Ep #35: Operating Your Own Business as a Clinician (Part 2)

Episode 35, Operating Your Own Business as a Clinician, Part 2. 

Welcome to Clinicians Creating Impact, a show for physical therapists, occupational therapists, and speech-language pathologists looking to take the next step in their careers and make a real difference in the lives of their clients. If you’re looking to improve the lives of neurodiverse children and families with neurological-based challenges, grow your own business, or simply show up to help clients, this is the show for you. 

I’m Heather Branscombe, Therapist, Certified Coach, Clinical Director, and Owner of Abilities Neurological Rehabilitation. I have over 25 years of experience in both the public and private sectors, and I’m here to help you become the therapist you want to be, supporting people to work towards their dreams and live their best lives. You ready to dive in? Let’s go.

Hi there, friend. I hope you’re doing well today. I’m recording this at the very, very end of August knowing that you will be hearing this, if you’re listening to this episode when it first comes out, in the first week of September. That literally blows my mind. 

I almost want to wish you a happy new year because if you’re anything like me, and I’ve shared this before, September to me really does feel like a new year. For us our calls for services have definitely picked up in the last few weeks, and it feels like there’s just this generalized shift in the air to create or go back to our new routine. 

So if listening to this podcast is any part of a routine for you, first, I just want to say thank you so much for doing this. This is my passion project and I love thinking about how I can help you to create a bigger impact for yourself and for others. 

If you are finding value, could you please stop for just a moment and follow and rate this podcast? That really would help other clinicians just like you know that there is support out there. And also, finally, if you could share it with a colleague that you think might benefit from this, that would be so amazing. 

And with that, I’m really excited for the second half of this episode. I really think Gabriel gives some amazingly vulnerable insights and practical tips if you’re considering any kind of entrepreneurial journey as part of your clinical career. So I’m so grateful that he’s graciously shared the way that he shared. So here’s part two. 

Heather: What other advice do you think you would give clinicians listening today? 

Gabriel: That are looking to start their own practice, you mean? Or just in general? 

Heather: Sure, sure. Or just in general, for sure. 

Gabriel: Yeah, I mean, I guess maybe I’ll talk a little bit more about it from kind of a clinic owner point of view because I feel I have more information to share versus being a clinician. Because I would say at my offices I’m definitely not the best clinician by any stretch of the imagination. 

Heather: Well, let’s pause there. Do you think you need to be the best clinician, as the clinic owner? 

Gabriel: No. Absolutely not. 

Heather: I agree. 

Gabriel: No, you hire people that are better than you. You always hire people that are better than you. 

Heather: I agree completely. I love that, yeah. 

Gabriel: And that goes for all positions, not just therapists, but office managers or educators or whatever. 

Heather: All right, well we’ll let you do business then, go ahead. 

Gabriel: Yeah, I mean, I guess it’s just if you are going down that road of thinking about owning a practice or starting a practice, realizing that you’re providing a job for other people, I think, is something that I didn’t really think about a whole lot when I was hiring people. I was just like, I just need more clinicians so I can have more volume and stuff. 

But at the end of the day they actually are relying on you for a paycheck to have a steady stream of income and an employer so they could apply for a mortgage and all this kind of stuff like that. And you don’t really think about that until it comes down to that. But people are relying on you. 

And having that onus on your shoulders and trying to sleep at night sometimes. I mean, Covid especially was an extremely big eye opener for me, just realizing that. That really put the spotlight on that aspect of owning a business, that people are relying on you to pay the rent and to put food on the table and stuff. And seeing the human side of it, of running a business and not just kind of making money and you know that type of stuff. 

It was really scary actually having to support a lot of people during that time. So, I mean, that’s something that I never really thought about at all when I was first getting going. But I realize that very much so now. 

Heather: Yeah. What do you think Covid taught you? What did you learn from that? 

Gabriel: Well, to be honest, if I had a chance to, I mean I did get an opportunity to sell my practice just before Covid and I didn’t. In hindsight I would have sold it in a second because it was just so challenging. 

Heather: Interesting, yeah. 

Gabriel: I mean, I converted all my, I mean I had contractors prior to Covid. I converted everyone to employees so they could not only take advantage of all the government handouts, and get EI and all those types of things because that shutdown was really tricky. And just even the fear that people had about coming back to in-person therapy was, it took a while. So my clinicians struggled, and therefore I struggled. And not even just kind of building back the case load, but financially for sure. 

I think I guess something that I learned was just kind of, I mean, of course you can never prepare for a situation like Covid, but I think just not putting on the cruise control. Because I think I was definitely on cruise control mode before Covid. Things were going really well. We were growing really quickly, my team was expanding. And then I was just kind of, oh, this is great. This is going to be like this forever. 

And then all of a sudden, I think it was like March 16th or whatever we were like, everything is shutting down tomorrow morning. It’s like, oh my God. I just got kicked in the teeth, and beyond kicked, they beat the heck out of me. And then, like I said, trying to manage the team and manage people’s emotions and manage people’s expectations and all that. 

So I guess don’t let yourself think that this is going to be in any situation, forever, good or bad. Life is like a roller coaster, right? There’s ups and downs and you’re never in a steady state.

Heather: Yeah. You mentioned in some of the stuff we were talking about before, about the hidden costs of running a business. I thought that was interesting. What are some of the hidden costs that you think clinicians might not be thinking of when they’re thinking about having their own business or expanding their business providing employment to other people? 

Gabriel: I mean, the funniest thing is when you said the hidden cost I always kind of thing financially, but one non-financial cost is time. And time is one of those things that are just finite. You can never get it back and you can never get more of it. 

But as a clinic owner, first come into work, last to go home, working the weekends, working six days a week, covering for everybody when they’re sick or on holiday and all that type of thing. If that’s what you really want, to be a clinic owner, be prepared for that because you’re going to be put into a situation where you’re going to have to give up a lot of your freedom and your work life balance to satisfy others. 

So that’s something that I would definitely make sure people are 100% aware of, 110% aware of. It’s a reality, especially when you’re getting going. 

The other costs, I mean, I don’t know. There’s so much. Where to start? I guess there’s a lot more cost to owning a business than just kind of the actual what you see when you walk into a clinic. I mean, there’s the renovation of even just renovating a place. That could run into the hundreds of thousands for sure, easily. 

Negotiating rent and rent increasing over time. If you know people that rent residential places and stuff, commercial rent is way worse. And I mean, I wish I’d bought my clinics in terms of the building, but I didn’t because they’re really crazy expensive. But residential rental versus commercial rental is a night and day difference. 

In residential, the renter, the tenant has, I mean this is kind of how I think about it, they have all the power. They have the rights and the legal ramifications as a tenant. But the commercial is flipped. It’s the landlord, I feel, that has all the power. So they can change things. You have to pay for every little thing from insurance to the broken door to the toilet leaking and all that. Everything is on you, not on the landlord. 

Heather: I would agree with that as a fellow owner, for sure. 

Gabriel: Yeah, they just walk away like, oh, your toilet is broken? Well figure it out, it’s your toilet. Whereas in a residential thing you’re like, my toilet broke, and the landlord is there the next day fixing it and everything. So that’s a huge cost. 

The legal stuff, having lawyers look over contracts and all that type of stuff, accountants, all that kind of stuff adds up dramatically. Marketing and promotion and that type of stuff, be it you need to build out your website, maintaining your website, social media, Google ads and all that type of thing. So that’s, like I said, I mean, I don’t even know where else there is. There are so many hidden costs that people don’t really think about. 

If the treatment table breaks, you’ve got to get that thing fixed. And you’ve got to get it fixed now, you can’t just wait for a sale or some sort of thing, that’s part of your business. And just little things like if the toilet is leaking you’ve either got to bring somebody in to fix it, or you’ve got to go fix it yourself. And that comes down to that time piece again. 

But it’s just those little day to day nuances as an owner. Especially as a clinic owner that owns just one or two little clinics, you’re the person that everyone is looking at to get things done and get things fixed. And every little thing like that costs money. 

Heather: Yeah. Do you see yourself as a clinic owner moving forward? Do you think that will be part of your clinical career? 

Gabriel: I mean, hard to say. I mean I love certain aspects about it. There’s certain things I would struggle not having. I think being able to build a team of really loving, cool people that you like to hang out with is pretty fun. Because I mean, I get to choose who I work with and it’s pretty fun. 

Heather: That’s a good thing. We’ve talked a lot about what the downsides are of being a clinic owner, what are the best things about being a clinic owner? 

Gabriel: Yeah, like I said, coming back to that point, building a team of really smart, energetic people that are constantly teaching you things. Like I was saying before, I’m definitely not the best clinician by any stretch, but bringing clinicians that are really good clinicians and they know so much and you’re like, holy cow, how do you know so much? And having that person teach other people and attract other people that are kind of of similar mindset is, like I said, really satisfying. 

And watching people grow as clinicians too. Like hiring new grads or more inexperienced therapists and watching them thrive and grow and become really, really outstanding therapists. I think that’s a really cool thing to watch and see. So I mean, I’d say that was one aspect of it. 

I mean, I guess for me, I don’t know. I guess I kind of like, I mean, this is weird maybe to say, but I kind of like the sales aspect of it. Like going out there and promoting the clinic. I mean, I guess just because it’s my thing, that I really believe in what we do and the services that we offer. 

And because it’s your thing, you are very passionate about it. I don’t have to pretend that I like what I do, or that I like the physio services that we offer and stuff. I mean, I truly do believe it’s the best physio out there type of thing, right? So being able to go and tell people. 

Heather: Right, I hear you fundamentally believe in physiotherapy. You believe in the work that you’re doing, that it is of value to other people and can benefit others. And when you believe that, it is a lot easier to share that with other people. 

Gabriel: Yeah, versus say you worked at some other business that sold some product or service that you didn’t really 100% believe in, I think that would be really challenging. But like I said, being able to really believe in what I do, I kind of enjoy it actually, which is kind of weird. And I didn’t think it would be something that I would ever do, but I think that’s an aspect of it that I really actually enjoy. 

Heather: Yeah, that’s amazing. What kind of nuggets of information do you want the listeners to walk away with today? 

Gabriel: I mean, I’m going to spin it back to just kind of the clinic owner kind of perspective because I think that’s kind of what I can help contribute today. But coming back to the team of people that you work with, I think hiring a team of people that share the same philosophy. Because there’s definitely some points in time where you had an option to choose, let’s say, a very experienced therapist or a newer therapist. 

But say the experienced therapist has a certain way of doing things or didn’t 100% agree with your philosophy of treatment and things like that. But you’re like, oh, well, this person has the FCAM to know all these types of things. Like, oh, I should probably hire that person, versus having some newer grad that maybe is a little bit greener but shares the philosophy that you have. 

I think building your team is huge because, like I said, the culture that you create at your practice can make coming to work a joy, or it can make coming to work a nightmare. So I think having a good team around you is really important. And like I said earlier about building a team of people that are better than you, I think it is super, super important. 

And I mean, I think obviously it depends on the stage that you’re at, but creating a good solid leadership team. Because, I mean, trying to do it all yourself is extremely challenging, if not outright impossible. I always thought initially I’m going to do this by myself and all this, but that’s going to lead to a lot of stress and burnout. 

Having people you can lean on, like I have a clinic director, I have a clinical educator, I have an office manager now. And having those people around me makes decision making so much easier. It’s having a group of people that you can trust around you because, obviously, I can’t share every single piece of information about the clinic to the whole team. 

I try to share as much as I can, obviously, but there’s just certain things, especially when you’re making decisions about service offerings or whatever that I don’t want to share with everybody because it’s just too premature to start sharing it. But having a set of people that you can brainstorm with and bounce ideas off of and take apart each other’s bad ideas, I think, is really important, for sure. 

Heather: Amazing. 

Gabriel: Yeah, for me, having a good accountant is huge because I initially didn’t really do a good job with my bookkeeping or accounting practices. And I didn’t really realize how important that is for just having a good understanding of how the nuts and bolts of your practice is actually doing. 

And I think having somebody, a third party, I mean, it might be a third party, it might be a partner even possibly, to just decide here, this is kind of where your numbers are at and how you’re working behind the scenes. Is this a viable business deal? Or are you guys going underwater here? 

But having that, I do a monthly meeting, bookkeeping meeting with my accountant. But I just find that so valuable now and I have such a better understanding where things are and how things are changing. And kind of setting goals around that, too, is so important that I didn’t pay any attention to before when I was just getting going. 

Heather: Yeah, in terms of the business side, that’s a very important objective part of our business team and our health, for sure. I agree with that completely. Is there anything you’re working on now that you’d like the audience to know about? 

Gabriel: I have one more point, actually, about the kind of key nuggets to take away. So to tie in, and maybe this is what I’m working on too, maybe. But I think the personal growth as well is something that I would make sure that you’re kind of always keeping in the back of your mind. I was talking about burnout and just kind of working crazy hours, which is true. But just thinking about your own personal growth. 

And it doesn’t always have to be business or clinical stuff. But making sure that you’ve got some time for your family and your loved ones, that it’s not all about – I mean, for some people maybe it is. It definitely isn’t for me. But blocking off time in your schedule. 

I mean, having a good kind of organized schedule, a calendar, I think, is really super, super, super important. So make sure you block off the time that you’re going to be at work and block off the time that you’re not going to be at work, so then you’re not constantly on your phone, checking emails or responding to texts or Slack messages and stuff like that. 

And booking time in your schedule to spend with your family and turning the phone off or getting into a different room or not needing to feel the urge to check emails. Because if you don’t have scheduled time in your calendar to do that kind of stuff, like check emails and stuff, you’ll find yourself constantly checking emails all day long and responding to text messages and all this type of stuff. 

And then even when you’re with your family or friends or whatever, during your relaxing time you’re distracted by like, oh geez, I should check my email. I’ve got to check my phone or I’ve got to get back to that person. But having that kind of blocked off in your calendar to know, okay, well, I know that I’m going to spend this next little bit of time with my family or friends or whatever because I know tomorrow between one and five, or whatever the time is, I’m going to be able to check my emails and do all that. 

So I think that’s a huge thing that I’ve learned over the course of time. And that was actually from a mentor, I learned that. To just make sure that you’ve blocked off time in your calendar for fun as well as for work. 

Heather: Yeah, and I think that’s true no matter where you’re working clinically. Whether that is as a pure clinician, as an educator, a leader, an owner. Consciously and deliberately deciding ahead of time how much time you want to dedicate to work and the different aspects of work, and how much time you want to dedicate to things outside of work. No matter how much or how little that is, it is in the deliberate, consciously deciding beforehand is where we’re going to be more successful, for sure. 

Gabriel: Very much so. I like that. I like that piece of advice, Heather, it makes a lot of sense. 

Heather: I’ll add value to you as well. Well, I know you’re always looking to add people to your team, so what kind of service providers do you have on your team? What kind of people are you looking for in your clinic? 

Gabriel: Yeah, so mostly it’s physiotherapy, but we also have kinesiologists as well. And funnily enough, we just had this woman reach out as kind of an acupuncturist traditional Chinese medicine practitioner that aligns almost perfectly with our value, which is really kind of out of the blue. It’s kind of like the universe speaking to us or something. 

But she kind of was practicing out in Ontario and then moved out here and surprisingly lives just down the street from our clinic and was kind of like, oh, I’m an acupuncturist and blah, blah, blah. I’m, oh, anyway let’s have a chat. And then found out that our values are super aligned in terms of treating the whole body and kind of a very kind of pain neuroscience kind of background. I’m like, holy cow, this is really cool. So we’re going to bring her on. 

But yeah, so typically we’re always looking to hire physios. I mean, as I mentioned earlier at the beginning, therapists have a lot of choices right now. And that’s not just physios, I think that goes for speech, OTs and everybody. But there’s a lot more jobs than there are bodies to fill those jobs right now. 

So if you’re coming out of school or looking for a new place to work, you basically have the pick of the litter. I mean, maybe that’s an over-exaggeration, but I feel you can basically walk into any clinic and be like, I want to work here. And they’re like you’re hired. You’ve got a pulse, you’re hired. 

Heather: Yeah, definitely there’s a lot of choice. Yeah. 

Gabriel: I would say so for sure right now. And I think that’s a result of Covid and all these other kinds of factors that were out of our control. But yeah, so like I said, if anyone out there is looking, we’re always looking to hire and expand our team and just grow our team, like I said, with like-minded individuals. 

So any therapists out there, and it doesn’t have to be physio. I’m always looking to expand services. I do feel that an interdisciplinary team is always more fun to work with and to be able to pick each other’s brains and to contribute to the care and well being of our clients and our patients, I think is really important. 

So like I said, I’m always open to anybody looking for work if you’re in the Port Coquitlam area, for sure give me a shout. 

Heather: Yeah. Yeah, and you’re in the Port Coquitlam area of British Columbia, just because depending on where people are. 

Gabriel: Correct. Yeah, exactly, exactly. 

Heather: Yeah, and so if they want to find you, I have some of the links. Do you want me to share those links? Or do you know the links off the top? 

Gabriel: Sure, yeah. No, please. 

Heather: Yeah, go ahead. 

Gabriel: I was just going to say basically if you search Westcoast SCI, like science, Westcoast SCI and you’ll find me on YouTube and Instagram and all that good stuff that everyone else is on. Yeah, we write blogs all the time. So maybe you’ll come across one of our blogs here and there. But I’m quite active on YouTube and all that type of stuff, too. So check out our videos if you’re interested. 

I mean, we do a very wide variety of stuff. Sometimes it’s educational. Sometimes it’s just kind of getting to know our team type stuff or kind of client experiences, that type of stuff. I mean just tips and tricks and all that type of stuff. So have a look if you’re interested and want to learn more. 

Heather: Well, thanks, Gabriel. We really appreciate you coming and just being really open, honest and vulnerable about your clinical journey. I appreciate it. 

Gabriel: Thanks for having me, Heather. No, it was really lots of fun. I always love doing this. 

Heather: All right, thanks. 

Gabriel: Okay, take care.

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Thanks for joining me this week on the Clinicians Creating Impact podcast. Want to learn more about the work I’m doing with Abilities Rehabilitation? Head on over to abilitiesrehabilitation.com. See you next week.