Don’t Let the Scale Tip Too Far


Strategies to help balance and to experience success in all facets of life

By Michael Manzo, PT, MPT

I was home one evening, allegedly enjoying time with my family (since far too often I would not be home for dinner). Physically, I was in the kitchen, but mentally, I was in the clinic stressing about the pile of work that was mounting on my desk. My then-five-year-old daughter asked me, “Daddy, why do you have that face on?” She squinted and scrunched up her face, mirroring my expression and looking like a very stressed-out little person. At that moment, I finally committed myself to some very needed changes.

Until that point, I had only known one speed in my work life: full throttle. My brother and I started our PT private practice in 2001. We grew rapidly and figured out how to run a business while I was still treating a full caseload. I was stretched and stressed, akin to the frog in the boiling pot of water, not realizing the toll it was taking on me. And with the blessing of a growing family — three daughters in three years — my life began to spiral. There were countless nights when I would be sitting at the island in my kitchen at midnight, catching up on treatment notes and saying to my wife, “It will NEVER change. I could hire 20 more physical therapists and it would still NEVER change.” Guess what? It was not changing! I continued to somehow work harder, see my family less, and complain all the time about how it would never change.

Yet I sit here today with time to write this article. I see my kids off to school and coach some of their teams. We had a bonus baby, and I am fully present to watch him grow and develop. I still work very hard, but I feel that I have achieved what feels like balance in my life. What changed? My mindset.

In the timeless book As a Man Thinketh by James Allen,1 the author describes how each of us shapes the events around us, thus creating the path of our life. Largely, what we believe about ourselves has a far greater chance of coming true than what we do not believe. A change in my circumstances could only occur if I altered my thinking and approach. Once I came to this realization, I started the heavy work toward taking concrete steps to change my situation. I began to take control of what I could do to enable a change, and I believed that a change could happen. Thereafter, a positive change occurred.


I began the practice of starting each day by reflecting on three things I was grateful for and writing them down. The list often repeated. Other times, unique things sprang up. When I focused on what I was grateful for, I started to notice more things around me to add to the list. As my aim changed, my perception changed. An attitude of gratitude crowded out the space that previously was filled by anger, resentment, and frustration. This transformation opened the door to further improvements.


I learned this strategy from Jamey Schrier at Practice Freedom U.2 Jamey says to create a list of all the things that you must do in your week. List personal things, work, household items…all of it. Next, identify which items make you feel like a superhero — invigorated, energized, enthralled. Then, mark the ones on your list that make you feel like a vampire is sucking the life out of you. Finally, identify which vampires you can either delegate or pay someone else to do. What is a vampire to you may be a superhero item to someone else. By removing some vampires, you will free up time in your schedule to allocate toward more of your superhero items.

As I finally mastered the art of delegation — passing off my vampires to team members — the dynamic of our company changed. Leaders emerged. They thrived in their new roles and responsibilities, often doing a better job than I ever did when I was stretched so thin. They felt more valued. Engagement and innovation soared, and our processes improved. Things that I had been giving only 10% of my capacity were now being done by others with 50% of their capacity. Their voices elevated, and the company became more diverse.


Since we live together, it had always been easy for me to cannibalize time I had intended to spend with my family. I would never miss a marketing lunch with a referral source or miss a shift when I was treating patients, yet I would regularly not make it home for the kids’ bedtime or for dinner. But then I started to specifically schedule family time and add it to my calendar. I brought my work level of commitment to my family time and now protect that time fiercely. I also found some crossover that was healthy and fun, like bringing the kids in to the office if I had to go in on weekends. They loved coming with me and would pretend that they were physical therapists working with patients.


Any time that you spend on yourself is time very well spent. It does not matter what you do, but you must take some time for you. For me, this is time surfing on my stand-up paddleboard. In summer months at the Jersey Shore, first light appears by 5 am, and I am there on the water, watching the sunrise and catching waves. I am home and showered before 7 am and off to my day. This does not take any time away from my sleeping family, and I am still at the office as early as anyone. This me time allows me to enter my day with my personal reservoir completely topped off, and as a result, I have great resilience to tackle the challenges of the day. If you are not in a good place yourself, how can you be good for anyone else?


“Be where your feet are” — be fully present where you are — is a motto I try to live by. When you are with a client, be there. Do not worry about the pile of bills to be paid. When you are having a family dinner, enjoy it; do not stress about the meeting you need to prep for later. The more you focus on the stress, the more stress you create for yourself and others.


It is Gandhi who wisely tells us, “The best way to find yourself is to lose yourself in the service of others.” As a practice owner, there are three ways you can advance your own personal growth and balance through service to others: 1) giving your time to your community; 2) committing your business to service to your community; and 3) employing the tenets of servant leadership, which start with focusing on the needs of others before focusing on your own needs. Not only will your scale tip the right way, but so will your staff’s, as research has shown that servant leadership is positively linked with employees’ perception of work-life balance.3

To this end, we instituted an Employee Engagement Program, modeled after a program created by Brian Hartz of Hartz Physical Therapy in Lancaster, Pennsylvania. We incentivize our team to do community-facing work while wearing their Atlantic PT Center gear. They get points for activities like organizing a food drive, volunteering at a local shelter, or donating blood. If they amass enough points, they qualify for a big company-sponsored event. As people do more good deeds, they are inspired to find new ways to contribute and bring this positive energy to the clinic and their patients.


I feel I have succeeded in finding my balance, which may look very different from yours. No doubt there will be times when the scale tilts far heavier toward work than the rest of life. That is OK — it simply means that you have to pay attention and, at some point, take action to ensure the pendulum swings back to the midline. Internalizing this approach and exercising these principles have transformed my life. Gratitude, relaxation, service, acceptance, and focus on the desired outcomes will produce in you a demeanor that will almost guarantee fortune in all aspects of your work and life. 

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1Allen J. As a Man Thinketh. Haldeman-Julius Co; 1924.

2Practice Freedom U.

3Tang G, Kwan HK, Zhang D, Zhu, Z. . Work–family effects of servant leadership: The roles of emotional exhaustion and personal learning. Journal of Business Ethics. 2016;137:285-297.

Michael Manzo, PT, MPT

Michael Manzo, PT, MPT, is co-founder and CEO of Atlantic Physical Therapy Center, which is 27 practices strong in central, coastal New Jersey. He can be reached at

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

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