Transitioning from a small to a big business owner involves a lot of elements to tackle, including handling a bigger staff and balancing a busier timeframe. Parents who are also business persons can fully relate to this balance struggle. In this episode, Nathan Shields interviews Aisha Wilbur, PT, DPT, owner of Willow Physical Therapy, as she shares her struggles between starting a business and motherhood. She teaches us her success formula – Reach Out + Step Out + Network. If you want to have the same freedom that she has while still having a strong vision for your PT business, listen to what Aisha has to say about how to not be stuck and continue moving forward.
Listen to the podcast here:
The Successful Transition Out Of Full-Time Patient Care With Aisha Wilbur, PT, DPT
I’m excited to bring on a fellow Alaskan. Aisha Wilbur, out of Fairbanks at Willow Physical Therapy, is joining me because I’m excited about her story. We don’t have any specific topic to talk about, but what it led to was recognizing the amazing transition she made within a couple of years out of such a horrible stuck situation to now doubling her business and not treating at all where she can focus on the future and vision of her company. In the meantime, she is affecting a greater number of people than she can do with simply providing hands-on physical therapy. She’s got a great story and there’s plenty of value within it that I hope you can glean from. If nothing else, it’s just a great story and should be an inspiration to all those owners out there who feel like they’re stuck. Let’s get to the interview.
I’ve got Aisha Wilbur. She is a pelvic physical therapist and practice owner of Willow Physical Therapy in Fairbanks. I’m excited to bring her on because I know a little bit about her story. I heard about her through Jamey Schrier, who has been influential in her growth, but considering how successful she’s been, I thought, “I’ve got to have her on.” First of all, thank you for coming on, Aisha. I appreciate it.
Thank you for having me, Nathan.
Tell us a little bit about your story. You’re in the far-flung reaches of Alaska, in Fairbanks. I’m in Alaska too, but Fairbanks is even further. Tell us a little bit about what got you where you are now and helped you develop a successful clinic in Fairbanks.
My story begins after I graduated from PT school in 2008. I practiced in Arizona for a year. I moved up to Alaska to be with my then boyfriend, now husband. I joined a practice and my goal was to become the best pelvic physical therapist. I joined a practice and my goal was to bring that patient caseload to the company. That was my task. That was in 2009. In the summer of 2010, the owner of that practice pulls me back into her office and I’m thinking, “I’m not doing a good job. We don’t have enough patients.” Scarcity-minded for sure. “I’m going to get fired.” Lo and behold, she’s like, “Aisha, I’d like you to take over the practice,” and presents to me numbers and stuff like that. Totally serious. She wanted me to buy her practice and I was like, “What?” I didn’t feel ready. I remember thinking in PT school that I wanted to have a practice, but it was so soon. It was barely two years out.
I was new to Fairbanks too. I didn’t know the people there as well as everybody else or the culture. It was a great opportunity and I said yes. Fast forward, anyone who’s gone to PT school, you don’t know the business ins and outs. Do you think you can do it? You have this mindset of, “I can figure it out. I’m smart. I’m a doctor of physical therapy.” You get into it and you’re like, “I don’t know what my numbers mean. I have all these that come my way. I don’t know if they’re good or bad. Marketing, whatever I had learned from others and in school,” and just all the other things. I took over the practice in 2010. By 2016, I was in a lot of trouble.
You were going blind for 5 or 6 years.
At first, it was okay because I had all this time. I didn’t have any children at that point. I can work a million hours a week. I could treat full-time and manage and handle the business stuff and make it work for the time being. I had my daughter in 2013. I started to realize I can’t work 60 hours a week. I got to start cutting back. My money was affected. There were times where I just didn’t get paid. I was working a ton and not bringing home much. I got pregnant with my son, my second child, and I knew I was going to be in trouble. I need to figure this out. I have to be able to take time off. I started seeking help. He was born in 2015, so I had started that realization of I need help. I worked with a company for a little bit, but just wasn’t a good fit and it didn’t work out for me for what I needed at the time.
I had my son and I’m back into treating four weeks after. I brought him to work. I was treating. I was managing, marketing, doing all this stuff. I give myself 30 minutes in the middle of the day to document, to check emails, to answer calls because my staff was calling me while I’m breastfeeding and pumping. I was eating lunch. It was just trying to do way too much in 30 minutes. My laptop’s in the sink. I have my food over here and my pumping parts over there. It was just a ridiculous scene. This one particular time, I sat in on a webinar. It was Jamey and his accountant, Craig, and they were giving good tips. I was like, “This is ridiculous. What am I doing here?” I just had this a-ha moment. This can no longer continue.
I did the online program that he had at the time. I started to learn about basic things like my dashboard. What does my money mean? Money in, money out, things like that. I had a call with Jamey and I decided to join his group at the time, The Lighthouse Leadership Group. That was a big deal for me to do that because there was such support there. Everyone was open and kind and just friends. They’re people just like me, private practice owners who are struggling and had resources. It’s just a brain to pick. I started to change my business then. Things started to change, but 2018 was a big change. I got pregnant with my third child. At the beginning of the year, I was like, “I’m due September 13th,” or whatever it was. I have this goal and my goal is that I will remove myself from treating altogether 100%. It was a good goal. On top of that, it wasn’t going to affect my money. That was the other thing. I could pull myself out, but then I wasn’t getting paid as much. I made that very distinctly. I wanted to be able to pull out of treating and still make the same money or more.
That was a year of focus. I focused on what I wanted and I think that’s where it began. I had a very clear vision of what I wanted and I wasn’t going to let anybody get in my way. I got organized. You begin with the end in mind. I had a very specific deadline, a due date that wasn’t going to change that much. You can push it up back a week or whatever, but not really. I have this deadline and then I worked backwards from there. I went through, “If I want to do, how many treatment hours am I working?” I worked backwards from that. I fully removed myself from treatment a month before my due date. I accelerated it a little bit. My biggest struggle was hiring and recruiting. It’s still a struggle. What I figured out was I just brought on a traveler. I brought her on a few months before so that I can mentor a little bit, do some training and she could take over my pelvic health caseload, because that was the biggest challenge. I can find maybe an ortho, PT traveler a little bit easier, but those pelvic health pts, those are hard to find.
What was 2019 looking like and what is 2020 looking like for you?
2019 continued, so I’m still not treating. We grew a ton in 2018. I was able to double the practice. The more you remove yourself and you work on your business instead of in it, the more your business succeeds. It’s hard to believe that until you do it and you see your numbers and you see your results. I decided, “I’m a business owner now. That’s my main role. I cannot delegate that.” I need to give this a go. 2019, I continued that and we doubled our space. We have a 6,200 square foot space right now.
Kudos to you. Going back into your story, first of all, you knew you needed help. There’s usually that inflection point in most of the owner’s stories that I interviewed where it just hits you like, “This sucks and I’ve got to do something different.” My challenge to the owners out there who haven’t got to that inflection point is don’t wait until it sucks before you make a change. There are things you can do and avoid all that heartache. What you did and why I want to say kudos to is number one, you did reach out, but you also recognized that it wasn’t a good fit and decided to move on and didn’t give up on the consulting path entirely, but rather found someone else. Kudos to you for finding someone and recognizing that maybe someone else to do a better job for me and recognizing that that was your path out. That’s just amazing. I think Jamey’s program now, is it still Practice Freedom U or something like that?
That’s what he’s calling the company. The Lighthouse Leadership Group is the group that I am a part of.
All of that together, I’m sure it gave you the business acumen to know your numbers, your stats, your finances, that stuff. It seems like it also changed your mindset.
One of the things I did in 2018 was to eliminate all negative talk, any negativity coming my way. I would find myself being negative to myself, just saying, “You can’t do this,” or “Why can’t you do this?” or, “You suck, Aisha,” or whatever it was, bringing myself down instead of saying, “You can do this. This is what you want. You’re not the first woman to do this. You can do it.” Eliminating any negativity coming my way or from myself or bad news. I stayed away from all of it and trying to stay focused on what I wanted.Lift yourself up by eliminating any negativity coming your way. Click To Tweet
The other thing that stood out to me is what you said where you’re working on your business and by doing so, you doubled the size of your practice. Because that’s something that I come up against again with some of the PT owners that I coach. When you’re a physical therapist, if you treat somebody, you get paid for that visit and you immediately know your productivity. When you take on the owner hat and sit in the owner’s seat, you don’t have that immediate productivity stat in front of you, “I’m not seeing so many patients. I’m rather just working on the business.” That’s abstract. What happens is that the energy and time that you put into the business returns multiple times because of the effect that it has on the entire team and making them more efficient, more productive. The opportunity to market more in energy and freedom and culture and all that stuff expands and accelerates because you’re able to work on it and put some energy into it.
I love the way you sum that up. It is. As PTs, our schooling teaches us that we’re with a patient. That’s our productivity. We get paid for that time. That mindset shift is important and I had to go through that. I’m still struggling a little bit with it.
My initial goal with the consulting was that I’d get some business acumen and then I will step aside and implement that stuff so that someday I can come back and treat again. I never made that turnaround.
I thought that way too. I want to have the option to, but now that I have the option to, I haven’t done it. I see where I could go a little bit backwards or the company could, if I decided to focus my attention on treating, then that means my focus is away from the business.
You recognize that your effect can be multiplied through so many other people if you’re not treating. One of my clients in particular said, “I do my patients a disservice if I am treating because as I’m treating the patient, I can’t concentrate on them. I’m worried about the accountability meeting I need to have or the marketing that I need to do next. My attention isn’t completely focused on the patient and that’s not okay. That’s not fair to the patient. It’s not fair to the business because the business needs your attention as well.” Sometimes treating is not appropriate because you should be spending time on the business and making it better. That would be better for the patient in the long run.
I agree with that. That would have been hard for me to agree with some years ago, but it’s true.
It takes some effort and some thinking to get over that. I know Jamey’s coaches help you through that. The mastermind group that you’re talking about helps you through that. Just the examples of others, that’s one of the reasons why I do the podcast is because here are people that I’ve done it before. They’ve gone through the same struggles. They’ve had the same questions. There are resources out there.
Yes, which is why I tried to absorb as much as I can through books or podcasts or whatever. I can hear other people’s stories and learn from them.
Initially, what were some of the more successful actions that you found? Maybe things that stood out that like, “As soon as I did that, it opened up a new avenue or path for me.”
I would say organizing my time and my schedule. Chunking my time, like in my story, I was treating, managing, doing all the things on the fly. I fit everything into my day. I started to say, “I’m going to treat from this to this time, and then I’m going to have dedicated admin time where I get to manage and do these things.” My brain wasn’t so tired because bouncing around, I’d be treating a patient and then going into the next room or patient session. Somebody would come in and ask me, “We’re having this billing problem. Can I just quickly ask you?” Because they needed my time and they didn’t have it any other time maybe. They had to find me and break into my treatment session to get that answer that they needed and deserved. I realized I needed to start to focus and organize my time so that I could get results and whatever I was doing.
That’s what I find and I had to do the same thing. The company I was working with said two half days a week, at least to begin with. You don’t need to take a full day. They tried to ease me into it, dedicate 4 or 5 hours one day and maybe another 3 or 4 hours the next day at least a little bit. Because I think once you get a taste of it and recognize some of the productivity that you’re able to generate and do and pay attention to some of these things, then it’s easier to open up that full day and then open up into that. Now I’m trying to get my clients to do the same thing. I think once you start recognizing that, that snowballs and you start chunking out more time.
At that same time, you’re struggling with, “Am I a PT? Am I an owner?” I think that’s part of the struggle as you’re trying to hold onto that patient care because you feel good about that. I am good at that. I went to school forever to do that. Breaking away from that is a challenge.
How did your team respond to that? I want to get your experience because I want to share the experience of my clients and my team members as well as I started pulling away more and working on the business. What was your team’s response?
It was different depending on the team member. Some realized the benefit right away. They could see that I wasn’t scatterbrained all over the place. I was making better decisions. Some didn’t like that because I had to start to organize my business and accountability. I hold people accountable for their work and their jobs. I probably had a range of like, “You’re doing such a great job. Thank you. You need time to do this. We’re not going to bother you.” There was kickback where I’m asking them, “What happened to this? You said we were going to do this. I gave you a deadline and it was never done.”
I’m assuming those people didn’t last long.
That’s another benefit. As you start organizing and incorporating your purpose, values, structure and accountability, the people that don’t align naturally start falling off. As they do so, the other team members are like, “Finally, they’re gone.”
You don’t see it until after sometimes like, “Why was I blind to that?”
I did have some say, “It took you long enough to finally get rid of that person.” I was like, “I didn’t see what you guys are seeing. I’m sorry.”
If I had known, I wouldn’t have acted sooner.
The place where you’re at, you said recruiting is always hard for you. Fairbanks, Alaska, it’s going to be hard, especially with your specialty. What are some other things that you’re working on now where you’re at that benefit the business the most?
We’ll go with recruiting and travel because I think that was another big one for me. That was a huge mind shift change where I was fixated on hiring a permanent person from the PT. What I found was I could pretty easily find travelers. We have ortho here too that we get. People love the sound of Alaska. They want to travel up here. They may not want to live here, but they want to come up here for a little bit and check it out. I can pretty easily find travelers. I didn’t want to for a while. I had one bad experience and then I was like, “Forget it. I’m not doing travelers anymore.”
I had to revisit that and make sure that maybe I should try this again. I know a little bit more, I need to screen these travelers a little bit better, ask better questions. That helped to grow the practice. Along the way, a permanent person may show up and that’s pretty much what has happened. I can replace some travel positions as a permanent employee. What we found as we keep growing, we keep those travelers. I’m on board and so I have good relationships with a few travel companies that I work with pretty regularly. We always have at least one to two travel positions. Those companies help out a lot.
You take the time and energy to filter some of the travel candidates that come through. Maybe you do a little bit of training with them or you are to a point where you have people training them, which is even better. The energy that you can spend on that or not just take the first travel opportunity that comes to you, you can pick and choose you because you have the space to do that.Any relationship begins with clear expectations. Click To Tweet
We’ve restructured our hiring process and our interview process so that we’re finding out what this person is about before they get on board. It’s not just me during the interviews. It’s me and some other people sit in the whole step of the way, not just me by myself, which I used to do a lot before. I didn’t pick up on everything.
How do you do that? Because another thing that I’m talking about with my coaching clients is so much of it is owner-centric. You have all the answers. You do all the things to make it run. If ever anyone has an issue, they come to you. What were the important steps to remove yourself from that position so that they could be self-sufficient, self-reliant, answer some of the same questions over and over again, train them and hire people without you the focus?
2019 was my big year of SOPs or Standard Operating Procedures, protocols left and right. Just creating them and making sure that everybody knew the steps and it wasn’t just me and my head. That was a big deal getting that on paper so that everybody knew and we’re still working on that. It’s like an ongoing process, but I think that was huge because now questions that I shouldn’t answer, maybe questions about the billing or questions about scheduling, those should be coming my way. Now other people can handle that. An office manager or financial director can handle that. That was a big deal for taking more things off of my plate.
Did you find yourself having to tell people to look up the policy and procedure manual even though you could have given them the answer? Did you have some issues like that? Because we had that where we’re like, “There’s a policy on that. Check that first and if it’s not clear, then come to me,” to make sure they get in that habit.
It is directing them to the right person. If the policy is not clear, then that’s a great question for the office manager and then she could come to me if it wasn’t clear. The whole point was not to have all those questions coming my way so that I can focus on some other things.
I love that you brought up policies and procedures. I assumed you were going in that direction. The other thing that I found important to maintain a culture that Aisha wants to see is purpose, values, mission statement. I’m assuming you’ve got all that incorporated as well and it’s part of the culture.
We tried to incorporate that into the interview process like, “This is what our core values are. This is what we’re about.” In our break room, it’s all on the wall, our mission statement, our vision, our core values. It’s there and visible to everyone. I’m serious about them. I’m not trying to be nationwide PT practice. I want what we have here to be special and unique and to provide a good service for our community and to anybody who’s here on the team.
That’s huge because I find as I’m talking to PT owners, I bring that up and sometimes it falls flat. They don’t understand the purpose or they don’t understand the significance of it. I have to tell them over and over again. It comes down to who you hire and how you fire, how you assess. It even comes down to so many times we get caught up as owners. I don’t know if you faced this, but as you’re trying to improve productivity, which we know would benefit the patient and the clinic, it turns back on us for those people who aren’t aligned to be, “You guys are just pushing numbers and stats.” You want to have that purpose firmly established because then you can say, “No, following those stats helps us fulfill our purpose and our mission statement.” If you don’t have that grooved in properly, all the things that you’re trying to push, you’re trying to become more corporate. You’re losing the feel, all that stuff.
This I’ve learned over the years too. Any relationship begins with clear expectations. When that person is interviewed and then I’m brought on board, there are clear objectives like, “This is what your job is. These are your numbers.” Start that way and they shouldn’t change much from there unless there was a big insurance shift or something like that, just being clear. If there is a change that the change is clear, why does that need to change? I’ve gotten pushback from things like that too. What am I about? Sometimes you have to revisit that and know that I have to maintain this business. My first goal is to be an owner and to make sure I have a good, strong, stable company so that employees have a good, stable place to come to every day.
Along the way, were there some influential books that you read that helped you that you would recommend?
I’m an avid book listener. That’s what I say. There have been lots along the way. The one that comes to mind right now is The E-Myth. I’m listening to it again. I listened to it years ago and it was before realizing some things. Now I’m listening to it again and it is hitting home the fact that my main job is an owner. I’m not a PT turned owner, which I am, I guess. I’m trying to leave that PT mind elsewhere, not bring it into my business so much because it is detrimental to my growth. That’s harsh to hear for some, but I’ve found that to be true.
The other one is the emotional intelligence book. I think Emotional Intelligence 2.0. It starts with a test. You test your emotional intelligence, which is something that can change in your life and generally it improves as you get older. Unlike your IQ, that does not change. What you start to learn is those who have higher emotional intelligence are more successful, whatever that means to you. They tend to be more in leadership roles because you can handle how you’re feeling. You understand others a little bit better and you can navigate communication better. That one’s been huge. I’ve incorporated that into our hiring here if it’s a leadership role. If it’s someone who’s in a management position, we’re going to check that out and see how it goes, especially if we don’t know them if they’re coming new into the company. That’s going to be good.
It sounds like you’ve developed like a leadership path. Do you have leadership trainings? Do you have something set up?
It’s not so structured, but that’s where I’m going. Because as we grow, I’ve created leadership positions. My job is now to mentor those positions and just trying to figure out what’s the best way to do it. I’ve grabbed some things that I’ve learned from my mentor, Jamey, and incorporated it into what we have here so that I can continue to nurture my team.
You eventually have to pull yourself out and as your team expands that you need leadership in place. What we did is there were certain business books that me and my partner both agreed on that were must-reads if you’re going to be a leader. They had homework assignments. They had delegated some things, like you’re going to lead out on team meetings once in a while or maybe a project here and there and see, are they able to rally the troops? Are they able to get buy-in? How do they interact one-on-one with people? That’s a period of time. That’s something that I think all businesses, as they grow, need to develop some leadership tracks that they grow. Because ideally, you’d like them to come from within because they’ve already bought into your values and purpose and you want to keep those people.
You want to provide an opportunity for them. That’s one of my things as an owner, I want to provide more opportunities to my employees and growth is one of those things. Moving up is one of those things.
If you were to look back to the early ownership years, maybe before you had kids or within the first two children, what would you tell your younger self?
Probably to read that E-Myth book sooner, the entrepreneurial myth that you fall into. I want to do my own thing, but that doesn’t mean you understand what a business needs. It took me a long time to figure that out. If I had come to that realization sooner, it would have just saved me from a lot of heartaches and crying and all that stuff.
Do you want to own a business or do you want to own a job? Because that’s two different things.
I used to say that to myself because I had to break out of that thought, “Do I want to own a business or do I want to own my job?” Because that’s what it is. That’s what you end up facing.It's okay to ask for help and to not have all the answers. Click To Tweet
Either way, you’re a slave. You’re either a slave to someone else or you’re a slave to the business. That’s not what you went into business ownership for. You want some freedom and some ability to do what you want when you want to do it. That’s how you become effective. I can see in your path, and not to be some guy on the mountain or something like that, but you’re going from a certain amount of success and you’re moving into significance and how you can affect more people and be a better influence in the community. I love to see that transition in owners.
That’s what I’m going for. I’m trying to think bigger. Before, it used to be how many patients I can see in a day. That’s the amount of lives I can touch. Now it’s like, “How many patients can we as a group see in a day and touch and help? There’s such a need out there. What can we do as a group?”
Thank you so much for your time. Is there anything else you want to share with owners out there that might be reading? Our audience is independent practice owners, any advice?
Reach out for help. It’s okay to ask for help and to not have all the answers. Even right now, I don’t have all the answers and I reach out for help. I have a mentor and coach. I have a group of people that I can ask questions to. It’s just a journey. Try to think of it like that with no end in mind. Keep going.
If people wanted to check out Willow Physical Therapy and your place, do you have any contact information you can share?
For those people who want to check out Alaska, they have a place to go when they want to work in Fairbanks.
There are lots to do up here. Just a little different, maybe. Fairbanks is a unique place. I’m from New Jersey, so it is odd for a Jersey girl to be out here, but there’s just a uniqueness to Fairbanks that I love.
Congratulations on your success. You are a great example to other physical therapy owners. Thank you for your time and wisdom. I wish you the best of luck.
Thank you so much, Nathan. I appreciate you having me.
- Willow Physical Therapy
- Practice Freedom U
- Lighthouse Leadership Group
- Emotional Intelligence 2.0
About Aisha Wilbur, PT, DPT
Aisha Wilbur, PT, DPT was STUCK back in 2016. Stuck in a bathroom during her only break from patient care trying to respond to emails, answer employee phone calls, catch up on patient notes, all while pumping for her newborn. It was in that moment that she knew she couldn’t continue to live (or run her business) like this anymore. She finally reached out and got some help from PT Owners Club friend Jamey Schrier and as of 2019 has doubled her business and removed herself completely from patient care. An amazing transition that needs to celebrated among fellow PT owners.
Aisha was dedicated and focused in her efforts, and is now reaping the rewards. But her path is not unique. She followed the success formula – Reach Out (for help) + Step Out (of treating full-time) + Network (with other small business owners). In doing so she has all the freedom she wants along with greater visions for affecting her community in the future.
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