Ron Tester | Coach for PT, OT & SLP owners @rontester
Business coach for PT, OT & SLP clinic owners. PT for 30 years, built and sold my own practice. rontestercoaching.com Atlanta, GA Joined September 2009-
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@SkylarSkye3 Yosemite
I work with owners who are still carrying a full caseload. I get why they stay in it. I stayed in mine too long too. The revenue felt safer with me producing. Patients asked for me. Stepping back felt like the risky move. But staying in was the risk. I just couldn’t see it yet.
Most owners hire because the schedule is full and the team needs help. That makes sense. But if the clinic doesn’t have a training structure or clear standards, the hire won’t fix much. You didn’t solve the problem. You added one more person to the same system.
As long as the business defaults to you for every decision, you're the limit on what it can do. Leading by design means choosing what runs through you and building the structure to handle the rest.
Before you post the next job, it's worth knowing whether you're hiring from strength or hiring to escape a problem a new clinician can't fix. I built a free two-minute scorecard: hire, wait, or fix first. RonTesterCoaching.com/hiring-scoreca…
Before you promote someone, ask this: If I stepped back for two weeks, what would they notice and handle without me asking? If the answer is “quite a bit,” they may be ready. If the answer is “not much,” don’t promote them yet. Give them more low-stakes reps first.
Most owners know their revenue and profit. Fewer know by Monday morning whether last week made money. The Monday Margin Check is a free, short read that helps you see that without building another report. [rontestercoaching.com](get.clinicvitalsigns.com/monday)
After enough denials, a therapist stops writing the plan she believes in and starts writing the plan she thinks the payer will pay. The payer didn't say no. The plan of care already shrank. That cost doesn't show up in your AR.
Put the new clinician’s training time on the schedule before you open up their patient slots. If you wait until after, that time will get filled with patients. It almost always does. Just because there are open slots doesn’t mean they’re set up for onboarding.
A title doesn’t make someone a leader. It gives them authority. If they can’t have one clear, kind, direct conversation before the promotion, they won’t suddenly have it after. The title doesn’t create the skill. It raises the cost of finding out.
You handed off the schedule, but the front desk still asks which patients to move when a provider calls out. That usually means you moved the task, but kept the judgment. They don’t need “more ownership.” They need to know what you’d decide and when it comes back to you.
A full schedule can still hide a thin margin, and a lot of owners don't see it until the month-end numbers land. You don't have to overhaul anything to catch it sooner. I made a free Monday Margin Check: a few numbers worth a look each week. clinicvitalsigns.com/monday
Something I had to change my mind about: I assumed a strong clinician becomes a strong owner. They're different skills, and I learned the second slowly, mostly by getting it wrong. Treating patients never taught me how to hire, set a standard, or read the numbers.
Thirty years as a PT, and I'm learning AI from scratch right now, making myself talk to a camera I'm not comfortable with yet. I ask owners to do uncomfortable things all the time, so I keep doing some myself. Keeps me honest about what I'm asking of them.
Early on, I knew no one who'd been where I was. No one to tell me which problems mattered, which mistakes were the expensive ones. I figured it out the slow, costly way. Most of why I coach now is to spare an owner a few of those years.
@niko_kukushkin @tszzl At least you said the quiet part. That matters.
Most owners bonus the therapists and never bonus the front desk, even though they shape how full those schedules get. Tie the front desk bonus to utilization, with a steep jump at the top tier, and the person answering the phone has every reason to fill the open slots.
When a candidate says she plans to leave in a year, most owners hear a warning. More often she's showing you ambition, the kind most candidates keep hidden. Ask where she wants to be in three years and build the role toward it. Do that, and a competing offer has a lot less pull.
Most clinics only post a job ad when they're desperate, fill it, then start from zero at the next opening. The clinics that rarely get stuck keep a pipeline warm before they need one: students, interns, rotations. They built it years ago.
Reimbursement rates are only part of the deal. A high-reimbursement service line that buries the front desk in paperwork, and can't be staffed can lose to a lower-reimbursement service line you can hand off and repeat. What does it take to earn and collect it?
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