#147: Losing $50,000 Every Month to $23,000 Profit in 60 Days / Increase Profits / Next Level Pros Podcast

Summary

Next Level Pros Podcast - Episode #147 Summary

Title: Losing $50,000 Every Month to $23,000 Profit in 60 Days / Increase Profits

Host: Chris Lee

Guest: Amber (Owner of Three Podiatry Clinics in Portland, Oregon)

Release Date: May 20, 2025

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Welcome to Next Level Pros, where host Chris Lee delves into the inspiring journeys of successful entrepreneurs. In Episode #147, Chris interviews Amber, who shares her transformative experience of turning her podiatry clinics from a monthly loss of $50,000 to a profit of $23,000 in just 60 days. This detailed summary captures the essence of their discussion, highlighting key strategies, insights, and actionable advice.

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1. Background of Amber and Her Business

Amber owns and operates three podiatry clinics in Portland, Oregon. Her husband is one of the podiatrists at their clinics, alongside two other doctors. The team also includes a clinic manager, billing manager, and additional support staff.

Key Points:

• Operations Before Joining Next Level Pros:
  • Managed the business alone with her husband.
  • Faced daily operational chaos without clear guidelines or accountability.
  • Resulted in significant financial losses, with a net operating income of -$144,000 from January to March (02:00).

Notable Quote:

"It literally was like fighting fires every day and trying to… Just like a disaster." — Amber 01:31

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2. Joining the Next Level Community

Amber connected with Chris after attending a Kyle Mallion event where Chris spoke about fundamental business principles and AI tools. Impressed by his approach, she followed him on Instagram and eventually decided to join the Next Level community despite financial struggles.

Key Points:

• Decision to Join:
  • Recognized the need for drastic change to escape the worsening financial situation.
  • Borrowed against their Home Equity Line of Credit (HELOC) to invest in the community (04:20).

Notable Quote:

"It was really scary. I mean, it was a heavy lift for us." — Amber 04:20

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3. Strategies Implemented to Turn the Business Around

Within two months of joining the community, Amber’s clinics shifted from a loss to a significant profit. Key strategies included:

a. Implementing Accountability and Metrics

• Staff Accountability:
  • Established clear metrics and Key Performance Indicators (KPIs) to ensure employees understood their roles in achieving success.
  • Introduced a chart of accounts to categorize and track expenses accurately (04:53).

Notable Quotes:

"Accountability of our staff members was probably like the biggest driver." — Amber 05:20

"We jumped in hard to the metrics immediately with Trent." — Amber 06:30

b. Enhancing Marketing Efforts

• Transition from No Marketing to Strategic Spending:
  • Initially, there was virtually no marketing expenditure.
  • Introduced pay-per-click (PPC) campaigns, significantly increasing call volume and patient bookings (03:30).

Notable Quote:

"We were doing no marketing. And so we started implementing marketing strategies." — Amber 05:53

c. Optimizing Operational Processes

• Billing and Insurance Management:
  • Improved accuracy in insurance information collection to reduce claim rejections and payment delays.
  • Implemented regular reporting and held the front desk accountable for billing metrics (44:32).

Notable Quote:

"If you could measure it, then you could control it." — Trent 07:37

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4. Financial Analysis and Opportunity Costs

A significant portion of the discussion centered around understanding and leveraging opportunity costs to optimize profitability.

Key Points:

• Current Performance:

  • April closed with a $23,000 profit (04:46).
  • Identified a potential $73,000 swing from negative to positive (05:20).

• Capacity Utilization:

  • Each clinic has a maximum capacity of 24 patients per day.
  • Currently operating at approximately 40% capacity, indicating substantial room for growth (09:00).

Notable Quote:

"You have cost of marketing, a cost of acquisition that scales, and you have $23,000 extra from this last month. The best advice I could give to you is spend $23,000." — Chris 00:01

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5. Staffing and Compensation Structures

Amber and Chris delved into the nuances of compensating medical staff to align incentives with business goals.

Key Points:

• Doctor Compensation Models:

  • Mizuho: On a fixed salary ($135k annually), incentivized to work harder without direct financial rewards.
  • Golf: Paid a percentage of collections (28%), motivating her to increase patient volume.

• Opportunity Costs:

  • Detailed calculations revealed that re-structuring compensation could unlock significant profitability, emphasizing the importance of aligning pay structures with business metrics (17:00).

Notable Quote:

"If you can enhance incentive structures, you can ensure that your front office is no longer a liability but an asset." — Chris 51:36

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6. Marketing Strategies and Opportunities

The conversation explored both traditional and digital marketing avenues, emphasizing the importance of measuring effectiveness.

Key Points:

• Current Marketing Spend:

  • Initially minimal, focusing on referrals and basic PPC campaigns.
  • Considering expanding into Facebook and potentially TV commercials to reach broader audiences (59:27).

• Recommendations:

  • Test and Measure: Start with incremental increases in PPC budgets and monitor results before scaling.
  • Diversify Marketing Channels: Explore social media advertising and local billboards to capitalize on high-margin services like orthotics (60:10).

Notable Quote:

"If you turn up a Facebook ad, people may be feeling pain while they're scrolling and decide to seek your services." — Chris 60:10

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7. Operational Improvements and AI Integration

To further enhance efficiency, Amber considered integrating Artificial Intelligence (AI) to handle front desk operations.

Key Points:

• AI Scribes: Potential use of AI to assist doctors with charting, allowing them to see more patients without compromising appointment quality.
• Front Desk Optimization: Training and incentivizing front desk staff to improve booking rates and customer interactions.

Notable Quote:

"Once you're there, now work on refinement, orthotics, sales, up sales. Those are all just slight, like training or whatever." — Chris 57:11

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8. Conclusion: Impact of Next Level Pros

Amber attributed her business turnaround to the strategic guidance and community support provided by Next Level Pros.

Key Points:

• Financial Recovery: Transitioned from significant monthly losses to consistent profitability.
• Strategic Insights: Gained clarity on opportunity costs, marketing efficacy, and operational metrics.
• Actionable Steps: Implemented measurable KPIs, restructured staffing, and refined marketing strategies.

Notable Quote:

"Next level has made a tremendous impact in our business. I mean, like, we talked about, we were negative, it was terrible, and now we're positive." — Amber 63:39

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Key Takeaways for Entrepreneurs:

1. Metrics Matter: Implementing clear KPIs and understanding financials are crucial for business health.
2. Opportunity Costs: Recognizing what you’re missing financially by underutilizing resources helps in making informed decisions.
3. Incentive Structures: Aligning employee compensation with business goals can drive performance and profitability.
4. Strategic Marketing: Investing in scalable and measurable marketing channels can significantly impact growth.
5. Operational Efficiency: Leveraging technology and optimizing staffing can maximize capacity and reduce costs.

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Notable Quotes with Timestamps:

• Chris at 00:01:

  "You have cost of marketing, a cost of acquisition that scales, and you have $23,000 extra from this last month. The best advice I could give to you is spend $23,000."

• Amber at 01:31:

  "It literally was like fighting fires every day and trying to… Just like a disaster."

• Trent at 07:37:

  "If you could measure it, then you could control it."

• Chris at 57:02:

  "The most important thing you can, you can focus on right now is fill in your calendar."

• Amber at 63:39:

  "Next level has made a tremendous impact in our business. I mean, like, we talked about, we were negative, it was terrible, and now we're positive."

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Final Thoughts

Amber's journey illustrates the profound impact that strategic planning, accountability, and community support can have on a struggling business. By meticulously tracking metrics, optimizing staffing, and strategically investing in marketing, Amber successfully transformed her podiatry clinics into profitable ventures within a short timeframe.

For entrepreneurs facing similar challenges, this episode underscores the importance of understanding your numbers, leveraging available resources, and making informed decisions to drive business growth.

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Note: Timestamps correspond to specific points within the podcast transcript for reference.

Transcript

[Amber]

That sounds scary, Chris.

[Chris]

One problem is you do not have visits. You have cost of marketing, a cost of acquisition that scales, and you have $23,000 extra from this last month. The best advice I could give to you is spend $23,000.

[Amber]

That sounds scary, Chris.

[Chris]

Can I give you a recommendation there?

[Amber]

Yes. Are you going to tell me not to do that?

[Chris]

Don't do that.

[Amber]

Oh, really?

[Chris]

Amber, thanks for joining us today on the show.

[Amber]

Yeah, thanks for having me.

[Chris]

Glad to have you. So, Amber, can you give us a little background? I know you own podiatry clinics, and can you give us a little bit more color behind that?

[Amber]

Yes. We own three locations of podiatry clinics in Portland, Oregon. My husband is a podiatrist, so he's one of our doctors. We have two other doctors in our other locations. Clinic manager, billing manager, and then Steph.

[Chris]

So you got a lot of interesting things, and I'll just like, kind of point them out and then we're going to dive into them. So, like, one up until you join the next level community, you were losing money. And we've seen some really cool things, and we're going to talk a little bit about that, how you've been able to turn that around, make some money. But, yeah, so you've got. You got some really, really cool things going on in the business. Can you give us, like, give us a little bit more color? So you joined the next level community back in. Was it February?

[Amber]

I think February, yeah.

[Chris]

Okay, cool. And up until February, what was taking place in the business?

[Amber]

So it was. It's me and my husband running the business and trying to figure it out without any idea of what we're supposed to be doing. And so it was just. It literally was like fighting fires every day and trying to. I guess, you know, I listened to, like, a lot of podcasts, and so I thought that I knew kind of what I was talking about, but I really just had no idea. So we weren't profitable. No accountability in place. Just like, kind of a disaster.

[Chris]

I'm looking at a p. L From January 1st to March 31st, it looks like you guys had a net income of negative or a net operating income of negative 144,000.

[Amber]

Yep. That's about. That's about right.

[Chris]

And so obviously that. That hurt cash quite a bit.

[Amber]

Yes. I mean, yeah. Then at that point, it's like desperation mode. You have no room to invest in marketing or anything.

[Chris]

Yeah. And so around this time, while you're going through, like, this cash crunch, I believe you had reached out to me or how did, how did we get connected?

[Amber]

Yeah. So I heard you talk at a Kyle Mallion event. You didn't pitch anything. You kind of just talked about basic business principles, life stuff. And I loved your vibe. So I followed you on Instagram. And then, you know, kind of during this, at some point, you started talking about the community. I previously didn't even know that you had a community, but it was your AI you were talking about, like, AI tools and how to incorporate AI in your business. So I reached out and.

[Chris]

Yeah, awesome. So. So I know that that was around, around February. And so during the, at this point, you're, you're negative cash flow, you're. You're struggling, you're listening to different podcasts, trying to figure it out on your own. Like, one, why would someone in a position like that even join our community? If one, you can't even afford to pay your own bills, why would you fork out money to join and I guess walk us through, like, what you had to overcome to be able to make that jump and like, what it's looked like since then.

[Amber]

Yeah. So I think that we knew that we were going in a bad direction, and so we had to do something drastically different. And education has always kind of proven for me to, like, be what I'm. I love educating myself. And so I wanted to be in a community with someone who had been there, done that. You talked, you talked about a lot about your bankruptcy. And, like, I knew that you had. Were in the hole and you got yourself out of the hole. And so I was in the hole and I could either try to figure out how to get out of it myself or speed up the process and follow in your footsteps. So it was really scary. I mean, it was a heavy lift for us. We took money out of our HELOC in order to join the community. We were super negative in the business, but it just, I knew I was going to go down a worse path if I didn't do anything.

[Chris]

Hey, guys, it's Chris. Hey. A lot of you leave comments asking for help. Do me a real quick favor, shoot me a text at 509-374-7554. That's 509-3374-7554. Shoot me a text. I'll answer and help you with whatever you need. Don't worry, I got you back. Let's go back to the show, baby. So fast forward. We're sitting here on May 6. How did the month of April close out?

[Amber]

April was fantastic. We were positive. $23,000.

[Chris]

Let's go.

[Amber]

I know, it's exciting. It's wonderful.

[Chris]

So you go from essentially losing $50,000 a month to positive 23. That's a $73,000 swing. What were some of the main things that you implemented over that time? And then once you answer that, we'll, we'll dive into like more of like, okay, what can we do now? What, what is the next big moves that we got to take? But yeah, what were, what were some of those, like, key things that let went from negative 50 grand to positive 23?

[Amber]

Yeah. So accountability of our staff members was probably like the biggest driver. So previously none of our employees knew what it meant to be successful. We didn't have those key metrics in place that contributed a lot to the chaos of the like day to day in the clinic. We had some AR issues also that we kind of figured out. And then marketing, we were doing no marketing. And so we started implementing marketing strategies and.

[Chris]

Yeah.

[Amber]

Yeah.

[Chris]

Awesome. Awesome. So, you know, one thing I remember from like when you were considering joining, joining the, the community was just a few questions I had about your business and, and they were around what we call impact metrics, which are our version of KPIs. And, and I remember clear as day that you're like, I don't know that. Yeah, you're like, I. I don't know. And like today we're, we're sitting, we're sitting over some metrics that are. Obviously when you talk about holding these people accountable, it's really what I mean, holding them accountable to these type of productivity. Right?

[Amber]

Yeah. Yeah. We jumped in hard to the metrics immediately with, with Trent. I think knowing, knowing the numbers was one of the first things that we clarified. So that was, that was huge.

[Chris]

Yeah, I mean, I'm looking at some things like, okay, what are, what is your break even? Right. $100,000 a month is kind of your, your what we call the nut that you have to cover to be able to start making money. Understanding, like your gross margin of 95% that your average revenue per visit is $250, what your total visits were last month versus this month, that type of thing. Like all these, these metrics are really where it becomes fun, right, to, to be able to like, you know, pull the levers and really just understand the game, understand the rules, understand the logic, understand, like when I do this, it results in this versus just kind of like shooting from the gut or from the.

[Amber]

Yeah, those numbers were non existent before I started. I mean, we had no idea I mean, I think even revenue per visit is a brand new number that we just came up with.

[Trent]

Yeah.

[Amber]

Not very long ago.

[Trent]

Yeah.

[Chris]

That's amazing.

[Trent]

We always said, like, if you could measure it, then you could control it.

[Chris]

Yep.

[Trent]

So her issue was she couldn't measure it and she couldn't control it. There was no visibility. And now that you have your chart of accounts dialed in, you're in a lot better position.

[Amber]

Yeah.

[Chris]

So, Trent, when you say chart of accounts, can you explain to the viewers more of what that means?

[Trent]

Yeah. So on your profit and loss statement, you have descriptions usually on the left hand side or almost always on the left hand side that are the actual items that you are the descriptions of the items that you're spending. So like materials, direct labor, your insurance, your rent, your. Your operational expenses, and having a clean chart of accounts where you can clearly identify sections where you should be spending a certain amount. Like marketing, as an example. What's the marketing spend? Help you gain clarity in your business so that you can protect that 25% net profit of your business.

[Amber]

Yeah. So like previously, things were not necessarily in the right buckets. We had way more buckets. And then there was no consistency as to like, this always goes in the marketing bucket. And we've even since dialed in deeper and have multiple different types of marketing buckets so that we can really see, like, oh, I spend a dollar in this and this is my return. And that's all brand new.

[Chris]

So one thing I'm not seeing on here, and I'm interested to know if you know about your business as far as like, capacity. Do you know your current, like, capacity metrics?

[Amber]

Yes, we are under utilizing all three of our clinics drastically. So yes, I think we can see, let's see, a full day of 24 patients. 24 patients.

[Chris]

How many days a week are you open right now?

[Amber]

Yeah, so that's another problem. So depending on the doctor and if they do surgery or not is how many days they're in clinic. So we have one associate who's non surgical, but she's in clinic four days a week. She's spread out throughout the three clinics. Got it.

[Chris]

But she's only ever in four. Four days a week.

[Amber]

Right. And that means that one of our locations is. All three of our locations are fully staffed, but like, one of them is only open two days a week seeing patients. One of them is open five days a week seeing.

[Chris]

And when you say fully sta. Staffed, are they fully staffed the other three days?

[Amber]

Yes.

[Chris]

Even though they're. You're only Seeing patients two days a week.

[Amber]

Yes. So, so sometimes the medical assistants travel with the doctors, but there are, there are several days where we have a front office and a medical assistant sitting in an empty clinic.

[Chris]

Hey guys, it's Chris. If you're finding value in what you're hearing, go ahead and like, and subscribe. That way people just like you can find this content for free here on YouTube. Now let's dive back in the show. Right? Yeah. So it's, it's interesting. So you have the capacity right now, well, like from a facility standpoint to have 24 visits. 24 visits a day per clinic. Per clinic. And if there were more doctors at those locations, could you see more than 24?

[Amber]

One of our clinics, for sure we could see 48 maybe because of maybe three times that we have enough exam rooms. The other two clinics, we really only have capacity to see 24 patients a day.

[Chris]

Yeah, because I think it's important, like you're in the capacity game, right? Like, what do you have capacity to fill? And like what percentage of capacity are you hitting? Right. And, and so when, when you're talking about that you have like a clinic, that you have two different rooms and you could be doing 48 a day. Right. Like the, the only limiting factor at that point is what?

[Amber]

Just volume of, getting to the right volume of patients.

[Chris]

But then also a doctor, right? Because you don't have. Yes. So the first, the first limiting factor would be the doctor. And the second limiting factor is like getting, getting to capacity.

[Amber]

We have the, the doctors are sitting and not seeing 24 patients. So really our problem right now is the patients.

[Chris]

Right? So if, if, like what I'm, I'm looking at these numbers right now. So you have your three different doctors, your husband, Dr. Maneo, which in March did 160, Mizuho did 94 and Goff did 153. And then that was in March. And then you look like month over month you had about the same, same type of visits from now Mizuho increased from 94 up to 130. So that was, you know, almost a 50% increase. And the golf was, was about the same. And so really where you're, if you just take 160 and you said the average clinics open four days a week.

[Amber]

Well, no, they're all open different days a week. One's open four, one's open five, and one's open two.

[Chris]

Okay, let's, let's call it, let's call it four.

[Amber]

Okay.

[Chris]

I guess the, the best way to, to look at it. And so if you're four days a week. Right. And, and your times 4.3 weeks a month. Right. You're 17.2 days essentially a month. That, that you're, that you're open. Okay. And a full capacity times 24 would be 412. So I think an easy round number would be like max capacity for one doctor four days a week would be 400. 400 visits. Yeah. And so if you're just comparing the numbers against that, like your top producing doctor is doing 160, right. And you said golf, she's full time, not doing surgeries, right?

[Amber]

Correct.

[Chris]

So like her only metric is this.

[Amber]

Right?

[Chris]

Right. There's, there's no other, there's no other metric. And so essentially and, and if they're seeing 24 a day, are they still able to have breaks and lunch? Like is that ustain to hit 24?

[Amber]

It depends on how much they talk to their patients. Four patients, 24 patients a day is 15 minute appointments. And so it would be busy. I mean in order to see a patient in 15 minutes and then chart on that patient, the charting is really where it squeezes. And I think that like AI scribes could play a big role. There's a lot of efficiencies that we can pull in there.

[Trent]

What's the average time that you expect the doctor to spend with the patient?

[Amber]

Depends on the doctor and how much they talk. And it also, it really depends on how complex whatever they're coming to see.

[Trent]

So I like to chit chat with my doctor, but it's a chatter but.

[Chris]

But an average of 15 is doable.

[Amber]

15 minutes is like that would be more than a lot of doctors spend with their patients.

[Chris]

Because my understanding the doctor isn't the only person seeing this patient. Right. Like they have somebody coming in beforehand checking them in. A nurse type. Yes.

[Amber]

So 15 minutes is with the doctor.

[Chris]

Right.

[Amber]

So it's not the full appointment time. Yeah.

[Chris]

Right. And so you know, it's interesting because yeah, if you look at, look at golf, she is essentially running at 40% capacity.

[Amber]

Right.

[Chris]

And so there's obviously a huge, huge opportunity because. And then how is their compensation structured?

[Amber]

They're, they're different. So Mizuho is on salary. Golf gets a percentage of her collections.

[Chris]

Percentage of collections. Okay. And what's, what's the percentage of collections there?

[Amber]

28%.

[Chris]

28%. Okay. So essentially what you're leaving on the table is 72% because outside of that you really, do you have any variable costs? Any like with an appointment per patient?

[Amber]

Ooh that's a good question. Not from like a. Not really because we don't really have cogs.

[Chris]

Right.

[Amber]

We sell orthotics.

[Chris]

Right.

[Amber]

And so that would be something. But other.

[Chris]

That's additional opportunities. That's not. Yeah, that, that's not from like an appointment.

[Amber]

Yeah. So right now. No, I mean we could see that many. We have the stat, we have the staffing already in place.

[Chris]

Right. So it's, it's interesting to, to look at it. Right. So if, if, if you increased capacity by 10% going from 40% to 50%. Right. So that would be another 40. 40 visits. 40 visits a month for, for golf times $250, times 70. 72%. Right. Because she would be getting the other 28. So that would be an additional seven, two hundred dollars a month just by increasing now if you were able to get them. So that's for every 10%. So to be able to do that times six, because essentially to get her to four full capacity, like a full capacity clinic would look like an extra $43,000 a month net.

[Amber]

I know, it's crazy. I know. I know these numbers.

[Chris]

Right, right. So it's, it's interesting to, to look at like just what that is. And then you got somebody like Mizuho, they're not getting paid for additional production. Is that right?

[Amber]

Correct. He's motivated though. He would, he would work harder even if he wasn't financially.

[Chris]

Why, why would he be motivated to do that?

[Amber]

He. He is. I don't know how else to.

[Chris]

Is there any other incentive plan or production structure?

[Amber]

Kind of. The, the thing with him was is that in order to get him to come on, he needed a salary because if he was going to be production based, he would start at zero.

[Chris]

And so what's his salary a month?

[Amber]

It's 135 a year.

[Chris]

Okay.

[Amber]

I don't know.

[Chris]

So yeah, 135. But then that's not fully burdened, so probably another 22%.

[Trent]

That's like your education fees and all the other stuff.

[Chris]

Everything that goes into.

[Amber]

Right.

[Chris]

So I'd say he's about 165 grand.

[Amber]

Which maybe closer to like 200 because we pay for his malpractice insurance. And so he, I would say like his, he costs like 200,000.

[Chris]

200,000. Got it. Okay. So which means your break even with him is $16,666. And so which means. So is golf just completely 28% of visits?

[Amber]

Yes, but no salary. Yes, but she is, she's working hard to get Additional benefits like her malpractice insurance paid for and continuing education. Continuing education. So we're, We're. Trent and I are talking about that contract after this.

[Chris]

All right, so. No, but this is, this is interesting to look at. Like, okay, at what point is Mizuho cheaper than golf? Right, Right. And so have you, have you calculated this?

[Amber]

No.

[Chris]

Oh, let's calculate.

[Amber]

Okay, let's do it.

[Chris]

Let's do some math. Okay, so. So Mizzou's making 28 of 250. Right. She's making essentially $70 a patient. Is that right?

[Amber]

Golf? Yes, that's correct.

[Chris]

So she. Sorry, I said mizzou. I meant golf. Yep. Golf is making $70 a patient. And if. If Missoula was on the same exact structure visiting he saw 130 patients, he would have made $9,100 and said you paid him $16,666.

[Amber]

Yes, I'm painfully aware.

[Chris]

Okay, so. So if you're at. But if, if you were to pay golf fully at 400. Patience. Right. Like if you got golf completely cranking, you would pay golf $28,000.

[Amber]

Yes.

[Chris]

Okay. So essentially, your break, even a win. Golf actually becomes more expensive. So if you take his. His salary divided by 70 is at $238 or 238appointments a month. Does that make sense?

[Amber]

Oh, totally.

[Chris]

Okay.

[Amber]

Yes.

[Chris]

So, so essentially, golf will be cheaper all the way up to 238. And then she becomes more expensive. And, and Mizuho will be more expensive up until they hit 238. And then he becomes cheaper.

[Amber]

Right.

[Chris]

Okay, makes sense.

[Amber]

Yes.

[Chris]

So which I guess if you're looking at these compensation structures, which one would you rather have?

[Amber]

I would rather have a percent of production.

[Chris]

Yeah.

[Amber]

Because it limits our liability.

[Chris]

Right.

[Amber]

And I think it motivates them as doctors to see more patients to a certain extent.

[Chris]

Exactly. And, and, but my, my question would be how hard is it to recruit people on just purely a percentage?

[Amber]

It's hard to get them like he will. Mizuho will switch over to a percentage probably next year after he's established himself a little bit. It's very difficult for someone to walk in the door and get paid $0 for at least 90 days because that's how long it takes to collect money. It's a tough.

[Chris]

So is there a better structure than either one of these combined?

[Amber]

I was hoping that you would tell me what that was.

[Chris]

So I. I do believe there is a better one.

[Amber]

Yeah, I'm sure.

[Chris]

I was just wondering. What. Do you know what it is what your thoughts are.

[Amber]

We've talked, Trent and I have talked a lot about profit sharing, about percentage of production. I think there's a lot of different ways. I don't know if we know.

[Chris]

I mean from a, from a recruiting standpoint, like a base salary is always going to be the strongest way to be able to bring in more applicants or more, you know, potential people that you can select from. Right. And so I mean what you're doing with Mizuho is probably overpaying, right? Like from, from a standpoint where, where you could probably come in and say, hey look, we will give you a base of, call it $80,000 and then a, and then a percentage of production. Right? So like, like I'm just gonna throw this out there, right? Like if you were to do. Because right now you're essentially, if Mizuho continues doing this exact at 160 times $70, times 12. Right? You're paying, you're paying her $135,000. Is, and, and are you giving her anything else besides that or is it just the 28%?

[Amber]

Currently it's just 28% but we, she's asked for additional. She came in as a part time doctor and that's why we did the percentage and she kind of ramped up since then and she wants to be more considered full time. So that's why she's renegotiating her contract.

[Chris]

Right. Which is totally understandable. So I'm, I'm looking at something like this. I'm like, okay, what if I were to provide like $80,000 base, right? And that way I attract more applicants in and I'm just shooting from the hips. I haven't even studied this right now.

[Amber]

So, so we'll see if the math. Math. Yeah, I write it down.

[Chris]

Well, we'll see if, we'll see if this thing maths. Right. Like so if I'm, if I'm looking at okay, 80, 80%, but then I could do maybe a 10% profit share. Like so then what. Let's, let's see where that would get us. If I was at 160 times $25 times 12. Right. So yeah, that would actually put this, this actually maths a little bit. So, so that would put us at $128,000 versus 135,000. What you have are currently structured at.

[Amber]

And I will say like 160 is, is a low. I would say that 200 visits per month is very comfortable. And where they should all be at least landing. What is the math at 200.

[Chris]

Yeah. So, and, and that's, that's the beauty of, of what you have. So if you're at 200 times, that would be, it would be $25 a visit because you're paying them 10%. You're following me?

[Amber]

Yep.

[Chris]

Okay. So that would be an additional $5,000. Okay. Times 1260. That would put her at $140,000.

[Amber]

Yeah. So there you go. That's.

[Trent]

Now is $140,000 for a doctor as a podiatrist, a salary that's, it's not very competitive.

[Chris]

It's not very. What's a competitive rate?

[Amber]

So the hospitals are bringing in new Doctors at over 200,000. They work them to death, and then when you retire in 30 years, you make $205,000. And so there's like an education piece here of if you want to make more money, you got to produce more. But it's not, it's not very competitive.

[Chris]

Right.

[Amber]

Just being honest.

[Chris]

What. So yeah, I, so I, I agree. Like, there, there's a give and take and I think there's a key thing to be learned here. Just for anybody that's watching the show is like money, Money is only one aspect to the solution. Right. Like you've got to, they got to be able to make enough money. Right. They got to be able to pay their bills and see opportunity and everything like that. But there's a lifestyle aspect. Right. If they're working at a hospital being worked to the bone, how many days a week are they working at a hospital?

[Amber]

Five.

[Chris]

Five days guaranteed.

[Amber]

Oh, sure.

[Chris]

And here we're talking about like a four day work week at capacity is 400.

[Amber]

Yeah, yeah.

[Chris]

Right. And so, so like, we're not even talking about like, like under this situation of 200amonth, you're still only hitting 50% capacity. So you're still sitting around, you're still not, you know, like running around crazy, and you're working four days a week. Like you've got some benefit there.

[Amber]

Yeah.

[Chris]

And so like, okay, what is this happy medium where we can create this, you know, structure and maybe, maybe the base needs to be higher. Maybe the base is, you know, $100,000 versus like the, I mean, essentially from a, you have a base of almost 200 grand because you threw in all these extras.

[Amber]

Right, Right.

[Chris]

So if you're, if you're at a hundred thousand with like a 10% profit share, then there's, you know, this additional incentive to be able to go and get it or maybe even, maybe even lowering the base back to 80 and bumping up the profit share, you know, 12%, 13% or something. Something along those lines. And, and that's not even profit share, that's rev share. There's also the opportunity to do profit share. Right. And you understand the difference. Yeah, yeah. You know, profit share would be even more important. Right. Because now once you're covering all your basis and actually making money, if they have the ability to share in that profit of that one clinic or that one facility like that, it can be highly motivating.

[Amber]

That would be great for us because our big thing is limiting our liabilities. And so if they have some. If they understand what they have to do to break even. We did a pro forma of 200 visits a month. And golf would make less money profit sharing at 200 visits a month than the 28% collections, is that right?

[Chris]

Yeah, yeah. So they would make less money at which one?

[Amber]

Profit sharing.

[Chris]

Profit sharing at 200amonth versus making their 28%.

[Amber]

Yeah.

[Chris]

Right. And so I think, I think one of the key things here is, is like, understanding, like, although you want buy in from these people and you want them to run good, profitable business, you also don't want them to have to worry about that. This is kind of one of, one of the things that we, we talked about offset. Right. The, the fact that, like, sometimes as entrepreneurs ourselves, we want everybody else to be entrepreneurs.

[Amber]

Yeah.

[Chris]

And I don't know about you, but I've been burned a lot in that type of situation, having that expectation.

[Amber]

Totally. That's been a hard lesson for me to learn that people don't think the same way that I think.

[Chris]

Right.

[Amber]

Kind of mind blowing.

[Chris]

Yeah. Yeah. Trent, have you ever had that type of experience where you're like, expecting somebody to operate like a business owner, but they're not?

[Trent]

Absolutely.

[Chris]

Yeah. Share with us.

[Trent]

Well, nobody loves your business like, it's your business. Right. Everybody's just, they get the paycheck, they go home to their families, and nobody thinks, hey, this company is. Doesn't have any money.

[Amber]

Right.

[Trent]

Right. So everybody else gets paid. The entrepreneur goes home and goes, like, what do I do? It's just like, you're working for everybody else. So when, when there is an element of profit sharing or equity or. Or any of those options, the employees feel a different sense of ownership, that they're also pushing the wagon forward.

[Amber]

But some people don't want to push the wagon.

[Trent]

Well, then you have your choice to work with them or not.

[Amber]

Yeah.

[Trent]

But if you want to recruit a players that want to push the wagon forward. That's, that's who you want on your team. Like Dr. Tim, your husband. Shout out, Dr. Tim, what up? He does a great, he does a phenomenal job of getting referral businesses. Right. He's always going out into the market, he's talking to doctors and he's getting those referrals. Those referrals have almost no customer acquisition cost other than coffee or bagels or whatever doctor Tim is bringing.

[Amber]

Yeah, right.

[Trent]

The other locations are not going out to do the referral business at that capacity. And you're leaning heavily on a higher customer acquisition cost through traditional marketing channels, traditional digital, social, etc. So if there was nothing else except that the doctors at the other locations had a different mindset to go acquire inexpensive leads through their referral business and bring patients in and they got to reap the benefits of profit sharing. It's a different. Again, it's a different mindset and it's the path to. Yes, it's the path to how are we going to make this work?

[Chris]

Yeah, some, some other structures that I've seen in the medical world that work really well is like where you have a quota that you have to hit and everything that's out over and above that quota, you get a, a bonus for. Right.

[Amber]

That would be good.

[Chris]

Right. And so, and essentially the way that you would, you would structure it is, is like, okay, you, you look at like what their salary is and what the quota has to be to basically compensate them at that. And then anything over and above that, you give them a spiff. And, and, and, and the reality is, because you have real. No, really, no, any cost of goods sold, like every additional dollar collected, like you can incentivize them a lot.

[Amber]

Right.

[Chris]

I mean, you could, I'm not suggesting you do this, but you literally could give them 80% of the revenue and you would still be more profitable past that quota.

[Amber]

Totally.

[Chris]

Right. Because up until this point, you're only hitting that quota. You're paying your bills, you're making your money. And so like, this is so important, like in any business, understanding your break even, like once you're at break even, every dollar over and above break even is so, so, so important. And so I think coming up with something along the line that's creative, where once they've hit quota, they, they have like this nice little bonus. And it could come in like patches, like for every like five visits over and above quota, you get X dollars or, or whatever else. And so then there's even like stairs. It's not just like every single one, they get extra money. It's like, oh, yeah, if I hit this, I get this, you know, type. Type deal. And they're really pushing to make sure that those things are.

[Amber]

Would you do that by visits or by dollars, like, collected?

[Chris]

Well, the, the real, the real question is, do the doctors have influence over the dollars collected?

[Amber]

If they sell products, if they sell.

[Trent]

Cbd, if they, if, yeah, there's some.

[Amber]

Ancillary stuff that they could do, kind of. So yes, they could go and, you know, have a more profitable niche and they could say, I see, like sports medicine for PRP injections, the lifetime value of that customer is higher. So if they like niched down into something that was, that was.

[Chris]

Yeah, I mean, the, the more alignment that you can create with the business. Alignment, right? Like, if the business makes more money on a certain product or certain service, creating the incentives and the alignment with that is absolutely important.

[Trent]

So that's the cool place that you're at. As long as you protect your 25% net profit, you have creativity to build up these step up programs that he's talking about. You know what your cogs are, right? You know what your expenses are if the 25 is protected, like, let it be creative, let it be art, and then once you find out what art works, let it become science.

[Amber]

So part of the problem is that we're not hitting our break even at these numbers because we haven't figured out marketing yet. Once we, like, once we are really breaking even at every single clinic, then it's easier for me to be like, oh, yeah, here's your incentive structure.

[Chris]

Do you know your current cost of acquisition?

[Amber]

No. We know from ppc, we know how much it costs to get a phone call.

[Chris]

Okay.

[Amber]

The booking rate is a black hole still. We have an ehr, not a CRM, and so it doesn't track those types of metrics. And so we've been getting our front desk gals to start collecting that type of data, but it's still like very much in the training process.

[Chris]

Got it, Got it.

[Trent]

That was one of the metrics that we wanted to dial in because she's spending an enormous amount of money on marketing and you're getting all these referral businesses and then the calls aren't being booked for whatever reason. You can't move it forward.

[Chris]

Do you have, do you have an idea of how much? So you said you do know your dollar per call right now?

[Amber]

Mm, $50.

[Chris]

$50. To get one phone call.

[Amber]

To get one phone call.

[Chris]

Okay. I have to imagine that the booking rate should be extremely high. As long as you pick up the phone.

[Amber]

That is what I told Trent.

[Trent]

And as long as when the person picks up the phone, they don't say, yeah, the doctor can't see you for three weeks. We'll call you back once we have.

[Amber]

That was a real life problem that we had, right? Yeah.

[Trent]

I mean, that's just money wasted, right?

[Chris]

I mean, if based on what I'm seeing here, you're operating at best at 40% capacity, which means you should have openings tomorrow.

[Amber]

We do. And that's one of our marketing spiels to especially urgent care is like we will do same day appointments. And they referring physicians love that because if a patient is going to an urgent care, but they really need a specialist, it's easy for the urgent care to just say like, call Pearl, Foot and ankle. They will get you in. That has been successful for us.

[Chris]

So when you, when you say $50 a call, these are $50 for a call from somebody looking for an appointment.

[Amber]

So this is for our Google Ads campaign. We started with $1,000 in marketing spend and got however, 1,000 divided by 50. We got that many calls and then we increased it to 2000 and it stayed. I just sent you that email. I was super stoked.

[Chris]

Yeah, 40 calls.

[Amber]

Yes.

[Chris]

Nice.

[Trent]

It doesn't always happen that way.

[Amber]

I know. I wasn't expecting it to happen that way. That's why I'm like, maybe we need to pour more gas on this fire.

[Trent]

I've been telling you that you're spending 5% marketing.

[Chris]

Yeah, I mean, the, the reality, the reality is if it scales at the exact same rate, you should have no budget.

[Amber]

Right.

[Chris]

Until you hit capacity. Capacity is the only determining factor of budget.

[Amber]

So how. So like we started with a thousand, then we did 2000.

[Chris]

Yep.

[Amber]

We reran it for 30 days at a thousand. 30 days at 2000. How. What would you. What's the next jump and what's the time frame?

[Chris]

I mean, so, so here's the thing is how much can you afford to lose?

[Amber]

Oh, to lose? Oh, I don't know. Well, 23,000 last month.

[Chris]

And so, so this is, this is the way I would look at it. If I have to imagine, okay, if I'm getting a phone call that I'm booking 80%. I have to imagine that.

[Amber]

Right, Right.

[Chris]

And if I'm not, then it's some basic twists. Like I personally, I've never called a doctor and shopped.

[Amber]

Right, Exactly.

[Chris]

Correct.

[Trent]

Unless they couldn't see you.

[Chris]

Unless they can't see You. Right, but again, but that's. That's not shopping, right?

[Trent]

That's not shopping.

[Chris]

That's not shopping. That's being turned down by the doctor.

[Trent]

Right, right.

[Chris]

And so, like, you're in the business where there literally is no shopping. It's a need. And if you can fulfill my need. Right, right. And so I got to imagine 80% booking rate, okay? So if I'm getting 20 calls per thousand, which means I'm getting 16 appointments per thousand dollars, okay, that means our cost of acquisition is 1,000 divided by 16. Okay? Now, now, this isn't 100% accurate because I don't know for a fact that it's an 80% booking rate. But I have to imagine that right? Now, that's. My hypothesis is going to be as a scientist, I'm going to say, look, this thing is probably going to book at 80%, okay? Because I have the capacity. I can see people tomorrow, the next day and the next day, right? Like, I've got to be there. Okay? So If I'm at $62, okay, that means out of 250 bucks, my cost of acquisition is 25%. Okay, makes sense.

[Amber]

Yep.

[Chris]

Okay. So which means what? How much is it going to take to fully get me to capacity? Okay.

[Amber]

Run that number.

[Chris]

Yeah, let's. So. So if I have full capacity is. Let's. Let's say full capacity is 300, okay? Like, because it's not. But it, like, you can move it around and make it work or whatever. So that would be 900 visits a month between the three clinics. Okay? One's open five, one's open two, one's open four. But I think I, for the most part, we can get to 300 average across per unit. Right?

[Amber]

Totally. Yes.

[Chris]

You there?

[Amber]

I'm there.

[Chris]

Okay. And now we have this. Last month you did 160, 293, 33, 433. So minus 433 equals 467 appointments to get to that 900 capacity times $62.50. That's your marketing budget.

[Amber]

Okay, well, 29,000. We're almost there.

[Chris]

Okay, but what. What. What I'm saying is, okay, if you made $0 next month as a net profit, would you guys be able to survive?

[Amber]

No.

[Chris]

Zero dollars.

[Amber]

Oh, zero dollars. Yes.

[Chris]

Right. Not negative.

[Amber]

No, zero is great.

[Trent]

Okay.

[Chris]

If you broke even next month, okay, so you have. The one problem is you do not have visits. You have a marketing. You have a marketing cost of marketing, a cost of acquisition that scales, and you have $23,000 extra from this Last month, the best advice I could give to you is spend $23,000.

[Amber]

Okay, that sounds scary, Chris, because do we know. So we've hired a marketing agency.

[Chris]

Okay.

[Amber]

Do we know that that's the best use of our $23,000?

[Chris]

Okay. Where else can you spend money and make money in this business?

[Amber]

Yeah. You cannot.

[Trent]

The other thing that's important for your business is that it's a repeat business. So your customer acquisition cost is offset by the amount of visits that the patient comes to see you. So that $62 customer acquisition on the second visit.

[Amber]

Right.

[Chris]

Zero.

[Trent]

Right.

[Chris]

Now. Now. Now it's $31.

[Trent]

And now they continuously offset.

[Chris]

Yes.

[Trent]

So if you know that.

[Amber]

Oh, I see. It's okay. I get it.

[Trent]

So if a patient is going to come see you, let's say four times, it's $62 divided by four. And then on the next one, you make money on the patient.

[Amber]

So.

[Chris]

So let's. Let's. Let's work through this. That is scary, Chris, because I think. I think it's. I think it's important. Okay. It's important to address the real things that hold us back as entrepreneurs. Okay. It's not the numbers. It's the feelings. It's the mentality. It's the. Right. Because, like, from a pure logic standpoint, you were losing $50,000 a month, right? Okay, yes. And you were like, it. That sucked, but you survived. Okay, so to. To. If you went from losing $50,000 a month to. To making zero. Losing zero, would you be okay with that?

[Amber]

Yes.

[Chris]

Okay, so why would you be scared of zero again?

[Amber]

Yeah, I guess I'm more scared of giving the marketing people our money and them not performing well.

[Chris]

But which. Which is valid. But. So you don't even necessarily have to bring 23,000. Here's. Here's the issue, though.

[Amber]

You.

[Chris]

You paid a thousand dollars and you got 20 phone calls, right? Then you doubled it. Cool. But you really only put a thousand dollars at risk. Right? Like, and. And so, like, what can you afford to put at risk right now? You can afford to put $23,000 at risk.

[Amber]

Right.

[Chris]

Okay. You don't even have to do all 23. But, like, let's get. Let's get a little bit crazier because the. The opportunity cost is what's killing you. So the fact that you did.

[Amber]

It's like a full circle. We're back to opportunity cost.

[Chris]

Yeah, we are 100 an opportunity cost. Because when we're. Because when we're at 400, what I. What I say 434. 434 appointments, minus. So 900. You have 466 appointments that you are. That. That's your opportunity cost. So not getting those booked cost you. With this cost you $116,000 last month.

[Amber]

Yeah. Okay.

[Chris]

Okay.

[Amber]

Yep.

[Chris]

So, like, that's what cost you. And that's not even at the 400 capacity. That's at a 300 capacity. Right. If. If we. If we add in 400 capacity, that's an extra $75,000.

[Amber]

Yeah, yeah.

[Chris]

Right. And so, like, literally, you're somewhere between 100 and $193,000 of opportunity costs. That is literally should be showing up.

[Amber]

On your P. L Per month.

[Chris]

Right?

[Amber]

Per month.

[Chris]

Per month on your P and L. So, like, like, are you more scared of potentially losing $23,000 or the fact that you're missing out on $120,000 every single month?

[Amber]

Well, I didn't know about that part, so I wasn't scared.

[Trent]

Now, one of the scary pieces for you, I think, early on, like, February, March, timeline, was that you're like, if I spent an enormous amount of money on marketing, but I'm not booking calls, people are saying they're dodging calls. And A, B, and C, I could see why you'd be afraid because of course, you're spending money without the backend infrastructure. Having said that, you've done. And I just want to say it to you and to everybody who's listening, you're an amazing operator. You've gone in there and really changed the way that the infrastructure of the company operates. You are doing one on ones with your teams. There's clear expectations, there's accountability. So now that the infrastructure is right, now it's time to invest more into marketing.

[Amber]

Yeah. The operations can handle it.

[Trent]

And like, operations can handle it.

[Chris]

Worst case scenario, okay, your. Your cost of acquisition goes from 62 to 150 bucks. Right? Like, you're. You're only booking 30% of your calls. Your systems are breaking or whatnot. Even then, you're still making more money. Yeah, like. Like, for you not to cover your marketing spend would mean that you. You would have to, like, only book 25% of your calls. Right. Or just like. Or somehow your. Your. Your cost per call just doesn't scale at all. But, but again, like, you don't even necessarily need to go to $23,000. Let's take that 2,000 bucks and go to 10. Like, and let's. Let's spend $8,000 more this next month. Like, what, what does $8,000 look like for you, $8,000 divided by $62. $62 a call, get you 100 and or, sorry, $62 a deal gets you an extra 129 visits this next month, which puts in another $32,000 into your pocket.

[Amber]

Yeah, right.

[Chris]

And so by putting that risk, 8,000 bucks, you're going, you're going to make an extra 32,000 bucks.

[Trent]

Like sitting with Rayman.

[Amber]

I know, I love it.

[Trent]

I love the numbers like that in Vegas too. He's like, you see all the, he's got to see all the numbers.

[Amber]

But like these are good numbers. I like these numbers.

[Chris]

But like this is the stuff that gets me like you're sitting on a freaking gold mine.

[Amber]

I know, okay.

[Chris]

Yeah, you know, and, and you're like beating yourself up over like, oh, this guy's not working, or I got culture issues or whatnot. Like, man, I would much rather be like, address this and then go address like, like this is science stuff that if you can get this down, opening a fourth, fifth, 50th, 60th, 70th clinic, all of a sudden becomes extremely scalable. Now you're sitting on a multi hundred million dollar empire. Right. All because you understand, like the basics of. These are my cost per call, these are my booking rates. This is, this is exactly what my cost per appointment. Average ticket. Average ticket. Everything goes into it. Now when we say 250 bucks, is that 250 bucks that's collectible or 250 bucks that's billable, no collected.

[Amber]

Okay, good, I got you on that one. 750, 750 builds. 250 collected.

[Trent]

That was another piece of the infrastructure that was broken early on where should be doing all these jobs. But the money wouldn't come in for 180 days when it should have come in in 90. And we identified one of the problems was that the information in the system wasn't inputted correctly. So then the insurance company bounces it back, says you need to redo this, you redo it with the proper information and it starts the clock back at 90 days.

[Chris]

Yeah.

[Trent]

Now you've solved that to a great extent.

[Chris]

So this is with the billing codes.

[Amber]

It's with our front desk. You know, when you're collecting insurance information, if you don't collect it correct then.

[Trent]

Or if you collect it correct and don't put the right information in.

[Amber]

Right. Like typos and stuff. Now we are running reports that show one that it's even in there. I mean there was a lot that There was just no insurance information put in there. And then we go over it, and if there's a typo, we won't be able to see if it's correct or not. But there are some glaring errors that were happening previously. So our front desk, they're doing a great job of that. And now we have KPIs, and they're being held accountable with those weekly, which is. They're all responding perfectly to it.

[Trent]

That was another piece early on where, like, everybody was busy, but nobody ever knew what they were busy with. People were just generally busy. And the question I asked you to ask your team was, how do you. If I was to ask you, how do I know if you're doing a good job or how do I know if I'm doing a good job, what would they say?

[Amber]

Yeah, they would look at me like, you're crazy, Right? I have no idea.

[Trent]

And now you can say, hey, I know I'm doing a good job because I have a 80% booking rate. I have a 92% accuracy on a, B and C. And we ask for reviews and we get this amount of views per. Per month. And so there's those metrics empower your employees because they know they have fulfillment. They know if they're doing a good job or not.

[Chris]

They know how to win.

[Trent]

They know how to win, Right?

[Chris]

I mean, going back to video game theory, like, if you're playing. If you're playing in a video game and you have no, like, scoreboard, there's no scoreboard, no destination, no end of the level. Right? Like, you literally do not know what the point of the game is. Like, you're wandering around aimlessly. And that's exactly how it works in business. Right. People have to have a clear, like, direction and way to know, am I winning? Am I losing? How am I being measured?

[Amber]

Yeah.

[Trent]

And then as the architect of the game, that gives you clarity and peace of mind that the infrastructure, the game that you put into place is going to work. Is going to work.

[Chris]

Yeah, absolutely.

[Amber]

Just to kind of like going back in time, talking about, like, an 80k base, all of this stuff was very scary to me because I just feel like it's just a liability. But if we can, if we do spend $10,000 in marketing and that hits, then that's like, way less ever. It makes everything less scary and more like, we can just reproduce this thing and, like.

[Chris]

Right.

[Amber]

Yeah, right.

[Chris]

And then you can go and track the right people and really, they're no longer a liability. They're an asset to the business.

[Amber]

Right, right.

[Chris]

Versus where you're spending. So previously, like when you were losing $50,000 a month, how much were you spending? Marketing.

[Amber]

$100. Yeah, I mean, there was no.

[Trent]

I.

[Amber]

We had no marketing spend.

[Chris]

And, and back then, what, I mean, what was your marketing strategy was just hoping a prayer that you get referrals over.

[Amber]

We did have a. And we still do use her. A gal that like goes and like knocks on referring physician doors. And so we, and we still do that. And that does seem to work. So.

[Chris]

But, but also somewhat of a hope. Hope and a prayer. Right. It's. It's like, it works.

[Amber]

Hope and a prayer.

[Chris]

You hope that they can bring it in. It's not very measurable. It's not scalable. Right. Like. Right. She may be good at her one thing, but you can't all of a sudden say, hey, I want three more of her.

[Amber]

Right, right.

[Chris]

Without having to go through a whole lot more training where you have like these incredible metrics, like through Google, where it's literally just increased budget.

[Amber]

Right, right. Yeah. And with, with the referral strategy, like what we're facing is that it's very doctor dependent and so you can't just pull out one doctor and put in another one. Whereas with Google, like, they don't know who they're booking with. And so, you know, whoever.

[Chris]

I love it. Yeah, I love it. And you know, it's crazy because you are in an industry where there's not a lot of entrepreneurs. And you know, I am constantly frustrated. In fact, I've been, I've been trying. I have an elective surgery that I've been trying to, to get done and I literally can't get a doctor to cross call me back. Like, like, isn't this like the health field is.

[Amber]

It doesn't surprise. It actually doesn't surprise me.

[Chris]

Wild to me. Like, I've been trying to do this for 12 months.

[Amber]

Well, what are you trying to get done? Can we help you out? Is it a foot problem?

[Chris]

Not, not a foot problem. I'm trying to be able to not have any babies anymore, so.

[Trent]

Oh, I got a guy for that.

[Chris]

I'm sure you do.

[Amber]

Dr. Tim's brother is a urologist.

[Chris]

Oh, nice, Nice. But yeah, again, it is the craziest industry to me. Like, like in no other industry, you have people begging to be able to give you service and people like turning you away.

[Amber]

Right.

[Chris]

Or not returning your phone calls. And so like, like understanding that that's your competition, all you got to do is just play this thing like A game and you'll be crushing it.

[Amber]

So let's talk about that a little bit because one of our, one of our struggles has been for our front desk staff paying them enough so that we get, we're competing with the hospitals again at all levels. And so like minimum wage in Oregon is ridiculous. Probably same here. So they're wanting more money. They're not doing a very good job. Well, we have two new ones and so, but we turn over front office staff like crazy.

[Chris]

So a couple things. One, up until now you haven't known your numbers. And two, you don't even quite know your numbers. You don't know your booking rate. You don't know these things. Like if these people don't know how to win, you're not going to be able to retain them.

[Amber]

Right.

[Chris]

And so, and if once they understand how to win, if you can create incentivized, incentivization structures that actually create alignment with winning. Right. Like, hey, you maintain a 90 booking rate, you, you get X bonus or X, you know, based off of how many appointments we do. Like, I mean these are people that you can like, you think about the two ends of the business. The front end of the booking and the back end of the fulfillment. Right. Like it's literally your, your people that are booking are your salespeople. Because once somebody shows up to an appointment, like they don't need to be sold.

[Amber]

Right?

[Chris]

Right. Unless they're being upsold on a product that's your doctor. Right. And so the same way as you incent in a, in a normal type business that you incentivize salespeople, you can incentivize these, these front end people. So now all of a sudden you don't only have to attract in minimum wage type talent. Because think about it, we talked about if you got up to 900 appointments a month, how much more money is that?

[Amber]

Can't remember.

[Chris]

It was like $112,000 a month.

[Amber]

Yeah.

[Chris]

Okay. With $112,000 a month, you think you can carve out a little bit for three, four from ladies.

[Amber]

Totally.

[Chris]

Right?

[Amber]

Yeah.

[Chris]

Right. So like, I mean an extra thousand dollars a month to each of those people that are running. That would be.

[Amber]

Yeah, it'd be huge.

[Chris]

Would be huge. I mean, I mean that's, and that is a small fraction. Now there's that option, but then the other option is like artificial intelligence, like, I mean, AI answering service, not like your, your, you know, 20 years ago AI, which is like press one, press two, book this. Did I hear yes? Did I Hear. No, no. It's like literally AI voices in a position now where they can have a conversation and be structured exactly how to get them booked. And so I think those are your two options and things like, really understand your opportunity cost. With these people, it's really easy to go cheap on them because you're like, oh, they're not doing anything. They're like, they're punching numbers into a computer and they're. They're answering phone calls and just, you know, doing that. But, like, understand the opportunity cost. Right, Right. Like, if. If they aren't booking. So one, you got to be able to measure them.

[Amber]

Right.

[Chris]

And if they're not performing to those measurements, how much is that costing you?

[Amber]

Right.

[Trent]

The interesting piece, to use Chris's example of his special appointment that he's waiting on surgery for. If that CSR were to continuously call him. Right. If that was the metric, like, hey, these missed calls or missed opportunities, and they were reaching out to him, he would of course say yes. Yeah, he's still shopping for it, right?

[Chris]

Oh, yeah. If I got a call from a doctor, a text from a doctor, I know, hey, you still want to get that surgery done? Reply, why would you know yes for. For tomorrow at three? Yes.

[Trent]

So that's the downtime that they have because again, we established that you're not at capacity there. We know that there is sitting time here. If it was. If it was a metric for outbounding for either patients that they've seen in the last couple months that, hey, are you interested in coming in for A, B and C, or for. Or for patients that wanted the service that couldn't be fulfilled for whatever reason, to call them out again.

[Chris]

So a couple things to think about right now. You have. So front desk people, Is it just one per location?

[Amber]

Yes.

[Chris]

Okay, so think about this. You made $23,000 last month, $23,000 in cash. And we've already said, hey, we're gonna allocate an additional 88 of that to marketing.

[Amber]

Okay.

[Chris]

That leaves you with $15,000 in growth capital. Okay, so if I took. And how much are you paying these front desk ladies or people?

[Amber]

$20 an hour plus benefits.

[Chris]

20. 20 bucks an hour. So they're making 40 grand a year. Right.

[Amber]

Okay.

[Chris]

Okay. If I went and I said, look, instead of hiring somebody that makes 40 grand a year, I'm going to hire somebody. I pay 65 grand grand a year. Okay, so 65 grand a year is going to be an extra 12 bucks an hour, which is going to be roughly about 15, $1500 a month. $1600 more a month. Okay.

[Amber]

Okay.

[Chris]

So from the 15 grand, I take $1600 a location, so that's 5 grand. 4800. Okay. Now I have $10,000 worth of growth capital. I have three way more qualified people running my front desk that know their metrics, know their incentive. They, they. You train them up on how to. How to do outbound. Like, I mean, what I would be looking at is, like, not even necessarily people that have medical experience. You would be like, loan processors. Right? Like people that have been in the mortgage space.

[Trent]

Friendly loan processors.

[Chris]

Yeah, yeah.

[Trent]

Friendly debt collectors.

[Chris]

But. But I'm saying. No, I'm saying loan. I'm saying loan processors on the. On the back end that are used to, like, going and collecting paperwork and gathering the stuff and doing outbound and those type of things. Like, how much more could you get from a $65,000 or a year employee versus a $40,000 a year employee?

[Amber]

Yeah.

[Chris]

Right. And. And now, like, yes, it costs you an extra $5,000 a month. But, like, again, what's the opportunity cost? The opportunity cost is $112,000 a month right now.

[Amber]

Yeah, we got to add that to the P and L. Just opportunity cost.

[Chris]

Right at the end. Every single time. Like, we lost 100. Like, yes, we made 23, but we lost 112. You know, like, like, that's. That's how every business owner should be looking at their business. Always, always, always, like, what are my capacities? What it. What did I actually miss on. Even though the bottom line shows positive production. Right. Because then it allows you to make strategic decisions. Like, I'm going to spend more money on the people my front facing. People that actually drive our whole reputation, our whole booking, our whole, like, schedule. Because ultimately that is, like, there's two things that lead to your, Your appointments not being filled. Marketing and your. And your CSRs.

[Amber]

Right?

[Chris]

That's it.

[Amber]

Totally.

[Chris]

That's it.

[Amber]

Yeah.

[Trent]

I would also say I would return customers as well.

[Chris]

So the doctors. Which cultural fit.

[Trent]

Right.

[Chris]

Would be huge.

[Trent]

Right. That's what I was going to add.

[Chris]

Sorry.

[Trent]

That's okay.

[Amber]

Yeah. And, you know, we haven't, like, there's so much opportunity. We haven't even sat our doctors down and, like, told them, like, Orthotics is a great example. The. The margins on Orthotics are crazy. Like, if we just sat the doctors down and said, like, talk to every single patient about orthotics, because this is how much money. Like, we haven't even done that yet.

[Chris]

Can I. Can I give you a recommendation there.

[Amber]

Yes. Are you going to tell me not to do that?

[Chris]

Don't do that.

[Amber]

Oh, really?

[Chris]

And the reason I say don't do that. The most important thing you can, you can focus on right now is fill in your calendar.

[Amber]

Okay.

[Chris]

That's it?

[Amber]

Yeah.

[Chris]

Once you're there, now work on refinement, orthotics, sales, up sales. Those are all just slight, like training or whatever. Because like the, for example, how much do you sell an orthotic for?

[Amber]

Well, we bill insurance. Okay, but how much we bill insurance? Eleven hundred dollars.

[Chris]

Okay.

[Amber]

We, we get collected anywhere between three to 800.

[Chris]

Okay. And what, what do you pay. Pay for that?

[Amber]

Our cost is 110, but we collect that from the patient before we bill insurance.

[Chris]

Okay, so you get the full cost covered?

[Amber]

Yeah.

[Chris]

Okay, awesome. So maybe there is. I mean, that obviously. That is sweet.

[Amber]

I know that.

[Chris]

That is, that is a sweet opportunity. But like, what things could you do that don't even require training that would allow Pete. Like, like in your rooms, do you have, do you have a thing that says ask your doctor about orthotics?

[Amber]

No, we don't. We should definitely.

[Trent]

I mean, good for the front desk lady, when you come in, do your, do your intake. Hey, here's a pamphlet while you wait on orthotics. It's really popular for 90% of our patients. Just ask the doctor if you're interested in it.

[Chris]

Like, literally without even having to like, implement better training with your people. You, you could do some things in your process that are just really simple, right? A couple posters. A couple, like, like, ask your doctor about this. I mean, literally, doctors don't have to do work anymore. Like, I watch television. It tells me what medicines to ask my doctor about. I go in, I say, hey, can you do this? I consult with Google, I consult with Chad, gbt. And literally I come in and I just get a prescription from the doctor.

[Amber]

Yeah. Like, yeah.

[Chris]

And so like, figuring out ways to, to be able to do that. But yes, obviously there's a, there's a huge opportunity there. But like, opportunity number one, get the calendar filled. Opportunity number two, figure out how to sell more orthotics.

[Amber]

So let's go back to like, marketing specifically, because I think that. So if we spent $10,000 on marketing this month, if I called my guy tomorrow, I'm like, up it to 10,000. When should we start looking at other marketing channels other than just ppc? Like, we don't do any Facebook or should I just like, double down on the PPC experiment. See what happens after 10,000?

[Chris]

No, that's a great question. I think there's a lot of opportunity with like Facebook and different things like that, like, hey, feet aching or whatnot. It is, it is an interesting, it is an interesting business because it's very inquiry based. Right, right, right. People feel something, they are looking for it. You know, I, I think I wouldn't be lean heavy on like Facebook, Instagram or whatnot, but I would always have it as a part of what I do.

[Amber]

Okay, right.

[Chris]

Just so that like, because people may be feeling pain while they're scrolling. Right. And then they see that and like, oh, yeah, I should get that looked at. This is going to be able. So I think there's an opportunity there, but I think most of it's going to be driven by an inquiry base.

[Amber]

Yeah. Okay. I guess it's like orthotics is a pretty good niche for Facebook. I feel like, yes, everybody could use orthotics.

[Chris]

Yes, like that, that is a huge niche, especially if somebody's coming in to buy it and you have an 80% margin, which is what it sounds like. Yeah, yeah, I, I think there's, there's a huge opportunity there.

[Trent]

You should find all the.

[Amber]

Covered by insurance, which like good feet store is not covered by insurance and people pay loads of money for those.

[Chris]

Yeah, I, I would, I would definitely be like, hey, have you looked into orthotics? Most are covered by Insurance. Contact Dr. Maneuver today or whatever.

[Amber]

Yeah, okay.

[Chris]

Yes.

[Trent]

They should find all the CrossFit locations and put up big billboards right outside of those.

[Amber]

Yeah, we've done, we've done running stores with QR codes. We could definitely up it, but maybe just do $10,000 PPC. Then we'll have even more capital to work with because like, Facebook seems really scary to me. Like, how are we gonna.

[Chris]

Yeah, I would, I would test it. You know, a thousand bucks a month or whatever. Yeah, would I. What I would call like a decent test.

[Amber]

Okay.

[Chris]

So get it, get it rocking and rolling. I mean, that's really only 30 bucks a day. Right? Like, yeah. And. But the beauty with all of these things is like you can turn it on and turn it off. Right? Like if you turn on, you say, hey, let's go $10,000 this month in Google and in a week you haven't seen a huge increase in, in call volume. Cut it up.

[Amber]

Yeah, okay.

[Chris]

Like, like don't just sit and wait until the $10,000 are spent. Like, like these are, these are things that should work. Or don't work. Yeah, like, it's. It's not like you give it time, let it, let it. You know, like a branding play is something. You have to give it time. Right. Like, hey, we put up a billboard and I didn't get a call right away. Oh, but you got to let people see it six or seven times or whatever else. Digital marketing is not that way. Digital marketing should yield a result. The minute it starts eating in the budget, it.

[Amber]

How do you feel about, like, TV commercials?

[Chris]

I mean, definitely, there's. There's all different kinds. Like, frankly, this is the way I think about anything. If it works, use it.

[Amber]

Yeah.

[Chris]

And I am. And I. One thing I've learned about marketing is, like, it's really hard to judge without testing.

[Amber]

Yeah, okay.

[Chris]

Right. Like preconceived notions, like perception on what. Whether something works, whether it doesn't kills more businesses than actually testing in those things.

[Amber]

Yeah, totally.

[Chris]

Right. And frankly, there's certain industries that just hit way better on certain marketing mediums. Right. And so you. So it's really hard for me to say, like, yeah, TV's gonna work great, because I don't know, I've never ran a podiatry clinic, so I. But it could be like that. These 60 and 70 year olds that are watching, you know, Fox news and baseball and everything else, they see a foot commercial that could be your primary audience, and that makes up 90 of the viewers.

[Amber]

Yeah. Right. Okay.

[Trent]

We'll take a great guy when you want to do that.

[Amber]

A TV guy.

[Trent]

I got a great guy.

[Amber]

Yeah.

[Chris]

Yeah.

[Trent]

I'll tell you about offline.

[Amber]

Okay.

[Trent]

He's great.

[Chris]

I love it. I love it. Amber, we appreciate you traveling this way, coming, sharing with us your experience. Last but not least for anybody that's watching this now that's hung on, by the way, if you've hung on this long, we appreciate you. We love you. Hanging on. What can you share with them how next level has changed your business?

[Amber]

Ah, next level has made a tremendous impact in our business. I mean, like, we talked about, we were negative, it was terrible, and now we're positive. And like, even this conversation, like so many light bulb moments, especially about opportunity costs, like, I'm serious, I'm putting that on our P. Ls from. From now on and like, these very tangible action steps, I've had these over and over again just with meeting with Trent, so.

[Chris]

All right, appreciate it. Thank you so much. Until next time.