Private Practice Owners Club

Nathan Shields

Episodes

Mentioned books

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Apr 7, 2026 • 43min

The Leadership Shift Every Business Owner Must Make To Scale With Spencer Shoemaker

Building a successful business isn’t just about working harder or having the best ideas. At some point, every owner hits a wall where growth stops being about individual effort and starts being about leadership, systems, and the team around you.In this episode of the Private Practice Owners Podcast, host Adam Robin sits down with entrepreneur and business leader Spencer Shoemaker to talk about the leadership shift every growing business owner must make. Spencer shares lessons from the last year of building and scaling multiple companies, including the realization that trying to be the most important person in the room eventually becomes the biggest bottleneck to growth. Instead of answering every question and solving every problem himself, he explains how stepping back, developing leaders, and empowering the team creates real momentum inside an organization. They also dive into the practical side of leadership: hiring the right people, holding team members accountable, creating clear standards, and building systems that make it easier for teams to win.Throughout the conversation, Spencer introduces the Momentum Formula, a simple framework that helps leaders diagnose why a team or business might feel stuck and what to fix first. Together, they explore:Why many business owners unknowingly become the biggest bottleneck in their companyThe leadership shift from “doing everything” to building and developing a strong teamWhy allowing team members to make mistakes is critical for real growthHow hiring for values and alignment matters more than hiring for experienceWhy accountability and clear standards are essential for scaling a companyThe Momentum Formula: Vision, Motivation, Roadmap, and CapabilityHow to diagnose whether a team problem is about clarity, motivation, systems, or skillWhy simple systems and clear processes reduce overwhelm and improve executionThe leadership mindset required to grow multiple businesses without burning outIf you’re a private practice owner, entrepreneur, or leader trying to scale your business without becoming the bottleneck, this episode will give you practical frameworks and leadership insights you can apply immediately. 🎙️ Tune in to learn how strong leaders build strong teams—and how the right systems and clarity can unlock real momentum in your business. 👉 Want help strengthening your operations, leadership systems, and growth strategy? Book a call with Nathan: https://calendly.com/ptoclub/discoverycall 👉 Join the Private Practice Owners community and access resources: https://linktr.ee/ppoclub 💡 Love the show? Subscribe, rate, review, and share! https://ptoclub.com/99.5% of successful owners interviewed on this podcast have at one time or another leveraged a business coach to improve their business. Private Practice Owners Club is coach you need - ppoclub.com
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Mar 31, 2026 • 16min

Using AI In Your Practice: How To Innovate Without Violating Compliance With Daniel Hirsch

Most therapists are already experimenting with AI. But very few understand the compliance risks that come with it.In this episode of the Private Practice Owners Podcast, host Adam Robin sits down with compliance expert Daniel Hirsch of Risk and Compliance Analytics to talk about one of the biggest shifts happening in healthcare right now: AI. From documentation automation to billing analysis and scheduling optimization, AI tools are rapidly entering clinical practices. But while these tools can dramatically improve efficiency, they also introduce serious compliance risks if used incorrectly. Daniel breaks down what private practice owners and clinicians need to understand before integrating AI into their workflows.This conversation is not about hype — it’s about using AI responsibly, ethically, and within regulatory boundaries. If you're curious how AI will impact documentation, compliance, audits, and patient care in the coming years, this episode will give you a practical framework for thinking about it.In this episode, you’ll learn:Why AI is becoming one of the biggest operational shifts in healthcareThe difference between using AI as a tool vs. letting AI replace clinical judgmentThe compliance risks many therapists overlook when using AI documentation toolsWhy HIPAA, security standards, and vendor agreements still apply to AI platformsWhat a BAA (Business Associate Agreement) is — and why every AI vendor must have oneWhy Medicare doesn’t care if AI wrote your note — they care if it’s medically necessaryThe dangers of repetitive AI-generated documentation and why auditors flag it immediatelyHow AI can actually improve compliance by identifying patterns, billing mistakes, and underbillingWhy AI analytics can help clinic owners detect operational risk earlierWhat a scheduling automation and communication tools improve patient adherenceWhy therapists must still review and verify everything AI generatesThe leadership responsibility owners have when implementing AI tools in their clinicWhy governance, training, and internal auditing are essential when adopting new technologyAI is not replacing therapists. But therapists who understand how to use AI responsibly will outperform those who ignore it. This episode explains how to adopt AI without putting your practice, license, or compliance at risk.🎙️ AI is not the risk. Using it incorrectly is.Show Notes:  Join the upcoming PPO Club workshop: https://ppoclubevents.com/04-17-26-workshop Want help building a stronger practice model? Book a call with Nathan: https://calendly.com/ptoclub/discoverycall💡 Love the show? Subscribe, rate, review, and share! https://ptoclub.com/.99.5% of successful owners interviewed on this podcast have leveraged a business coach at some point in their journey. Private Practice Owners Club is the coach you need — ppoclub.comExplore upcoming workshops, free resources, and tools to help you scale revenue without burning out your team: https://linktr.ee/ppoclubWant to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycallLove the show? Subscribe, rate, review, and share! https://ptoclub.com/Annual Strategic Planning will ensure that your next year keeps you focused on on-target to complete your growth and expansion goals. Go to ppoclub.com to talk with Adam about how we can help you.
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Mar 24, 2026 • 15min

RTM In 2026: What Compliance Will Demand From Your Practice With Daniel Hirsch

Remote Therapeutic Monitoring (RTM) is no longer “the next big thing” — it’s here, it’s evolving fast, and in 2026, it’s becoming one of the most powerful levers for revenue growth, patient engagement, and long-term practice sustainability.But with opportunity comes responsibility.In this episode of the Private Practice Owners Podcast, host Adam Robin sits down with Daniel Hirsch, CEO of Risk & Compliance Analytics and one of the most trusted voices in compliance, to break down what RTM actually looks like in 2026 — and what compliance will demand from practice owners who want to do it right and keep the money they earn.Daniel pulls back the curtain on why RTM struggled early on, how recent rule changes have made it far more flexible (and forgiving), and why the practices winning with RTM are the ones that treat it as a system — not a billing hack. Together, they reframe RTM as a tool for controlling time, improving outcomes, and increasing touchpoints with patients, not just another CPT code to chase.They dive into:Why RTM adoption stalled early — and what changed heading into 2026How new payment rules reduce risk and reward consistency over perfectionWhat compliance actually requires when billing RTM (and where practices slip up)Why documentation, timing, and patient communication still matterHow RTM fits into an active plan of care — and where owners get in troubleThe real financial upside of RTM when enrollment reaches scaleHow to think about staffing, vendors, and workflows without burning out your teamWhy Medicare’s continued investment in RTM signals where the industry is headedThis is a practical, no-hype conversation for practice owners who want to grow smarter — not riskier. If you’ve been sitting on the sidelines with RTM, worried about complexity, compliance, or whether it’s “worth it,” this episode delivers clarity, confidence, and a roadmap forward.🎯 Takeaway: RTM in 2026 isn’t about being perfect — it’s about being intentional, compliant, and consistent.Want to talk about how we can help you implement RTM the right way, strengthen compliance, and protect your revenue?👉 Book a call with Nathan: https://calendly.com/ptoclub/discoverycallLove the show? Subscribe, rate, review, and share: https://ptoclub.com/
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Mar 17, 2026 • 18min

Choosing The Right CPT Codes: How To Stay Compliant And Audit-Ready With Daniel Hirsch

CPT coding isn’t what therapists went to school for. But it is one of the most common — and costly — areas of compliance risk in private practice.In this episode of the Compliance Series, Adam Robin sits down with compliance expert Daniel Hirsch from Risk & Compliance Analytics to break down how CPT codes should actually be used — and why most audit problems aren’t caused by fraud… but by bad habits, unclear documentation, and misunderstood workflows.This is a fast-paced, practical conversation about how to stay audit-ready without drowning your therapists in unnecessary documentation.They unpack:Why CPT coding is one of the highest-risk audit triggersThe three questions auditors always askWhy “medically necessary” and “skilled” must be clearly documentedhy total treatment time doesn’t automatically equal billable timeThe biggest mistakes with time-based CPT codesHow lumping treatment together creates audit exposureWhy cloning notes and identical documentation raise red flagsThe power of one strong assessment sentenceWhy therapists often underbill — not overbillHow AI tools may improve justification clarityWhy chasing higher-paying codes can backfireThe single most important rule when billing time-based codesDaniel also explains why auditors aren’t trying to “catch” you — they’re simply looking for consistency, progression, and clinical reasoning that supports skilled care.If you want to protect your clinic, defend your billing, and build documentation that survives scrutiny — without overwhelming your team — this episode is essential listening.🎯 Takeaway: CPT codes aren’t about listing tasks. They’re about telling the story of why your clinical brain was necessary.👉 Want help strengthening operations, leadership, and growth strategy?Book a call with Nathan — https://calendly.com/ptoclub/discoverycall💡 Love the show? Subscribe, rate, review, and share! https://ptoclub.com/.99.5% of successful owners interviewed on this podcast have leveraged a business coach at some point in their journey. Private Practice Owners Club is the coach you need — ppoclub.comExplore upcoming workshops, free resources, and tools to help you scale revenue without burning out your team: https://linktr.ee/ppoclubAnnual Strategic Planning will ensure that your next year keeps you focused on on-target to complete your growth and expansion goals. Go to ppoclub.com to talk with Adam about how we can help you.
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Mar 10, 2026 • 37min

Is Your 'Therapist Heart' And Aversion To Metrics Killing Your Business? With Adam Robin

They explore how ignoring financial metrics can erode culture and morale. They explain tying weekly visit targets to urgency and accountability. They discuss assigning KPI owners, daily scorecards, and clear red-or-green targets. They stress prioritizing schedule fill before optimizing billing. Practical tactics for restoring focus, ownership, and momentum are highlighted.
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Mar 3, 2026 • 1h 14min

The Master the Art of Recruiting Webinar: How to Out-Recruit Hospital Systems Without Matching Their Salaries with Adam Robin, Brian Weidner, and Nathan Shields

Most private practice owners say recruiting is hard. But very few have a real recruiting strategy.In this episode of the Private Practice Owners Podcast, Nathan Shields and Adam Robin sit down with Brian Weidner of Career Tree Network to break down what’s actually happening in the 2026 hiring market — and why many clinics are struggling to keep up. From clinics closing locations due to staffing shortages to new grads locking in jobs months before graduation, the recruiting landscape has shifted. And if you’re still relying on job boards and hope, you’re already behind. This conversation is a practical, tactical deep dive into what it really takes to attract, convert, and retain clinicians in today’s market — without overpaying, overpromising, or operating from fear.In this episode, you’ll learn:Why recruiting in 2026 is not getting easier — and what’s changedHow new grads are securing jobs months before graduation (and why you never see them hit the open market)Why posting on Indeed alone won’t fix your hiring problemThe difference between optimizing for applications vs. optimizing for inquiriesHow to identify and target high-intent candidates instead of spraying cold outreachWhy your offer — not your ad spend — determines your recruiting successHow to extract real value from your clinic’s strengths (culture, mentorship, flexibility, autonomy)Why you can’t compete with hospitals on salary — and why you shouldn’t tryThe dangers of negotiating from fear and bending on compensationHow speed in the hiring process can win (or lose) great candidatesWhy building a recruiting engine gives you leverage in leadership conversationsPractical ways to use AI, automation, and systems to remove yourself from daily recruitingHow consistent outbound effort creates predictable hiring resultsAdam also shares how his clinic went from hiring 18 therapists in one year… to watching momentum stall… to rebuilding a stronger recruiting engine that produced five hires in two months.If you’re tired of feeling like your team has more leverage than you do, or you’re anxious about the next resignation letter, this episode will reframe how you think about recruiting — from reactive panic to proactive system.🎙️ Recruiting isn’t a luck problem. It’s a systems problem.👉 Ready to build your own recruiting playbook?Join the Clinician Magnet Intensive Workshop on April 17th and walk away with a step-by-step, plug-and-play recruiting system you can implement immediately: https://ppoclubevents.com/04-17-26-workshop👉 Want help strengthening operations, leadership, and growth strategy?Book a call with Nathan — https://calendly.com/ptoclub/discoverycall💡 Love the show? Subscribe, rate, review, and share! https://ptoclub.com/.99.5% of successful owners interviewed on this podcast have leveraged a business coach at some point in their journey. Private Practice Owners Club is the coach you need — ppoclub.comExplore upcoming workshops, free resources, and tools to help you scale revenue without burning out your team: https://linktr.ee/ppoclub
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Feb 24, 2026 • 16min

Before You Offer Cash-Pay Services: What The Law Actually Requires

Building new cash-pay services can be one of the fastest ways to grow a private practice — or one of the fastest ways to create legal, compliance, and licensing risk if it’s done wrong.In this episode of the Private Practice Owners Podcast, host Adam Robin sits down with Daniel Hirsch, CEO and Founder of Risk & Compliance Analytics, for an action-packed installment of the Compliance Marathon — a series designed to help owners stop fearing compliance and start using it strategically.Daniel breaks down what most practice owners misunderstand about cash-pay services — including the dangerous assumption that “cash means no rules.” From Medicare landmines to pricing consistency, documentation requirements, and licensing exposure, this conversation gives owners a clear framework for expanding cash services without putting their practice, revenue, or license at risk. Together, they unpack:Why cash-pay services are not “rule-free” — and where risk actually increasesThe biggest Medicare mistake owners make when offering cash servicesHow inconsistent pricing, discounts, and “buddy deals” create legal exposureWhy documentation requirements still apply — even when insurance isn’t involvedHow to clearly separate cash services from covered therapy to avoid compliance overlapWhat must be transparent: pricing, good-faith estimates, refunds, and consentWhy protecting your license should always come before chasing new revenueCommon gray areas where practices get burned — including “free” screeningsThe simple steps every owner should take before launching wellness, performance, or specialty cash programsHow to build cash services that are compliant, defensible, and scalable This is not a lecture on rules — it’s a practical roadmap for owners who want to grow aggressively and responsibly. If you’re thinking about adding wellness programs, memberships, dry needling, laser therapy, women’s health services, or any cash-pay offering, this episode will save you time, money, and future headaches. 🎯 Takeaway: Cash-pay doesn’t eliminate compliance — it changes it. Build your services with clarity, structure, and transparency so compliance becomes an asset, not a liability. 👉 Want access to Daniel’s cash-pay compliance resources and tools?Check the show notes for his free guides and templates.👉 Want help building scalable services, strengthening operations, or avoiding costly missteps?Book a call with Nathan: https://calendly.com/ptoclub/discoverycall❤️ Love the show? Subscribe, rate, review, and share: https://ptoclub.com🧠 Join the conversation and access additional resources: https://linktr.ee/ppoclubWant to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycallLove the show? Subscribe, rate, review, and share! https://ptoclub.com/
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Feb 17, 2026 • 43min

Navigating The Possibilities Of AI In 2026: Realistic Implementations For Private Practice Owners, With Sharif Zeid Of Empower EMR

Most practice owners feel the pressure to “keep up with AI” — but few have real clarity on what actually works, what’s hype, and what could quietly overwhelm their team.In this episode of the Private Practice Owners Club Podcast, host Nathan Shields sits down with Sharif Zeid, longtime EMR leader and representative of Empower EMR, for a grounded, practical conversation about where AI is truly delivering value in private practice — and where expectations need a serious reset.Drawing on years of experience working with hundreds of practices, Sharif breaks down how AI adoption is accelerating faster than any technology wave we’ve seen before — and why documentation, scheduling, compliance, and phone systems are at the center of that shift. They also unpack the hidden risks of chasing tools without systems, and why “AI as the solution” fails without strong operational foundations.Together, they explore:Why documentation is still AI’s biggest and safest win for practicesHow generative AI (scribes, summaries, chart review) is actually being used in real clinicsWhy “perfect” AI is the wrong benchmark — and how partial wins still create massive ROIThe growing AI arms race between providers and insurance companiesWhere AI helps with compliance — and why trust-but-verify still mattersWhy billing automation is over-promised and under-delivered (for now)The real cost of stacking tools — and how to evaluate ROI per providerWhy team overwhelm is the biggest risk of fast AI adoptionThe rise of AI in phone systems, scheduling, and patient self-serviceWhy patient portals and foundational systems must come before automationHow AI should support decision-making, not replace leadershipIf you’re a practice owner trying to decide where AI actually belongs in your clinic — and how to adopt it without breaking your team, your culture, or your systems — this episode offers clarity without hype.🎯 Takeaway: AI isn’t the system — it’s a tool. Practices that win will be the ones that build strong foundations, guide the technology intentionally, and keep humans firmly in the driver’s seat.👉 Learn more about Empower EMR: https://www.empoweremr.com👉 Want help evaluating systems, operations, and growth strategy? Book a call with Nathan — https://calendly.com/ptoclub/discoverycall❤️ Love the show? Subscribe, rate, review, and share! https://ptoclub.com 💬 Join the PPOClub community and access resources: https://linktr.ee/ppoclub
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Feb 10, 2026 • 39min

120% Over Medicare: The Work Comp Playbook Every Private Practice Owner Needs With Josh Farley

Most private practice owners know work comp pays better — but very few know how to actually leverage it without blowing up operations, documentation, or staff confidence.In this episode of the Private Practice Owners Podcast, host Adam Robin sits down with Josh Farley, PT, former state association president, and workers’ compensation consultant, to break down what really drives profitable, sustainable work comp programs — and why so many clinics get it wrong.Josh pulls back the curtain on why work comp is one of the most misunderstood (and underutilized) revenue streams in private practice. With average reimbursement hovering around 120% over Medicare — and even higher in some states — work comp can dramatically improve margins. But only if you understand the systems, players, and rules that govern it.This conversation goes far beyond “take more work comp patients.” It’s a practical, operational deep dive into how work comp actually works — from referrals and networks to documentation, communication, and clinical decision-making.In this episode, you’ll learn:Why work comp consistently reimburses higher than traditional payers — and how to protect those marginsThe biggest mistakes private practices make when trying to “add” work compHow referrals really work (patient-driven vs. doctor-driven vs. case-manager-driven)Who actually approves care — and why confusing case managers and adjusters kills revenueWhy being out of network can completely block referrals (even when people say they want to send you patients)How network pricing strategy impacts volume — and when lower rates unlock bigger opportunityDocumentation landmines that trigger denials and delays (wrong body part, scope creep, poor intake)How to think strategically about work conditioning, FCEs, and higher-level services without wrecking capacityWhy communication — not notes — is the real driver of trust and referrals in work compWhat realistic timelines look like for seeing financial impact (and why this isn’t a “flip the switch” play)How a diversified payer mix protects your practice as reimbursements continue to declineIf you’re feeling squeezed by traditional insurance rates, unsure how to grow revenue per visit, or curious whether work comp could be a meaningful lever for your clinic — this episode gives you the clarity, context, and playbook to approach it the right way. 🎙️Learn how to turn work comp from a confusing headache into a strategic growth engine — without compromising care or compliance.👉 Want to learn more or talk directly with Josh? Reach out at Josh.Farley@LighthouseComp.com or call 601-927-3011👉 Want help building a stronger, more diversified practice model? Book a call with Nathan — https://calendly.com/ptoclub/discoverycall💡Love the show? Subscribe, rate, review, and share! https://ptoclub.com/99.5% of successful owners interviewed on this podcast have leveraged a business coach at some point in their journey. Private Practice Owners Club is the coach you need — ppoclub.comExplore upcoming workshops, free resources, and tools to help you scale revenue without burning out your team: https://linktr.ee/ppoclub
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Feb 3, 2026 • 17min

Why Buyers Look At Compliance Before They Buy Your Practice With Daniel Hirsch

Most practice owners think valuation starts with revenue and EBITDA. But when buyers step in, they look somewhere else first — risk. And more often than not, compliance is the silent deal-killer owners never see coming.In this episode of the Private Practice Owners Club, host Adam Robin sits down with Daniel Hirsch, compliance and risk analytics expert, to unpack what buyers actually evaluate before they write a check — and why strong compliance can increase leverage, speed up deals, and protect your exit value.Daniel breaks down why compliance isn’t about being “perfect,” avoiding audits, or living in fear — it’s about control, predictability, and trust. When compliance is weak or unclear, buyers don’t just lower the price — they change the entire deal structure… or walk away altogether.Together, they dig into:Why buyers assess risk before growth — and how compliance sets the baselineHow compliance issues can stop a deal before financials even matterWhy two practices with identical EBITDA can receive very different valuationsHow weak compliance triggers deeper diligence, longer timelines, and higher deal costsThe real impact of compliance on deal terms: cash vs. escrow, earnouts, reps & warrantiesWhat buyers look for beyond policies — and how they test real-world executionCommon red flags: documentation gaps, supervision issues, credentialing, and unlicensed staffWhy “unknown risk” scares buyers more than managed riskWhen to start preparing (hint: don’t wait until you’re ready to sell)How simple, practical compliance systems can be integrated into daily operationsWhy compliance should add value, not just create overheadIf you’re a practice owner thinking about selling in the next five years — or even just building a business that’s truly durable — this conversation will change how you think about compliance, valuation, and leverage.🎯 Takeaway: Compliance doesn’t kill deals — surprises do. Build control, clarity, and predictability now so buyers see your practice as an asset, not a headache. 👉 Want to learn more about Daniel’s compliance frameworks and access free resources?Check the show notes for his lead magnet and tools. 👉 Want to talk about how we can help you strengthen operations, value, and exit readiness? Book a call with Nathan — https://calendly.com/ptoclub/discoverycall ❤️ Love the show? Subscribe, rate, review, and share! https://ptoclub.com 💬 Join the conversation and access resources: https://linktr.ee/ppoclubLove the show? Subscribe, rate, review, and share! https://ptoclub.com/

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