March 11, 2025 • 42 mins
Are you running a private practice but struggling with financial management? You’re not alone. Many healthcare professionals find accounting, metrics, and financial strategy overwhelming—but mastering these areas is the key to business growth and long-term success.
In this episode, Will and Keith break down the most common financial mistakes private practice owners make and how to shift your mindset for sustainable profitability. They discuss:
- Why financial awareness is crucial for business succes
- How technology can provide clarity and forecasting power
- The key financial metrics every practice owner must trac
- How coaching can help bridge knowledge gaps in business finance
- The mental shift needed to go from clinician to business leader
- The future of accounting in private practice
If you're a PT, healthcare provider, or private practice owner looking to grow your business and take control of your numbers, this episode is packed with insights you can’t afford to miss.
Virtual Rockstars specialize in helping support or replace all non-clinical roles.
Learn how a Virtual Rockstar can help scale your physical therapy practice.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:03):
Thank you so much for tuning in to today's episode,
Rockstars.
Today we've got Keith Campagna,who's the growth officer at a
company called Accounted For.
They are specialized in thephysical therapy space to help
all things accounting.
So before you turn off theepisode by hearing that most of
you are like I don't want tohear an episode about accounting
, you are going to, I promise,love this episode.
I will tell you from personalexperience, rock stars, that my
(00:26):
journey in changing my mindsetwas significant around this
thing called accounting.
So, whether you're afraid toadmit that you don't understand
what a P&L is, or whether youare fully aware of your numbers
and you think you mastered it,if you're looking to sell one
day, I want you to pay attentionto this episode because we're
going to be talking about themindset that accompanies growing
(00:48):
our business through ouraccounting.
We're going to compare it to aconductor creating music and how
accounting and the financialpiece is the theory of it, but
together we can create the artand be controlling our future
together in our businesses.
It's a very fun episode.
Keith is an amazing guest.
Enjoy the show, All right,Keith.
So listen, man, we were talkingabout growth and you were
(01:11):
talking to me about what youthink limits PT, OT, SLP leaders
from growing their practices.
Can you talk a little bit aboutwhat you were saying earlier
about what's limiting them?
Speaker 2 (01:22):
Yeah, I think for anybody and I think it extends
beyond private practice, I thinkfor anybody who's trying to
build on a dream or a visionthey have a sense of instinct,
gut instinct, that they followand it's worked and it got them
where they were.
But what really helpsbusinesses grow is knowing their
numbers, and what we weretalking about was this idea that
(01:44):
, like in all of the challengesinside of the private practice
space, what seems to be lyingunderneath it is just an
inherent unawareness of whereare my numbers, because every
practice owner will that I knowyou've met and I know I've met.
They're really smart people.
They're super, superintelligent.
But there's this thing aboutaccounting where people are a
(02:06):
little bit like keep the numbersaway from me.
I don't know.
I have an accountant.
They should be handlingeverything.
But at the end of the day,that's not the truth and that's
what we're doing at Accountant 4.
We're exposing that.
Speaker 1 (02:18):
Yeah, I think, rockstar, as you're listening to
this, I want you to really dialin, because many of you are
listening going.
I already know my numbers.
We're not talking aboutproduction numbers.
We're not talking about patientvisits.
We're talking about the numbersthat, if we're being honest,
you may not understand as muchas you would like.
Or, like Keith said, you mightbe giving to somebody else and
having them in charge.
And I will tell you, keith, inmy business networking
(02:39):
experience, having been withhundreds of companies over the
years in and out of PT, thenumber one thing I hear, when
people go south like theirbusiness almost loses everything
, is because they've delegatedtheir financial aspects to a
fractional CFO or someone thatthey just literally put over
there so they can go back totheir work.
And then, all of a sudden, oneday their cash flow starts
(03:01):
shifting if they even know whatthat is and then their accounts
start.
What they notice is when theiraccounts start dropping.
That's right.
Conversely, conversely, I'vegot clients who are listening
and you know who you are guysI'm thinking of specific names
of people who are probablylistening to the show who wake
up every day and they look attheir cash flow in their bank
account, and if it varies by asmall margin, it's enough to
(03:23):
send them into a mindset whereit ruins their day.
So, there's extremes.
You've got one extreme of likedelegate forget.
You have this other extreme oflike not knowing how to read the
numbers in your accounting sothat you're reactive to every
minor difference.
So, like dude, just talk to me.
I feel like I've said a lotLike talk to me about what comes
(03:44):
to mind when I say that.
Well, what comes to?
Speaker 2 (03:46):
mind is that we almost have to take a step
outside of the private practiceindustry and talk about
accounting for just 30 seconds.
I promise to all of the rockstars out there this will not
put you to sleep, Keith is goingto make it entertaining.
Speaker 1 (03:59):
He can literally make anything entertaining to me.
Let's do it, let's do it.
Speaker 2 (04:03):
So if you look at the accounting industry and you go
online and you searched crisisin accounting, you'll find out
that in 2020, the industry thatoversees the certified public
accountants identified 75% ofthe certified accountants in
this country hit retirement agein 2020.
(04:24):
Wait, how many 75%?
What the crap.
That's insane.
If you think about the industry, what comes to mind?
Old white dudes and taxes,right, two things that people
aren't overly excited about.
Now, something that I know frombeing in the world that I grew
(04:44):
up in from a softwareadvancement position accounting
is laggard.
They simply manage taxes andthat's what everybody knows
about accounting for.
It's why accounts work four anda half months in the beginning
of the year, because nobody doesany work until it's too late,
and then the accountant's got toclean it all up, and then they
(05:05):
take two months off to figure itout how to fix all that and
then they re-kick their businessdevelopment right.
But at the end of the day, allof these accountants are leaving
the industry and all of theirhuman capital is going with them
and, with that being said,they're losing their touch with
(05:28):
the world.
The business owners, the entiresoftware industry is trying to
fix a CPA problem, and nobodyvery few people are addressing
the small business owner problem, and that is that business is
way more than just tax from anaccounting perspective, it's way
more than taxes.
It's cash flow, and maybe oneout of 10 business owners
(05:51):
understand the differencebetween cash flow and profit,
let alone EBITDA or all theother metrics that come into
play when growing a business.
Speaker 1 (05:59):
Yeah, man.
So that is a huge insight isthat all of these experts are
leaving the industry and the waythat it was traditionally
worked it worked was brokenanyway.
I went through in my businessesum five different CPAs in my
timeframe and I have actuallydone a number of combinations
and bookkeeping and all theseelements, but for me from
personal experience, rock stars.
(06:20):
Everything went from likeworkable to incredibly
productive and profitable.
When I got that, I still don'tknow everything about numbers,
but I'm not afraid of my P&Ls.
I know the 20% that I have toknow to manage and uphold my
bookkeepers and I wouldn'tconsider myself an expert, but
(06:40):
compared to many small businessowners, they might think I am
because I can talk about cashflow and some of these terms.
So talk to me, keith, from yourperspective.
How do you help your PT ownersand or other business owners
understand their metrics?
What do you do that's differentaround all that?
Speaker 2 (06:58):
Well, there's two things.
One there's this softwareeveryone's heard of called
QuickBooks right, yeah.
And the funny thing aboutQuickBooks is that eight out of
10 small businesses use it, butvery, very few of them are
actually using it.
Again, because it has to dowith accounting and there's a
real mental block as it relatesto getting close to accounting.
So the data inside QuickBooksis not very accurate.
(07:21):
If you think about bookkeeping,it inherently takes place in
the past.
So, as a small business ownerwho's got a billion things on
their mind, their best chance atlooking at accounting is
outdated information based offof tax reporting purposes.
What we do differently is weactually take the data out of
QuickBooks.
We refilter it and put a bunchof rules in our software, then
(07:42):
put it back into QuickBooks.
So youilter it and put a bunchof rules in our software, then
put it back into QuickBooks.
So you, the business owner, youdon't have to learn new
technology.
But we give data integrity toQuickBooks, which takes you out
of the bank account mathbusiness the one that freaks out
everyone that you'd mentionedright and we take and it gives
(08:03):
you clarity, it gives youcurrent state cashflow.
I know my revenue is coming in,I know my expense is going out,
but the key will.
We all have technology, but itdoesn't mean that we're using it
.
What we do is we leverage againour proprietary tech to build
forecasting trends andprojections and we coach the
clients on a very fractional,based off of their need, basis
(08:26):
on what to do with the numbers.
And that's the big gap.
That just is what we felt, wefell into literally as we
entered the private practiceindustry.
Speaker 1 (08:38):
How did you guys enter the private practice
industry?
Like what led you to that, justlike anyone else.
Speaker 2 (08:42):
Well, references like the, the, the relationship
inside this industry isdifferent and, for what it's
worth, my background is insoftware sales.
I've worked in every industryand every size company.
I've talked to the owners ofthe people that work in there.
I've never experienced any likeprivate practice.
Simply put, my co-founder, seanhe was working as a business
(09:05):
development partner for anaccounting firm and him and
three of the partners were at atable and a private practice
owner said, pointed his fingerat all three of them, one at a
time, and asked where his moneywas, and not one of them could
tell him the answer.
And so Sean decides to meetwith the guy to understand it.
(09:25):
And, sure enough, seanrecognizes this opportunity and,
just like you and I would, overthe weekend he goes out and
builds code, because that's whatSean is about?
No, he never did it before.
He literally learned the codeto build this process that
allows us to clean the actualdata and provide the going
(09:45):
forward metrics.
So you know what to do if youwant to improve your numbers or
you know there's a ready forthis one.
You know there's a three monthpayroll or three payroll month
coming up.
How do I accommodate that?
Besides crap my pants as asmall?
Speaker 1 (10:01):
business owner.
It's another way of saying thatis doing nothing, because you
see it coming and you're like,well, cross my fingers, let's
just see how it happens.
Speaker 2 (10:08):
Right.
Imagine having, instead of justyour revenues which, again,
this is a gap that we fill withthe industry instead of having
all of those metrics that comein from the insurance providers
and how much reimbursementyou're getting, you have to
assign your expenses to this.
So, when you combine your costand your revenue, well, guess
what?
Now you know your financials,and that's the part that I think
(10:30):
you were mentioning.
That makes you much morepowerful.
It's that simple.
Speaker 1 (10:35):
Absolutely, and I have so many questions.
It's hard because, rockstars,there's like eight episodes
built into this that we couldtalk through right now.
But I will tell you this thatin my world that when we got to
the point where I was able tounderstand those metrics again,
it was an accelerant, I mean.
But it's so much harder, Ithink, when you don't have a
(10:56):
financial background, that a lotof PT owners, ot owners, they
just think, man, there'ssomething wrong with me.
I honestly feel there's a lotof imposter syndrome going on
around their accounting numbersand it can be an incredibly
overwhelming world for people toget into because it can just be
(11:17):
this scary piece of it.
So what would you say would bea baseline focus for listeners
who maybe, who almost, are there, like, what would you say the
essential reports are and whythey should?
They should like, pay attentionto those reports?
Speaker 2 (11:33):
yeah.
So really good question.
So, the things that we do weoffer a free quickbooks
assessment, so I'll just sharewith you what we do and then
your, your rock stars, canbasically go about doing it.
If they want to talk more aboutit, well then we'll see where
that goes.
But, all things consideredequal, we look at P&L, we look
three years back and we want tosee macro trends.
(11:55):
Yes, my revenue grew, but why?
Yes, my revenue declined, butwhy?
One of the things that sticksout more often than not is
marketing.
Numbers will go up, costs willgo up, but revenue doesn't.
What happened there?
Because people don't take thetime to understand the numbers.
They don't realize what's goingwrong.
(12:17):
We had a client who literally,oh, it looks like you're
spending $3,000 a month inmarketing.
What's your ROI?
I don't have any.
And then they stopped paying$3,000 a month in marketing.
What's your ROI?
I don't have any.
And then they stopped paying$3,000 for something that wasn't
getting them an ROI.
Well, like $36,000 back intoyour bank account, boom, right.
So there's the P&L, there's thebalance sheet, right, what's it
(12:38):
look like right now?
And what can I look at from alabor?
Like, labor is the big one.
What does my labor look like inpercentage of total cost and if
you're above 55%, why?
It doesn't mean it's bad.
That's a key thing.
Numbers inherently aren't bad.
It's the thing that got youthere and the context, which is
what comes when you work withsomebody who can help provide
(13:01):
context.
And then the other one is thethird.
One would be like a vendormanagement report.
Try to figure out where you'reputting your money to.
You might not realize like,again, just as an example, we've
had clients where we'veuncovered $20,000 plus of paid
subscriptions that were of nouse whatsoever, just purely
(13:24):
outdated money going out.
So if you can keep an eye onwhere the trends are, it could
peak to start curious why did itget there?
Or why is it working?
And then you can double clickon it and then, with the vendor
management report, it gives youperspective on how to reduce
your expenses.
We've had a client where theirpayroll vendor just decided to
(13:47):
start doubling their charges,their fees.
Just double their fees.
No conversation, no, nothing,if not for the bookkeeping
service, right?
Why did this double?
I don't know.
Boom, go back, save six grand,get six grand back.
Speaker 1 (14:01):
You said something really powerful in the end.
That really highlights thebalance, in my opinion, of what
the owners should be responsiblefor versus the accounting
experts that they work with,because, again, it's kind of
like a medical billing company,in the sense that PT owners
don't have the knowledge base,so they sacrifice this knowledge
and just give it like amonopoly to the person that
(14:21):
they're outsourcing it to, andthat lack of balance creates
issues.
Accounting is the same way, butI also sent I also, at the
beginning of this episode,talked about clients I've had
who are holding every detail oftheir accounting themselves, and
what I've seen in that case isthey get so granular that they
start worrying about thesereally small decisions because
(14:42):
they've put so much time andenergy to find them.
So you need an accounting groupthat's going to bring
everything to your table andgive it the right gravitas, the
right emphasis of everythinggoing.
Hey, here's a subscriptiondifferential.
This is low-hanging fruit.
We can just cancel it if youwant.
Or, hey, your labor cost was atthis percentage, which, by the
way, rock stars.
That was the number of all theaccounting numbers that changed
(15:04):
my world, because I got grossand net income.
I understood in general okay,I'm making more money than I'm
spending, and that kind ofconcept.
But the number one thing that Ifigured out with the help of a
great accounting solution who'sno longer even doing it anymore
was the percentage of payroll toincome.
How much do I spend on mypayroll based on my income?
(15:28):
And that became the North Starmetric financially.
That led all of mydecision-making because, like
you said I'll rephrase itinformation leads to inspiration
.
Where you guys come in and Iwould say all of us need to have
, if we don't have this solutionis the information from the
(15:49):
financial perspective that leadsto the inspiration of the
decision making.
And the most key of those wasthe second thing you mentioned
for me, which is understandingthat payroll to income piece.
Just a more personal curiosityhow do you work with your
clients around that number, like, like, what does that
discussion even look like?
Do you bring that to them andsay, hey, you're paying 80% of
(16:09):
your income to, you know, topayroll Like, what do you guys
do to support them in that?
Speaker 2 (16:14):
Oh, hell, yeah, it's the number one.
It's the number one obstacleyes, and it's the number one
opportunity Opportunity Right,thank you, and it's the number
one opportunity Right, thank you.
Right, like at a very baselevel, what we're talking about
(16:36):
is how obviously unaware aprivate practice owner is about
their business not theirprofession, but their business
because they don't know that.
They're probably aware that itcosts a lot of money to pay
people, but they don't know thatthey're.
They're probably aware that itcosts a lot of money to run to
pay people, but they don't knowhow it falls into the actual
landscape, the whole landscapeof the business.
And something you mentionedabout the clients that are, or
(16:57):
contacts of yours that are, inthe weeds you mentioned, they're
like stuck on all these details.
That's the thing that can getyou wrapped up I say wrapped
around the axle, right, like youhave to see business as a game
and this is where the coachingcomes into play.
There's an offense and adefense, and if you're paying
attention on this little thinghere and you don't pay attention
(17:21):
to the labor that you'respending, what's the point?
The big win is in the labor.
You know that the second, nextwin may be very well in how do I
streamline efficiencies, how doI reduce my cost in certain
areas by bringing in technologywhich, by the way another
episode Our industry is so youngin accepting technology that
(17:48):
the opportunity and this is whatbrings us at account we're like
super pumped about being at PPSand helping.
It's just this notion of there'sso much opportunity, because
it's not like you can't figureout how to get more money.
It's not how you.
You can't figure out how torecruit, you can't figure out
how to improve a patient'sexperience.
(18:09):
All of that's out there.
You just have to figure out howto align the pieces in with the
business that you have and then, like you, you'll get better
results.
Speaker 1 (18:18):
Yeah, and that's one of the reasons I have the
podcast, because for me, I wantto be able to bring solutions
like you guys to the table,because there's so many services
and technologies that peoplejust don't even know about.
We are the very youngest in allof healthcare, you know quick,
just like highlighted, that iswhen I talk about virtual
assistants on my company's endof people, they're very much
(18:38):
like oh, tell me more.
If I go to a non-PT event, if Igo to dentists or anyone else,
they're like yeah, I've alreadygot my.
They've been doing it for 10years.
And we on like AI, we're earlyadapters of all these things.
But that's why there's so muchopportunity for owners.
It's always like well, how arewe going to make greater profits
with declining reimbursements?
It's like well, we have thiswhole efficiency realm that we
(18:59):
haven't even tapped into,notwithstanding baseline
services like yours that arejust like oxygen that you have
to have, that people don't evendo that appropriately.
There's so much opportunity forgrowth.
I have friends who have sold 10, 20 locations After they stayed
on for a while.
They're starting more locations.
Why?
Because it's such a profitable.
Ptot is such a profitableindustry.
(19:21):
It's so easy to make money whenyou've got the right solutions
in place, and it comes down todollars and cents, like you guys
do, it accounted for.
Speaker 2 (19:30):
And you used the term imposter syndrome earlier, so I
want to bring that back,because one of the things that I
got to enjoy I get to enjoy isthis I'm not a trained PT, ot,
I'm certainly not an accountant,so I get to walk into the
industry eyes wide open, earswide open, mouth shut and I just
(19:52):
listen, and the thing that Ikeep realizing and learning is
that it takes a differentmindset to go from a clinician
to an owner, to an entrepreneur,to an exeter, to maybe even
coaching, going back into theecosystem.
Right, it really requires amindset and with each shift
(20:14):
comes the imposter syndrome.
I don't know what.
I don't know, I feel worse, I'mnot going to move towards it
and it's not easy.
It's not easy.
Speaker 1 (20:24):
No, it's over.
I will tell you this.
I think most people who arelistening to this show rock
stars.
I'm hoping you're already awareof these stages of mindsets.
I'm hoping that's not a newtopic because if it is new,
quickly you go from independentowner, where you're exchanging
time for money, to where youstart developing a team and
systems and processes andeventually become a business
(20:45):
owner where you exchange peopleand processes for money.
This is all rich dad, poor dad,stuff and then you go
eventually, the end goal beingthat you're an investor in your
own company where you'reexchanging money for money and
other people are running yourbusiness.
And that's where friends ofmine have scaled to dozens of
practices and sold and so forth.
But maybe what's not clear topeople who are listening is that
(21:07):
their mindset shift has tooccur around this, amongst some
very key divisions of theircompany, and what you're saying
is that one of those key areasis accounting.
When you talk about accountingwe're not talking about medical
billing.
That's the end result of that.
The collections it goes intothe accounting side of things.
(21:29):
That's revenue cycle.
Revenue cycle, I would say,also is another area where our
mindsets have to shift over time.
Accounting.
It has to shift, Like earlystages, they just need to know
their income and their expenses.
But if they're going to scaleand ever become an independent,
freedom-based owner, they haveto know how to lead their
leaders through finances, yes,and not just their leaders, but
(21:53):
the clinicians on the floor,right Like there's this big
movement.
Speaker 2 (21:57):
Right and funny enough, a lot of this.
I have my own personalexperience with helping a
private practice that's local tome here, because I had my
shoulder I needed work on.
Sure enough, I go see somebodyand I can't shut it off Will.
So I'm looking around and Iasked the woman that was the PT
(22:18):
that was working on me.
She was the manager of thelocation.
So I started asking all theserevenue questions because I am
sitting on a table and I saidwhat challenges are you having?
And she said ancillary services, laser treatment, massages, all
of these things that cost money.
I can't get my therapist to talkabout these services, and so I
(22:39):
wound up getting a client layingon a table because of the
different approach that really,when we think about the
experience of the patient in adifferent way, you're able to
lock in all of these elements.
But if you don't going back towhat we're talking about, if you
don't know the numbers, youcould be going in the wrong
(23:02):
direction or you could bespinning your wheels.
But if you know the rightnumbers, it's just copy paste,
copy paste all day long.
Speaker 1 (23:09):
It's very simple.
What I love about accounting isthat once people get a baseline
understanding with the rightpartner, like an accounted for,
it becomes very objective.
A lot of what we do as leadersrequires creativity and like
there's something very black andwhite about the story that is
told through our numbers.
You know, the biggest mistake Imade in my business was looking
(23:31):
at my numbers as a postmortem,meaning I only looked at reports
from like what happened lastquarter so I could and that was,
by the way, that was still verygood.
That was a mindset of like amanager level owner where I was
still very much a manager in mybusiness because it was good to
know what happened historicallythat put me in the seat that I'm
in right now.
But history is only half ofwhat numbers tell us.
(23:53):
They're also the greatestpredictors of future success and
that's one of the keys I tellpeople and at Rockstar I would
encourage you if this is anepisode that's really
interesting, you and you'refeeling even a little bit
overwhelmed I would encourageyou to do this is to sit down
and watch Shark Tank.
Watch Shark Tank with yourphone and chat GPT and listen to
the discussion and not letanything go.
(24:16):
When Kevin O'Leary talks about,you know, acquisition cost.
Right then, what is acquisitioncost?
What is it?
And start like having adialogue with artificial
intelligence while you'rewatching the show.
It will be relaxing in someways, but it'll also surprise
you how easy it is to understandthese concepts.
And then, once you put yourarms around these, then it puts
us in a position where, goingback to what you and I are
(24:37):
talking about, we can lookforward and go, based on
historic trends.
I can project, if I keep doingthe same things, this outcome.
Do I want that or do I want totweak it?
And that's where the fun comesin.
Right?
I'm guessing that's where youguys have a lot of fun is
helping owners kind of createthat future.
Speaker 2 (24:55):
Yep, yeah, and like, two of the questions that we ask
every time with our clients iswhat did we do well and what
didn't we do?
Speaker 1 (25:02):
well, when you say that you're talking about, like
we, as their practice, you'renot Right right right For you.
Speaker 2 (25:09):
Yeah, right, right, yes, yes, like what went well
and what didn't go well for ourclients, right.
And it really boils down toyour point.
If you understand the leadingindicators right, the past is
the lagging indicators.
The future is the leadingindicators.
If you understand, because nowyou were able to map what your
expenses look like and what yourrevenues look like into the
(25:30):
future.
Well, now you could startmaking educated guesses on
things, not just what othervendors for other software
companies tell you, not what youheard from somebody else.
And then, all of a sudden, yourealize that they forgot to
mention this one thing, whichblew, sunk your boat, so to
speak.
It's you get to choose on yourown numbers, leveraging your own
(25:53):
experience.
It's the best.
You have the most fun growingyour business.
Even you, like you, smiledbrightly when you got to that
point, right?
Speaker 1 (26:02):
Well, yeah, because it's at that point you feel
empowered.
I even now get really excitedabout thinking around these
numbers because you start tofeel more at cause, like I know
what happened historically, Iknow what my leading indicators
are, so I can get again being avisionary.
As leaders that we all are,it's our job to predict the
(26:22):
future and there's always someart to that.
But the numbers that we can usethrough accounting is the
science of it, and the scienceis predictable.
The science is easy with theright support.
So when I love talking aboutthese topics to people because
the least attractive, the leastsexy topics in healthcare,
(26:44):
medical billing, accounting nooffense, but perceptively,
that's how they view it thoseare the most fun Because when we
can control that, we can startwriting the future in our own
handwriting and go this is whatI want to build, this is what I
want to create, and so havingthe ability to wrap our arms
(27:05):
around our numbers is one of themost fun things that people can
learn to do, and they don'tknow that until they work with
somebody like you, obviously.
Speaker 2 (27:13):
Well, it makes it a lot easier when they do, for
sure.
And the part that I'm hearingand which you know I'm smiling
now because you got meremembering things that I love
about business is that if youlook at a musician, indulge me
for like 30 seconds.
If you look at, music, which Ido, and you've got rock stars,
so this applies right.
I was born to be a rock star.
I have no musical talent, so Ilove being around other rock
(27:36):
stars.
But my point is that when youlook at musicians, they make
work, look like play, and whenyou can do that which is totally
what you just described whenyou can, as a private practice
owner, restructure the way yournumbers look and your business
looks and your mind works sothat the work becomes fun, you
(28:01):
nailed it, dude You're playingthe game, you're no longer
stressing, you're growing, andthe best way to know you're
playing a game right is to knowthat you're having fun.
If you're having fun, otherpeople will come and have fun
with you and away you go.
Speaker 1 (28:14):
Yeah, and that shifts everything.
I want to just for the rockstars are listening.
I want to keep going on thisanalogy of accounting being like
music theory and like the ideathat as people are learning, you
know the structure of the songof their business through the
theory of their business,through accounting.
It is going to be a little bitleft-brained.
(28:35):
It is obviously left-brained.
You're going to be learning howthat works.
My youngest son is a musicalsavant.
He can listen to any sound andtell me the exact note.
He's been doing that since hewas three.
He's a master pianist at theage of 12.
And what's funny is that hespends a lot of his time
obsessing with music theory.
He'll take out these pieces ofpaper with the lines and he's
(28:57):
just sitting there not playingmusic, drawing the notes and
connecting them, but he hearsthe song in his head and that's
what's so.
Crazy is that there arebusiness owners out there, guys
who are like my son, who arebusiness savants.
They just get this stuffintuitively, but most of us 99%
(29:18):
aren't.
But there's a lot of reallytalented musicians who aren't
like my son, who just love thesound of music, who love to
write the theory and then, whenthey start connecting their
ability to create on paper andthey can start hearing that song
in their own head.
Then it's like, okay, what kindof song do I want to write?
And that's where the fun andthe beauty comes out.
Speaker 2 (29:34):
And no musician ever learned music alone.
They leveraged someone else'smusic and no business owner
created a business alone.
They all had somebody, a mentoror a coach.
And that's the part againearlier in the conversation.
What's missing, it's not justtechnology, it's having a coach
that can easily either A keepyou accountable or B.
What's missing it's not justtechnology, it's having a coach
that can easily either A keepyou accountable or B keep you
(29:56):
motivated, or C let you remindyou to be excited about what's
happening right.
You're breaking out of the oldmold and becoming someone better
.
Speaker 1 (30:07):
Yeah, no, you're so spot on, you know.
Going back to my son again,he's constantly looking for the
next teacher who's going toteach him more of what he needs.
So it'd be like someone playingthe piano without a teacher
going.
Well, I'm a loser because Idon't know how to play piano.
It's like no man, like everyoneneeds their instructor and they
need the theory, and when westart to slowly progress, we go
(30:28):
from chopsticks to Beethoven'sFifth.
It's all about that.
It's not the age, it's thestage that we're in.
And I do want to validatesomething, keith, for our rock
stars right now that rock starsI brought in a financial expert
once, when I had about fivelocations, I think we were doing
roughly $4 million a year.
(30:53):
I brought in a financial expertbecause I was just really
struggling in that space, and soI went out and I found someone
with no healthcare experiencewho had worked in every other
industry though, who came intoour business, and after three
months he resigned and I waslike what's going on?
He's like this is too hard.
I was like what do you mean?
And it was because he was a CFOtype, so it wasn't just
accounting, it was like CFOlevel stuff.
He goes well, I was forced tothink that healthcare would be
(31:16):
just like everything else andwhat I've realized is that
healthcare is completelydifferent from a financial level
because of medical billing.
Like the biggest thing he wasstruggling with was more on that
revenue cycle side, but how itdiluted and confused him on the
accounting side is where he drewthe line.
And so since that timeframeI've worked with people.
I think it's really important.
The lesson on this is number one.
(31:37):
Like if you're struggling inthis on any level, you know
maybe you get it at a base levelbut you're realizing now you
need to know it even better.
Good, you know, just realizethat's the wonderful stage
you're in and that, like a lotof people struggle in that, I
would argue, everybody I've evermet required a coach in
healthcare.
I don't think there aren't anysavants who could figure that
(31:58):
complexity without help.
But number two is that whenyou're working with somebody
who's an expert, that you findsomeone who's really dedicated
to the healthcare space and evenbetter if they're PT specific.
And you know, that's one of thethings I really appreciated
about you, keith, is that youguys are all in on PT.
I mean, you guys have visionsfor PT owners.
Why is it that you guys are soconnected and passionate about
(32:19):
the PT industry when I see acompany like yours come in?
Obviously, when it comes toopportunity, that could be in a
lot of different areas and I'vebeen told by other mentors
there's better opportunitiesoutside of PT and healthcare.
What is it about you guys in PTthat you're so passionate about
?
Speaker 2 (32:34):
I mean I can't, I'm not going to take away from the
opportunity that's there right.
So there's the business.
Opportunity excites us as abusiness because we could grow.
But my mother's retired in ICU,ccu nurse so, and Sean's mother
, the founder, I believe sheretired in healthcare, I don't
know to what level, but thepoint is that the community
(32:57):
inside of PTOT is trulyremarkable.
From my own personal experience,the passion that goes into
patient's care, the knowledgethat it takes to be the amount
of debt that one has to incur tobe able to help someone feel
(33:18):
better, is remarkable.
And then you get into a privatepractice company and you start
working with other like-mindedindividuals and then they start
branching off and, like, you'vegot within PPS, you've got the
peer-to-peer groups, you've gotso many networks that are all
designed to help and, honestly,I fell in love with the business
(33:43):
world decades ago.
I love small business, I thinkin a time I don't know if this
is what happens on your side ofZoom, but in a time where
everyone's freaking out aboutbad news and aliens and all this
stuff and the way corporateAmerica and corporate behavior
gets written about in the newswhat's always worked and
(34:06):
arguably has been the reasonthat things are still better
than they're not is smallbusiness, and that things are
still better than they're not issmall business, and so private
practice, I think, epitomizeshealthcare.
The thing that matters most isthat people feel better as soon
as they can, and at their owncontrol and maybe
non-pharmaceutical manner.
Right yeah, and then theopportunity to build an
(34:30):
ecosystem that works inside of amarket that rewards people for
hard work and good decisions.
It's just super fun, will.
Speaker 1 (34:37):
It's super fun.
It is fun.
I think, at the end of the day,two things can be true at the
same time it can be super fun tobe in this business and there
can be incredible challenges.
Those two things can be true atthe same time.
It can be super fun to be inthis business and there can be
incredible challenges.
Those two things can be true atthe same time.
I think what makes it fun iswhat you and I were talking
about earlier this idea of whenwe're in it with people, we're
not alone, we're getting theright story and baseline
(35:00):
understanding of our business sothat we can start controlling
our future.
Then it becomes really worth itbecause of the business that we
are in.
I just want to second what yousaid, too, to our rock stars is
that the business that you guyshave taken on is no small thing.
Like every little stand everyPT, ot or speech therapist makes
in their community is a standagainst Big Pharma, it's a stand
(35:23):
against dependency, it's astand against the centralization
or what do they call it wherethe consolidation of healthcare.
Right now, private practicesare diminishing in every sector
of healthcare, so every day whenthat PTOT, slp owner gets up,
turns on their computer ordrives to their office.
(35:44):
They're taking a stand for thegreater good of all humanity.
Not to be dramatic, this isliteral, because what they're
standing for is the best qualityhealthcare, because no one and
everyone would agree to this.
No one gives better healthcarethan private practice does in
any of the healthcare segments.
So for us to fight the battle,I want Rockstars, as you're
(36:06):
listening, to think ofyourselves as generals of an
army and not minimize that, notminimize the impact or the
importance of what you do,whether you have two employees
or 20 locations that every dayyou're getting up, you're taking
a stand in big ways in thatcommunity, but you have to have
generals, you have to havegenerals underneath you, you
have to have admirals, you haveto have these leaders and
generals underneath you.
You have to have admirals, youhave to have these leaders.
(36:26):
And one of the single mostimportant elements of your army
is going to be the ammunition.
It's going to be the energythat you have as a business.
And what is that?
That's the money.
And who's your admiral overyour finances?
Who's in charge of youraccounting?
Do they have healthcareexperience?
Zero to 10, where's yourmindset on that?
Like, are you advancing yourmindset around that.
(36:49):
Do you have someone who's goingto help you?
Do you have a service you referto?
Do you have a guy that you talkto once a year when you pay his
bill, after he tells you whatyou owe in taxes?
Or do you have an admiral who'son the front lines with you?
And the only reason I broughtKeith to the table is because
that's who he is and his company.
This is a very passionateperson who I have heard multiple
times through my network of howhe is there with you as you
(37:10):
fight this battle in yourcommunities.
So sorry to put you on the spota little bit there with a
slightly dramatic monologue, butit's true, keith.
I think you guys are making animpact in that way.
What do you guys see for thefuture, like if you could create
if you got your own pen foraccounted for?
Speaker 2 (37:32):
what do you want to see happen for your business in
the PT space?
I want it to become a commonbehavior.
One of the things we say a lotas it relates to accounted for
with our clients is that there'scommon sense and there's common
behavior.
Right?
So like the idea that thecareer let's, maybe we even
started smaller the curriculumof learning private practice
includes business managementthrough accounting, basic stuff.
(37:56):
So like the dissemination ofinformation would be the answer.
Right?
The idea that you too canunderstand this stuff that would
be the thing that I would wantto see the most, because with
that becomes everything that youjust talked about, right?
The idea that you know yournumbers, you can be inspired by
data.
That is there for action.
(38:17):
It's not just the result.
You now have something that youcould move towards or away from
to improve the overall business.
So to me, I want to see morepeople become aware that it's
out there.
You know, listen, accountant4is a great company, but we're
not.
You know you can go online.
You can go and ask your currentbookkeeper how they help with
(38:39):
forward-looking projections andtrends.
That's out there.
Go ask for help.
And then, the more that thathappens, I think the groundswell
will just rise up, I love itAll, right man.
Speaker 1 (38:51):
So, keith, you're a leader.
You're obviously an owner.
Give me one of your favoritebusiness books that you've read.
Speaker 2 (39:00):
What comes to mind is Outliers by Malcolm Gladwell.
What comes to mind is how toWin Friends and Influence People
, by Napoleon Hill.
I really like the FourDisciplines of Execution.
Is it the Four Disciplines ofExecution?
I think so.
Yeah, yeah, 4dx.
Yes, let's see.
(39:23):
Rich Dad, poor Dad's a good one, and I mean dude, I used to
read a lot.
So the Challenger Sale is agood one, because it really
brought to light the idea thatif you want to make change, you
have to challenge the status quo.
Sounds silly, right, but I'm ahuge fan.
I'll call it business, becauseI certainly applied to business
(39:45):
Steven Kotler.
Anything Steven Kotler haswritten about flow state.
Read those, because you couldapply that mindset to what
you're doing every single day.
Speaker 1 (39:57):
By the way, that was a surprise when we got to know
each other is that when you meetsomeone who's in accounting,
you have, like you said at thebeginning of the episode, a
pretty clear idea of what youthink you're.
You said at the beginning ofthe episode, a pretty clear idea
of what you think you're comingup against in terms of
personality.
You're thinking you're comingagainst the pretty stale, you
know, left-brained individual.
You are so far opposite of that.
You're this flow state,creative individual who's
(40:21):
inspired by the art ofaccounting, and it's just a cool
encounter to what most peopleexperience, I think, in that
space.
Speaker 2 (40:29):
I love it.
Thank you for that.
Appreciate that very much, butI would say I'm inspired by the
art of business.
Speaker 1 (40:35):
Yeah.
Speaker 2 (40:35):
Like accounting just happened to come with business,
and here we are talking abouthow accounting influences
business.
But at the end of the day, Iappreciate what you said there
it's a lot of fun it.
But at the end of the day, Iappreciate what you said there
it's a lot of fun.
It's a lot of fun helping and Ilike to think we're doing a
pretty good job.
Speaker 1 (40:52):
I will second that.
Keith, thank you so much forbeing on the show today.
If people want to get a hold ofyou, how's the best way they
can do that?
Speaker 2 (40:59):
Go to the Accounted For website.
It'saccountedforthenumber4llccom.
You can hit me up on LinkedIn,keith Compagna.
You can email Will and he'llintroduce it to me.
Either way, come, find me.
I would love to talk to you and, again, we can help in a lot of
ways when the timing is right,Love it man.
Speaker 1 (41:20):
Well, thank you again for being on the show.
It's been great to have you.
Speaker 2 (41:23):
Yeah, you're the best .
We'll appreciate everythingyou're doing.
Congratulations on all of it,thank you.
Speaker 1 (41:29):
Thank you so much for taking the time to listen to
today's episode.
As a thank you, I have a gift.
In today's show notes there's alink for you to join the
Stress-Free PT newsletter.
This is a comedy newsletter foranyone who works in healthcare
and of course we're gonna havecomedy bits.
We're gonna have inspirationalstories, leadership bits.
It's gonna be a weeklynewsletter just to lighten your
(41:51):
week, to help you do what youlove with more passion.
So click that link below andjoin that newsletter and we'll
see you in our next episode.
Thank you so much for tuning in to today's episode,
Rockstars.
Today we've got Keith Campagna,who's the growth officer at a
company called Accounted For.
They are specialized in thephysical therapy space to help
all things accounting.
So before you turn off theepisode by hearing that most of
you are like I don't want tohear an episode about accounting
, you are going to, I promise,love this episode.
I will tell you from personalexperience, rock stars, that my
(00:26):
journey in changing my mindsetwas significant around this
thing called accounting.
So, whether you're afraid toadmit that you don't understand
what a P&L is, or whether youare fully aware of your numbers
and you think you mastered it,if you're looking to sell one
day, I want you to pay attentionto this episode because we're
going to be talking about themindset that accompanies growing
(00:48):
our business through ouraccounting.
We're going to compare it to aconductor creating music and how
accounting and the financialpiece is the theory of it, but
together we can create the artand be controlling our future
together in our businesses.
It's a very fun episode.
Keith is an amazing guest.
Enjoy the show, All right,Keith.
So listen, man, we were talkingabout growth and you were
(01:11):
talking to me about what youthink limits PT, OT, SLP leaders
from growing their practices.
Can you talk a little bit aboutwhat you were saying earlier
about what's limiting them?
Speaker 2 (01:22):
Yeah, I think for anybody and I think it extends
beyond private practice, I thinkfor anybody who's trying to
build on a dream or a visionthey have a sense of instinct,
gut instinct, that they followand it's worked and it got them
where they were.
But what really helpsbusinesses grow is knowing their
numbers, and what we weretalking about was this idea that
(01:44):
, like in all of the challengesinside of the private practice
space, what seems to be lyingunderneath it is just an
inherent unawareness of whereare my numbers, because every
practice owner will that I knowyou've met and I know I've met.
They're really smart people.
They're super, superintelligent.
But there's this thing aboutaccounting where people are a
(02:06):
little bit like keep the numbersaway from me.
I don't know.
I have an accountant.
They should be handlingeverything.
But at the end of the day,that's not the truth and that's
what we're doing at Accountant 4.
We're exposing that.
Speaker 1 (02:18):
Yeah, I think, rockstar, as you're listening to
this, I want you to really dialin, because many of you are
listening going.
I already know my numbers.
We're not talking aboutproduction numbers.
We're not talking about patientvisits.
We're talking about the numbersthat, if we're being honest,
you may not understand as muchas you would like.
Or, like Keith said, you mightbe giving to somebody else and
having them in charge.
And I will tell you, keith, inmy business networking
(02:39):
experience, having been withhundreds of companies over the
years in and out of PT, thenumber one thing I hear, when
people go south like theirbusiness almost loses everything
, is because they've delegatedtheir financial aspects to a
fractional CFO or someone thatthey just literally put over
there so they can go back totheir work.
And then, all of a sudden, oneday their cash flow starts
(03:01):
shifting if they even know whatthat is and then their accounts
start.
What they notice is when theiraccounts start dropping.
That's right.
Conversely, conversely, I'vegot clients who are listening
and you know who you are guysI'm thinking of specific names
of people who are probablylistening to the show who wake
up every day and they look attheir cash flow in their bank
account, and if it varies by asmall margin, it's enough to
(03:23):
send them into a mindset whereit ruins their day.
So, there's extremes.
You've got one extreme of likedelegate forget.
You have this other extreme oflike not knowing how to read the
numbers in your accounting sothat you're reactive to every
minor difference.
So, like dude, just talk to me.
I feel like I've said a lotLike talk to me about what comes
(03:44):
to mind when I say that.
Well, what comes to?
Speaker 2 (03:46):
mind is that we almost have to take a step
outside of the private practiceindustry and talk about
accounting for just 30 seconds.
I promise to all of the rockstars out there this will not
put you to sleep, Keith is goingto make it entertaining.
Speaker 1 (03:59):
He can literally make anything entertaining to me.
Let's do it, let's do it.
Speaker 2 (04:03):
So if you look at the accounting industry and you go
online and you searched crisisin accounting, you'll find out
that in 2020, the industry thatoversees the certified public
accountants identified 75% ofthe certified accountants in
this country hit retirement agein 2020.
(04:24):
Wait, how many 75%?
What the crap.
That's insane.
If you think about the industry, what comes to mind?
Old white dudes and taxes,right, two things that people
aren't overly excited about.
Now, something that I know frombeing in the world that I grew
(04:44):
up in from a softwareadvancement position accounting
is laggard.
They simply manage taxes andthat's what everybody knows
about accounting for.
It's why accounts work four anda half months in the beginning
of the year, because nobody doesany work until it's too late,
and then the accountant's got toclean it all up, and then they
(05:05):
take two months off to figure itout how to fix all that and
then they re-kick their businessdevelopment right.
But at the end of the day, allof these accountants are leaving
the industry and all of theirhuman capital is going with them
and, with that being said,they're losing their touch with
(05:28):
the world.
The business owners, the entiresoftware industry is trying to
fix a CPA problem, and nobodyvery few people are addressing
the small business owner problem, and that is that business is
way more than just tax from anaccounting perspective, it's way
more than taxes.
It's cash flow, and maybe oneout of 10 business owners
(05:51):
understand the differencebetween cash flow and profit,
let alone EBITDA or all theother metrics that come into
play when growing a business.
Speaker 1 (05:59):
Yeah, man.
So that is a huge insight isthat all of these experts are
leaving the industry and the waythat it was traditionally
worked it worked was brokenanyway.
I went through in my businessesum five different CPAs in my
timeframe and I have actuallydone a number of combinations
and bookkeeping and all theseelements, but for me from
personal experience, rock stars.
(06:20):
Everything went from likeworkable to incredibly
productive and profitable.
When I got that, I still don'tknow everything about numbers,
but I'm not afraid of my P&Ls.
I know the 20% that I have toknow to manage and uphold my
bookkeepers and I wouldn'tconsider myself an expert, but
(06:40):
compared to many small businessowners, they might think I am
because I can talk about cashflow and some of these terms.
So talk to me, keith, from yourperspective.
How do you help your PT ownersand or other business owners
understand their metrics?
What do you do that's differentaround all that?
Speaker 2 (06:58):
Well, there's two things.
One there's this softwareeveryone's heard of called
QuickBooks right, yeah.
And the funny thing aboutQuickBooks is that eight out of
10 small businesses use it, butvery, very few of them are
actually using it.
Again, because it has to dowith accounting and there's a
real mental block as it relatesto getting close to accounting.
So the data inside QuickBooksis not very accurate.
(07:21):
If you think about bookkeeping,it inherently takes place in
the past.
So, as a small business ownerwho's got a billion things on
their mind, their best chance atlooking at accounting is
outdated information based offof tax reporting purposes.
What we do differently is weactually take the data out of
QuickBooks.
We refilter it and put a bunchof rules in our software, then
(07:42):
put it back into QuickBooks.
So youilter it and put a bunchof rules in our software, then
put it back into QuickBooks.
So you, the business owner, youdon't have to learn new
technology.
But we give data integrity toQuickBooks, which takes you out
of the bank account mathbusiness the one that freaks out
everyone that you'd mentionedright and we take and it gives
(08:03):
you clarity, it gives youcurrent state cashflow.
I know my revenue is coming in,I know my expense is going out,
but the key will.
We all have technology, but itdoesn't mean that we're using it
.
What we do is we leverage againour proprietary tech to build
forecasting trends andprojections and we coach the
clients on a very fractional,based off of their need, basis
(08:26):
on what to do with the numbers.
And that's the big gap.
That just is what we felt, wefell into literally as we
entered the private practiceindustry.
Speaker 1 (08:38):
How did you guys enter the private practice
industry?
Like what led you to that, justlike anyone else.
Speaker 2 (08:42):
Well, references like the, the, the relationship
inside this industry isdifferent and, for what it's
worth, my background is insoftware sales.
I've worked in every industryand every size company.
I've talked to the owners ofthe people that work in there.
I've never experienced any likeprivate practice.
Simply put, my co-founder, seanhe was working as a business
(09:05):
development partner for anaccounting firm and him and
three of the partners were at atable and a private practice
owner said, pointed his fingerat all three of them, one at a
time, and asked where his moneywas, and not one of them could
tell him the answer.
And so Sean decides to meetwith the guy to understand it.
(09:25):
And, sure enough, seanrecognizes this opportunity and,
just like you and I would, overthe weekend he goes out and
builds code, because that's whatSean is about?
No, he never did it before.
He literally learned the codeto build this process that
allows us to clean the actualdata and provide the going
(09:45):
forward metrics.
So you know what to do if youwant to improve your numbers or
you know there's a ready forthis one.
You know there's a three monthpayroll or three payroll month
coming up.
How do I accommodate that?
Besides crap my pants as asmall?
Speaker 1 (10:01):
business owner.
It's another way of saying thatis doing nothing, because you
see it coming and you're like,well, cross my fingers, let's
just see how it happens.
Speaker 2 (10:08):
Right.
Imagine having, instead of justyour revenues which, again,
this is a gap that we fill withthe industry instead of having
all of those metrics that comein from the insurance providers
and how much reimbursementyou're getting, you have to
assign your expenses to this.
So, when you combine your costand your revenue, well, guess
what?
Now you know your financials,and that's the part that I think
(10:30):
you were mentioning.
That makes you much morepowerful.
It's that simple.
Speaker 1 (10:35):
Absolutely, and I have so many questions.
It's hard because, rockstars,there's like eight episodes
built into this that we couldtalk through right now.
But I will tell you this thatin my world that when we got to
the point where I was able tounderstand those metrics again,
it was an accelerant, I mean.
But it's so much harder, Ithink, when you don't have a
(10:56):
financial background, that a lotof PT owners, ot owners, they
just think, man, there'ssomething wrong with me.
I honestly feel there's a lotof imposter syndrome going on
around their accounting numbersand it can be an incredibly
overwhelming world for people toget into because it can just be
(11:17):
this scary piece of it.
So what would you say would bea baseline focus for listeners
who maybe, who almost, are there, like, what would you say the
essential reports are and whythey should?
They should like, pay attentionto those reports?
Speaker 2 (11:33):
yeah.
So really good question.
So, the things that we do weoffer a free quickbooks
assessment, so I'll just sharewith you what we do and then
your, your rock stars, canbasically go about doing it.
If they want to talk more aboutit, well then we'll see where
that goes.
But, all things consideredequal, we look at P&L, we look
three years back and we want tosee macro trends.
(11:55):
Yes, my revenue grew, but why?
Yes, my revenue declined, butwhy?
One of the things that sticksout more often than not is
marketing.
Numbers will go up, costs willgo up, but revenue doesn't.
What happened there?
Because people don't take thetime to understand the numbers.
They don't realize what's goingwrong.
(12:17):
We had a client who literally,oh, it looks like you're
spending $3,000 a month inmarketing.
What's your ROI?
I don't have any.
And then they stopped paying$3,000 a month in marketing.
What's your ROI?
I don't have any.
And then they stopped paying$3,000 for something that wasn't
getting them an ROI.
Well, like $36,000 back intoyour bank account, boom, right.
So there's the P&L, there's thebalance sheet, right, what's it
(12:38):
look like right now?
And what can I look at from alabor?
Like, labor is the big one.
What does my labor look like inpercentage of total cost and if
you're above 55%, why?
It doesn't mean it's bad.
That's a key thing.
Numbers inherently aren't bad.
It's the thing that got youthere and the context, which is
what comes when you work withsomebody who can help provide
(13:01):
context.
And then the other one is thethird.
One would be like a vendormanagement report.
Try to figure out where you'reputting your money to.
You might not realize like,again, just as an example, we've
had clients where we'veuncovered $20,000 plus of paid
subscriptions that were of nouse whatsoever, just purely
(13:24):
outdated money going out.
So if you can keep an eye onwhere the trends are, it could
peak to start curious why did itget there?
Or why is it working?
And then you can double clickon it and then, with the vendor
management report, it gives youperspective on how to reduce
your expenses.
We've had a client where theirpayroll vendor just decided to
(13:47):
start doubling their charges,their fees.
Just double their fees.
No conversation, no, nothing,if not for the bookkeeping
service, right?
Why did this double?
I don't know.
Boom, go back, save six grand,get six grand back.
Speaker 1 (14:01):
You said something really powerful in the end.
That really highlights thebalance, in my opinion, of what
the owners should be responsiblefor versus the accounting
experts that they work with,because, again, it's kind of
like a medical billing company,in the sense that PT owners
don't have the knowledge base,so they sacrifice this knowledge
and just give it like amonopoly to the person that
(14:21):
they're outsourcing it to, andthat lack of balance creates
issues.
Accounting is the same way, butI also sent I also, at the
beginning of this episode,talked about clients I've had
who are holding every detail oftheir accounting themselves, and
what I've seen in that case isthey get so granular that they
start worrying about thesereally small decisions because
(14:42):
they've put so much time andenergy to find them.
So you need an accounting groupthat's going to bring
everything to your table andgive it the right gravitas, the
right emphasis of everythinggoing.
Hey, here's a subscriptiondifferential.
This is low-hanging fruit.
We can just cancel it if youwant.
Or, hey, your labor cost was atthis percentage, which, by the
way, rock stars.
That was the number of all theaccounting numbers that changed
(15:04):
my world, because I got grossand net income.
I understood in general okay,I'm making more money than I'm
spending, and that kind ofconcept.
But the number one thing that Ifigured out with the help of a
great accounting solution who'sno longer even doing it anymore
was the percentage of payroll toincome.
How much do I spend on mypayroll based on my income?
(15:28):
And that became the North Starmetric financially.
That led all of mydecision-making because, like
you said I'll rephrase itinformation leads to inspiration
.
Where you guys come in and Iwould say all of us need to have
, if we don't have this solutionis the information from the
(15:49):
financial perspective that leadsto the inspiration of the
decision making.
And the most key of those wasthe second thing you mentioned
for me, which is understandingthat payroll to income piece.
Just a more personal curiosityhow do you work with your
clients around that number, like, like, what does that
discussion even look like?
Do you bring that to them andsay, hey, you're paying 80% of
(16:09):
your income to, you know, topayroll Like, what do you guys
do to support them in that?
Speaker 2 (16:14):
Oh, hell, yeah, it's the number one.
It's the number one obstacleyes, and it's the number one
opportunity Opportunity Right,thank you, and it's the number
one opportunity Right, thank you.
Right, like at a very baselevel, what we're talking about
(16:36):
is how obviously unaware aprivate practice owner is about
their business not theirprofession, but their business
because they don't know that.
They're probably aware that itcosts a lot of money to pay
people, but they don't know thatthey're.
They're probably aware that itcosts a lot of money to run to
pay people, but they don't knowhow it falls into the actual
landscape, the whole landscapeof the business.
And something you mentionedabout the clients that are, or
(16:57):
contacts of yours that are, inthe weeds you mentioned, they're
like stuck on all these details.
That's the thing that can getyou wrapped up I say wrapped
around the axle, right, like youhave to see business as a game
and this is where the coachingcomes into play.
There's an offense and adefense, and if you're paying
attention on this little thinghere and you don't pay attention
(17:21):
to the labor that you'respending, what's the point?
The big win is in the labor.
You know that the second, nextwin may be very well in how do I
streamline efficiencies, how doI reduce my cost in certain
areas by bringing in technologywhich, by the way another
episode Our industry is so youngin accepting technology that
(17:48):
the opportunity and this is whatbrings us at account we're like
super pumped about being at PPSand helping.
It's just this notion of there'sso much opportunity, because
it's not like you can't figureout how to get more money.
It's not how you.
You can't figure out how torecruit, you can't figure out
how to improve a patient'sexperience.
(18:09):
All of that's out there.
You just have to figure out howto align the pieces in with the
business that you have and then, like you, you'll get better
results.
Speaker 1 (18:18):
Yeah, and that's one of the reasons I have the
podcast, because for me, I wantto be able to bring solutions
like you guys to the table,because there's so many services
and technologies that peoplejust don't even know about.
We are the very youngest in allof healthcare, you know quick,
just like highlighted, that iswhen I talk about virtual
assistants on my company's endof people, they're very much
(18:38):
like oh, tell me more.
If I go to a non-PT event, if Igo to dentists or anyone else,
they're like yeah, I've alreadygot my.
They've been doing it for 10years.
And we on like AI, we're earlyadapters of all these things.
But that's why there's so muchopportunity for owners.
It's always like well, how arewe going to make greater profits
with declining reimbursements?
It's like well, we have thiswhole efficiency realm that we
(18:59):
haven't even tapped into,notwithstanding baseline
services like yours that arejust like oxygen that you have
to have, that people don't evendo that appropriately.
There's so much opportunity forgrowth.
I have friends who have sold 10, 20 locations After they stayed
on for a while.
They're starting more locations.
Why?
Because it's such a profitable.
Ptot is such a profitableindustry.
(19:21):
It's so easy to make money whenyou've got the right solutions
in place, and it comes down todollars and cents, like you guys
do, it accounted for.
Speaker 2 (19:30):
And you used the term imposter syndrome earlier, so I
want to bring that back,because one of the things that I
got to enjoy I get to enjoy isthis I'm not a trained PT, ot,
I'm certainly not an accountant,so I get to walk into the
industry eyes wide open, earswide open, mouth shut and I just
(19:52):
listen, and the thing that Ikeep realizing and learning is
that it takes a differentmindset to go from a clinician
to an owner, to an entrepreneur,to an exeter, to maybe even
coaching, going back into theecosystem.
Right, it really requires amindset and with each shift
(20:14):
comes the imposter syndrome.
I don't know what.
I don't know, I feel worse, I'mnot going to move towards it
and it's not easy.
It's not easy.
Speaker 1 (20:24):
No, it's over.
I will tell you this.
I think most people who arelistening to this show rock
stars.
I'm hoping you're already awareof these stages of mindsets.
I'm hoping that's not a newtopic because if it is new,
quickly you go from independentowner, where you're exchanging
time for money, to where youstart developing a team and
systems and processes andeventually become a business
(20:45):
owner where you exchange peopleand processes for money.
This is all rich dad, poor dad,stuff and then you go
eventually, the end goal beingthat you're an investor in your
own company where you'reexchanging money for money and
other people are running yourbusiness.
And that's where friends ofmine have scaled to dozens of
practices and sold and so forth.
But maybe what's not clear topeople who are listening is that
(21:07):
their mindset shift has tooccur around this, amongst some
very key divisions of theircompany, and what you're saying
is that one of those key areasis accounting.
When you talk about accountingwe're not talking about medical
billing.
That's the end result of that.
The collections it goes intothe accounting side of things.
(21:29):
That's revenue cycle.
Revenue cycle, I would say,also is another area where our
mindsets have to shift over time.
Accounting.
It has to shift, Like earlystages, they just need to know
their income and their expenses.
But if they're going to scaleand ever become an independent,
freedom-based owner, they haveto know how to lead their
leaders through finances, yes,and not just their leaders, but
(21:53):
the clinicians on the floor,right Like there's this big
movement.
Speaker 2 (21:57):
Right and funny enough, a lot of this.
I have my own personalexperience with helping a
private practice that's local tome here, because I had my
shoulder I needed work on.
Sure enough, I go see somebodyand I can't shut it off Will.
So I'm looking around and Iasked the woman that was the PT
(22:18):
that was working on me.
She was the manager of thelocation.
So I started asking all theserevenue questions because I am
sitting on a table and I saidwhat challenges are you having?
And she said ancillary services, laser treatment, massages, all
of these things that cost money.
I can't get my therapist to talkabout these services, and so I
(22:39):
wound up getting a client layingon a table because of the
different approach that really,when we think about the
experience of the patient in adifferent way, you're able to
lock in all of these elements.
But if you don't going back towhat we're talking about, if you
don't know the numbers, youcould be going in the wrong
(23:02):
direction or you could bespinning your wheels.
But if you know the rightnumbers, it's just copy paste,
copy paste all day long.
Speaker 1 (23:09):
It's very simple.
What I love about accounting isthat once people get a baseline
understanding with the rightpartner, like an accounted for,
it becomes very objective.
A lot of what we do as leadersrequires creativity and like
there's something very black andwhite about the story that is
told through our numbers.
You know, the biggest mistake Imade in my business was looking
(23:31):
at my numbers as a postmortem,meaning I only looked at reports
from like what happened lastquarter so I could and that was,
by the way, that was still verygood.
That was a mindset of like amanager level owner where I was
still very much a manager in mybusiness because it was good to
know what happened historicallythat put me in the seat that I'm
in right now.
But history is only half ofwhat numbers tell us.
(23:53):
They're also the greatestpredictors of future success and
that's one of the keys I tellpeople and at Rockstar I would
encourage you if this is anepisode that's really
interesting, you and you'refeeling even a little bit
overwhelmed I would encourageyou to do this is to sit down
and watch Shark Tank.
Watch Shark Tank with yourphone and chat GPT and listen to
the discussion and not letanything go.
(24:16):
When Kevin O'Leary talks about,you know, acquisition cost.
Right then, what is acquisitioncost?
What is it?
And start like having adialogue with artificial
intelligence while you'rewatching the show.
It will be relaxing in someways, but it'll also surprise
you how easy it is to understandthese concepts.
And then, once you put yourarms around these, then it puts
us in a position where, goingback to what you and I are
(24:37):
talking about, we can lookforward and go, based on
historic trends.
I can project, if I keep doingthe same things, this outcome.
Do I want that or do I want totweak it?
And that's where the fun comesin.
Right?
I'm guessing that's where youguys have a lot of fun is
helping owners kind of createthat future.
Speaker 2 (24:55):
Yep, yeah, and like, two of the questions that we ask
every time with our clients iswhat did we do well and what
didn't we do?
Speaker 1 (25:02):
well, when you say that you're talking about, like
we, as their practice, you'renot Right right right For you.
Speaker 2 (25:09):
Yeah, right, right, yes, yes, like what went well
and what didn't go well for ourclients, right.
And it really boils down toyour point.
If you understand the leadingindicators right, the past is
the lagging indicators.
The future is the leadingindicators.
If you understand, because nowyou were able to map what your
expenses look like and what yourrevenues look like into the
(25:30):
future.
Well, now you could startmaking educated guesses on
things, not just what othervendors for other software
companies tell you, not what youheard from somebody else.
And then, all of a sudden, yourealize that they forgot to
mention this one thing, whichblew, sunk your boat, so to
speak.
It's you get to choose on yourown numbers, leveraging your own
(25:53):
experience.
It's the best.
You have the most fun growingyour business.
Even you, like you, smiledbrightly when you got to that
point, right?
Speaker 1 (26:02):
Well, yeah, because it's at that point you feel
empowered.
I even now get really excitedabout thinking around these
numbers because you start tofeel more at cause, like I know
what happened historically, Iknow what my leading indicators
are, so I can get again being avisionary.
As leaders that we all are,it's our job to predict the
(26:22):
future and there's always someart to that.
But the numbers that we can usethrough accounting is the
science of it, and the scienceis predictable.
The science is easy with theright support.
So when I love talking aboutthese topics to people because
the least attractive, the leastsexy topics in healthcare,
(26:44):
medical billing, accounting nooffense, but perceptively,
that's how they view it thoseare the most fun Because when we
can control that, we can startwriting the future in our own
handwriting and go this is whatI want to build, this is what I
want to create, and so havingthe ability to wrap our arms
(27:05):
around our numbers is one of themost fun things that people can
learn to do, and they don'tknow that until they work with
somebody like you, obviously.
Speaker 2 (27:13):
Well, it makes it a lot easier when they do, for
sure.
And the part that I'm hearingand which you know I'm smiling
now because you got meremembering things that I love
about business is that if youlook at a musician, indulge me
for like 30 seconds.
If you look at, music, which Ido, and you've got rock stars,
so this applies right.
I was born to be a rock star.
I have no musical talent, so Ilove being around other rock
(27:36):
stars.
But my point is that when youlook at musicians, they make
work, look like play, and whenyou can do that which is totally
what you just described whenyou can, as a private practice
owner, restructure the way yournumbers look and your business
looks and your mind works sothat the work becomes fun, you
(28:01):
nailed it, dude You're playingthe game, you're no longer
stressing, you're growing, andthe best way to know you're
playing a game right is to knowthat you're having fun.
If you're having fun, otherpeople will come and have fun
with you and away you go.
Speaker 1 (28:14):
Yeah, and that shifts everything.
I want to just for the rockstars are listening.
I want to keep going on thisanalogy of accounting being like
music theory and like the ideathat as people are learning, you
know the structure of the songof their business through the
theory of their business,through accounting.
It is going to be a little bitleft-brained.
(28:35):
It is obviously left-brained.
You're going to be learning howthat works.
My youngest son is a musicalsavant.
He can listen to any sound andtell me the exact note.
He's been doing that since hewas three.
He's a master pianist at theage of 12.
And what's funny is that hespends a lot of his time
obsessing with music theory.
He'll take out these pieces ofpaper with the lines and he's
(28:57):
just sitting there not playingmusic, drawing the notes and
connecting them, but he hearsthe song in his head and that's
what's so.
Crazy is that there arebusiness owners out there, guys
who are like my son, who arebusiness savants.
They just get this stuffintuitively, but most of us 99%
(29:18):
aren't.
But there's a lot of reallytalented musicians who aren't
like my son, who just love thesound of music, who love to
write the theory and then, whenthey start connecting their
ability to create on paper andthey can start hearing that song
in their own head.
Then it's like, okay, what kindof song do I want to write?
And that's where the fun andthe beauty comes out.
Speaker 2 (29:34):
And no musician ever learned music alone.
They leveraged someone else'smusic and no business owner
created a business alone.
They all had somebody, a mentoror a coach.
And that's the part againearlier in the conversation.
What's missing, it's not justtechnology, it's having a coach
that can easily either A keepyou accountable or B.
What's missing it's not justtechnology, it's having a coach
that can easily either A keepyou accountable or B keep you
(29:56):
motivated, or C let you remindyou to be excited about what's
happening right.
You're breaking out of the oldmold and becoming someone better
.
Speaker 1 (30:07):
Yeah, no, you're so spot on, you know.
Going back to my son again,he's constantly looking for the
next teacher who's going toteach him more of what he needs.
So it'd be like someone playingthe piano without a teacher
going.
Well, I'm a loser because Idon't know how to play piano.
It's like no man, like everyoneneeds their instructor and they
need the theory, and when westart to slowly progress, we go
(30:28):
from chopsticks to Beethoven'sFifth.
It's all about that.
It's not the age, it's thestage that we're in.
And I do want to validatesomething, keith, for our rock
stars right now that rock starsI brought in a financial expert
once, when I had about fivelocations, I think we were doing
roughly $4 million a year.
(30:53):
I brought in a financial expertbecause I was just really
struggling in that space, and soI went out and I found someone
with no healthcare experiencewho had worked in every other
industry though, who came intoour business, and after three
months he resigned and I waslike what's going on?
He's like this is too hard.
I was like what do you mean?
And it was because he was a CFOtype, so it wasn't just
accounting, it was like CFOlevel stuff.
He goes well, I was forced tothink that healthcare would be
(31:16):
just like everything else andwhat I've realized is that
healthcare is completelydifferent from a financial level
because of medical billing.
Like the biggest thing he wasstruggling with was more on that
revenue cycle side, but how itdiluted and confused him on the
accounting side is where he drewthe line.
And so since that timeframeI've worked with people.
I think it's really important.
The lesson on this is number one.
(31:37):
Like if you're struggling inthis on any level, you know
maybe you get it at a base levelbut you're realizing now you
need to know it even better.
Good, you know, just realizethat's the wonderful stage
you're in and that, like a lotof people struggle in that, I
would argue, everybody I've evermet required a coach in
healthcare.
I don't think there aren't anysavants who could figure that
(31:58):
complexity without help.
But number two is that whenyou're working with somebody
who's an expert, that you findsomeone who's really dedicated
to the healthcare space and evenbetter if they're PT specific.
And you know, that's one of thethings I really appreciated
about you, keith, is that youguys are all in on PT.
I mean, you guys have visionsfor PT owners.
Why is it that you guys are soconnected and passionate about
(32:19):
the PT industry when I see acompany like yours come in?
Obviously, when it comes toopportunity, that could be in a
lot of different areas and I'vebeen told by other mentors
there's better opportunitiesoutside of PT and healthcare.
What is it about you guys in PTthat you're so passionate about
?
Speaker 2 (32:34):
I mean I can't, I'm not going to take away from the
opportunity that's there right.
So there's the business.
Opportunity excites us as abusiness because we could grow.
But my mother's retired in ICU,ccu nurse so, and Sean's mother
, the founder, I believe sheretired in healthcare, I don't
know to what level, but thepoint is that the community
(32:57):
inside of PTOT is trulyremarkable.
From my own personal experience,the passion that goes into
patient's care, the knowledgethat it takes to be the amount
of debt that one has to incur tobe able to help someone feel
(33:18):
better, is remarkable.
And then you get into a privatepractice company and you start
working with other like-mindedindividuals and then they start
branching off and, like, you'vegot within PPS, you've got the
peer-to-peer groups, you've gotso many networks that are all
designed to help and, honestly,I fell in love with the business
(33:43):
world decades ago.
I love small business, I thinkin a time I don't know if this
is what happens on your side ofZoom, but in a time where
everyone's freaking out aboutbad news and aliens and all this
stuff and the way corporateAmerica and corporate behavior
gets written about in the newswhat's always worked and
(34:06):
arguably has been the reasonthat things are still better
than they're not is smallbusiness, and that things are
still better than they're not issmall business, and so private
practice, I think, epitomizeshealthcare.
The thing that matters most isthat people feel better as soon
as they can, and at their owncontrol and maybe
non-pharmaceutical manner.
Right yeah, and then theopportunity to build an
(34:30):
ecosystem that works inside of amarket that rewards people for
hard work and good decisions.
It's just super fun, will.
Speaker 1 (34:37):
It's super fun.
It is fun.
I think, at the end of the day,two things can be true at the
same time it can be super fun tobe in this business and there
can be incredible challenges.
Those two things can be true atthe same time.
It can be super fun to be inthis business and there can be
incredible challenges.
Those two things can be true atthe same time.
I think what makes it fun iswhat you and I were talking
about earlier this idea of whenwe're in it with people, we're
not alone, we're getting theright story and baseline
(35:00):
understanding of our business sothat we can start controlling
our future.
Then it becomes really worth itbecause of the business that we
are in.
I just want to second what yousaid, too, to our rock stars is
that the business that you guyshave taken on is no small thing.
Like every little stand everyPT, ot or speech therapist makes
in their community is a standagainst Big Pharma, it's a stand
(35:23):
against dependency, it's astand against the centralization
or what do they call it wherethe consolidation of healthcare.
Right now, private practicesare diminishing in every sector
of healthcare, so every day whenthat PTOT, slp owner gets up,
turns on their computer ordrives to their office.
(35:44):
They're taking a stand for thegreater good of all humanity.
Not to be dramatic, this isliteral, because what they're
standing for is the best qualityhealthcare, because no one and
everyone would agree to this.
No one gives better healthcarethan private practice does in
any of the healthcare segments.
So for us to fight the battle,I want Rockstars, as you're
(36:06):
listening, to think ofyourselves as generals of an
army and not minimize that, notminimize the impact or the
importance of what you do,whether you have two employees
or 20 locations that every dayyou're getting up, you're taking
a stand in big ways in thatcommunity, but you have to have
generals, you have to havegenerals underneath you, you
have to have admirals, you haveto have these leaders and
generals underneath you.
You have to have admirals, youhave to have these leaders.
(36:26):
And one of the single mostimportant elements of your army
is going to be the ammunition.
It's going to be the energythat you have as a business.
And what is that?
That's the money.
And who's your admiral overyour finances?
Who's in charge of youraccounting?
Do they have healthcareexperience?
Zero to 10, where's yourmindset on that?
Like, are you advancing yourmindset around that.
(36:49):
Do you have someone who's goingto help you?
Do you have a service you referto?
Do you have a guy that you talkto once a year when you pay his
bill, after he tells you whatyou owe in taxes?
Or do you have an admiral who'son the front lines with you?
And the only reason I broughtKeith to the table is because
that's who he is and his company.
This is a very passionateperson who I have heard multiple
times through my network of howhe is there with you as you
(37:10):
fight this battle in yourcommunities.
So sorry to put you on the spota little bit there with a
slightly dramatic monologue, butit's true, keith.
I think you guys are making animpact in that way.
What do you guys see for thefuture, like if you could create
if you got your own pen foraccounted for?
Speaker 2 (37:32):
what do you want to see happen for your business in
the PT space?
I want it to become a commonbehavior.
One of the things we say a lotas it relates to accounted for
with our clients is that there'scommon sense and there's common
behavior.
Right?
So like the idea that thecareer let's, maybe we even
started smaller the curriculumof learning private practice
includes business managementthrough accounting, basic stuff.
(37:56):
So like the dissemination ofinformation would be the answer.
Right?
The idea that you too canunderstand this stuff that would
be the thing that I would wantto see the most, because with
that becomes everything that youjust talked about, right?
The idea that you know yournumbers, you can be inspired by
data.
That is there for action.
(38:17):
It's not just the result.
You now have something that youcould move towards or away from
to improve the overall business.
So to me, I want to see morepeople become aware that it's
out there.
You know, listen, accountant4is a great company, but we're
not.
You know you can go online.
You can go and ask your currentbookkeeper how they help with
(38:39):
forward-looking projections andtrends.
That's out there.
Go ask for help.
And then, the more that thathappens, I think the groundswell
will just rise up, I love itAll, right man.
Speaker 1 (38:51):
So, keith, you're a leader.
You're obviously an owner.
Give me one of your favoritebusiness books that you've read.
Speaker 2 (39:00):
What comes to mind is Outliers by Malcolm Gladwell.
What comes to mind is how toWin Friends and Influence People
, by Napoleon Hill.
I really like the FourDisciplines of Execution.
Is it the Four Disciplines ofExecution?
I think so.
Yeah, yeah, 4dx.
Yes, let's see.
(39:23):
Rich Dad, poor Dad's a good one, and I mean dude, I used to
read a lot.
So the Challenger Sale is agood one, because it really
brought to light the idea thatif you want to make change, you
have to challenge the status quo.
Sounds silly, right, but I'm ahuge fan.
I'll call it business, becauseI certainly applied to business
(39:45):
Steven Kotler.
Anything Steven Kotler haswritten about flow state.
Read those, because you couldapply that mindset to what
you're doing every single day.
Speaker 1 (39:57):
By the way, that was a surprise when we got to know
each other is that when you meetsomeone who's in accounting,
you have, like you said at thebeginning of the episode, a
pretty clear idea of what youthink you're.
You said at the beginning ofthe episode, a pretty clear idea
of what you think you're comingup against in terms of
personality.
You're thinking you're comingagainst the pretty stale, you
know, left-brained individual.
You are so far opposite of that.
You're this flow state,creative individual who's
(40:21):
inspired by the art ofaccounting, and it's just a cool
encounter to what most peopleexperience, I think, in that
space.
Speaker 2 (40:29):
I love it.
Thank you for that.
Appreciate that very much, butI would say I'm inspired by the
art of business.
Speaker 1 (40:35):
Yeah.
Speaker 2 (40:35):
Like accounting just happened to come with business,
and here we are talking abouthow accounting influences
business.
But at the end of the day, Iappreciate what you said there
it's a lot of fun it.
But at the end of the day, Iappreciate what you said there
it's a lot of fun.
It's a lot of fun helping and Ilike to think we're doing a
pretty good job.
Speaker 1 (40:52):
I will second that.
Keith, thank you so much forbeing on the show today.
If people want to get a hold ofyou, how's the best way they
can do that?
Speaker 2 (40:59):
Go to the Accounted For website.
It'saccountedforthenumber4llccom.
You can hit me up on LinkedIn,keith Compagna.
You can email Will and he'llintroduce it to me.
Either way, come, find me.
I would love to talk to you and, again, we can help in a lot of
ways when the timing is right,Love it man.
Speaker 1 (41:20):
Well, thank you again for being on the show.
It's been great to have you.
Speaker 2 (41:23):
Yeah, you're the best .
We'll appreciate everythingyou're doing.
Congratulations on all of it,thank you.
Speaker 1 (41:29):
Thank you so much for taking the time to listen to
today's episode.
As a thank you, I have a gift.
In today's show notes there's alink for you to join the
Stress-Free PT newsletter.
This is a comedy newsletter foranyone who works in healthcare
and of course we're gonna havecomedy bits.
We're gonna have inspirationalstories, leadership bits.
It's gonna be a weeklynewsletter just to lighten your
(41:51):
week, to help you do what youlove with more passion.
So click that link below andjoin that newsletter and we'll
see you in our next episode.
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