Selling your practice is not an exit
Paul Martin is the president of Martin Healthcare Advisors, the firm he founded in 1999 to help outpatient physical therapy businesses grow, get ready for a transaction, and take that business to market. This Consulting Rainmakers episode, hosted by Mikulas Zach, is about one idea, in Paul's words: Selling your practice is not an exit.
Is selling a physical therapy practice really an exit for the owner?
Paul Martin: Many sales are partnerships where the owner sells most of the company and acquirers expect them to stay on for years, so owners should begin preparing long before they want out.
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About Paul Martin
Paul played football at Gettysburg College and left it with the idea of building a physical therapy company, so he went to PT school to learn how to run one. He and two partners built a practice from three clinics to 21, with a consultant named Alan Cox spending a week a month with them, and Paul walked out of that transaction knowing he wanted to do what Cox did. Martin Healthcare Advisors serves one industry only, and its team pairs investment bankers with former physical therapy business owners, because due diligence throws up clinical and operational questions a banker cannot answer.
Expect to learn why selling a physical therapy practice is a partnership rather than a clean exit, why the runway is seven to ten years instead of three, the two mistakes that cost owners the most in a transition, where AI is already cutting work out of a deal, why Paul wants a six-to-eight-month transaction down to three or four months, and much more…
Paul Martin: LinkedIn · Website
Chapters
- 0:00Intro
- 0:45From college football to 21 clinics
- 1:42Founding Martin Healthcare Advisors
- 3:29The biggest mistake owners make
- 4:14Choosing the wrong advisor
- 6:13The hardest call he had to make
- 7:38Where AI changes the business
- 9:42What hosting a podcast taught him
- 12:09What actually brings in new clients
- 14:03Find the people ten years ahead of you
- 18:26The leverage you build years before exit
- 19:53Why it takes seven to ten years
- 22:42The next 24 months
- 24:56Where to find Paul
Transcript
So welcome back to Consulting Rainmakers. my guest today is a president at Martin Healthcare Advisors, Paul Martin. What a coincidence, and also a podcast host, which is also very interesting. And he has an impressive backlog. So Martin, let us start at the beginning. It's good to have you here today.
Thank you, Mikklas. It's great to be here.
So tell me, you've been running a business where you advised practice owners kind of through transitions. how did all of this come together? Was the story.
Yeah. So the story is gosh, going way back, I went to Gettysburg College, played football at Gettysburg College, and that's really when I had an idea in my mind that I wanted to start a phil physical therapy company. and I think the confidence I gained from how hard I worked in football and the results that we had. You know, prompted me to then go to physical therapy school. But from the very beginning, I knew that I was in physical therapy school to learn how to build a physical therapy business. We did build a dis business, myself and two partners. we grew a business to 21 clinics. We used an advisor to sell that business to Novicare all the way back in 1996. I spent three years with Novacare, primarily working in their acquisition department. And in 1999, I left Novacare and started this company, Martin Healthcare Advisors. And in this company, we really do three things for the physical therapy business industry. And that is we help businesses grow, we help businesses prepare for the market, and then we run a full professional process taking companies and taking them into the market, finding the best partner.
Right, that's great. And from your experience, what sort of type or in industry do you serve the best?
Yeah, we serve really only one industry, and that is the outpatient physical therapy industry. ABA applied behavioral analysis has sometimes been a another industry that we have done some work in because there's ABA clinics that have therapy and therapy clinics that have ABA. So we've done a little work there, but we've really become complete specialists in. As I said, growing, preparing, and taking physical therapy businesses, small, medium, and large size businesses into the market, getting them the best price in terms and the best partner.
Yeah, that's great. The kind of power of niching down, as they say, and being expert on one industry. I think that's a big thing that most firms don't do, right? Is they boil the ocean, as they say, and they offer everything to everybody and Tell me more from your experience, what sort of mistakes do you see these physical therapy businesses make when it comes to transitions?
I think the first mistake is they try to do it themselves. And I think that is the biggest mistake you could ever make. You're taking your life savings, essentially, the biggest asset that you'll probably ever have in your life. And you're going to try to then take that business and sell your business, and you're going to be the only person at that negotiating table that has never had that has never done this before. And so I think that that becomes the biggest mistake I think that business owners can make. The other is choosing the wrong advisor. And I say that because when I built Martin Healthcare Advisors, I had attained a degree called a certified business intermediary and a mastery level intermediary. And in attaining that degree, I learned how Main Street business brokers work. Mainstream business brokers are really good at relationships with their clients, walking them through every step in the process, staying right by their side. I also learned about how investment banking companies worked. Investment bankers and investment banking companies that lead mergers and acquisitions, they have a discipline, they have a process, and they have a way of putting all the companies on the same starting line at the same time and running that process. What we've done is we've taken the best of both of those worlds. We've hired investment bankers, but we also have physical therapy, former physical therapy business owners who have built companies and have sold companies. And we put our entire team on the line when we are working with a company going into the market. There are questions that investment bankers related to due diligence will never be able to answer because they're physical therapy questions. They're down in the dirt operations, clinical type questions. and our physical therapy business owners, they're able to answer those questions without a problem. So we've assembled a team that I think is very, very unique certainly to this industry. and For our clients, we believe we built the b we've built the best team.
Hmm. Tell me about kind of your hardest call that you had to make throughout all of these years that you've been running the firm.
Yeah, it it was a very difficult call I had to make. it was probably eight months ago. And somebody who had been working at the firm, an analyst had been working with our firm since 2017. And it just got to a point where his skill level was not matching the folks that I put around him. and so Folks in the company started losing some trust. great guy, great with our team, but just could not keep up with the at the level that we had become. And so I had to make the decision to replace him. And that was a very difficult decision.
Hmm. Yeah, it's it's I can only imagine when you have a relationship that's strong, right? Throughout all of the years. And then but it's for the better of others also. You have to keep them accountable and yeah. When you look at AI, I think we we talked about this off record. Where do you see AI really changing the game for you, either in personal or business?
Yeah. So in our business, we use AI primarily for research and efficiency. And there is research that AI can do that we always, absolutely 100% always ask AI to then give us the links so that we can go in and check the research that has been done. And so we've used AI for again research. We've also used AI just to make us more efficient. And so if we can feed into Claude how to build certain models and how to build certain spreadsheets. And we're able to then go in and double check that. We're able to work faster. And it is The efficiency of our process. I think where it has helped the physical therapy industry, I think first and foremost, it is helping the industry in helping physical therapists who are very difficult to hire, and who are many of them are young, wanting to use AI, and they're able to no longer go home at the end of the day with a stack of notes. That they have to continue to do on the patients that they've seen. And, you know, Front Desk is able to get verifications with an AI agent. So I feel like at the at the level of the clinic, that AI has been transformational in allowing physical therapy businesses to be able to see more patients and to be able to be more efficient and to not have to, you know, burden physical therapists. With having to take home stacks and stacks of notes at the end of the day.
Hmm. Tell me more about your podcast. you have much more episodes recorded in the backlog, so tell me what what has been some interesting kind of takeaways now looking back, you know, at all of the episodes that you have done.
Yeah, it's the learning that I'm able to experience when we're reaching out and we're talking to business owners, we're talking to CEOs of companies that are the acquirers in our industry, finding out and understanding their strategy and the types of companies that they're looking for. So it's also been just a great way for me to connect with folks in the industry. we go to all the conferences and you know we're we're out on social media, you know, somewhat, but you know, for to be able to, as you know, when when you do a podcast, that could be the start of a relationship with somebody. And I have found over and over and over again that when we are doing podcasts and we are able to engage folks to come on our podcasts, it's a great way to, again, for me to learn as well as to to put great content for those in the physical therapy industry to be able to come and watch. And a great way to engage folks out there to stay connected.
Right. Yeah, that's exactly spot on what I found out. And you know, for me the the bonus is is I can improve my English speaking skills. So it's a it only has benefits, at least from what I found out.
Your English is a okay, Micholas. A okay. You're good.
Yeah, by by Cambridge, it's somewhere between B two and C one, but I I really don't think it's at the level where I can have these conversations without stuttering, so I'm still kind of getting the hang of it. tell me, you've already kind of answered my next question, but In terms of your marketing efforts, what has been really working to, you know, drive new business for you? Is it people referring you from the great work that you've done or are you running ads?
Yeah, really good question. I think the place that we get the most of our clients are attending conferences. we attend just about every large physical therapy conference where there are physical therapy business owners. and I speak at those conferences almost every year. I think second to that are referrals from former clients. And that's where we see a lot of our business coming from. and you know, when you have a referral, there's already trust, that that that built-in trust. And then after that, I think it is the video work that we've done and putting out videos, putting them on every podcast link that you can possibly have. And what we find that that does is it it's a way to build trust. Once somebody has been able to be on and watch you in a podcast. And you know, they almost feel like they know you. And getting to know somebody, I think, is the first step in trusting somebody. So we've done a lot of work. And what we find is once somebody has watched our video, they call me and they say, I've been watching your videos for a number of years. And immediately I say, Well, this person has that first step in in the trust carrot category. and I think that's a big part of. the clients that we do have is that we have to build their trust. And if we can do that online and in other ways, you know, we we we certainly start there.
Hmm. Do you have any good advice around just business and entrepreneurship that you've learned kind of throughout the years?
Yeah, I do. And I and I I do a lot of that work, especially for the college right back there. You can see the Gettysburg College Bullets. I've stayed in very good contact. actually recently was inducted into their athletic hall of honor. And I have a whole handful of football players from Gettysburg, as well as other students at Gettysburg that I talk to routinely. About where they're headed, you know, whether they're going to physical therapy school or business school, whatever it might be. And what I tell a lot of them is that, you know, being successful in business does not have to be completely reinventing the wheel. Look for people that are three, five, ten years ahead of you. And what do you strive to be? And if There's someone out there, or maybe multiple people out there that are what you want to be. You can learn from them. Now there's opportunities to watch some of these people on their podcasts. But you can also just pick up the phone and talk to them and see if they would be willing to talk to you about how you could achieve what they've achieved. You know, in many industries, there's not only one successful person in the industry. you know, I can tell you back when I was in physical therapy school, there was a guy by the name of Pat Croce. and he had a large physical therapy business, and he also became the owner of the Philadelphia 76ers. And when I looked at him, he and what he had accomplished, said, you know what? I think I want to be him someday. And I went and visited him at his beach house. I had many breakfasts with him, and he was never shy to help me along the way. there was a guy by the name of Jim Corey who would be on the radio and talked about staying in shape and you know, and that was something I also always wanted to do. And I did that for a period of time early on with my company with physical therapy sports services. I got on the radio and and talked about how to stay fit and how to stay healthy, et cetera. And so again, it was it was seeing people that were ahead of me and then trying to understand what and how they did it. and I know you younger people think you need to change the world, but there is ability to be successful and follow what others have done and then put your mark on it. And I feel like I've put my mark on the physical therapy industry.
Ha ha ha. Yeah, I think you're totally right about this. and I think it's one of the kind of biggest misconceptions that for example, I'm still in university and some of the things that I learned, for example, are very useful, but there are there there are some concepts like as you said, reinventing the wheel and kind of start trying to start the next space X. which you know is not needed like most people don't want to be billionaires and most people just want to have and make a good living and help people and you can do that with a existing model and so totally with you there
And I'm all for if there's somebody out there that's a billionaire and you want to follow that track, you can follow that track. There are pluses and there are some minuses of being a billionaire, right?
Right. And you know, that's the big question if you're ready to take and make those sacrifices. what what I found pretty interesting is on your LinkedIn headline you have something that says that the leverage an owner needs at exit gets built years earlier. So tell me.
Absolutely. Absolutely.
What what does it mean? And if you could go back kind of to, you know, year one, twenty seven years ago when you were starting out, what's one thing that you would have built sooner?
Yeah, I think as far as physical therapy business owners and them, you know, you know, preparing years before, in the physical therapy industry, when you when you sell your practice in the physical therapy industry, many of the sales are really partnerships. So I sell 70 or 80% of my company, and then the big company becomes a partner with me. They own 20 to 30 percent. And so because of that, most physical therapy acquirers are looking for former owners to stay on for minimum, minimum of three years, and in most cases, more like five years. So if you want to prepare for your ultimate exit. It can't be start preparing three years before you want to be out and not working anymore, because you can't give then that acquire that three to five year commitment. So business owners in the physical therapy industry really have to start somewhere between seven to 10 years. Because in most cases, it's two to three years of preparation to really get your business ready to sell. Unless it's something that you've been doing, you know, since you started it, you know, and unless there's been some consultant that's been working with you to make sure that business has always been ready. But most business owners, their business is not ready. It takes a couple of years to prepare, then they do their deal, then they have another three to five years. So as far as physical therapy business owners, I think that's that's seems to be the time frame that they need. I started looking at this business, Martin Healthcare Advisors. When I was in my final year or final three years of being in my business called physical therapy and sports services, we hired a consultant in 1993 by the name of Alan Cox. He would come and spend one week a month on site with us. And I learn so much from him. First, he helped us grow from three clinics to 21 clinics. And in his company, it was called Cox and Associates. He had some others, and he had run a large physical therapy business of over 100 clinics. So he was the perfect company in person to help us through our transactions. And having that assistance through our transaction, I knew right then that I need I I looked at Alan Cox, I said, I want to do what he is doing someday, help companies grow and help them successfully partner and sell. And so I modeled this business really after a lot of the things that he had taught me. And then, as I mentioned earlier, trying to bring it all together with the investment banker approach, the main street business broker approach. And the approach of physical therapy business owners who know inside and out how these businesses run and operate.
Right. Yeah, it all comes down to finding someone that's as you said, few steps ahead of you and really kind of walking the same path as them. what's your next goal in the foreseeable, you know, twelve, twenty-four months? Everyone talks about growth, but what is it for you?
Absolutely. Absolutely. Yeah. you know, my clear goal over the next 12 to 24 months is to continue to try and work on ways that we can serve companies in this industry that want to grow. They want to grow and they're gonna need recruiting, they're gonna need marketing, they're gonna need all the things that drive the top line revenue down to the bottom line. That's charge capture, that's schedule management. And for us to just continue to get better and better and more efficient at helping those companies get to the point where they want to get to sooner. So if in the past it's taken us one year, two years, three years, I want to take that down to one year, six months, three months. so that that's my that's my primary goal on the gross side. On the execution of a sale process and a professional sale process. I want to be able to have our team be able to move that process even more efficiently than we do currently. And we move it very, very efficiently. I know we can get better at that process. We can start to streamline the due diligence process. And in some ways, if we're working with acquires that are also utilizing AI, I think we can squeeze that timeline. From now, which is a six to eight month process, down to a three or four month process. And I'm hoping the acquirers are gonna come along for the ride because our business owners that we represent, they're ready to do it faster. Six to eight months going through a transaction is a long time. We take the bulk of that work on us, but it still is a long time and it's very, very emotional for business owners. So those are my two biggest goals. on the gross side for physical therapy business owners and on the transaction side.
Hmm, wonderful. Well, we'll see how it plays out, and I'm happy to do another one. this was Paul Martin. Where can people find you? What's the best place?
Yeah, on our website, www, in the name of our company, dot martinhealthcareadvisors.com. my email address is pmartin at the same martinhealthcareadvisors.com. But we are on YouTube, next level owner podcast. We are on LinkedIn, we are on Facebook, we are on Spotify. we're on about just about every podcast, and it's next level owner, Paul Martin.
Sounds great. Well I will leave links down below and Paul thank you for joining.
Mikolas, this was this was fantastic. Thank you for having me.