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Welcome to Business School for the Rehab Chiropractor where we coach you on how to run the practice and business of your dreams. Your host is Justin Rabinowitz - a multiple Rehab Chiropractic practice business owner and investor. In addition to running his own locations, Justin works with Rehab Chiropractors across the US talking about everything from sales to marketing, and creating the business systems necessary to succeed.
Cat Rotti:
The week of my wedding, so I just got married this month, I had 27 patient hours and I think I had five hours' worth of phone calls that week as well and was up 4:00 AM on my wedding day. That's not something that's going to be sustainable.
Justin Rabinowitz:
That's Cat Rotti. She's a former top chiro student who lost her way. However, she's been on a long journey and she's now a proud clinic owner with a thriving practice. She's managed to do that by betting on herself.
On today's episode, we'll dive into Cat's story. Along the way, tell you why business is a skill you have to train for, how to cultivate a new identity in your practice, and how you can move from being just a clinician to being a leader in your practice. We'll also detour into Cat's time in a big corporate environment, how her experience there led to burnout and indecision, and what kind of lessons you can learn from it.
If you're new to the podcast, every episode we share the stories of chiros who are learning how to build their businesses, and along the way, learning the lessons they won't teach you in chiro school. If you want the kind of help I give out on the podcast today, click the link in the show notes to book a call with our team. It's a simple, no pressure, no obligation, conversation to help you figure out the next right steps. And if anything you hear today is useful to your practice, please like and follow wherever you get your podcasts or leave a review. We'd love to hear from you. I'm Dr. Justin Rabinowitz, and this is Business School for the Rehab Chiropractor.
So Cat, I knew you as a student, that's when we first met. How do you remember that version of yourself?
Cat Rotti:
Yeah, so as a student, I was definitely more of a go getter. Before I even started school, I had actually already taken courses like FRC, had taken FMS. And in undergrad, I was, just like any other rehab chiro, deciding whether or not I wanted to go the PT route or whatever it was. But as I was shadowing for PT, I really saw that it was not what I wanted to do because it was more of that insurance-based model. And I was working as a trainer, and Edgar Rodriguez, who was actually the person who started R2P at the school that I went to, which was SU, was a chiro at the facility that I was at. And I was like, "This is the coolest thing that I've ever seen."
I, during chiro school, was just doing everything I could under the sun to learn more about rehab, to learn more about business. I was joining things before I was even ready. I was spending money on courses left and right. I think a lot of people during school will go on that two-week break that we have and go on vacation. And my idea of vacation during that time was what course could I go to? And, "Oh, it's in New Jersey. Let's go on a little mini vacation to New Jersey to go to the Business Mastermind."
Justin Rabinowitz:
So many chiropractors figure out what works for them after they've been in the wrong environment because of simple human psychology. Most people don't start out doing the thing they love or what they thrive to do or what they strive to do. Most people have to see the downside. They have to see the dark side. It's actually quite common. Think about your patients. Most of your patients don't come to you thinking, "I'm feeling really good. I want to feel amazing." It's usually it's like, "I am staring down the barrel of surgery," or, "I've had a really bad experience with a PT or chiro or orthopedist," and so they've seen that dark side. And so for most of us, we have to see that contrast. We have to see the downside of things first, and then and only then can we make the changes we need to change.
So if you're listening to this podcast, you've probably spent a ton of money on continuing education as a clinician, and you live in a world where growth and learning is really important to you, but we have to start looking at the reality of being in clinical practice. For many of you, you often think that another clinical seminar is going to be the thing that's going to finally help people say yes to you, or another machine that you add in your practice is going to be the one that's going to finally make you profitable. But the reality is most of us have enough requisite clinical skill. We might not know how to translate that clinical skill, we might not know how to connect the dots for patients to help them understand why that specific clinical technique is what they need. We might not be able to translate that and communicate it in a way that the patient understands, but the clinical skills 99% of the time are enough.
So let's fast forward. We graduate and you go to look for your first job. What was that experience like?
Cat Rotti:
Yeah, so I'm from California. I grew up there and I was talking to my boyfriend and we were just like, "We don't know if we want to go to Austin. We don't know if we want to go to Florida. We don't know if we want to stay in California. What should we do?" So I started reaching out to people in Austin and it was very quickly that someone reached out to me and they were like, "Yeah, come down, visit." I actually flew down, went into the clinic, and what they actually did instead was they offered me to go and work in this corporate setting. All the appointments were 30 minutes, so it really wasn't a terrible setup. It was you could adjust, you could do soft tissue, but what I very quickly realized was that it was not the place that I wanted to be for long-term. It was a lot of just, "Let's do the adjustments. Let's do soft tissue."
And it was really hard to actually give patients the care that they need. I think a lot of the care was more reactive. They would come in and hurt and just want a rub. And there's nothing wrong with that, but it's just not a model that I fall into. And so very quickly I realized like, "Hey, this isn't something that's going to be long-term for me." And I was promised that I would be going into the outpatient clinic that the person who ran the corporate contract was running, but I just wasn't given a timeline. So I was just like, "I don't know what I really want to do. Should I stay here? Should I do this?"
I had always known from a young age, though, that I did want to build a business. I wanted to create something that was meaningful. The corporate setting was just weighing on me and I was starting to get a little bit burnt out because I was working there 32 hours, you have notes on top of that, and treating patients most of the time that I was there. And so I was asking around and someone was like, "Hey, do you want to do a 1099 for me?" That lasted maybe a week or so, not even that long. And I then started to ask around, was DM'ing you a ton, I'm sure we'll talk about that later, but I recognized that this wasn't where I wanted to be and what I wanted to do. And so I ended up being able to rent a room for a very, very cheap overhead, started that, and went part-time for my business from August until February.
Yeah, I think it was talking to you a lot where I was like, "I'm losing myself and I am so indecisive," and I felt like I'd never really been that way before. And so I was making decisions that were just like, I knew weren't right, but I was making them anyway for whatever reason. And so I was just very ... I felt like I was running in circles. I was on a treadmill that I just couldn't get off of. So I was like, "You know what? I just need to do this." I knew I always wanted to do it. I just was, for whatever reason, talking myself out of it.
Justin Rabinowitz:
What was that internal dialogue? How would you say, "I need to do this, but I'm going to talk myself out of it?"
Cat Rotti:
I think I was just getting so many options too, where I didn't know which one would be the best one for me. So it was like, "Okay, you can come do this 1099." And then right after I rented the room, I actually got the call from the clinic that I was working for under the corporate contract and they were like, "Hey, we're actually going to bring you up. If you want to do it, what's going on with that?" And I was like, "You know what? I just rented a room. I think I'll give you an answer in a week or something like that."
And then luckily they made a decision for me too, where they started to pull off some of my hours, which they should have. That was a really good decision on their part because they did need to get someone into their clinic, but started to cut my hours a bit. And I was like, "Hey, you know what?" You go into a job thinking you have some sort of safety, right? And I think a lot of the times we actually don't, especially in 1099 and even some W2 jobs. So I was like, "The only way that I can actually have some safety is if I figure out what life I want for myself and what risks I'm willing to take to build my own business."
Justin Rabinowitz:
So is it better for clinicians to suck it up and work in a difficult environment and pay their dues? Or to pick up and be in a more supportive work environment from the very beginning? I hope it's neither. One of the main goals that I've always had with building this community of rehab chiros is that people don't have to choose. The reality is people graduate school in this rehab chiro model or idea, and most of the time they don't have a better option, and so they just open up their own practice. And so I don't want that to exist anymore. I've always started and thought about our community in a way that I want people to build a business where then they can support clinicians who are coming out of school. Because the reality is when you graduate you shouldn't open up your own practice, but unfortunately most people don't have a better option.
And so my long-term vision and dream, which is now coming into fruition, people like Cat and other people I've interviewed on this podcast are now hiring clinicians and they're providing not only a solid work environment, a place for people to grow, and a place where they can practice their skills and really treat in an ethical and in a way that they feel value and they deliver value. And so the long-term goal is that I don't want people coming out of school to have to choose either or.
This episode is brought to you by Jane, a practice management software, an EMR built to support you in the day-to-day work of running your business. If you're a health or wellness practitioner, you already know the care you provide starts well before your patient arrives and extends far beyond the treatment room. Jane is here to support every part of that experience. With online booking, your clients can book at a time that works for them. And with features like wait list notifications, they'll even be able to grab last minute openings when they pop up. It's an easy way to keep your schedule full while getting your patients the care they need.
During your appointment, Jane's AI-powered documentation feature can help you thoughtfully take notes so you can stay present with the person in front of you. And after appointments, you can end your time together on a healing note, not a transactional one, by charging the card on file.
So guys, when Jane reached out to me to become an ambassador for them, it was a no-brainer. In my community Slack channel, we have 140 chiros, PTs, US, Canada, and all over the world. And this is like the one piece of equipment software that consistently gets a 10-out-of-10 rating. They talk about it all the time. They absolutely love it. And so when Jane reached out to me to help them and be an ambassador for their brand, it was an absolute no-brainer and I'm so excited to be able to work with them.
To learn more about Jane, how they could support you and your patients, head to jane.app/demo. And one last thing. If you're ready to get started with Jane, you can use my code RehabChiro1MO for a one-month grace period on your new account. Let's get back to Cat's story.
As we go through that process, I knew you as a student and then you kind of went off and worked and we've reconnected, but I remember we had a lot of difficult conversations during that time. Is there any conversation that sticks out to you that really stood out?
Cat Rotti:
Yeah. The biggest one that you said was that you just didn't really know this version of me. You were like, "I haven't really seen this side. What is going on with you? You were not acting like you were before." And it was just very true. I was very indecisive. I was making decisions. I was scared to spend money, which in school I was spending thousands of dollars on courses. I was spending thousands of dollars to go and do things and didn't have an issue with it. But then when it came to making this risk, I was very hesitant. I had already gone and done another course. So I did your EYSL and then stuck with that for a bit of time, ended up going into a different course, which was hybrid and online stuff. Didn't really have much success with that and then I started this job.
And then was thinking about coming back to you. And I even remember being like, there was another conversation we had where I was like, "Oh, you're coming to Austin in January or something like that." And you were like, "Yeah, I am." And I was like, "Oh, maybe I'll go to that. I think that would be a good time for me to get started." And you were like, "Well, why don't you just come to the September one?" And I was like, "Well, I don't really know. Maybe. I'll think about it." And then you're like, "Well, that's what your patients are going to tell you." And I was like, "All right. Yeah, something needs to change."
I knew then I was like, "This isn't who I am and this isn't the future that I want for myself either." So I knew at that moment that if I didn't figure something out then or make a decision that I was just going to keep having the same complaints over and over again, and so something had to give.
Justin Rabinowitz:
So you open up part-time and like every business for a long time, it is tough and you don't know if you're going to make it. But if we fast-forward to the present day, you've had quite a bit of success and you've almost, I always say congratulations, you sort of maxed out what you could do. Why don't you take us through that journey of when it was really tough and what was the breakthrough moment that you had of like, "Oh, okay, I'm onto something here?"
Cat Rotti:
So actually a breakthrough moment would probably be the September live event of last year and talking to Hannah. So Hannah is super, super helpful. I met with her on a clarity call. I was like, "Hey, I don't know if I should hire. I'm only making 10K-ish. I think it would be probably not the best decision. But my social media, all of my people are coming in person and I'm running ads. I feel like I'm wasting a lot of money. What do I do?" And she was like, "Why don't you just hire someone?" And I was like, "Okay." So I ended up hiring someone, went to the live event in September and then took the leadership course afterwards. And since then, I have someone that just runs my entire Instagram and he does such a phenomenal job and he is literally one of the best, not only employees, but just best people that I could ask for, just truly a genuine person. And I think that helped change a little bit and where I was like, "Sometimes I just need to make decisions before I'm even ready to."
Justin Rabinowitz:
Where did you find him?
Cat Rotti:
So I found him in the Philippines. So he just, onlinejobs.ph, ran some things, followed your interviewing process a little bit, as well as made him do some projects and things like that. And first hire was not good at all, but I had interviewed him and his personality, I was like, "You know what? He doesn't have the experience, but he matches some of my core values." And I think that was a good learning lesson too of maybe some people don't have the experience, but if they have the core values that you're looking for, they're worth a chance.
And then also letting him make mistakes because the mistakes that he makes are honestly better than doing nothing because I was doing nothing and I was getting nowhere, right? I was getting maybe one to two calls from Instagram a month, maybe. And last month was actually my most leads I've ever had and I had 40, I think, Instagram leads. It was insane. Now it's just like, how can we make it cleaner? So yes, we let him make mistakes, but now let's clean it up a little bit so that these leads are quality. But if I never allowed him to make mistakes in the beginning and was just like, "You know what? This is how you have to do things every ..." Very, very, very structured and stern about it. " I don't think we would've got anything done.
Justin Rabinowitz:
A lot of chiros say, "I can't afford to hire anyone." Often that has to do with ego. They're afraid of hiring the wrong person or they're not confident as managers. But trust me, the pain of hiring the wrong person is nothing compared to the pain of doing nothing and then burning out because you did too much. It's an important lesson every chiro who's building their practice has to learn. And if you go to the link in the show notes, we can talk you through how and when to hire the right people for your practice.
You were a trainer before. You were the clinical guru like many of us are. We've gotten every clinical course, DNS and whatever, the whole thing. And so you said something that I think is worth talking about that, "I want to run the business more," which requires a level of identity shifting from sort of that old Cat version. How have you been able to reconcile this in your head of, "Yeah, that's good. However, there's another path for me here?"
Cat Rotti:
I just think it comes down to what do you want out of your life? And I love treating patients. I love my patients. My patients are amazing. I'm extremely lucky every single day to go and treat the people that I treat. But to be able to treat more people at a higher scale, I can't be the only person to do that.
The week of my wedding, so I just got married this month, I had 27 patient hours and that is a lot for someone who runs a business on top of taking phone calls. I think I had five hours' worth of phone calls that week as well and was up 4:00 AM on my wedding day figuring out ad stuff. If I want a family in the future, or if we want a family in the future, that's not something that's going to be sustainable. And so how can I create something that I truly believe in at a bigger scale and it's not just going to include me? It just doesn't. That's not how it works.
Justin Rabinowitz:
I want to transition a little bit. We joke about Cat in our group of five degrees of separation. Somehow there's a connection back to you. So you have a lot of connection back to a lot of colleagues and you kind of know everyone. And you also know many of them who are currently stuck or have heard stories about them being stuck. What patterns do you see them falling into?
Cat Rotti:
A lot of them were where I was. I think they're just very indecisive. They really don't know a ton about the business stuff. They're good clinicians, but they haven't put in the effort to learn the business. And I think in business, you have to reverse engineer things, right? It's like, "Okay, if I want X amount per month, I need to have X patients, which is going to be X evals, which is going to be X DVs, which is then going to be X amount of phone calls." And when you talk to them, it's like, "You know what? I think I'm going to charge 200 bucks an hour. I'm going to have," you call it the Cheesecake Factory menu of chiropractic, where it's like adjustment, options, soft tissue options, Normatec, whatever it is, and they don't just have one product. It's just all of these major amounts of products that they're offering or services that they're offering. And I think that they try to do too much. And when you try to do too much, you also run out of time.
So I only treat Tuesday, Wednesdays, and Fridays. Those are my treatment days. My Mondays are for phone calls, some meetings, and then my Thursdays are for meetings and phone calls as well. And so when you try to just shift your brain too much and like, "This is what I want to do," you get too distracted and you're not focused on just the one service that you provide.
Justin Rabinowitz:
So the Cheesecake Factory menu for chiros is such a big mistake because people with too many choices never decide. I was at the Cheesecake Factory last week and I was sitting there with my wife and she's looking at the menu and she's like, "I don't know what to order. There's too many options." That's the same problem so many chiropractors have. They often have a 30-minute session, an hour sessions, a 15-minute session, an acupuncture session, a dry needling session. They want to offer all the things to the patient and the patient can't decide because it's too much.
And so what we often say in your practice is you want to have enough options, but not too much, which is why we believe you can get to $1 million in revenue with one offer with a couple different tiers, and that's it. So when you present something to a brand new patient, at the most, it's three options for them to choose from.
This is certainly a trap I fell into early on in my practice when I wasn't making the money I wanted. Rather than going back and fixing the core product, what I thought about was maybe I need to add a physical therapist, or maybe I need to add a different machine, or maybe I should get a laser. And luckily I didn't do that because I wouldn't have solved the right problem, which was that I didn't have the requisite marketing sales and communication skills to build the primary product in my practice. Let's get back to our conversation with Cat.
What is the one piece of advice, one piece of action that you would tell them to take at this point other than hire a coach? What tactically would you tell them to do?
Cat Rotti:
I would say that business is a skill and at each new level, like zero to 10K will get you so far, but the same tactics that you use from 10 to 20 are going to be completely different. And I mean, I'm sure people tell their patients all the time when the patients are like, "I don't know if I'm doing this right. I don't know." It's like the movement you're learning is a skill. This is the first time we are doing it. You're going to make mistakes. You are going to mess up. That is fine. The more you do it, the better you get at it. And it's just the next step is going to be a new skill and you're just going to have to start over. And the worst thing about a skill, though, is when you're in that unconscious incompetence where you don't even know that you have a problem.
So figuring out how you can grow and, like I said, be around people who have been through it before so that the skill gets easier to learn, because learning the skill on your own is a lot harder than having someone teach you.
Justin Rabinowitz:
If you're listening to this and you realize that you've lost the drive you had early in your chiropractic journey, go to the link in the show notes and talk to our team. We have a live show coming up in early May called Rehab Chiro Mastermind Live, and we still have some tickets available. The links and the details for all of that are in the show notes.
Don't forget to follow the podcast, leave a rating or a review and comment wherever you get your podcasts. I'm Dr. Justin Rabinowitz, and this has been Business School for the Rehab Chiropractor. Thanks for listening.