Do You Have a “Who” Problem or a “How” Problem?


By Paul Gough, BSC (HONS), MCSP, SRP, HPC

If you are a physical therapy business owner, manager, or clinic director, the feeling of burnout is something that you are likely to be familiar with. Can you relate?

If you are working too hard, which can lead to burnout, the first thing you have to ask yourself is this: Do you have a “Who” problem or a “How” problem going on in your business?

So many business owners get stuck doing tasks that someone else should be doing. It’s easy to say “get someone else to do it for you,” but when you dig into the question further, the real problems you are likely facing will present themselves to you. And once you know what the real problems are, you can work out a solution.

For example:

If you are stuck inside your practice doing something like marketing, for example, and you don’t like to do it, don’t want to do it, or get frustrated because you are not very good at it, then the option is to outsource it! First, agree with yourself that outsourcing would be the better solution. Then, when you realize that you don’t/can’t/won’t want to make that decision, ask yourself why.

Are you avoiding the decision because you don’t know Who to hire or because you don’t know How to financially since your current revenue doesn’t support the financing of the hire? Whatever is the answer, there’s a solution when you keep digging beneath the surface.

If it’s a genuine Who problem, then it’s about getting clear on what a successful outcome would look like for you. That could be someone who is able to bring in an extra 10 patients per week via Facebook or Google, or design ad campaigns that bring in cash-pay patients. You want to see evidence from someone that they’ve run a marketing campaign in the past that has generated cash for the business they were working for.

Alternatively, if it’s a lack of revenue issue, then you may need to look at changing the business model. This is classic cause and effect. If the effect (the lack of profit) is happening because reimbursements are too low (cause), then working out How to convert 20 percent of your insurance patients to cash-pay at twice the price may be the solution.

Either way, when you adopt this type of thinking and ask yourself quality questions like this, you start to get closer to a real solution to avoiding burnout.


Paul Gough, BSC (HONS), MCSP, SRP, HPC, is a former professional soccer Physiotherapist and founder of the Paul Gough Physio Rooms, 4 Clinic Private Physiotherapy Clinic in the UK where health care is free. He can be reached at paul@paulgough.com or www.paulgough.com.