Ben Lynch: G'day, good people. Welcome to the Grow Your Clinic podcast by Clinic Mastery. Here's what's coming up inside of this episode. Should I roll out a tiered pricing model for my team?

Jack O'Brien: Have you planned out the couple of days before Christmas what your January 1 fee schedule update looks like?

Bec Clare: We're leaning to things like AI, so note taking for AI so that clinicians are not needing extra time to do notes.

Jack O'Brien: The disparity across physio fees is deplorable. Flowers are on their way to the APA as well with a nice little note and a bottle of wine. Sometimes learning your numbers and finances is a language and that's okay to be incompetent to begin with.

Ben Lynch: And a lot of clinic owners are afraid of their numbers, don't like their numbers. Of course there's a cohort that are just sickos, they love it.

Jack O'Brien: My kind of sickos. You're looking at two.

Ben Lynch: This episode will be right up your Allie if you're looking to increase your fees. We're diving into sustainable pricing models. And trust me, you want to hear Beck's take on getting your team aligned with your pricing structure. Plus, Jack talks us through how to add more value right before you raise your fees. Before we dive in, today's episode is brought to you by AllieClinics.com. If you're the kind of clinic owner who loves to feel organized and stay ahead of the chaos, you'll love Allie. Think of it as your digital clone. It's the single source of truth for all your clinics, policies, systems, and training. Test it for free at AllieClinics.com. In other news, applications are now open to work with us one-on-one at Clinic Mastery. If you want support to grow your clinic and bring your vision to life, just email helloatclinicmastery.com with a subject line, podcast, and we'll line up a time to chat. All right, let's get into the episode. It is episode 325 and something rather important came across our desk in the last week. Jack O'Brien, you shared this particularly notable release regarding physiotherapy services and the hourly rates, the fees. But whether you're a physio or not, this is going to be of interest to folks listening or watching in as to how they might think about setting their fees now and into the future. So, this great report was shared. I'm going to share my screen here, Jacobin, and we'll talk through it. So, the Australian Physiotherapy Association, the APA, engaged the NAUS group, or NUS? NAUS? Now let's go with Nows, the Nows group to provide some guidance on a sustainable and value based hourly rate and associated loading for skill levels, experience, qualifications and location to support members to identify sustainable fees. They say, these low fees that we're charging as physiotherapists, or insert your own profession, I challenge you to think about where you fit in context with your peers. They say these low fees are creating sustainability concerns in two forms. One. unsustainable working conditions for physiotherapists, and something near and dear to our heart in particular, by extension, is unsustainable business models, i.e. profits for physiotherapy practices. It seems reading this report, perhaps a meaningful catalyst, has been changes in things like the NDIS and physios going, this is not going to work for us into the future. Jack, when you saw this come across your desk, what did you think when you had a read, had a pass through it?

Jack O'Brien: Yeah, I thought it was needed. We often, particularly as physios, I'm a physiotherapist by trade, recovering physio, as you like to put it. And we don't typically talk about prices as a profession much. There are other professions that do this really well. So in the first instance, I was really glad to see that they were talking about it. They tabled it as a conversation point. I will just say for listeners who might not be physiotherapists or don't have physio in your clinic, stick around because everything we're gonna cover here today, different funding models, sustainability for your team, sustainability for your profits, all of this is relevant regardless of your profession and regardless of your size of practice. You might be at 10K a month or 410K per month in revenue. This is all going to be relevant because we all charge fees.

Ben Lynch: Bec how did you respond when you read through this? Was it a sigh of relief? Was it some excitement or anticipation like, yes, they're championing that we should be charging at a higher rate broadly or charging appropriately for our skill set? How did you respond to seeing this?

Bec Clare: Oh, absolutely. In a similar way to Jack, a bit of a hooray, we are, as a profession, putting this on the table and having a discussion, not just about what the hourly rate should be, but the disparity state-based, the disparity across multiple funding models. And then that creates this inconsistency that means we're all really quite confused about what we should charge and how we should value ourselves. I read the report in conjunction with the APA's workforce consensus as well, which also talks about how much physios are paid generally across the country and also levels of job satisfaction. Because here, as you pointed out, Ben, they're referencing unsustainable workloads and unsustainable clinic practices. We know that our largest investment when it comes to finances in our clinic is our team. We want to pay them appropriately, so we need to couple the two together. Definitely a welcome conversation.

Jack O'Brien: Yeah, I mean, I'll say this. I was happy sad to read it, or sad happy. It was like, I'm grateful that it's been tabled and it's part of the conversation. I was also lamenting the fact that maybe the, I think the bar's too low I'll just come straight out and say I think it's too low. And there was also no commentary, at least to my knowledge, around how frequently they're going to review this and should we consider indexing it. There wasn't a lot of long-term commentary. It feels like a little bit of a flash in the pan. So I'm hopeful that it's part of an ongoing conversation. But I do think, broadly speaking, it is low.

Ben Lynch: And the bar specifically that you're referring to is not a Snickers bar, but this bar here of you're on the Snickers, surely with the triathlon, you know.

Jack O'Brien: If it's got carbs, I'm in.

Ben Lynch: Yes. Burn those carbs. Anyway, so we're over here now back on the report sharing the screen. And they said, our analysis suggests an appropriate hourly rate for physiotherapy in Australia is $261. They then have a table down below that explains it a little bit more and says, for instance, if you're doing a 30-minute session, you would charge half that, so $130.50. And then they are essentially advising you can change this or load it based on years experience. So more years experience, a higher rate. They give $300 per hour for physiotherapists with extensive experience. I actually couldn't find the specific Definition of that. I mean in other areas they took about five to ten years so let's go with that. Titling or equivalence if you've done further studies that being slightly higher at $313 per hour or if you've done specialisation $365 per hour. I think at least there's, to your point, like there's paint on the canvas. There's something to anchor to and compare where am I now so that we could entertain what do we do moving forward. Bec as you think about setting fees in your clinic, what are some of the parameters that you use? Like just talk us through it, how frequently you do it. What are some of the anchor points or reference points that you use in deciding how much do we increase our fees to moving forward?

Bec Clare: Yeah, it's been, and perhaps I'll paint the picture of where we were a couple of years ago. So only a couple of years ago, we were actually part of a preferred provider. And so for those who are not familiar with those, essentially you sign up to an agreement with the major health funds. Each one has their own. They stipulate how much you can charge, and it is capped at that. In return, they say that they'll push more members your way. Essentially, you're listed on their website as a preferred provider, and members receive a greater benefit back. The trick there is members receive a greater benefit back because you're charging less. So it's actually not necessarily that they're providing a member with more in terms of their funding. So we moved, this was two years ago, we moved from charging $70 for a 30-minute consult actually what we deemed were valued at, which was quite a transition for us and a really critical headspace we had to go to. In terms of how we did that, we actually sat together as a team at one of our team retreats, and we said, here is what we're currently charging. We've gone away and done the research. Here is every clinic within 10 kilometers of us. Here is what they are charging. We said, OK, where do we sit? And we were way off the pack. It was this moment where our team went, oh my goodness, we are worth more than this. And it was that collective buy-in that really helped us move forward with deciding to exit from that and then navigate those changes. What I will say to anyone considering that is the fallout, if you like, provided you can communicate really well to your clients about your value proposition and you can back in your value, which I'm sure if you're listening to this podcast, you're already backing in your value. Then go for it and do it. We were, it was 35 to 40% of our business. We were really worried about losing. We lost two clients as a result. Just two. And it came down to how we communicated that and how our team practice their scripting. Every team member practiced that scripting. So where we ended up being, what are the clinics around us charging? There was some really at the top end of the scale, some somewhere in the middle. We landed somewhere in the middle. We didn't want to be the cheapest. We felt uncomfortable at the time being the most expensive. If you ask me now, I'd probably still raise our fees. Again, because of what we do provide and how we can then pass that onto our team. We review our fees every six months. And so there's a bump in our fee schedule. It's a fee review versus a fee increase or an updated pricing versus a fee increase. And that's how we talk about it. If we look at all of the expenses and investment that we put into our clinic, I'm constantly receiving emails or new updated service agreements with the cost of running a business has gone up, therefore we're passing that on to you. In healthcare, we shy away from that so much. Yet if we looked at what it costs to run a clinic even six months ago to now, we need to also be adjusting our prices to be able to keep up with that.

Jack O'Brien: Bec, I've got a question for you. You mentioned six monthly fee adjustments or reviews. Is there any particular reason you've chosen a short frequency rather than say every second year, for instance? How do you think about the pros and cons of regular updates versus long-time updates?

Bec Clare: We figured that the regular updates meant that the updates could be a little bit smaller. Therefore, there's not so much of a conversation. Yeah, there's not so much of a conversation we need to have with our clients. It's just this little bump more frequently. It helps us keep our finger on the pulse where our expenses, our investments are jumping by those little amounts as well. It just meant that we're continuing to move. We choose to do them 1st of July and 1st of January. Most people in the community think 1st of the new year, there's an update of some kind and the 1st of July being the new financial year. So people are sort of expecting or anticipating businesses to do that at those intervals.

Jack O'Brien: Yeah, and I think that's what we did at our clinic personally and it's what I think the best clinic owners are doing. It's interesting, I'm sure you both had different experiences with clinic owners who are quite resistant to this idea of regular fee updates because they think that their team will get funny about money or their patients will resist. But it's almost a case of like once you do it, you're like, oh, I should have done this years ago, should have got into this rhythm or this routine. Benny, have you found that when you were coaching clinic owners?

Ben Lynch: Yeah, I like the idea of the small frequent changes. As you said, Bec I think it takes a lot of the stress off you as the clinic owner rolling it out. What I love is how you brought your team along the journey with you in sort of articulating here's where we sit in the marketplace and also getting them to look at what are all the things we feel are value and valuable in our service because they explicitly called out in this report. I'll just come back to sharing the screen. A great opportunity. They say practices often do not understand how to communicate the value of their services. This speaks to our marketing, but to your point, Bec, of the scripts of the communication internally, the party line, if you would, that our team have in understanding the costs that go into it. We've talked about the $200 activity exercise on the podcast before as an activity and illustration of where the money goes in the clinic. But being able to actually have a conversation with your team about the value that we deliver and what that's worth and put it in context of the marketplace is a really worthwhile activity to do, Jack, to your point of clinic owners or teams that feel uncomfortable about it actually addressing the value piece.

Jack O'Brien: Yeah, and if you leave that up on the screen share, you know, there's three bullet points there around different stakeholders being private consumers, practices, and compensable schemes for those listening along. I think there's been an omission here, an omission. There's a fourth dot point left out. And I will say, I have a lot of sympathy and compassion for the authors, the VU group or VAUS group, whatever we call it. NAUS. NAUS group. They're pulling together a proverbial dog's breakfast across all of the professions, and I can say this because I am one, the disparity across physio fees is deplorable. You know, I look at some professions and I'd argue that probably psychology has a very consistent model of fees generally, followed by some others, you know, Speech Pathology Australia and OT Australia do a great job as well. that physio is so disparate but what I'm getting at is they've left off a key stakeholder here being the profession itself or the professional association because what I see to this point of different stakeholders influencing fee perception is that My profession, physiotherapy, has done a terrible job, in my opinion, of positioning our profession as valuable. And so we can, I'll say, whinge and complain about the profession. And look, I've spoken to different folks at the professional association. If the professional association isn't going to position your profession as high value, you can see there as we're sharing screen, physio is the lowest value.

Ben Lynch: I'm backing you up. You're giving good vibes here, but here's the data.

Jack O'Brien: We can blame the association for not doing a good job of representing us well, or We can blame or we can take responsibility and you with your marketing as a clinic owner in your local community can position your care, your profession as highly valuable. You know, there are some different campaigns that have happened, I think, that devalue our profession. Just a simple hands-on massage or simple strapping representation is not indicative of the breadth and value of our profession. So we can complain or we can make a difference. And so my encouragement to clinic owners is when you see this, like right time to step up and show the value of not just your profession, but show the value of your practice and your care.

Ben Lynch: There's a couple of good points here. I used to be on the Podiatry Association of South Australia back in the day before it all became a national body. And I think it's great. There's a lot of things that associations are juggling, but it's always great to get positive, I'll say reinforcement or requests from members, not in a we hate you. Why? Why do we pay for our membership? But to say, hey, this is great of the APA to be doing initiatives like this, the workforce report, the fees report. Clearly they are listening as an example. So if you're a dentist, if you're a GP, if you're a speech or a psych, we have all of those listening. Reach out, have a good dialogue with your professional association to get them to do reports like this, to invest your membership dollars, to do this and raise the bar. It also helps. What I also love is that they're allocating more to some private practices here because I think at least half of the profession works in private practice. Just to explain this and then throw to you in a sec, Bec what we're showing on screen here, these are hourly rates for standard service in Comcare 2024-25. Reference point here, again, just to look at physiotherapy in the context of other professions. It is the lowest hourly rate at $172. Psychologists up at $268. Nearly $100 an hour difference. Osteo at $235.

Jack O'Brien: Well, it's interesting that they're recommending $261 as the new rate up close to that psychology. But yeah, interesting that physio is low. And again, for all of our other professional listeners, other professions are below the $261 pin for physio. So there's an argument for if I were another profession, Ben, I would be downloading this report and sending it to my professional association and saying, hey, here's what the APA are doing. and I would love for you to do this. Now, we've gone down the association rabbit hole. I will say, I love associations, I advocate for them, got some great friends in there. I was a paying member of my association when I was a practicing physio for a long time and would encourage people to be paying members of their association because when you pay for your membership, you get a say and you should make a difference with your membership. Ben, back to you.

Ben Lynch: The flowers are on their way to the APA as well with a nice little note and a bottle of wine. Oh, he's just cozying up a little bit there.

Jack O'Brien: Give me another speaking gig. It's the APA Association's conference, I think this week in Adelaide. They'll all be listening to this, I'm sure. And so to all of my mates in the APA, I love you still. Please have me back.

Ben Lynch: Keep layering it on. Ah, gee whiz. Bec, just talk a little bit more about the exercise in bringing the team members along in understanding the value, like specifically what questions or activities are you doing to get your team members on board with understanding their value and feeling comfortable to charge appropriately for their services?

Bec Clare: Absolutely. One of our core values is we are world class. So we lean on that a lot in terms of being that 1% better every day. Literally, this exercise was we had one of those big post-it notes on the wall. We said, OK, let's brainstorm all of the incredible things about our clinic. and whether that be what happens in the consult, what clients get beforehand, what they get after, their management plan, the skills that we provide, the technology like Vault as an example. What are some of the things? We have a gym space. We have a beautiful new clinic. We have a client care team there whenever we are open. There is always more than one therapist at the site at one time, so there's always camaraderie. It was this enormous list. We said, OK, well, how do we fund all of that? And how do we keep all that going? We then did a second page, which was what are all the things that we want to do as a clinic? How could we add even more value to someone's journey with us? And there were some amazing ideas that come out of that. We then went, well, how do we invest? How do we find that, the funds to invest that? And so the team then came along, well, we need to generate more revenue. Okay, well, how do we do that? So, increase fees, add more value with other things that we can be doing outside of the consult, whether that be adding value via product. or looking at what are the other incidentals that we could be doing in our non-client facing time, phone calls, reports, et cetera. Now, in South Australia, under the Return to Work scheme, we're actually able to invoice and generate revenue for all of those things. I was looking today about what that looks like, and Jack, to your point about the disparity in the profession, but I see this across other modalities as well, is that where we have fee schedules that are perhaps state-based, some states you can bill for phone calls and reports and attendance on site and get to a case conference. Case conferences are great for building our networking and relationships as well. But there are other states where you just can't invoice for any of that. It's just not even available under the scheme. And that's where I also feel that particularly physio is not valued by allowing our physios to interact in a client's management like that.

Jack O'Brien: And I'd say we've allowed physio to be devalued by not advocating years ago. I think about the podiatry association, for example, and podiatrists have umpteen dozen, you know, billing codes and Medicare codes, and they've been reviewed over time. Physio was stuck with two codes across almost all billing parties, and they've hardly been reviewed. I mean, we all get excited when DVA goes up by a couple of cents per year. It's like, give me a spell. We are so undervalued.

Bec Clare: Don't even start.

Ben Lynch: That's a rabbit hole. We do not want to go down today. To your point of some of the other things that they're doing, they alluded to it in this report. They said, quote, there are also rising expectations of quality and safety alongside increasing regulation. which will likely contribute to lower utilisation for physiotherapists and increase the burden of senior practitioners to spend more time mentoring others, taking your best performing therapists away from revenue generation. We've spoken about this a number of times recently on the pod about going into clinical pathways. And they also mentioned it later on when they talk about the workplace report and how physios are looking for career progression. And so they want this, but also they're straddling the line of this is unsustainable and unprofitable. So how do you start to weigh up for your senior therapists, Bec the balance of how much time they're, quote, off the tools and not consulting versus doing some of the behind the scenes stuff to support the team slash their caseload. Just talk us through how you manage a sustainable caseload for a senior therapist whilst also handling their other duties.

Bec Clare: Oh, this is a live challenge. We are talking about this right now in the clinic in terms of what the additional commitments are beyond consulting. How much, how many mentees should be allocated to a mentor? What's the perfect ratio? How frequent? We're still trying to find that balance. I'll be completely honest. And then you have changes like support at home, which for those following along at home is the Change coming in the 1st of November, which is my aged care is changing to support at home. Significantly more compliance required. Significantly more time that is non-client facing. Again, that cannot be generated in revenue for our therapists. We're leaning to things like AI. So note taking for AI so that the clinicians are not needing extra time to do notes. That's all taken care of and they can spend it with the team. From a senior therapist perspective, we look at what impact can that senior therapist have in their mentoring and setting some measures and benchmarks per practitioner. So we know that if they're looking after, say, three clinicians, if they can help those three clinicians excel. have greater utilisation, some of their CEIs, clinical excellence indicators start to turn more positively, then that is also a value proposition. Certainly as a senior therapist, they're likely also to have clients who want to see them. They might bill out at a higher rate. We in clinic have a tiered fee structure. And that's in part how we make up some of that ground, where a clinician who is more senior builds out at a higher rate, therefore they don't need to see as many clients in order to generate a benchmark of revenue.

Ben Lynch: But it's a real challenge. It is. We routinely get the question in our Slack community, typically from business academy members, those that are reasonably established businesses with five or more practitioners asking this question, should I roll out a tiered pricing model for my team? Jack, how do you think about tiered pricing, which addresses this, and essentially the report is advocating for this, that more senior therapists, as vague as it is in their definition, should bill more for their services. So Jack, how do you answer the question of a clinic owner, should I implement tiered pricing for my practitioners?

Jack O'Brien: I'm going to channel a little bit of Peter Flynn here, the great D-man and say it depends. Now, I'll say both ways can be right. Having a standardised fee structure can be right and a tiered fee structure can be right for you depending on your clinic. I would say that what are you trying to achieve? What are you trying to achieve? Because sometimes a tiered fee structure might not achieve what you want it to achieve, and it might achieve something else. Typically what we see, if the clinic owner is trying to shift some load off their, say, experienced team member or highly sought after team member, trying to shift load off them, put their prices up, and the load doesn't shift, That therapist stays just as busy if not more busy because of the anchoring and perception of value. They just end up more busy. I don't know if that's the right language. Someone in the Spotify comments can tell me. Yeah, they're not more busier. In the comments on Spotify, grandma Nazis come at me. But that senior clinician becomes busier. and billing more, which is not necessarily a bad thing. But if your objective is to shift load and utilisation elsewhere, it probably won't achieve that. If you're looking to maximise dollars per consult and increase the profitability, et cetera, then it can achieve that. So in short, if you would like the short answer, yes, have a tiered fee structure with your eyes wide open that it might achieve a myriad of impacts.

Ben Lynch: Well, I believe Peter shared this on the podcast before, that when he was consulting, he raised his fees pretty meaningfully as a physiotherapist. Like doubled them or something? Yeah. And he actually ended up busier. And it sort of, you know, did the opposite in a way. So that's, yeah, real world example there. I think what this does, it forces me to think about how well clinic owners are budgeting and forecasting into the future, let's say over the next 12 months, because it's likely their team members are going to want pay increases. And hopefully you're on the front foot and you've already prescribed how that happens at your clinic, though many don't. And if you need help, reach out to us. so that you're already factoring in these increasing costs to your base as a clinic owner that are going to come. Like you said, Bec in a number of different other suppliers, you're getting higher bills. That's the nature of the base. So what is our fee strategy and how do we calculate that to know where we're going to sit in six and nine and 12 months from now? We use a tool like a rolling break even to give you a good proxy for where things are at. But there's nothing like getting into your zero account, as an example, and starting to budget these things out into the future so that you don't end up in a bind where you're unprofitable and you're stressed to the max with this business. So, Bec how do you go about making sure that, you know, you're looking out for future Beck and the future team with some of the projections that you put down?

Bec Clare: As part of when we first joined Clinic Mastery, the big emphasis was around know your numbers and less so from a how profitable are you, it was more around actually the power of knowing those means you can make informed decisions and that things don't come as a surprise. The last thing you want is a massive tax bill arriving or a blowout in certain expense where you think you're sitting pretty and then bam, everything changes for your family. That shouldn't happen. Knowing your numbers provides you that predictability. So a beautifully sorted profit and loss statement. I just love that numbers person. Makes me sleep so beautifully at night, even with a toddler. And being across what is likely to change. So then coupling that with something like the rolling break-even forecasting document. We use that rolling break-even document in real time to go, okay, where are we sitting? But also what do we want to do? We want to add a new team member. We want to do this. We've seen an increase in these expenses. We also know that there's a proposed award change coming. It is proposed, I will emphasise that. We don't know what that looks like, but we do also need to be forecasting for what happens if that comes to fruition. The knowledge and power that that provides you means that you can go about making decisions in your business that are more values aligned versus being worried day to day about where the money's going to come from and will you survive the next pay cycle. We were pay cycle to pay cycle. It was horrible. and we've been able to get to a point where we're not.

Ben Lynch: very uncomfortable position to be in. Jack, we know how tough it is to get these systems in place around your numbers, to be accurate, to be timely, to be ahead of yourself. Where can clinic owners actually start if they've never done this? We've seen what mastery looks like. We've just come off a meeting ourselves, right, of continuing to refine things and get better internally. And then those things bleed out into the rest of the community. But knowing how much is required in terms of attention to detail, follow-up, there's a lot. And a lot of clinic owners are afraid of their numbers, don't like their numbers. Of course, there's a cohort that are just sickos. They love it.

Jack O'Brien: My kind of sickos. You're looking at two.

Ben Lynch: And for me as well, I wasn't super natural. I didn't love it. You kind of learn to love it. I think a bit of competence breeds confidence and you learn to like it. So where do you start, Jack, in looking? Because really the message I get out of this report is, hey, physios, hey, health professionals, With all the costs of living, with the demands of your team members wanting pay increases, with all the cost base increasing, we project two to three years from now, there's going to be a real squeeze. And a lot of people are feeling that squeeze already on the profitability of their business and questioning, do I continue with this or do I sell an exit? How do you help those people get clear on their financial future, Jack?

Jack O'Brien: In order to get financially clear, you must start with your diary. Get things in the diary. Schedule your fee adjustments now. It's the time of recording, we're in the middle of October. Have you planned out the couple of days before Christmas what your January 1 fee schedule update looks like and what your comms to your team Potentially, probably not, comes to your clients, looks like in the first week of January. There are three things that you can put in the diary right now because if you're using Cliniko or any other practice management software for that matter, Halaxy, Splose, Nookle, all of those four integrate with Allie. If you're looking to join, AllieClinics.com. Come on, join us. But what I'm getting at is you have to manually update those fees, right? So you need to set yourself a reminder for January 1. It's a wonderful New Year's exercise to enjoyably update your fee schedule. Get things in the diary. Put them in for June so you can roll out July 1. Put them in the diary now. But when it comes back to that financial literacy piece, Ben, you said competence breeds confidence. How do we become competent? We get the reps in. And so I would say carve out time in your week every single week to sit in front of your zero. Now, you might just stare at ones and zeros and a white screen. That's okay. you're getting the reps in and just like we touched on at the top of like learning a new language sometimes learning your numbers and finances is a language and that's okay to be incompetent to begin with so get stuff in the diary for your fee adjustments get stuff in your diary to regularly review you can work out what you do in that time later but just get the time in And then I'd say you must have a third party help you with your numbers. As humans, we choose willful blindness very often, particularly if we're incompetent or there's things that we're ashamed of or afraid of or just ignorant of. We are blinded and we are biased. beings that is the nature of our brains and so having a coach is invaluable now it could be us at clinic mastery it could be someone else it could be your accountant if they're a you know an up-skilled progressive open-minded accountant they're few and far between but we can help you find a good one but having a coach review your numbers with you collaborate with you is critical. So get stuff in the diary and get someone else's eyes on your numbers. Bring things to the light. That's when things get healthy and can grow. Things go weird in the dark and if you just put your head in the sand and ignore it, it ain't gonna get any better than what it is currently.

Bec Clare: Jack, to your point, things get funny in the dark. Prior to joining something like Clinic Mastery, as an example, we would go to our yearly review with our accountant. I didn't even know how to log into Xero at that time. And the number of clinic owners that I meet as a coach as well as a consultant who haven't logged into their Xero fund, you know what, we're starting from some progress over perfection, okay? Log in. would be the first thing I would do. Yeah. Play. You can't break anything. It's fine. You know, have a bit of a play and get some, go along to those accounting meetings and have your third party and be able to ask them questions. Hey, I don't understand what this is on my profit and loss. Can you help me? They'd be happy to educate you, I'm sure, as is your coach or someone as a mentor. The amount of people that will not or don't log into their Xero file, particularly those that are maybe shy of numbers or, you know, words and networking are more their thing. Numbers, scary. We become more competent as we try.

Jack O'Brien: And you'll start to spot patterns. You know, I think about it, I compare it back to our studies at university. If you're a health professional, it's like you're starting with anatomy and just staring at endless lists of, you know, body parts. And it doesn't make sense until you start to go, oh, when they, like this Latin part of a word means this Latin part of a word. And so when you're looking at your numbers, you start to go, oh, when we see more, let's say, DVA patients, that affects the profitability of that particular therapist, or that time in the diary is underutilised. You make these connections. And we know that humans are very good at pattern recognition once you've got thousands of hours of reps under your belt. Now, you can shortcut that thousands of hours by getting a coach who's had thousands of hours, but we must get the reps in and start looking because you'll spot the patterns over time.

Ben Lynch: Jack, you raised a good point, and I'm going to ask you for a couple of book recommendations and for you too, Beck. So you've given a couple of really good ones recently. But you raise a reasonable point here, Jack, around how this fee report actually prompts us to think more about our business strategy, our marketing strategy, our team strategy for support and mentoring. Here's another point from this. here, which says, current fees in many cases do not meet the costs of providing services. Fees are often lower than other allied health professions, despite the distinctive scope of physio. Point one is, it creates significant risks in two ways. One, it creates unsustainable businesses with low profits, because Even when they charge high fees to private clients to offset the losses from compensable schemes, they still can't charge enough overall to achieve sustainability a la profitability. So I think that's really important when we think about 12 months out from now. If I look at the pie chart, of the clients that you are seeing and serving and the funding models that they're coming to you from. What does that look like and how is it different from today? And then what does that change about our marketing strategy moving forward? If I'm creating a marketing plan for the new year coming, how am I going to purposefully try and attract more private paying clients as an example? So I think this just catalyses so many conversations and actions. I got a book. I got a book to recommend. Yeah, right here. It's called Financial Intelligence. This cover is horrid. But anyway, the book is great. Don't judge this book by its cover. It's called A Manager's Guide to Knowing What the Numbers Really Mean. Now, it is more for our American friends that listen into the pod. This is perfect for you because it's written by like an American accountant. For those that are in the UK, for Australia, there's a lot of sound fundamentals that still carry across. What I love about this, Jack, you're more numbers inclined than I am. This spells it out. It might as well be called financial intelligence for dummies. And so it's perfect for me. in that it talks about this whole language of accounting. They use these interchangeable words and they just confuse you to no end. And so it kind of calls BS on a whole bunch of accounting words and just says, here's what it means. And it just simplifies it beautifully. So if you want to understand essentially the three big financial statements, your profit and loss, your cashflow and your balance sheet, This, I couldn't recommend enough. Financial Intelligence by Karen Berman, Joe Knight and John Case.

Jack O'Brien: That's interesting, Ben. I will say I have a number of personal finance books that I recommend, but when it comes to small business finance, I actually don't have a lot of book recommendations because there's two observations that I've made. Number one is that a lot of financial intelligence books are geared at large companies, maybe publicly owned, and it ends up very jargonistic. So there's a lot of material directed at that side of the thing. But also I've learned so much more from mentors in the space because it's one of those things you must, there's gotta be a bit of back and forth like, you know, rallying like in tennis, asking this and pointing to that and getting your hands proverbially dirty in the cloud by playing around with your zero file. You got to almost rub shoulders. It's not, in my opinion, it's not something that you can pick up with textbooks and smarts. That's what you go and study accounting if you want to learn that. It's something that you need to let the rubber hit the road, get the reps in alongside someone who can speak management language or leadership language, not just accounting language. There's a big distinction. And When we help clinic owners to set up their Xero file, we often say to them, your accountant will handle your Xero file in a particular method and that's fine. You as a business owner need to handle and interpret your Xero file differently, in a way that is meaningful for you to lead and manage and strategise for your team. That is very distinct from tax management.

Ben Lynch: And on a recent episode, we did a video walkthrough of how to look at your profit and loss as an example, how to set it up in meaningful categories for you as a clinic owner.

Jack O'Brien: Right, right, so back to your comment there, Ben, around the mix and the pie chart, Bec, I'm curious for you, when I think about that, like I think about the discrepancy or disparity across fees, yeah, at one point NDIS was the highest rate, no longer, hasn't moved, come down in most cases. You've got Medicare somewhere in the middle, typically DVAs on the bottom, we've got privates, we've got Comcare, all these different funding models. I find it a really challenging concept, Bec around this fees and marketing, because for my clinic, we were in a military area, had a RAF base around the corner, a lot of retirees, so therefore a lot of DVA patients. One of my team members, their ideal client was helping RAFies and ex-military, and that's very noble, and we did do that at our own expense often, but it's not sustainable. But we don't also just want to market to the rich and famous. So how do you think about marketing to your team's ideal clients in light of their funding mechanism and the fee they'll pay? How do you think about that, Beck?

Bec Clare: Really great point. We tend to pick what is in and around the highest of those fees. So if you think, you know, return to work SA, we've got Medicare, we've got DVA, NDIS, et cetera. We go, what is the benchmark? And let's ensure that our private fees are at least meeting that. Okay. When it comes to then marketing, we really want to be adding more value versus discounting our services. That is how we really look at that. So often we'll meet with referral partners and they're like, Oh, Hey, so can we get a discount by being affiliated with your clinic? We then go, let's add more value to the package that we're able to provide you so that we maintain a base level. There are still going to be funding models that are lower than that. However, we can, On average, we're looking at how can we get a really nice solid average.

Jack O'Brien: Great way to think about it. I like that. And I think that's a really good note is for clinic owners to think about pinning their private fee to the highest possible marker. Historically, that was NDIS, not so much now. Maybe it might be physio clinics in particular. Think about anchoring your private fees to 261. That is the recommendation. And I guess the reality is, Ben, I might get your perspective on this. This report, will just gather dust if people do nothing about it. It's almost like the impetus, the ball's in the court of the clinic owner now to take this recommendation, have the intestinal fortitude to back it up with a fee adjustment and match it. What do you think to that, Ben?

Ben Lynch: The way I've thought about fees recently has been by increasing them, what do I need to do to make myself totally comfortable with that fee? Right. And to your point, Bec it's like, how can I add more value than the fee adjustment that I've made? So I've offset my own uncertainties and fears and discomfort because I can back it up and go, no, I feel really confident what I'm doing and the changes I've made recently and will be making in the short term. offset this and I feel comfortable. And I've done that quite literally very recently. So I, and it is unease, there is an element of unease. So that's how I certainly have navigated it is looking at providing overs and above in value. And I know that can maybe just be thrown around like, oh yeah, add value. I think it's gotta be nuanced to the patients that you serve. the groups that you work with to actually understand what are their needs, what are perhaps their unmet needs, and how could we satisfy those or increase the satisfaction of meeting those needs moving forward? Is it products? Is it services? Is it education? Is it a combination of those things? So it is quite unique to the people and players. But that would be my advice. J.B., what do you think?

Jack O'Brien: Yeah, I really like that. So if the rubber hits the road here, we're talking about for clinics that are running 30 minute subsequent standard consults, we're talking about adjusting your fees up to $130 per session. And that might be a small jump for some, might be a large jump for others. But how can you add so much value or create so much value in that consult where you feel super proud that it's $130 and the patient looks at it and goes, Oh, that's high compared to down the road, but that's still a ripper deal. Sign me up. I believe that's the place I need to be. I think that's a great way for us to think about rather than the fee is high, more so for what you get, the fee is super reasonable.

Ben Lynch: That's a really good point. There's a pricing survey called the Van Westendorp Pricing Sensitivity Survey. It is typically used, I believe, in the software world, though it may be applicable external to that. I've become quite familiar with it, of course, in building Allie and understanding how do we provide incredible value at a very reasonable price. It's great. Everyone absolutely loves Allie for the price that they pay. And there's a kind of a band that you get to. You ask essentially four questions. And whether you would actually do this to your patients or not is not the point. It's more a mental model for how you might actually think about this. Though, feel welcome. You might actually find value in doing it. It's essentially along the lines of, at what price point would it be so expensive that you wouldn't buy it? At what price point would it be so low it would seem too cheap and the quality wouldn't quite be there? So you kind of get your upper and your lower limit, and then you try and find the band in the middle. So you ask the next question, the third question, which is along the lines of at what price point would it be on the high side, you'd think about it, but you'd still buy it? And then the next one is along the lines of, at what price point would it be like a bargain for you? So it's on the bargain side. You don't feel like you're losing quality out of it. Now, you can Google this and find the explicit, clear phrasing of those questions, but directionally, that's correct. And it gives you a band to work within to understand the value of the service. So, I found that particularly useful in understanding where value sits. I'm not sure if it's real world applicability in, say, healthcare services, if it's been used. I've only known it in a software context. But it's been useful. as a mental model. Well, as we look to wrap here, Jack, you kind of put a bit of a call to action there, but I'm interested in what your call to action is for folks listening and watching us on YouTube here. For folks that have read this, have digested it, or if, again, you're not in physiotherapy, you're just hearing this for the first time and you're questioning, okay, what does this mean for my clinic, the fees that we charge, the services and value we bring? Jack, what is your call to action for folks listening in? I'll come to you then back off the back of this episode.

Jack O'Brien: Yeah, okay, let me be really specific. If you're a physio clinic owner, I would be adjusting my fees towards this recommendation. You may or may not be close enough to go straight to the recommendation, but move towards this recommendation before Christmas, because you've got a reason a As I touched on earlier, get something in the diary for a January 1 fee schedule update and plan that before Christmas. Plan your comms, schedule your comms, schedule your thing so you can go into Christmas, celebrate with your family, have a great time, smash the prawns and the champagne and go to enjoy all the things knowing that January is going to be more profitable than December. You'll feel so much better by scheduling for January. So physio move now, everyone else move for January.

Bec Clare: I'd be getting two sheets of paper. What value do I currently bring to my community? What value could I bring if I adjusted my fees?

Ben Lynch: Very nice. Mine is very similar. I would say schedule in the fee adjustment January 1. And if you're uncomfortable, you've got a figuring out a forcing function to your point, Becca, of what am I going to do between now and then to increase the value that I provide my patients to make and offset that incredibly more than the fee itself. Well, great session. Great to see you both. We will continue down this path of looking at how do we continue to operate the practice behind the scenes? How do we make good decisions about efficiency and installing a clinic operating model, a comprehensive model that allows your business to thrive into the future? Jack, you've got something on the desk about Spotify comments.

Jack O'Brien: Yeah, look, Spotify's getting lit up. There's a movie quote, I can't remember where it's from. But nevertheless, I just wanted to, yeah, shout out those that are jumping in on the Spotify's and getting in touch. John Menzies said, great episode, heaps of gold nuggets there regarding the reactivation of clients episode recently. Someone said, speak faster, please, Ben.

Bec Clare: What a great comment that is. I think that's the first time Ben's ever heard that. We need to counsel Ben through this, Jack.

Jack O'Brien: Well, folks, I'm interested. Again, if you're listening, jump over to Spotify and let us know. Does Ben need to speak faster? That could just flood the comments. Someone else has said, I'm loving these podcasts. As a person in leadership role at our clinic, they've been super insightful to me to help me to assist the owner to scale the business more sustainably. And so my request for listeners is twofold. Number one, head to Spotify and comment, please. It's super insightful for us. And number two, share this podcast. It could be with someone in your team. It could be this episode or another episode. Maybe this episode's probably not quite for those on your team, necessarily. Maybe it is. But share this episode or recent episode with someone in your team or a clinic owner colleague. We are on a mission to support as many clinic owners as possible to amplify their impact and grow your clinic for good. And so please, please share this episode. Maybe it's in the Instagram DMs, maybe it's forwarded via email or text message. Pass our podcast on to a clinic owner colleague. We will give you virtual high fives and be eternally grateful, Ben.

Ben Lynch: Insert prey emoji, also known as thank you. All right, we'll catch everyone on another episode very soon. Head to clinicmastery.com for all the things that will help you grow your clinic. Jack, Bec, see you on another episode very soon. Bye-bye.