Jack O'Brien: It's past coffee o'clock. It's monster o'clock, White Monsters. If you know, you know. Hit me up in the DMs actually with some White Monster reels. If you're a White Monster gal or guy, the algorithm is going after me for my White Monsters.

Bec Clare: Your background even matches the White Monsters.

Jack O'Brien: It's my personality currently. If you know me, you'll know that the odd thing becomes my entire personality. Here we are. G'day, good people.

Ben Lynch: Welcome to the Grow Your Clinic podcast by Clinic Mastery. Here's what's coming up inside of this episode. This episode will be right up your Allie if you're looking to grow your clinic profitably. We're diving into the six pillars that you need to get right in order to avoid chaotic growth. And trust me, you want to hear Marcio's take on navigating change management with your team. Plus, stick around for when we discuss how financial forecasting will help you understand your numbers and lead to profitable growth. Marcio, CEO of Move Beyond that went from eight locations to 18 in under a year.

Marcio Ferreira: I stuffed up payroll because we were bringing two states together and trying to get the bookkeepers to align how they were running that.

Bec Clare: Ultimately we want to be also building our clinic as an asset.

Jack O'Brien: What is your exit strategy? Everyone says, I don't want to exit. The word exit seems scary. How many clinic owners often come to us and struggle with the notion of vulnerability or what will my team think?

Marcio Ferreira: I mainly think that we shouldn't be afraid of losing people. The one thing you should expect forever is that there's going to be fluctuations with teams.

Ben Lynch: At the summit, when you said, you know, I rated myself 10 out of 10 in finance, I'm going to talk about financial discipline. 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 clinic's policies, systems, and training. Test it for free at AllieClinics.com. And 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 hello@clinicmastery.com with the subject line podcast, and we'll line up a time to chat. All right, let's get into the episode. It is episode 359. Get my words out. I haven't enough coffee. I'm again joined by Bec Clare director and owner of Physio West, two clinics, a team of 30. Bec, curious to know, we often talk about books or podcasts you're reading or listening to. Question is, what have you been reading or listening to recently?

Bec Clare: I actually went back to the archives and I've been listening to Rich Dad, Poor Dad. something different in the car. It's been really good, actually. Just some little pearls again, just to revisit. I just like going back and revisiting some books from time to time, just figuring out what else I could take as a level up.

Ben Lynch: The principles remain relevant today. Keith Cunningham has one of the better educational series that's free, it's on YouTube, about understanding the three major financial statements like your cash flow statement, P&L, and your balance sheet. It is tremendous. I recommend people go and check that out as well. Anyway, that's a little rabbit hole. I'm also joined by Jack O'Brien, former physio, exited Terrace Physio, plus JB, same question to you, what have you been reading or listening to recently that you recommend to listeners?

Jack O'Brien: Well, this is definitely left field. I enjoy reading Cold War Russian spy books. I love the problem-solving, the dedication, and it's really my little escapism. The Traitor and the Spy, if you're looking for it, that is my all-time favourite read. I'm reading his autobiography at the moment, Oleg Gordevsky.

Ben Lynch: Fantastic. That is good. Today, we're also joined by a special guest, Marcio, a friend of the pod, a team member here at Clinic Mastery, and notably CEO of Move Beyond that went from eight locations to 18 in under a year across New South Wales, Victoria, and South Australia. There's a team of 200 people. And Marcio, you spoke at the GRU Clinic Summit recently about all the things that can go wrong when you grow quickly like you have. You are the best person to speak about this. Welcome to the pod. I'm actually interested in what is your escape or vice? When things get tough, you're going to talk about avoiding some of the hardships of growth, but I'm interested when you need to get away from it all, what do you go to? Is it like I don't know, gardening, kitchening, cooking. What do you do? What do you do to get away from it all?

Marcio Ferreira: I've gone through a few phases. Recently, it's being handy at home, DIY. I've been doing some wall panelling. Over the weekend, I was doing some micro cementing.

Ben Lynch: What is micro-cementing?

Marcio Ferreira: It's the new trend in home design. It's a type of concrete that you put over anything from furniture to walls and it makes it look really modern and cool.

Jack O'Brien: I'd love your opinion on my panelling.

Marcio Ferreira: It looks amazing. It's better than mine.

Jack O'Brien: Someone said perfect.

Ben Lynch: For those that aren't watching, Jack is using a virtual background, so it looks really quite plush, quite nice.

Marcio Ferreira: Is there anything you can't do, Marcia? Yeah, that's true. I don't know if I do anything well, but I like experimenting with things, so it's good to just get away from the screen. Obviously, I went from being hands-on as a physio to having a lot of computer time now, so things that get me away from that and using my body somehow feel good right now. It just feels like I'm resting my mind. But whether it's done well or not is a different story.

Jack O'Brien: Are you like the hobby becomes your entire personality? For a while sometimes. Good. You're one of us. You're good.

Ben Lynch: I was going to say that was a very leading question. That's what Jack does. Are you still, are you still riding bikes J.O.B. and putting on all these sorts of helmets that- I am.

Jack O'Brien: Yep.

Ben Lynch: I'm a middle-aged man in Lycra. Fantastic. Yeah. Yeah. Great. Great sight for all I'm sure. Anyway, uh, we're going to- I'm going for a fast, you can't see me, that's the problem. It's all relative. Okay, so you're going fast. That's good. Well, we're going to get into some of the practical elements that you need to proactively and maybe more reactively put in place to help growth be a little bit smoother because lots of lumps and bumps. But before we do, a warm welcome to A number of clinic owners that have installed Ally into their clinics to support their practitioners, their growing practitioner team. It is the HR hub that clinic owners need to scale and support their team. Welcome Renee, Lauren, James, Kate and Lona, Lorenzo, Abby, Oscar, and in fact, many more because it's been going crazy since the summit, which has been tremendous. And J.B., you got quite a few viral videos going on at the moment, which is awesome to see. So, I might turn over to you, J.B., for a few announcements before we dive in.

Jack O'Brien: Yeah. The April intake for Clinic Mastery Business Academy and Elevate is open and almost full. So, warm welcome to those clinic owners joining us on the inside. Cara Lee, We've got Sean, Sam, Vilma, Jonathan, and another Sam. So that's all just in the last week or so. Again, if you want in for April, the intake is almost full and May is upon us. If you want to get on the wait list, you can email me, jack@clinicmastery.com. No AU, just jack@clinicmastery.com. And we'll see if you're a good fit, see if we're able to help, and we'll offer you an invite.

Ben Lynch: Very nice. We love helping clinic owners grow their clinics. Name of the pod, name of the book. And I think a lot of people think if I grow my clinic, it will solve a bunch of problems that I've got today. You know, if I just get that next therapist, if we just get the next 20 new patients in the month, if we can just get that next location, it will solve a bunch of problems. And we all know that it brings a new set of problems. And in fact, it only magnifies the problems that exist today. And that was the essence of the presentation that you gave, Marcio, at the summit. In fact, you called out six key pillars that you've learned the hard way that are super important to be across to work on to make growth a little bit easier, a little bit smoother, or at least allow you to react perhaps to growth. Do you want to just zoom out and give us a run through of those six key pillars and then we're going to unpack each one of them and sort of discuss and debate different ways of actually applying them in your clinic.

Marcio Ferreira: Sure. Yeah. So vision, culture, change management, finance or financial discipline and rhythms, systems and a growth mindset.

Ben Lynch: So let's go with vision. I think you gave a great story around. an investment banker that you're having a conversation with who really challenged you on your thinking around exit strategy. Do you want to just tee us up here and then talk us through some of the practicalities of what you mean by this? Because I think a lot of folks would look at vision and think of it as, I don't know, fluffy, a bit vague, a bit hard to drill down. So we want to get to the practicalities, but help us understand vision.

Marcio Ferreira: Yeah, and I got to say, for a long time, I was one of those. I'm a very to the point, direct type of person. You're pragmatist. let's call it whatever sounds nice but it is hard to define a vision because what most people say is that like they just don't know yet like they don't know they know they're trying to do something they know they want their business to do well they often know that they want a better work-life balance but what they're actually working towards very clearly is hard to define and I just have always found that we're stuck having to make hundreds of decisions in business. If we want to get somewhere quicker, then if we know exactly where we want to get, then those decisions become a lot easier to make. And sometimes when it really takes up our headspace, it's because we are conflicted in what that decision should be. It's become a really worthwhile exercise and I've seen a lot of different ways of framing it and doing it, you know, from looking shorter term to just saying, you know, a 12-month goal or a four-month goal to setting a desire statement which, you know, has elements of personal and work and different areas to thinking about an exit strategy. What I really liked in that story about the exit strategy, what it really taught me first of all was you really think about the word strategy and this has been interesting because every time I've had this conversation when I've asked people what is your exit strategy everyone says I don't want to exit or I don't know when I want to exit and everyone focuses on that word because they're so invested in their business, their idea that the word exit seems scary and the follow-up question is always will we all exit at some point. We just do, we don't live forever and businesses don't last forever and so do we want to link that to chance or do we want to be intentional? And being intentional means learning to define it or getting as close as we can and it also means knowing that the way we define it today doesn't have to be permanent, it can change and we can do that as frequently as we want. as we do it more often, we become more confident in what that vision is, in understanding and taking that step back from the exit point and being able to define different aspects of it from what does our brand mean and represent, what does this mean for my team, so how many team members do I want to have, what I want them doing, why would they want to work here at that point to, you know, where do we position ourselves in the market, what are we charging and what services we have. There are so many aspects that start becoming clearer and then bringing that into practice becomes so much easier.

Ben Lynch: So talk us through the framework there. There's a couple of questions that you've just articulated that you've used. Did that land in like a one-page doc, a three-page doc? Did it have a certain structure to it? How did you land on that? Because to your point, maybe people haven't thought about it. If they have thought about it, maybe they're not sure what a good version looks like. you know, where should this get to? And I love your point that it can change over time, depending on the circumstances. But if we were to articulate our vision today, what was the framework you landed on? Maybe it's not for everyone, but where did you land in how that is shaped up and articulated?

Marcio Ferreira: In terms of how we document it, it can be done in different ways. If you think about where it gets reflected, a lot of businesses think first about their core values and how they define those. And ultimately, those are things we believe in. Those are cultural aspects and mindset aspects and behaviour aspects that we believe we should all have within our business. that lead us closer to something. And so that is one way to document, to plan and to keep the company accountable to what the vision might be. For a long time, I didn't believe in it, having those written down. I always thought, well, how many companies have core values written down? And then if you ask their team what the core values are, they don't actually know it. And so what's the point if it's not actually reflected in the culture and in the humans you have. But that's one way, and it's okay, and it's okay for it to be a work in progress in terms of people understanding what those values are and incentivizing them. I've seen companies set, if we look at Tristan White, you know, him setting the BHAG, or Big Hairy Audacious Goal, like, again, that's another way. If you think about the difference in all these different ways of documenting is it's that Some have a time frame on them. Some don't. Some are just a set of rules that always push you towards a vision. I don't think there's a right and wrong way. I think it's fairly fluid, fairly flexible. I think the important aspect of this is that The more people within your organization that understand what the vision is, even if they can't really define every single aspect, if they understand why your company exists and what you're trying to build, then things like change and growth become less scary because they're no longer a surprise. The decisions you make, and this is really important because if you think about a lot of the conversations that we have with business owners, they're often quite, I want to say afraid, but they're very careful with how their team takes things on board to any change, anything new, that happens more if they're not aligned with that vision, right? So again, bringing this back to your question, It's not always only about how it gets documented. We can have several ways to document it but then what do we do with that? Whether it's a single sentence and that sets what a company means to whether it's a set of values or all of the above. How do we then apply that? How do we make sure people understand it so that what we're trying to do becomes less of a surprise, becomes expected, and so that everyone's engaged?

Jack O'Brien: There's a couple of things that come to mind, Marcio, when you speak. It's like to have an exit strategy doesn't particularly matter what it is, or even when it comes to vision, it doesn't particularly matter what it is. The fact that it exists is the key. Right? Going from zero to one is often the hardest part. Going from a blank piece of paper to something with writing on it. It's not a blood contract. You're not bound to it. But getting it started is, in my observation, a key distinction between action takers and clinic owners that are going somewhere versus those that are kind of floundering. Is that your observation, Marcio?

Marcio Ferreira: I think, I think practice makes perfect, right? So start somewhere, write something down. If you find in a few months that actually I want something different than change it. Um, and that's completely fine. Uh, same as, uh, I think I spoke about my finance rhythms. a few years ago, they were quite inadequate. But the fact that I started there and then got it wrong a bunch of times meant that they became better. Same thing with defining a vision or understanding our own vision. Often we start in business with very, I wouldn't say simple, but simpler personal goals around our job and our lifestyle. I want to make more money. I want to have more balance. I want to work a specific way and that's the starting point but it doesn't mean it's the forever point and so define it that way. In a year, if it's evolved, define it differently and just keep doing that. Make it part of your base rhythm. Again, it's a pillar. Pillars often mean that they get applied but they get reviewed. They have a rhythm attached so that they're fresh, so that they're current and that they're working.

Ben Lynch: I get some micro concrete applied to them so they look modern and updated. So the second part is culture. And I want to go into this because something really caught my attention in your presentation. You said this is a deal breaker. Culture is a deal breaker when we're reviewing whether we buy a clinic or not. It's a key risk. And you said that you try and learn more about it. Specifically, how do you learn more about culture? Like of a clinic that you're looking at assessing, coaching, acquiring, how do you assess and learn more about their culture?

Marcio Ferreira: There's a purely human element to culture, right? So this is probably the key. In that chat, I was talking about someone that looked at property and they looked at how businesses stack up versus us. We're a services business. And when we look at investing, we look at what stacks up. You also touched on the fact that when your business grows, there are more problems. There are more things that get added. Why? Because there are more humans, right? That's the complex nature of it. It's that there's more of us working together and there's a lot of strength in that when those people are aligned. There are a lot more problems when they're not. There are a lot more things to solve. And so we look at it in several ways. So again, that distinction between looking at property where you're just looking at numbers, you're looking at what the paper says, We could have that approach in a healthcare business. We can look at P&Ls, we can look at all of that, but we understand culture from talking to the humans, from getting to know them the same way we look at, even at the back of our mind when we're hiring, we think about the same thing. Does this person align? Are they the type of human that would thrive in this environment? It's not a judgment on whether they're good or bad. We understand our identity. We don't need them to be exactly the same, but we need to know whether there's alignment or not, whether we're going to push together. And so I think that's a really, really important aspect in both growing your existing business, but also investing in others and bringing them into your work family. Meeting the owner that's looking to sell or looking to be a part of a group, meeting the team, understanding their rhythms, understanding points of difference. So bringing this back to vision, often in a purchase there's change and in a change there's resistance and resistance occurs because more often because people are scared of what might come or they're not expecting it, they don't know it. And so those conversations help understand whether the business that you're buying already had a vision. Was it similar? Did the humans that they hire already align with that? Or was it completely different to the point where we think there are going to be layers and layers of friction? Why? Because that informs us on what we're up, like what we're about to get into as well and what we're going to have to resolve. And so often that's, that could be a deal breaker. If we're comparing that with, just like any investment, if we're comparing a purchase with starting a new clinic, we're really not only just looking at the numbers, but we're looking at all the problems we need to solve in a new clinic, yet we need more new clients. Maybe we have that in the purchase clinic, but we then have an issue with transitioning team and getting them to align and getting them to be engaged with what we're trying to build. So there are really important aspects. The numbers aspect is actually the easiest because it's fairly objective.

Ben Lynch: Because we've talked about HR problems, turning them into performance opportunities in our conversations with Sarah and the people plug in a great partner of ours here at CM. But Beck, yeah, how do you think about the culture side of things as you're assessing it? And what are the questions you have for Marcio and the lens that they use when putting it together in a deal format?

Bec Clare: Yeah, I'd love to know, Marcia, because I guess one of the key risks of acquiring or bringing another group or acquiring a clinic into your own fold and your own brand is that you might be purchasing something, yes, a list, but really what it is is that you're bringing and welcoming these new team members. And from a cultural piece, is that also in part to a lay some risk, I guess, in terms of if you were to welcome those people in and they don't adapt well to change or they don't align, that you could well risk losing a whole lot of practitioners, which in fact is a whole lot of the value that you're trying to bring in.

Marcio Ferreira: Absolutely. If you think about what you're buying, it's the energy that those people have at that time. It's obviously the goodwill and client base that's there as well. but they do have a direct impact on each other. So you might have great client base, but a group of people that then, you know, negatively impacting that and so the value of what you bought gets impacted but also we know that mindset and culture and it spreads. You know how one person feels often impacts how other people around them feel whether it's at the same clinic or within a group. It's really important. I think I had mentioned I had said that culture just becomes harder to protect as you grow. It becomes harder to protect because there's again there's more people involved and They are humans, they connect, they talk, they share their feelings, they share their energy with each other. It's almost unfair if you're not considering that and then bringing in people that through, not through their fault, that could thrive in different types of cultures or different types of organizations, but might not thrive in what you're building. And it will have an impact on your team, on how they perform and how they feel at work. And so there's, there's big risk there. It's, you know, it's, it's our job to protect that.

Bec Clare: I really like that distinction of it's not the person, it's that this environment and this culture is not right for them and potentially not right for them right now. It might have been previously and it may not be into the future. Marcia, in your experience, you balance the numbers and you balance the cultural elements. By getting that cultural aspect, do you feel like you've significantly reduced the risk purchasing a clinic or welcoming a clinic into the fold and you lose half of the team. What would be a success metric, I guess, for you? You bring in a team, how many would you go, yeah, that's who I want to retain? Or are you like, 100% want everyone to stay?

Marcio Ferreira: I mainly think that we shouldn't be afraid of losing people. Deals where large groups would purchase clinics and part of the contract would be your team needs to stay for a certain period. And the financial side or risk mitigation side of that sort of deal. But it's a lot worse for someone to have to stay against their, not stay against their will, they're not prisoners, but someone that's fully disengaged, unhappy. Again, there's no assignment of blame here. People can need change and can feel like they don't align with something, whether it's good or bad, but often keeping someone there that's not engaged, not working towards the same goal is worse than losing them. One of the things I tell business owners a lot when we have this conversation is like they'll often have a bad quarter and say, oh, it's because this person left, something happened to this other team member and I wasn't expecting it. What I tell them is, The one thing you should expect, always. forever is that there's going to be fluctuations with team. Those fluctuations are going to occur naturally because they've got their own life and it's also going to occur sometimes because of what's happening here. That's going to be amplified with misalignment, with change that is, as an example, in a purchase, that is a fairly big change. That's an opportunity for people that are part of that business to think. and if they feel they're not aligned, it's enough sometimes for them to go have a look and look at something else. So I think if we're purchasing, we should be okay with the fact that We're probably going to lose half the team at some point, not straight away, but within a period we will. And so what do we do to mitigate that risk? Are we a business that is confident in recruiting, retaining and bringing people in that align with our culture, but also again, bringing this back to that being a potential deal breaker. If there are a few items in our mind that we think are going to cause a lot of the team to leave, whatever they are, that's probably a sign, right? If we're looking at the business saying, man, there's some key, key differences here, and 80% of the team's probably not going to be happy with those, that's a sign that there's an issue there with alignment, with culture, and it doesn't mean we're better or they're better. It's just, it's different. It's a different direction. and we need to consider that. It becomes easy to understand how excited and engaged people are when you talk to them. Uh, you take the time to be open about, again, we're talking about companies here and how we run, you know, when there's a conversation, you're both in a purchase, but also with people in your team. And when we're having these conversations about, Hey, look at what we've done this year, look at what we're planning for next year, or look, we're bringing in this change and this is what we expect it to do. We can, it doesn't become that difficult to notice, uh, who really. And it's not about them having to agree with everything. Disagreement is very healthy, but you can disagree and be engaged. You can disagree and want to be a part of that conversation to elevate the organization together. And so whatever your vision is, whatever the values you've set, it's not hard to notice over time with more contact, with more openness, with more communication, whether people are pushing with you or not.

Ben Lynch: So it sounds like engagement is kind of what you're looking for in the team.

Marcio Ferreira: Yeah, I think yes, engagement with several aspects of the business, whether it's careers, think about where conflict occurs and where disengagement does occur and what are those items. It's not that you're assessing them, but you'll notice how people think about those things and whether they align or not.

Bec Clare: distinction there that's been made is that Marcio is using that as a lens for am I willing to engage with this clinic to potentially acquire them or purchasing a clinic. To the exit strategy, we don't often think about that as business owners, but ultimately we want to be also building our clinic as an asset that we could also exit from on our terms. It may not be that we want to exit for some time, but in terms of constantly refining and working on that culture, that's that's really, other than the P&L, that's where our asset is most valuable. So it's really helpful to hear from Marcio that if we're wanting to build an asset that we could potentially exit from in the future on our terms, culture is not just this warm fuzzy thing that helps us go to the clinic day to day and feel good. It's something that others value.

Ben Lynch: And for those that haven't caught the previous episode, a recent episode that we did with Sarah from the People plugin around performance and looking at culture through a framework of the Uber, the outputs and outcomes, behaviours and attitudes, a really pragmatic framework to look at. the controllable and the assessable. How are you actually assessing culture within the clinic? Let's move on and it's closely tied to this, which is change management. As you mentioned, Marcio, there's often going to be resistance because of perhaps a number of reasons. Uncertainty is often key. And so a lot of communication, there's a lot of emphasis on communication. Hence, going back to point one, having your vision, a version of that documented, shareable, is one way to help the communication be super clear about where we're going and why these decisions ultimately connect to the direction of the clinic. But how do you think about change management? Are there certain principles or practices that you find yourself coming back to regularly to be more effective at change management across such a huge team and so many locations?

Marcio Ferreira: The main principle is that we are always changing. And as a joke, but not really as a joke, I've told our team in the past that if you don't expect any change, then this is probably not the right company.

Ben Lynch: Well, I recall a conversation with you at Noosa at one of our sort of retreats just for a couple of clinic owners, sort of 15 to 20 high achieving clinic owners. We're having this conversation about how you use this in your recruitment process. Like you literally pre-frame it. So to that whole point of culture being really the collection of humans on your team and the behaviours, the attitudes, the outputs, the outcomes they achieve together, it starts at recruitment, who you're attracting in the first place. Do you want to just run through how you actually frame that up, weave that in into your screening process right from the beginning?

Marcio Ferreira: It would literally be like that and saying, look, we have changed a lot over the years. This is how we looked a few years ago. This is how we look more recently. This is how we're looking to operate in the future. Does that scare you? What are your thoughts on that? I think we know that people experience change differently and that's okay. But we also know that one of the reasons people sometimes push back against change is because it can be unexpected. They may think that they don't know the full context on why something's changing when it's a policy or a procedure or something about work. when it's something that they've created, there's a little bit of an element of tying that into their personality as well. So there are all these layers that seem to open up a bit when you just tell people quite directly and casually, hey, this is something we do, like it's part of our company to change, to look at even the things that are going well, and have that thought about, can I be better? And the way I'd frame it and recently had a talk when we'd merged, we'd been on and beyond merge and we got our leaders together, we had a bit of a talk about that and the question I asked them was, what I got them to think about was, what do you think that means about the company you work for? If you're at a company that's willing to look at the good things, the things that are working well and rethink them, change if needed, not randomly, not just change for the sake of changing, Is that a type of company that's looking to grow together, that's looking to create more opportunities for everyone? Or is it a company that is closed and has a big element of ego attached? And which of those two would you prefer to be working at? You can see here that when you frame it like that, they're probably going to be inclined to the first option. But when people first think about change, sometimes they're scared and pushed back. So there's a bit of a contradiction in thinking there.

Jack O'Brien: I like that. It's like people don't like change often because of the way change has been done to them previously. It's like their past experience shapes how they view it. And so change doesn't always have to be negative, right? It can be done really well and positively. And to your point of like, well, if we're not growing and we're not changing, we're not evolving, what are we doing? We're dying and stagnant and stuck. So I really like that framing, Marcio. It's like change is a good thing. Growth, progress, evolution is a very healthy, necessary process. And it doesn't have to be done to you like it was done previously, perhaps.

Marcio Ferreira: Yeah, absolutely. And often people just want to be a part of that. They want to be a part of the change. They want to understand it. They want to be engaged. They want to be heard. Often when that happens, even the ones that disagree, at least understand. And so it makes things a little bit easier. It's hard to do at scale. Of course, it's harder and harder with more humans. But it doesn't mean we should just not do it.

Bec Clare: Marcia, to that point that it's harder with more humans, and you've mentioned as well, and we all know that as you grow, you've got to protect your culture more and more because there's more people. How do you go about facilitating a big change, say in an organization of your size now, and what would you say to the clinic owners who are just starting out? What are some of the things that you wish you'd known operating, say, a smaller clinic to what you know now and how you implement change with a huge number of team members?

Marcio Ferreira: I think if that's a part of the identity of the company, then protecting culture is still pushing through with change versus saying we've got all these humans now and there it's going to cause friction. So we don't, um, that's where you start losing that element of. you know being a changing growing company and that impacts culture because then the expectation becomes that we don't change because it's it's too hard with a lot of people. That's a big part of actually protecting that culture is head on conversations regarding change. We definitely haven't done this perfectly right. So in terms of learning Especially more recently, because we've done a lot in a short period, there were times where we didn't want to overload the team with information. We're doing this, we're doing that. It can be too much when they're focused on things like training the clients. But what we realized is that they probably do want a timeline. They probably do want to understand what's going to happen in a month or two. Not that they have to prepare, but When that time comes and they, you know, it feels like it was part of the plan. And so, uh, it's easier to take it on board. Um, they probably do want to know the stuff ups when we did something that didn't, didn't go well. Um, they want that context and they probably want us to put a hand and say, Hey, sorry, like we made a mistake. This was the intention. And so, um, I think just being authentic. is probably the biggest takeaway and doing that as much as we can. Ultimately, if we're aligned, like if we're all aligned or mostly aligned, then we all see that change as positive or as working towards that vision. It doesn't mean it's always going to be perfect. It doesn't mean we're always going to do it the best way, but being open, communicating, sharing timelines, sharing stuff ups, going in that way, then going to feel like we've got the ability to go back and fix and change again. That's the culture you want. That's what gives you that resilience moving forward as you bring more humans in because they understand that's part of it.

Jack O'Brien: What does sharing stuff ups mean? Are we talking you just airing dirty laundry? Do you think about like the size of stuff up? How do you think about it? Because I know how many clinic owners often come to us and struggle with the notion of vulnerability or what will my team think. So yeah, give us some keys on how to think about sharing mistakes.

Marcio Ferreira: What you just said, what will my team think. If we let that define how we react to a problem, I want to save face because I'm worried about what people will think, then maybe we will achieve something but we'll do that at the cost of trust, of alignment. When I say that, I mean it in very practical scenarios like when I stuffed up payroll because we were bringing two states together and trying to get the bookkeepers to align how they were running that and we were doing that because there was a scalability problem with the systems we had. And it caused problems. It caused a hundred people to be paid the wrong amount. Some overpaid, some underpaid. Owning that, being authentic about it was getting people together. I mean, everyone's in different clinics, so it was on Zoom. And actually showing them, look, this was what happened. This was the spreadsheet that got used. This is how it was done in the past. And this is why we wanted to do it this way. We knew that would raise more questions, but in that time, those questions needed to be raised and needed to be answered and people needed to understand. because they got to understand that we were changing a system that was working because now it was going to work better and part of that meant there were some unexpected items or there was oversight. Going through that process could have created division or separation or people feeling a little bit against that change or it could have in the end, potentially brought us closer together if people understood what was happening. And so that I felt was a really important element of going, we need to say that there was a mistake here. It's part of what we do. We change. This is why we did it. This is how we're going to fix it and give everyone confidence again.

Bec Clare: I think what that does as well, Marcio, is for clinic owners listening who are going, I'm not sure that I want to own that, what if I get it wrong, often halts us in actually implementing anything at all because we want it to be perfect. And the notion of progress over perfection, and you might just have to put your hand up from time to time and go, I broke this system and that's a healthy part of change. Something we've been working on in the clinic for us is taking that one step further for our team implementing a new system is you might break it. You might not get it perfect the first time and that's okay. And if I can, as your leader, put up my hand and say, hey, I haven't got it perfect, I want to encourage and bring to life a culture where change is normal and where we do. We break things from time to time and all that does is it makes it better.

Ben Lynch: You bring up a great point and this was point number six for you, Marcio, which was the growth mindset. You were actually using a team member's example of I wanted to be perfect. Beck, you're saying clinic owners do it and we see this every day and they're scared to make mistakes. So, we'll come back to point four and point five in a moment, which is financial discipline and then systems. But let's just speak to that growth mindset because it is a barrier, as you said, Beck, to so many people putting in change because they've done it, they've had the reaction from the team and they go, oh, you know. I can't really roll out another system because my team will react in a certain way. How many times have we heard a clinic owner say that? And then they sort of build this culture tax, this slowness to actually making progress. As you're having done it now over 18 clinics, 200 team members, a lot of this change management, how do you encourage skills, support, nurture, foster a growth mindset amongst the team and also the leadership team to back themselves. It's okay to make mistakes so long as we fix them.

Marcio Ferreira: It's definitely that. It's backing yourself to be able to fix things like knowing that you are curious enough to try. It doesn't mean we're wanting to make mistakes. It doesn't mean we're saying, hey, I want to sit here and make mistakes today. Yeah, you can have that curiosity of trying new things or trying to grow or trying to change existing things, knowing that there's a pretty good chance that if you do enough of it, some are going to break, but also using your experience. And it doesn't mean you're not thinking about how to mitigate risk and avoid breaking things, but you've got that energy to at least attempt it because I think that's what moves people forward? If we always sit and say, I'm only going to do what I already know. Well, I mean, how do you know if you know enough and how do you know if you're going to If that's going to be enough to achieve your goals, how do you know if there's more to be able to do if you don't try it here and there? I think that's a really important part of growth, whether it's scaling and doing clinics or changing systems or looking at changing the way of operating. It's just be curious enough and open enough to break a few things here and there.

Jack O'Brien: It's a really good point, Marcio, because that's a common conversation piece that we hear from clinic owners all the time, right? I don't have the confidence, I don't have the certainty, and we all have varying degrees, but so much of the growth mindset is how confidence breeds competence. and it creates this flywheel of just do the thing and as you do the thing, you'll gain more confidence. As you do the thing, you get the reps in and you make progress that way. So, I really like that framework for clinic owners to think about growth and think about communicating that with their team that it's like competence will breed confidence over time.

Ben Lynch: One of the things and we'll get to point four and point five next. The thing I think I've learned the most about this, Marcio, and I think you're touching on it or at least I'm putting my bias, which is whenever we're testing something new, I think we want to go into it as intentional as we possibly can. Like practically, I find that is just simply documenting. Here's a couple of assumptions we have about this area of the business and some version of a hypothesis. These are the things we're going to do and these are the outcomes we're hoping to achieve. I think when you kind of just roll something out and you're kind of figuring it out as you go without having done just a little bit of pre-thought, and I like to just write it down, then it's like, yeah, you're being a bit too fast and loose or reckless. No one expects everything to work. At least they shouldn't. But I think there needs to be, in a clinical sense, we would do this with a patient. You go through the assessment, the history, you formulate a diagnosis, and then you sort of assume these interventions are going to help. And we figure it out in subsequent sessions that some of this works, some of that didn't, and you adjust. So I think Part of adopting the growth mindset, I always looked like, what's the system? And I think just being able to write intentionally, it's almost like scoping the new piece of work, the new thing for the team, the new pay structure, the new AI system, whatever it is, just be intentional about what you're trying to do. Let's get to financial discipline because I think this is really key. To run the business of your size, I know you've come a long way and continue to evolve in your mastery and all these elements, but I found it fascinating. At the summit, when you said, you know, I rated myself 10 out of 10 in finance, and we're going to talk about financial discipline. but I didn't have a budget and I would close my eyes, cross my fingers and hope that the bottom line was positive when I opened my Xero account. I thought that was a really humbling way to enter into financial discipline. Obviously, you've come a long way over the many years, but just talk to us around what that means, especially for a fast changing or a fast growing clinic, how you get that certainty or discipline over the money management side of things.

Marcio Ferreira: It's through having multiple layers of control and having rhythms and adapting those to the scale of your operation. There were definitely times where I thought we were doing well but wasn't sure. And what that told me later on was that I didn't know enough about my numbers. And how this plays out sometimes, I've seen a lot of conversations or a lot of questions from business owners where, as an example, they're looking to make an investment. And the investment might be in hiring a new person. That new person they're looking to hire kind of falls outside of what they're used to investing in. So they either might want more money or have a different expectation of what clients they should see or how many or different incentive structure. And the thought process is often, it's just this one person. So I'll do it anyway. Because I really just need one person. And when you get stuck making one decision like that, two or three, then it rolls into a bigger problem. Or when you don't know if that person falls outside of what your benchmarks on all systems would be. And so as you grow, those problems just become bigger, right? Like right now for us, a mistake in terms of spend can be really, really large. And so part of the learning was just looking at, at what level does this get controlled? You know, we've got monthly reporting that our clinic directors look at and they work on some aspects of finance. We've got now, recently, regional leaders that look at groups of clinics and have a layer there. We've got a rolling budget, not just a yearly budget, but a budget that gets updated frequently because we're growing fast. We've also got a 10-year financial forecast and we've then got rhythms around review of that. And the key here is just becoming more and more analytical Even though there are bigger numbers, we're looking at forecasting for different periods, but we really look at levels of control of those different areas within. So, knowing exactly how much we would spend on occupancy, knowing exactly how much we would spend on a fit out and why. because of what that leads to over the next year and the year after that and year after that. The forecast and review and understanding and those rhythms have just become more frequent so that we have a little bit more control over what's happening because at scale it becomes harder. When there's more zeros behind, especially when you start getting used to spending with more zeros behind, can become harder to control. So I think that was definitely the evolution of obviously at one clinic I could kind of know by looking at our revenue if I was going to make money that week or not, kind of, but I didn't know if I overspent that week as well. And so there was those elements of making decisions that were not guided, that didn't have backing to them and then that could lead to problems.

Ben Lynch: It sounds like the forecasting side of the finances was a key capability that you needed to develop, especially as you grew. Maybe if I just distinguish between historical analysis slash current analysis, like where are we, kind of where have we been, and then starting to project the impact of decisions into the future was like a key area that you've levelled up in. Yep.

Marcio Ferreira: Yeah. So it's almost like, it's very similar to vision, right? Vision guides a lot of decisions we make. Strong financial forecasting and analysis and rhythms guide a lot of the financial decisions we make. If I get asked exactly what I'm willing to pay for a new clinic, I don't have to go back and do thorough analysis because I know that number now. I know the square meter rate. I know the total rent amount that we can pay for our model to work. And that's just one example of the many areas. The clearer we become on all of those figures, then the chances of being wrong, we're still going to be wrong, we're still going to make mistakes, but the chances become slimmer. And so we can invest with more certainty. And when we invest with more certainty, we're probably going to be willing to invest more frequently. And then that's going to boost our, that's going to accelerate our growth really, because we're confident in what we're getting into.

Ben Lynch: The fifth point was systems, and growth magnifies problems. As you said, it will turn cracks into substantial fractures. What are some of the key systems that you feel you overlooked as part of your growth journey? You gave a great visual of an elephant sitting on a small chair and cracking it. What were some of the key systems that you needed to install or refine in order for you to go through this rapid growth journey?

Marcio Ferreira: This is a constant work in progress. I think the really simple way to look at systems and whether they're adequate, and this obviously doesn't cover all of it, but look at any area of your business and is it completely dependent on one or a small amount of people, like completely dependent. If this person goes away tomorrow, what happens? What does it break? And you can do that for each person in your business. You can look at the work they do, remove them, and what happens. But if it doesn't almost fully flow as normal, or if there's no way of it easily continuing to flow as normal, then there's a systems problem. And it can impact on everything, on anything. We noticed that as an example, during our merge, that we were onboarding and training up our front of house really well, but the documentation of that training was inadequate. And so when someone else stepped into that role and there was change, it was really difficult for that person to know how to reconcile that change with what we were actually doing, because they had learned a way. Again, the training systems and documentation weren't adequate. The training occurred perfectly. But because one person was away, that became really difficult. And so that was one example. And there's obviously systems, or there should be systems for everything that you're doing recurrently within your business.

Ben Lynch: That certainly helps with the sustainability of the business, right, is getting these systems in place and reducing reliance on certain people or roles. And I love your point around that it's just always ongoing. And if we've created this culture that is always looking to be better, always looking to improve, kind of the mastery really is the core value, the core principle that's at play here is striving for excellence and always looking for improvement. then ideally we've created a team where they are looking to improve systems as they go along and not waiting to be off-boarded to say, oh, yeah, there's a whole bunch of stuff that I do that hasn't been documented, though that is a good forcing function to systemize your business pretty quickly. I'm interested in your key insights from Marcio here, Beck, and Jack in just a moment. I think one of the things that I'm picking up, there's so much in all of this, from the vision, getting super clear on that, and that being the primary filter through which every decision is made, and also being able to share it with your team as the ultimate version of context for why change is happening, through to the, we've pre-framed, we're always changing culture. at recruitment, therefore screening and getting the right people on board. It's the ultimate pre-framing. But I think one of the key things for me is as you grow, your forecasting ability or the competency that you have to understand the impact of the decisions that you're making. is such an important one and I think kind of the precursor is obviously being able to understand where you're at today and kind of where you've come from as like the building block. But we see this time and time again with clinic owners that we work with, no matter the age or stage of business, they might have built a quote-unquote big business or they might be early in their journey. But those that are able to understand the financial performance of their business and forecast the impact of their decisions, just have so much more certainty over all of these other areas that you spoke to, even in an unknown future. So, I think that for me is a key one for listeners to say, how good am I at this? And in your humbling sort of comment, Marcio, at the scale that you're at saying, I thought I was good, but there were so many levels to go in this, is sort of the perfect kick up the butt for anyone who feels like they're doing it particularly well. JOB, what's your key insight from Marcio's six points to growing with greater smoothness?

Jack O'Brien: I think it is that piece around vulnerability. Yeah. And a lot of that keeps you close. It reduces that distance and the ivory tower and not knowing what's going on and team feeling disconnected and disgruntled. So that piece around being open, transparent, vulnerable, and bringing the team along the journey is probably what resonates most for me.

Ben Lynch: Yeah. Nice. Beck, what about you?

Bec Clare: One line that Marcia said is you can't over communicate when it comes to change. So if you're thinking about implementing change, you think, oh, I've communicated this a lot with my team, maybe go one more rep.

Ben Lynch: Yeah. Lesson I've learned multiple times. I continue to learn. Beautiful. I wrote that one down too, Marcio. We can't over-communicate on my pad next to me.

Jack O'Brien: As you say that, Ben, I can feel Daniel Gibbs' visceral reaction at the double negative, the can't over-communicate. We must communicate more.

Ben Lynch: Let's go with the positive framing.

Jack O'Brien: Go one more. That's a good one, Beck. You don't know the play on words there, but any Nick Bear fans and VPN sups will know all about go one more.

Ben Lynch: Okay, nice. Well, Marcio, thank you so much for sharing your insights here and joining us on the pod. Beck and Jack, thank you for your insightful questions and comments as well. For listeners who are members, you can head along to the Learning Portal and check out a recording of Marcio's session, even if you are there at the event. Go watch it again because you'll hear it with a different lens. And also, we have the Traffic Light Review System, which is also in the Learning Portal, which is a great practical activity that you can do to assess all of the different areas in your business that Marcio has spoken to in this conversation. All right. Well, we're going to love and leave you and see you on another episode of the Greater Clinic Podcast very soon. It's bye for now. Bye-bye.