard work and really just building on my skill set. He was more of a "you can do it as one, or you can do it with many."

That was a big thing for me. But I could name off a dozen mentors that have been just instrumental in my career development.

I'll tell you what, that whole phrase of "if you're not growing, you're dying." I had my mentor that I guess I was calling and probably complaining, like I guess that's what I was doing. He says, "Hey, Ephrain, every time I'm talking to you, it's always the same thing. By the end of the year, if you're still doing the same thing, we just can't be friends."

Some people probably would have felt some type of way, but I got it. He was saying, "Ephrain, you got to do something and move. I'm here elevating, and you're just still in the same spot."

A lot of times you outgrow people. Do you feel like in your life you outgrew people in this space? Friends? Family?

Oh, absolutely. Absolutely. Yeah, I mean, I think we all do that if we are highly motivated and driven. There are going to be people that get left behind because, you know, I'm a person that if I go into a room and it's a gripe session, I don't want to be a part of that room.

That doesn't fit with me. All those sessions turn into excuses and passing the buck on why we didn't do something successfully. So I choose to kind of go in a different direction of, "Let's identify the problem. Let's do root cause analysis on it. Let's figure out why things happen the way they did, and then let's plan for the next time because there will be a next time."

I think there's even more importantly, it's really identifying the successes, breaking them down, doing the root cause analysis, and then really determining how can we do this better the next time.

Dave, you just mentioned at your level today. How do you even define success, man? Is it the growth? Is it patient outcomes, leadership development, or what is it?

It's a lot. I think for me at this stage in my life, it's seeing others successful. So, you know, it's when you go in and interview that new graduate, they're coming fresh out of PT school or PTA school. They're hungry, they're young, they don't know really which direction they want to go, but helping to shape them and mold them into becoming an expert clinician, becoming a great leader of yourself, and then becoming a great leader of people.

Really trying to develop a pathway for as many people as we can and giving them the opportunity. Not everybody's going to take it.

Yep. And then you're also going to have those folks that you pour into, and in five years they leave. I don't look at that as a bad thing. You did your job. You created or helped create someone's success, and they're able to actually go on and do something different. It doesn't have to be with your company, but it's for this profession typically, whether it be going from the clinic to education or going from the clinic to leadership in a different organization.

All of those things are important. But I would tell you the idea of pouring into people on a daily basis, giving them not just busy work, but giving them something to look forward to tends to lead to a better outcome. I've always been successful with that, and I don't see changing that.

I read an article this morning where one of the great leaders in our industry was talking about people versus EBITDA. EBITDA is really just your profitability of an organization, and the argument was that people are more important because if you don't have people, you don't have an EBITDA.

I agree. If you don't have people following the mission, the vision, the values of an organization, you don't really have the success that you should have. So, I really think that's stuck with me, and it's my philosophy, and I think it's several others in this profession. We're a very touchy-feely profession. We like the emotion.

From a leader perspective, one thing that just stuck with me when you said that is I love the new fresh people in the space because you really get to mold them. They don't come in with bad habits. It's always harder to fix all this bad habits that leaders have created.

When I used to manage people, I never minded someone that had nothing on their resume because I'm like, "Oh, this is going to be great." I really get to show you the right way. When you're a great leader, that just excites you. Are you still excited like that every time you see someone that has nothing on their resume?

Absolutely. I look for one key component to anyone that I want to bring into the organization, and that is really culture. Will you fit with the culture of the organization? Are you optimistic? Are you looking for personal growth? Because we can teach you how to be a good clinician.

I mean, quite honestly, when you come out of school, you're probably a pretty decent clinician. You know what you know. Our job is to really kind of continue to shape and mold and offer the opportunities, whether that be continuing education, different degree focus areas, and things like that or leadership development.

I'll be real honest with you. I ran subways for eight or nine years, and one of the things that bothered me was when someone came out of school. I just worked my ass off. From 15 years old, I was working. By 19, I was already running my own location and did multiple locations and ran a million-dollar location.

I was really successful at this young age, and when it came time to do more, the more went to the person that had a degree. My whole mindset has always been like, "Even maybe he's better than me on the black and white, but he's not better than me at people skills."

You could be, I don't know, this is just my opinion, but to what you just mentioned, it's like you could come out of school and be decent, but now you got to learn how to treat people, all the different types of personalities. I feel that's where I've succeeded.

What are your thoughts on that? Is that kind of what you're referring to?

Yeah, absolutely. I mean, you come out of school and you have all this knowledge on how to take care of the human body, right? You don't get a lot in school on how to run an organization or how to really read a balance sheet. You also don't get that people side of it, which is so important in healthcare.

I mean, we've all experienced healthcare where it's not been so great. People are rude. They're inconsiderate. They don't really seem to care about you. You seem to be a number in an insurance card. But teaching people that the more that they pour into that person, the more personality they put into that person, whether they're negative when they come in or not, helps them to kind of see on a bigger plane.

I think that for me has been the most successful. Back to your example of running subways and starting early, I think that true grit of an individual when they come in and they're telling me, "Hey, you know, I had my first job when I was 16," and I worked all through high school and college, that's meaningful to me.

I also look for people that were in the service industry because they know how to deal with all kinds of different personalities, and you can shape their career in physical therapy off of what their previous experiences were. Personally, I started working at a young age. I think my first job was at eight years old, picking up shingles and nails for my dad, who was a contractor.

Hello.

And so I can say I started working around eight years old, and I wouldn't change a thing from that because it taught me so much about that grit and just hard work. But then it took so many others to teach me how to shape it and how to make it more of a benefit for those around me versus just, "Hey, you're going to work a job, you're going to get a check, and then you're going to retire in 40 years."

Well, that doesn't sound very fun.

Not at all. But I would also say, man, it wasn't easy, right? Was it difficult to step away from the hands-on patient care and then focus on leadership?

I would tell you it was one of the hardest things I ever had to do. I absolutely loved patient care. When I was a regional director, I think I had like 22 or 24 clinics. I was still treating three 10-hour days a week in the clinic. The reason being is I just love patient care. I love the interaction, seeing people come in and get almost immediate results from the care that we provided.

So, it was tough. But one of those mentors, we were having one of our conversations, and he said to me, "You know, are you more valuable seeing 15 patients a day, or are you more valuable in getting 10 people, 20 people, 30 people to realize the value of that?"

Really, how it's not about working people to death. It's actually about getting people better, which is why we're called to this field and why we're doing what we're doing. That was kind of a turning point for me.

I quickly began really researching and studying the philosophies of coaching, developing people. I got a couple of certifications, one of them through John Maxwell's team, which I'm still involved in today, and really just getting additional information because you can listen to all these gurus out there.

There's a lot of great ones out there, but they're really all saying the same thing. What are you doing for the people around you? And do you know why you're doing it? That's why I love Simon Sinek's "Start With Why." That's got to be the center of your focus. If you don't know why you're doing something, you just don't need to do it.

For me, that really kind of helped shape my why of why do you need to leave the clinic and the clinical care? It's because with your experience and your people skills, you can actually get other people to do that.

I love that, man. You mentioned you're building leaders. I know you have been, right? That influence of building leaders and other clinicians and probably other business owners at some point in their journey. What do you look at in a leader?

Now, I know we talked about what we look at in a great add-on to the team, but what does it look like when you're actually trying to build up a leader?

You know, I think first of all, it still goes back to the culture. Is that person driven? Do they have the heart for what you're trying to do, or is it just about numbers? It can never be just about numbers. Those are really just a byproduct of doing a good job.

So I look for culture. I look for someone that's driven. They have grit. They've had some struggles. It's not necessarily everything's roses and perfect. They've had to work through those.

But it's also about raising their hand. You can offer the career path, and not everybody's going to accept it, but those people that raise their hand and they're willing to step up, take a risk, and be vulnerable, that's important to me.

I also look for people that are solution-oriented. It's kind of the opposite of those negative conversations we talked about earlier. Someone that's solution-oriented saying, "Hey, we had a problem, and this is what I think we should do," versus, "Hey, we have a problem, and this is terrible."

Same problem, two totally different answers. So, I look for people that are kind of in that mindset of we can make a positive difference. Even if it's just that little 1% a day, we can make a positive difference and come out on the other end better and then do it better the next time.

You're saying so many great things. You also mentioned about just going through something, right? Everyone has a story. Your story, though, I don't think many people may know. Can you kind of go back to how you grew up and what that actually looked like?

Sure. I grew up in a family of nine children. Mom and dad had nine children, so we lived in a massive single-wide trailer. I think it was probably about 1,000 square feet total. We were very, you know, what people would consider poor.

All those people in one place, and I think there were many years that my folks made it with all of us, and we all ate every day. We all went to school. We all became somewhat successful in getting our lives together and did that on less than $20,000 a year.

I couldn't even imagine doing something like that these days. But what they taught us is that you communicate, you talk to each other. We didn't have cell phones or anything at that time. You basically make sure that you're communicating. You're all in this together. You're working to do the same thing, and that's what a family does.

They taught us that from a young age. They also taught us to work for what you get. Nothing's free in life, and you need to be able to really earn what you get and not expect a handout. My mom and dad were two of the greatest people in the world in my mind.

My father's passed on now, but they took a house in the middle of a small town in Florida with myself and my sister, and they had a heart for children. They adopted seven children from two different groups. Both of these groups were abused. The younger group of three were sexually abused. The older group of four were mentally and physically abused.

My mom and dad, with their hearts, took them in and adopted them. Those brothers and sisters now came into a loving home, a home that not only provided love but also tough love. Everything didn't go great. If you screwed up, which I firmly agree with, I think discipline is a great thing.

They did that part of it. But the other side of it is it taught me so much about drive and initiative and not making excuses with your life because someone could turn around and say, "Well, I was poor when I grew up, so I didn't have the opportunities or the advantages that this group had."

At some point in your life, you got to stand up and say, "I'm going to make a choice." Whether it be at 12 years old or 25 years old, I'm going to make a choice, and I'm either going to go this path or that path. They always taught us to look for the positive path and look for something that could help others.

I look at my siblings now, and most of us have done pretty well in life. Family-wise, we have families, we have jobs, we can pay our bills, things of that nature. There were a couple others that grew up in the same household that chose a different path, and they didn't do so well in life.

I think it all comes down to the personal choice you decide to make as you progress in your age.

And that's all mindset, right? Like I definitely was telling my wife today, and I'm probably that harsh person at times. She says something to me, and I'm like, "You have to want it." Your mind has to want it.

And then she looked at me like, "It's so true." I could want it for you, but you have to want it for yourself mentally, physically, all those changes. We can get deep into it. That's a whole probably another conversation.

But I think growing up in your situation, man, that's where that resilience and work ethic comes from. You agree?

Oh, absolutely. Absolutely. I mean, your dad and mom, we got to give them their flowers. My biological mother had 10 kids and didn't raise any of them. Biological father had eight kids and didn't raise any of them.

So, kudos to your mom and dad for being willing to say, "Hey, I don't care what the situation is. We're going to stick together. We're going to figure this out." That in itself is, you know, flowers to both of them, man.

And that's where I can imagine your strength comes from, seeing your mom and dad just never giving up. What great role models are those two?

That's right. I think that leads you to other people like that. That early learning and having that look at family and people are important. No matter who the person is, they're important because they're a person.

All of that stuff continues to lead through the rest of your life, whether it be personal or professional. It led me to having a great wife, four great kids, and hopefully now they're all going to do the same thing. That would be the goal.

Oh man, that's what success looks like for me. It's like my kids could just be better than me, man. Because we all have choices, right? As you mentioned.

I want to go back into communicating because you did mention back in the days, right? We didn't have cell phones. It was really just talking to each other. What have you learned about communicating vision when your organization spans hundreds of locations?

Are we is that a struggle sometimes? How have you guys been able to do that?

You know, it's absolutely a struggle. Look, we all hit our pitfalls. Every day, there's probably a thousand mistakes that I make, and I try to correct a few hundred of those a day. But I think it is about communication, and I'm a big fan of face-to-face communication.

One of the things that we do at Pro that I feel is different and something that's a little bit unique is we don't send out a bunch of emails. I've been in organizations where I've got 250 to 300 emails a day. Do you think that someone can read 250 to 300 emails every day? It just doesn't happen.

So email is very antiquated at this point. Yes, there's a purpose. There are some things you can do, but for me, it's about developing tools where people can see how they're performing and what they're doing.

The other thing that we do that I think is very powerful and people tend to love is we do a monthly podcast. It's five to seven minutes. That monthly podcast is myself, our vice president of operations, who started this podcast for Pro. We do a monthly update, and we just communicate, communicate, communicate.

Here's what's going on. Here's who we brought into the organization. Here's the new system that we might be looking at. A lot of it is also, "Hey, here's a shout out to these folks that really did a great job last month."

It's just as simple as that versus sending five emails every day to say, "Hey, this is going on, that's going on. Here's a shout out. Here's something we need to improve."

In our organization, we have a pretty strict limit on meetings because if you're in meetings, you're not working. You're not doing anything.

I agree.

I got one better for you. I worked for the airline industry recently, probably three or four years ago, and it always bothered me why you had three of our leaders—the supervisor and the two managers under them—in the same meeting.

Only one person needs to be there, and the other people need to be managing the team because now when we need someone, no one's available because three people are in the same meeting.

Why?

You know, people just make dumb decisions. That goes back to leadership.

But I love the podcast setup. I don't know that I've ever heard someone do that. It just takes me back to when we used to have morning announcements in schools. Like just as fun, right?

You could do whatever you kind of want to it. I can imagine the production if you want to have a fun day today, a serious day today, like let's vibe it out. That's cool.

Yeah, something different as well. A lot of innovation. When we talk about innovation, what else are you guys doing at the communication level?

You said you talked about educating, resources. How are we getting that message out as well?

Yeah, we have an internal training center, so to speak, and it's done through technology. Any kind of training that we have, if there's something new, it goes onto this platform, and everybody has the opportunity to watch it and review it.

But I think it's also in our world. I think in healthcare, there tends to be a thousand changes per day. It's my job to really make sure that we're not changing just because change is there or just for the sake of change.

We know why we're changing if we're changing. We know why we're communicating. We only put information out there, whether it be on a training platform, an email, or a podcast, that's going to be useful and not just kind of be there just because, "Hey, this is the way we've always done it."

So we use a lot of technology for our training. But in PT, we also offer multiple courses and things like that for additional clinical training, and most of that is in person because we're a hands-on profession.

It's harder to learn a new skill or technique, although it's very doable. It's harder to do and keep someone's interest when you're sitting in front of a computer screen trying to learn versus in the clinic or with people that are in the same profession.

I don't think we have anything that's not available to any other organization, but we're utilizing technology like every other practice in the country. We're using technology to try to make the days easier on our people and increase their bandwidth through automation or different types of technologies.

There's so much going on in healthcare right now. I mean, there are so many different AI tools. I don't even begin to think I understand it at any depth.

But, you know, being able to do clinical documentation through ambient listening and taking 10 to 15 minutes off someone's day of typing an evaluation, things like that are important.

It's the check-in systems at the front desk of having a kiosk instead of having two or three people there trying to huddle in a line of people trying to check in. It just kind of gives different abilities there.

What is the staff count? You guys got a pretty large team, it seems.

You know, we're a smaller organization, but we have just under 400 people.

Still big, man.

So a lot of people that manage and lead and communicate with.

No, that's pretty good.

Yeah. The vision says we're small, but we're going somewhere. I love the team. I love their motivation.

It's nice for me to get phone calls from directors usually a couple of times a week, and they just want to tell me about the solution that they've come up with. I think that is such a huge win in the culture of our organization.

I'm fairly new there. I've been there five months or so, so I definitely won't take credit for that. I think Todd Martin and Ronnie Inod, who started this organization 25 years ago this year, have built the culture of people that take the bull by the horns. They have their autonomy. They run their organizations.

Our job is to give them the tools and clear the path for them to do it in a more successful way.

What gets you? You're so chill. I'm sitting here just laughing to myself because I'm like, man, the whole time you've just been so mellow. What gets you, Dave, like hair standing on the back of the neck?

You know?

Well, two things there. If it's in a negative fashion, folks that come along and really are just complaining, that gets me in the wrong way.

You probably will never see it, but it is something that really kind of gets under my skin a bit. But what gets me excited is when I'm with the team and actually seeing them be successful.

I've got an example: we really put out a vision for the next five years, a strategic plan, and I have a couple of the clinical directors that have really taken this to heart.

To listen to them talk about, "Hey, I'm going to be helping to start a clinic here, here, here. We're going to offer these services to communities that don't have this opportunity right now."

So now people aren't going to have to drive 20 or 30 minutes. That's exciting. Or someone that's taking scheduling patients seriously and really taking ownership of, "If I see open spots in my schedule, I'm going to fill them up."

It's someone at the front desk taking charge, a technician, you know, when I walk into a clinic, and a technician is up front bringing a patient back, and they're courteous, asking that person how they're doing, asking them if there's anything they can get for them before they start the session.

Those are the things that get me amped up. And then really, I mean, growth. Growth means so many things. Yes, we need to have more facilities so we can offer this service to more people. But it's personal growth.

It's a technician that comes to us and says, "Hey, I'm leaving the organization because I'm going back to PT school." Those are wonderful days.

It's a front desk person saying, "Hey, I've been taking online courses, and now I have a degree in communication or business or whatever, and I'd like to continue to help serve the team. How can I help?"

It's physical therapists that have been with the organization for, you know, six months, 12 months, 18 months saying, "Hey, I want to go into the leadership development program because I want to be able to be more than I am today and produce more for this organization."

Those are the things that get me excited.

Love it. Yeah. No, man, I love someone that's taking initiative. I used to, when I hired people, I can't remember what the three were, but when I was in subways, it's like you have to have speed, initiative, and maybe it was customer service just because they were all three very important, especially at a subline.

You got to hurry up. People come in, and surprisingly, people thought that making subs was like rocket science. So there were those times they're like, "Come on, what are you doing? Just wrap it. Let's go."

I don't miss those days, to be quite frank. I love leading others, as you mentioned. Those I want to be led. But when I feel like pulling teeth, that just drives me crazy.

You got to go. At that point, it's like, "Hey, I've tried." I have that conversation with so many leaders, man. It's like when you see that bottleneck, don't think that it's going anywhere. You have to fix that bottleneck, man.

Yeah.

You know, and it seems like you guys don't have too many of those, man, because you, as a leader, are not allowing it.

No, and you know, I think that takes time to learn, especially when you're in a profession that is very emotionally driven. It's hard to stand up and say, "Hey, this isn't working right."

But I think that's one of the things I've learned over the years. I'm a firm believer that you pour everything into an individual that you can. If they were good enough for you to hire and bring into your organization, you're going to try to do everything you can.

But there's a point when if they're not accepting it, you have to stand up and say, "Hey, you're not happy here. Let us help you kind of find happiness elsewhere."

That may sound a little bit curt, but it's more of if they're not happy, then that's seen by the rest of the team. It's seen by the patients.

What you'll find is most of the time when that person departs, people are coming up to you saying, "Man, I can't believe it took so long." We, as leaders, have to be able to take that constructive feedback and say, "Well, where could I have done better?"

Yeah.

How could I have done better to serve my people?

Dave, I know you got plenty of things to do than sit here and talk to me, but I do appreciate the conversation that we had today. For other leaders that are listening as well, I leave you with this blind question, man. If you could point to one moment in your career where everything could have gone different, what happened, and what did it teach you about leadership?

You know, I would go back to probably early in my career with Benchmark. I was very successful at turning a clinic around. My first clinical director role was able to turn it around, and that was noticed outside in the community.

Chattanooga is a small town, so people kind of know everybody. I was offered a position to direct and operate the rehab center at a local hospital. A lot more money. It was very tempting.

But instead of turning in my resignation, I went to the owner of the organization at that time and said, "Hey, I'm not going anywhere. I love what I do, but I need to know that I'm appreciated."

I started the conversation with, "I'm not going anywhere." I told him what had been offered out there, and you know, I'm not expecting anything, but I'm going to tell you what's offered out there.

Within probably about three hours, the CEO called me and basically outdid the other deal, which in all honesty was not my intention.

But they outdid the other deal, and it wasn't just the financial end. The CEO also had a very frank conversation about a leadership journey and if you really want something, you got to stick in it for the long haul.

You've got to be able to demonstrate wins over and over and over. It can't be just this one clinic. I think that was a huge turning point for me.

That guy, many times over the years, has been instrumental in helping me not only to go into different positions with that organization but also gain positions and understand the value of networking within this profession. I wouldn't trade it for a thing.