0:00:02 - Mark Henderson Leary

Welcome to Practice Freedom. What if you could hang out with owners and founders from all sorts of healthcare private practices, having rich conversations about their successes and their failures, and then take an insight or two to inspire your own growth? Each week on Practice Freedom, we take an in-depth look at how to get the most out of both the clinical side and the business side of the practice, get the most out of your people and, most of all, how to live the healthy life that you deserve. I'm Mark Henderson Leary. I'm a business coach and an entrepreneurial operating system implementer. I have a passion that everyone should feel in control of their life, and so what I do is I help you get control of your business. Part of how I do that is by letting you listen in on these conversations in order to make the biggest impact in your practice and, ultimately, live your best life. Let's get started. Welcome back, practice leaders. 

Another great conversation coming up, this one with Michael Silva. He's a great guy. I love the conversation. I was excited to talk to him because I know he and I kind of grew. He's a business coach now and his background is 25 years of fitness and healthcare. He ran his own practice that he grew across multiple states and ultimately, after having run it for 20 years, sold it and has a lot of experience there, and so our conversation really digs into. Well, we start off. I'm thinking we're going to talk about exit and what's going on with sort of growth and exit, but that's not really where we went. We really talked about the growth mindset of him as a leader, and what's really been on my mind lately is strong and passionate leadership, and I think what you hear in the narrative is his mindset shift into people growth and how he did that and how that manifests. So I'm eager to get some feedback from you guys. I think it's valuable. 

I think it's a good mindset to compare to how much of this are you doing? Are you stuck doing this? Is this you? Is this not you? Is there another way? So before we dive in, of course, the reminder is if you're stuck, don't stay stuck. Please reach out If you want to create a high value practice that gives you the life you deserve. That's realizing your vision. But if you're stuck, in some way, please reach out. We don't want you to stay stuck. Practicefreedomcom slash schedule. Take a few minutes to get you unstuck and see what a next step or a first step could look like for you. But with that and no further ado, michael Silva. Well, good morning Michael. How are you, sir? I'm doing wonderful. How are you doing? I'm really well. Catch me up, since we last talked, what's going on in the world of scaling and selling practices? 

0:02:40 - Michael Silva

Coaching people to do that anyway. It's funny, you ask. I just got back from one of our industry conferences in the APTA and the private practice section. It's all practice owners from all over the country coming together learning, connecting, networking, drinking. It was a very good three to four days. 

0:03:00 - Mark Henderson Leary

So what did you learn? I got some thoughts, because one of the things that keeps coming, up is investment private equity, the industry, this and all that. So what did you learn? What happened? What's actually the? I got some thoughts, because one of the things that keeps coming up is investment, private equity, the industry, this and all that, so kind of what's what's trending? 

0:03:10 - Michael Silva

Yeah, so that's still really hot in our industry, as you know. You know the the unfortunate trend is everyone's still just pointing fingers at. You know, private equity and insurances are destroying everything and they want to keep pointing fingers. And I think there's a small percentage of practice owners that are realizing we can control a lot of this and we can make it better, which is why I love and why I'm still in this industry and trying to help practices, because I think these passionately led private practices are going to be extremely successful and fulfilling for people, and I saw a lot of that. So there's a lot of the finger pointing it's their fault, it's their fault. But then I see a lot of people like no, we can do it different. Let's not fall back into that like we've been doing for the past 15 years. 

0:03:55 - Mark Henderson Leary

Okay, man, you absolutely hit the nerve for me right now. I didn't predict this, but I have, and it's the passionate leadership, and so context for this is that I teach a system and I. The system is so powerful for helping people manage and create accountability, and create a strong communication and solve for the complexity of management, and so it's so powerful and simplifying. It is not a substitute for powerful leadership, though, and and I and I could go on and on, but I'll but you talked about that what do you see in powerful leadership and passionate leadership? What? What is that to you? 

0:04:34 - Michael Silva

so powerful. Leadership is just not a strong personality filled with ego and um like courage and I was going to use a derogatory term but I'm not going to do that but passion leadership is, you know, um having a passion for either a niche or a community a niche or community and then um trickling down that passion and finding the people that share that passion with you. You know, and I think passionate leaders help build their teams up, which leads to successful passionate teams, successful passionate practices. I just don't like dictator type approaches to business. Maybe it's because I wasn't like that and I've worked for people like that that did not enjoy that early on in my career. So I think, empowering others, sharing the passion, fueling together, empowering others sharing the passion fueling together. 

0:05:32 - Mark Henderson Leary

Beautiful things happen when you get a bunch of passionate people on a like mission, which is what I think is extremely important. 

Yeah, I think it's a complex, sophisticated message, because I think we can and I can get excited around the phrase like passionate leadership and you got to lead strong. And then there's all this mixed message of servant leadership and listen well and empower people and the things that go with that, and I think that this is the real subject that we need to, you and I, in the next 30 minutes or so and, as a community, show some examples, because I don't think you can give a formula that always resonates, which is my phrase. Again, it's a concept. You know, you've got to have high standard of excellence for your truth, for your leadership, which hopefully includes servant leadership, empowerment, teaching, mentoring, but not laying down and being sort of weak in the face of poor execution. Or, you know, this is again the mixed message Like, oh, you got to allow them to make mistakes, which is different than they're actually ruining it, ruining it, actually sinking the ship. You have to know the difference. 

0:06:46 - Michael Silva

Right. I think there's the art there of a true leader, right, and I use the term. Fortunately I didn't have to do it too many times. But if I had someone who wasn't stepping up and either behaving in a level that I'm expecting or treating our clients on a level that I'm expecting, I would have these conversations and then, yes, I was a kind person, but I was not a weak person and I would say don't mistake my kindness for weakness. And like, just because I'm being empathetic and giving you another chance and mentoring you and I take responsibility for that too. If I have someone on my team that's just not getting it, shame on me for either missing that in the interview process, not mentoring and onboarding them properly. 

So I took it as a personal, like a personal failure in my business. Yeah, but I think like I wish I could say I did it perfect. All the time I tried to lead by example, lead by kindness, set the bar high but also demonstrate that I'm going to meet that bar or exceed it every time. But I'm sure when I was younger, like maybe I don't know if all guys are the same, but my young male ego is all about me and I'm sure I didn't lead in a great way early on in my business, but I think I evolved as I aged and learned from my mistakes and became a more, more empathetic and uh, mindful leader. I would guess I would call it. 

0:08:02 - Mark Henderson Leary

Is there a point you think that empathy leads to low standard of excellence? 

0:08:07 - Michael Silva

Yeah, I think if you lean too much on that side, for sure, again, that's where the art comes in and I think it's different with different people. It's the key of being able to understand people and develop good relationships with your employees, but still have that I'm the leader, you're part of my team, part of this mission relationship and I'm sure we've all made mistakes on leaning towards too much leader or too much on the friendship side of things. 

0:08:35 - Mark Henderson Leary

Yeah, see, I think that, in theory and this is where it's tricky that I think that it allows me to go back to the principles and say that I don't believe that's the case. I believe you can be 100% empathetic with someone else and have total high standard of excellence. I think, though, that it becomes an imbalance of empathy toward yourself, and that is I know this person is struggling, and am I going to give to them more than I can afford to give up? Okay, okay, put the empathy back in yourself. I have an accountability to lead this organization, and it is very hard for me now to do that, and I'm going to have to give myself some grace about the difficulty and the sacrifice of maybe firing someone or telling someone that they cannot be put back on the field. Somebody wants to help Put me in, coach, I got this. You know I love your enthusiasm and this is a very hard conversation for me, but you cannot play, rudy. 

0:09:34 - Michael Silva

That's right. I hate those conversations. They're so tough. 

0:09:37 - Mark Henderson Leary

Yeah. 

0:09:38 - Michael Silva

Yeah, yeah, for sure. 

0:09:39 - Mark Henderson Leary

And I think it's easier just to be able to for those people which I'm not in that category, to just sort of lock down and say I'm going to stop feeling anything for myself or for you. 

0:09:49 - Michael Silva

The leader, you're saying yeah, yeah, yeah, exactly. 

0:09:52 - Mark Henderson Leary

It's like, okay, this is starting to get complicated. I'm starting to feel mixed emotions about the difficulty here, so I'm just going to shut it down and I'm just going to get tough and we're going to go. 

0:10:03 - Michael Silva

Done that Weirdly though. 

0:10:04 - Mark Henderson Leary

Yeah, yeah. 

0:10:05 - Michael Silva

Yeah. 

0:10:05 - Mark Henderson Leary

And I'm not good at that. I'm not, and so that's why I need people around me who can kind of call the BS, and that's truly the secret of when I'm successful. You can see it, and I've got the right people around me who can bring back to me the truth and say like Mark, you know you're hyper-rationalizing here, you're doing something that's that's not and you know it. And it's like yeah, that's true, and I can behave well if that, if I can see that, right, but if I'm locked in a closet with myself, uh, I have to really learn to give myself some stern talkings to in some pain, to give myself some empathy and say you deserve better. 

And this is that's the weird message, like it's probably hard for a lot of people to understand. Like leading is oftentimes this organization, this vision, this mission deserves better. Raise the standard of excellence. Trust that these people who are not fits in your organization will take care of themselves. Again, we're lots of nuance here. Themselves, that's again, we're lots of nuance here. Sometimes we over we, you know, we enable bad behavior because we're thinking, oh, this person's not succeeding in this position with us and and so, but I got to help them. Well, you don't necessarily. They're probably an adult and they and if you say, hey, I wish I could help you in the next phase of your journey, but I can't because I have a job to do, I'm sure you'll do. Well, ask me for help along the way, but in the meantime, you know this road has ended. 

0:11:30 - Michael Silva

Right, I like how you said they're probably an adult because they look and maybe act or everything about them looks adult-like. But, as you probably know, there are many adults that are very childish, right. And going back to the empathy thing, like, yeah, I lacked empathy in myself because I, but, as you probably know, there are many adults that are very childish, right, yeah. And going back to the empathy thing, like, yeah, I lacked empathy in myself because I was much of a people pleaser most of my life and I used to give people the benefit of doubt and I actually, early on in my career, settled for mediocrity, which I now am so against, because, well, if I get rid of this person, then I got to go back to the hiring and we're going to be short staffed. 

And then I got to do more and you get caught up in that and I always and I had this feeling for a small point in my business where I needed people more than they needed me, and it took my wife, who she helped me start the business. She's a PT as well and she was the top one. She's like you got to get rid of that one. You got to get rid of that one. You need to step up. You need to do this. It was having that in the back, in my back pocket, which was extremely helpful to get me out of that people pleasing, I need them, I need them and um, and then I just decided I'm never again going to settle for mediocrity and I think that led to you know, arguably a pretty successful company that we had. 

0:12:41 - Mark Henderson Leary

Yeah, I had, I had a mentor at one point, talk to sort of coach me around this idea of sometimes people like you, mark, get it, you know, start working on something and it doesn't work. You just keep trying harder on that until and you know, keep trying harder and harder. And at the time I was like, well, what else would you do? Like yeah, he's like that's the plan. 

You follow through on the plan, and it took me years to hear what he said, which was let go of the plan, like if you're going down a path and it runs out of trail, don't keep necessarily pulling out the machete and going on the trail. You might need to go back and find another path. And I think that people like me, the visionary mindset, we get committed to the plan and we feel like we're on the path to something behind schedule, already urgently needing to get there. And for me to admit failure in this person, this process, is to say that not, I'm going to take steps back, we're going to get even further behind on this. 

And there's this so like no, we cannot go backwards. And there's there's this unwillingness to say that if you keep trying to go forward, you're actually getting more and more stuck. Yes, it's you. It's a sacrifice to take two steps back, but without that you're not going to be able to make any progress. And this which ties into what you were describing If I fire this one person, I got to fire 15 people and I got to solve all these problems at once, and so it all becomes overwhelming in the moment, right, right. 

0:14:19 - Michael Silva

And with you, I can assume just the type of person well, you're macheting that path because you're driven right. You don't want to maybe admit that the process or the people are failing. With me sometimes it was a stubborn mindset where this is the only thing I see. Like I got the blinders on, like I don't, I wasn't open minded and seeing other options like this is the way. Oh no, that's exactly where my mind exactly where I'm. 

0:14:42 - Mark Henderson Leary

Certainly there can be a commitment, but I think that commitment comes from awareness. You take a step back and you say does this still work? Is this? Because a lot of times it's super demotivating that it's you're not getting traction right, and and so the mindset to me has definitely been exactly what you described like I would do something else if there was something else, but, but I really haven't tested if there was something else, but, but I really haven't tested if there is something else. I just sort of was holding this belief that there was not something else, and it really took some space. I tell her we talk about him as clarity breaks, as a leadership, leadership role, like get a step back, ask yourself some bigger questions like what's working? Have I truly considered the options? Get out of the fray a little bit, because that adrenaline and that sort of urgency and the scarcity mindset of like it's you know they're coming for us. We got to get this done. That is not create, does not create creative thinking, no, no, it's almost. 

0:15:42 - Michael Silva

It's almost space, almost fear at that point right 100, yeah, yeah that not very. 

that's not a long-term strategy. And on that point, marshall, like I mentioned, my wife it was. She was in and out of the business. You know we had children. She stayed home with the kids, um, and then I think I got the most clarity when I hired a business consultant early on when we started growing and I was like overwhelmed in a good way, like we were busy, and I'm trying to hire and I'm hiring just any anyone with a heartbeat, you know, making all the mistakes that a busy young entrepreneur does. But then getting a new set of eyes and to see that things clearly because I wasn't, because I was so entrenched in the business and then sitting down and having someone with no emotional ties to your business say you're not doing well here, you're not doing well here, you're not doing well here, that person's not right for the business, this process thing. 

Well, it was so humbling. But at that point that's when we I think I became a better leader in the business improved, because I needed some. I need someone to show me the clarity, because I couldn't see it. I was so entrenched, I was so like adrenaline, I was so flooded I couldn't see anything, which, um so I, I, I loved my consultant. I still talk to her to this day, even though she's been retired for years and it really helped. 

0:16:54 - Mark Henderson Leary

So I'm guessing that, if you're like me and and and many people, that you were not open to that feedback from just anybody, no, how did you find the opening in yourself and the person who could go through that opening? 

0:17:12 - Michael Silva

So how did I find that? That's a really good question. 

0:17:17 - Mark Henderson Leary

Because where I'm going with that is, I've recognized in my past so many times I deflected and pushed away, and part of it was the people giving me the feedback weren't the right voices with the right message Like you're not in my business, you're not in my situation, you don't understand Right, and that was true, and so it contaminated their perspective and I don't think I would advise myself to go back and start taking the advice of just anybody. But it was like there was a very different thing when somebody who showed up in my life and similar advice, maybe not exactly the same, whereas we did land, and it was like oh yeah, ok now it stings, now I can grow, and unlocking those tumblers is so important, and the faster you can do that, the better you are. 

0:18:03 - Michael Silva

So, amen, yeah, how did you get there? Um, my wife's like so. Again, early on, with my male ego, you know, I was the face of the business. I was running it and I was succeeding. I was growing. I had a, you know, I was in the running world and I was growing my reputation as the man to go to for being a runner. I started growing this practice. I had employees, so my, my ego was getting bigger and my wife was home and you know she's my wife and she's giving me advice. I'm like, well, you're home with the kids, like, and you know, taking advice from your significant other can be tough at times. And then she's like you need help, like this is out of control. Um, and then when I finally met this consultant who I immediately clicked, I didn't have to go through a few. 

She was much older than me, just had this really motherly approach, which I think you know, the little boy in me needed, you know, and I don't know if it was some like young guy in a, you know, a $3,000 suit, I might not have listened, but she, you know. And then and I've admitted this many times over the years she gave me some of the same advice my wife did, but I didn't listen to my wife, but listen to this woman, because I paid her and what she wasn't. My wife, yeah. But so I think I'm so fortunate and lucky and when I was using, I guess you could call her a coach or consultant. 

Back then they weren't as many of us around right now, at least in our world, like so many people call themselves a business coach, business consultant. Some of them are extremely good and valuable, some of them, I don't think, are. But um, I was lucky to find her through, uh, another practice owner and, um, you know, just clicked. And I'm glad I didn't have to shop around and, yeah, it was just the right person at the right time to fill the need. Um made me aware that, um, you know, I could be a better leader, I could run a better business, I could be more efficient, and it just all clicked, man, I was so fortunate that I found that and was open enough at that point and you know my wife was involved and got us to the point where we brought her in and it really helped. I don't know if I answered the question there or not. 

0:20:06 - Mark Henderson Leary

No, it's great. Well, yeah, no, I think you nailed it. Okay, I think it's well. I mean, let's unpack it and make sure the formula is reusable, and that was somewhere in there. You got some reflection in a mirror. That was something might not be working, which created a curiosity in you and a willingness to be open to something. And then there was a search to go find a source that was credible, and when you found it, you went with it. 

0:20:35 - Michael Silva

Amen, right, yeah, that's a perfect summary, and I'm not sure who held the mirror in front of me first, either my wife or the consultant or both but it worked and I'm really glad I looked into that mirror. 

0:20:50 - Mark Henderson Leary

I mean, I'm sure it was your wife. There was something in there that made you open to something, if anything, just to say like, well, I'm sure she's wrong, let me go find somebody who can prove that she's wrong. 

0:21:04 - Michael Silva

And so, yeah, I told you, I was right, I told you. 

0:21:08 - Mark Henderson Leary

Exactly, and in the jury you found somebody who you trusted Right, I think everybody. 

And I think that everybody I say this a lot, especially in health care there's a lot of belief that that physicians and healthcare providers in the organization are not the kind of people who want to be led. 

And that is not true in my belief, a hundred percent. Everybody wants to be led, if only by their God, whatever they feel that is, whatever their most important guiding principle or thing or power is, and so we just got to rise up to that and we as leaders need to recognize that if we're the most powerful leader in our world like how lonely should we feel in that moment? Like there's always somebody, something that can teach us something deeper and powerful. And so I think of the calling at some point is to maybe there's a youthful exuberance, like I've got enough fuel to go down the path and sometime down the line it's like whoa, where am I going? That's right, I need some help here and hopefully without extreme narcissism, sociopathy or psychopathy, there's some awareness. So, like you know, I I can learn from people and I can do better by by being humble in some capacity and finding that Right, and I think you said something about youthfulness. 

0:22:30 - Michael Silva

I think, like youth can mask a lot of mistakes and bad things, like I'll just work harder, I can do it, I got the energy, I got the time, I've got the physicality to do it. And, um, as you get older, when youth starts to slowly get away from you a little bit, um, then you really need to start opening up. And you know it's it's very cliche, but, um, I realized around that time that I needed to surround myself with people much smarter than me I was. I never wanted to be the smartest guy in the room, um, and at some points I thought I was, and I wanted to do that early on, um, but that didn't get me anywhere. 

0:23:07 - Mark Henderson Leary

Well, I love you said that too, because I've talked to a lot of people kind of in their forties and fifties and I'm 52. And I do think there are two concepts that come together that kind of create a almost a little bit of an exponential humbling. And the first one is what Dan Sullivan would call. It does call in his concept, the gap in the gain and as part of strategic coach, they talked about this idea of these high performers, as they get more and more accomplished in life, become less and less satisfied with their progress, and his model is to say that those high performers are always thinking about a perfect future and and and so, as you're when you're youthful, you're like man, I can just, I'm getting faster, I'm getting better and I'm going to get to that perfect future faster and faster. 

But what ends up happening is it ends up being like this horizon you look at the horizon line and if you've ever driven a long car trip, you see the horizon line. You need to drive for a day and you're like you know, after a day of driving, the horizon's still at the edge of the earth, not any closer, it's infinitely far away. And I think in our youthful mindset we're not. We don't snap to that. And at 40s and 50s you're like sun looks like it's the exact same place on the horizon. 

Huh, I don't think energy, more energy, faster is going to be the way out of this, and his antidote to that is to measure backwards and look at the progress, and that's I believe that that's absolutely true. Right, look at how far you've come. But I think the other part that makes this realize that that's not going to happen is somewhere in your 40s and 50s you start to feel like but seriously, more energy is not the way out of this. I have to start editing where my energy goes so I can put it in places that matter most, because I'm starting to have a better sense of my priorities. The time is slipping away to some extent and I wanna maximize the areas that matter most, and now I'm really well aware of when I spend energy someplace not high value, how much of a sacrifice it takes and a price I pay in the areas that matter most. So then you start editing more aggressively in that regard. So those two things coming together are like a really big wake-up call for leaders in their 40s and 50s. 

0:25:10 - Michael Silva

I think statistically, and I think that comes with the wisdom of just making mistakes and going through life and learning these lessons. And you know what was the quote from? Oh, what was the movie? It was Joey Joe Petsche, I believe. The youth is, oh, no, no, he said these two youths. He was talking about youth. Sorry, I'm getting off topic, but I think, like you, you the youthfulness is wasted on the young right. 

And we learn these lessons as we get older, and you know the other cliche term is work smarter, not harder. Like I didn't know any other way, but to just work hard, and I was like you, I had a big machete and I'd cut down anything in front of me to get there. But there's a. There's a better, easier way to do things, and that probably starts with surrounding yourself with some really good people, right, yeah? 

0:25:56 - Mark Henderson Leary

for sure. So, when you were starting to have the realization that maybe you needed some help, what was in your mind for the vision? Were you thinking we're going to dominate, I don't want 100 locations? Or were you like I'm falling short of my current expectations? Or what was on your mind that was driving you? 

0:26:20 - Michael Silva

oh, great question. I think at first it was just like I need to come up for air, right, I just needed to find, to improve my processes, find out a better way to find my people. You know, I had the passion and I was already developing a niche and a reputation. I just didn't. I was just like I was like the duck. You know, you see the ducks gracefully floating on the water and underneath I was just peddling and swimming and trying to survive, and so I was just looking for some calm and organization. 

I had no idea at that point. I had one office. I knew I wanted more. I didn't know what. I never wanted to go to a hundred clinics or anything like that. So I didn't have a. I didn't have a long-term business goal, I just wanted to be successful and enjoy some free time. I was had a young family, um, so it was more just to like be able to breathe and sleep at night a little bit better. And they 100% accomplished that. And then guess what happened. The next office opened, and then guess what happened. 

0:27:18 - Mark Henderson Leary

The next office opened. 

0:27:18 - Michael Silva

They guess what happened. Like I started traveling with my family, like all these beautiful things in life started happening because I stopped swimming and drowning, because I got help and figured out how to do that, and then I was able to, you know, rinse and repeat and did that and built teams and empowered people and um, so I think, yeah, it was my. My first goal and vision of this was like stop drowning and enjoy this, rather than just going at it like putting in 90 hours a week and not sleeping and stressing and people pleasing and all those other things we talked about. 

0:27:56 - Mark Henderson Leary

Yeah, so I guess, thinking about those stair steps, how ready for you, or what was your next humbling? I'm assuming that you kind of reached this, oh, this feels great. And then you open up the next location. Were you 100% ready for the next location? Or it was like whoa, okay, here we are, deep end of the pool again, and now I've got to level myself up to the next level. 

0:28:21 - Michael Silva

No, I think I was much more ready than I would have been pre, getting help for sure. Like we had the process we were you know, we're at numbers um, where we needed to be. In the first one, I had already, importantly, like began through some being open-minded enough and getting the, the consulting, like. Like had a team in line. Like I knew, before I opened the next office, I already had some people lined up for the certain position. So, um, and I did it and yeah, and then my workload increased a little bit. My stress has increased a little bit, but then that that works itself out. 

And then, thankfully for me, my second office became one of our most profitable and it was a smaller one, but it just we got the right team in place and I was like, ooh, okay, so we can do this again. And then at that time my wife, the kids were older, I was like I'm coming back in the business. Then we opened one closer to home and so, yeah, there was that temporary increase in stress and signing leases and negotiating, all that, getting the team on. But then it worked itself out and it was good. It was definitely good and I would not have been able to do that totally on my own for sure, and I think it goes back to what I said before too having the people and then empowering them and giving up some of the control and not being, um, which was so liberating, like like, why did it take so long to see how liberating this could be? Um, but it was great. I'm not sure if I answered the question and the liberation, yeah. 

0:29:50 - Mark Henderson Leary

So, and I actually want to dig into this- yeah. So the liberation was realizing that it was about the people. 

0:29:55 - Michael Silva

Yes, not about me and making and slowly turning a business that was all about me into not being about me. It was hard. But I remember walking into um like I would go usually once a week and meet with my managers and I was going into these offices and I'm looking at these patients everywhere and I don't know them and they don't know me and at first I was like that's kind of weird. But then I was like, wow, this is really liberating Because I've got no emotional ties to these clients who are being treated by my team and I know they're doing well, because the numbers show how great the team was doing. I'm like, wow, this is kind of cool, I like this and it just felt really good. 

0:30:38 - Mark Henderson Leary

So I want to dig in a little further on this, recognizing that leadership has different flavors, right. So there's really, if this is not your style, it makes sense that you should do something different. You shouldn't copy this, but I do think it is. Fundamental level leadership involves enrolling other people. There's a way to do that. 

I think the number one disease symptom in a healthcare practice is what I call hyperdependency. There's that leader, that founder, and I think much more so in healthcare than almost any other profession or industry. That founding healthcare provider in any form has more power throughout the entire organization, more ability to move the needle. And if you're a plumber I use this example all the time there's no way the founding plumber, when you've got 10, 20, 30 people in the organization who can just like you know I'm just going to hustle this month and I'm going to unclog more toilets than anybody else and that's going to make us profitable this month. That's not going to happen. Not enough toilets. It doesn't work that way. 

The margin is not that strong, but in healthcare it can be that way. It's like you know what I'm going to do one more day a week in clinic and that's going to move us across the needle. Let me show you how this is done, and it can really get out of whack and stay out of whack and you can build a really good size organization where the entire organization really is depending on one or two people in a very unhealthy way. And so you were able to get to the point where let's really focus on the people and reduce that dependency on me and increase the dependency on a bunch of other people, not just like one or two others, dozens of other people who all had a piece of the puzzle right and really lifted that weight and it was great to see, like to see how, how engaged and motivated these people were in their roles, just felt good. 

0:32:38 - Michael Silva

it felt good to see that and you wouldn't use the term again it was liberating for me to not have to be tied down into the micromanaging of people and processes, because everything was set and it was great, it was inspiring. I mean, I had many meetings with my staff and I had tears in my eyes because the vision that I'd slowly developed for this practice was coming true and, you know, selfishly, I was able to step away and do some other things that I was passionate about and spend more time with my family. Like I remember, when my first child was born, my son, I had, you know, these, uh, a couple of guys that were my clients, who were investors, and, like you know, I was home two days a week and my wife was coming back to work. So I would work. You know, yeah, I would work Monday, wednesday, friday. My wife would come in Tuesday, thursday. 

We'd run the business, we'd see clients. We were small as one practice at the time. Um, and these guys are like, listen, if you just got a nanny and you both worked 60 hours a week you can make X amount of dollars. Blah, hold on man. I said I saw my son take his first steps on a Tuesday afternoon at 1 30 PM. 

0:33:45 - Mark Henderson Leary

Yeah. 

0:33:46 - Michael Silva

That was priceless to me, Like just being able to be home and make the decision that my wife and I were going to split roles, which I enjoyed at that time. Um, I just thought that was great and I just I'll never forget that. Yeah, Maybe if I took their advice and invested more, I would have grew faster, and but I don't know I got a pretty good relationship with my kids, which is extremely important to me. Being able to balance growing and running a business and having good relationships with your family was, uh, was not easy, but I think I did it All right. 

0:34:19 - Mark Henderson Leary

So that's an interesting topic, probably a subject of an entire other podcast, digging deeper, because I like that, but I do think that there is a danger of I deserve it versus I've earned it. I deserve to be home, yeah, but you're losing money every month. You've not earned being home, right. And so when do we earn the right to choose this and build this vision? And I think it's a gray area, right All right, we've earned this and we are choosing what altitude we're going to be at. 

We're not going to crash and we're not going to be in the stratosphere. We're going to be just about treetop level and that's cool for us. And I think that takes some discernment and awareness, which I think kind of goes back to what I think the story is. You're telling that once you got out of the frantic ducks mentality, you could start paying attention to what you were doing and being intentional like well, these are the roles we need. This is how I know when somebody is in that role succeeding and this is how I know when they're failing and I can get them out of that. And when I open the next location, I know what we need and I know how to make those changes. The next location, I know what we need and I know how to make those changes. And there is an awareness, a forward thinking, prediction, coupled with what has to have been the ability to respond to it. That's that's. 

Both of those don't always happen. If you see somebody who can respond quickly to what kind of blows up, which is a good skill, but there's also somebody who can see the future. But we oftentimes see people who don't do both. You see people who just are frantically working responsive in a firefighting mode all the time, and other people were like see where this is going. And then it kind of goes off track and it goes off track and it goes off track and it's like this frustration, right, and so you have to have both. Like okay, so I see where we're going, I'm going to have these three seats, we open this location, I'm going to have a front desk, a practice manager or whatever, and like uh-oh, practice manager made the wrong call 30 days in. I'm going to have to get them out and you have to do both. 

0:36:29 - Michael Silva

Was that natural to you? No, was that? 

0:36:30 - Mark Henderson Leary

natural to you, or were you okay? 

0:36:32 - Michael Silva

No. 

0:36:32 - Mark Henderson Leary

How did you figure out that sort of balance? 

0:36:34 - Michael Silva

That's really good. How did. But I was a much more reactive person, which is kind of like healthcare in general, which is another topic for another podcast. But yeah, like I waited, oh, there's a problem, let me, let me fix it. You know, and it goes back to the you know um, stephen Covey's four quadrants where was I spending my time? I was, I was reacting and for to urgent things, cause I didn't spend enough time in quadrant two and you know, preparing for these. 

So I think it was a fine balance. I think I just learned from putting out so many fires and realizing that you know reacting and solving these problems versus taking time like sitting down, getting clarity, like you talked about earlier, really looking at the business, getting some guidance, taking the time to forecast and see what the future is holding and prepare for it. So I did, and I don't know how I did it. I think probably just I got fed up with putting out fires, maybe, and then the guidance and just having a little guidance telling me like, do you want to just sit here and put out fires all day long or do you want to like prepare for this and do this the right way? Shouldn't say the right way or a better way yeah, so that. 

0:37:43 - Mark Henderson Leary

So I love it. It goes back to what we were talking about that compassion, that empathy for yourself, like do not abuse yourself. Like, seriously, we've suffered this pain. Are we going to learn the lesson or not? And forcing yourself to follow through with the discipline, and, I'm guessing, having that coach in your corner, definitely. Hey, we've been here before, michael. What'd you have to do last time? 

0:38:04 - Michael Silva

Right, I know, sounds like a familiar story. Exactly. 

0:38:10 - Mark Henderson Leary

So all the people I'm trying to make this as tangible as possible has anybody come to mind in terms of, like the one or two most important, or whoever comes to mind, and like people, choices, people, decisions that really changed the game, for allowing you to step back and have the vision come to life in the organization? Tell me the story of one or two people who, like the change happened here, where suddenly people could carry the vision and I didn't have to do it the way I used to Justin, I didn't even have to think about it. 

0:38:44 - Michael Silva

Okay, can I tell you about Justin? Right, I love it Absolutely. All right, so early on, it was just me. I think I had hired a personal trainer to come in, I had another therapist, but it was all clinicians and I realized I'm missing phone calls, the phone's ringing off the hook. I needed some administrative help. So, you know, put an ad out and I was getting every you know, um, middle-aged mother of three just wanting to get back into work that wanted to come like enter the phones. 

And I'm thinking about my experience at healthcare offices and what the front desk people were like. You know, like I don't want to do that. And then a long time client of mine said hey, my daughter's boyfriend, a 21 year old kid at the time, is working construction. He's he went to school for writing, needs to make money while he writes and he was working construction. He really doesn't like it, wants to get out. I'm like I'll meet him more out of respect for my client. I'm like, okay, give me my number so I sit down with Justin. He's this 21 year old kid. It looks like he's 12. You know, 21 year old boys don't run the healthcare front desk Right. 

0:39:47 - Mark Henderson Leary

So I was like Hmm. 

0:39:48 - Michael Silva

Okay, well, something told me, just just do it and give this kid a try. Hmm, hands down the most valuable employee I've ever had in my business. He was with me for a total of 11 or 12 years. He took from just the role of answering phones to then became our biller and then became our head administrator and trained every front desk and anyone who had anything to do with customer service and hospitality. He put together systems of doing like he would do these, like secret calls, and he would pretend to be a patient. He helped put together my handbook, all my policies and procedures. 

This kid took on his role as the head administrator and biller, like it was. His life depended on it. And until the day I sold my business, people still commented on the role. Justin, and I tell him and I'll get it, I'm getting a little teary eyed thinking about it, like when I see him. Like he was so keen, he was the most calm individual, he was the Buddha of our business and so smart and just took on a role in an industry. He had no desire or no plans on being in and just absolutely killed it. And I remember when my consultant came in and he worked really closely with her also like developing our billing procedures and like just a lot of our SOPs, and she's like there's something special about that kid. I'm like hell yeah, there's something special, like whatever it was like. I cannot be more thankful and more blessed to have come across him early on in my career, so he's numero uno best employee ever. 

0:41:22 - Mark Henderson Leary

I love that story. 

0:41:23 - Michael Silva

Yeah. 

0:41:24 - Mark Henderson Leary

I think it speaks to a couple of things. It speaks back to this tie-in around passionate leadership. There's a connection there, right, you know, there's something very human, well beyond the disciplines, the writing, the goals, the numbers. It's like there's a human connection that was powerful there. He was a leader and you recognized it. You recognized it and I think that you know the cautionary story there is. Oh, I you know, all great businesses are founded by diamonds in the rough. We're going to find these diamonds, like and so people just find dirt and like I got a bunch of people with no experience and it's like it's going to be great, it's like, no, it's not. 

does not work that way. There is an intangible or something. It is not work that way. There is an intangible or something. It is not from the hope side, it's not from the desperate side. It's not from the I have, I have. I'm going to treat the world like everybody must be another meat. It's more about huh there's something here. I don't know what it is, as opposed to, I really want there to be something here, right. 

0:42:24 - Michael Silva

And it's not it is not there. I've done that for sure. 

0:42:28 - Mark Henderson Leary

Yeah, yeah. 

0:42:33 - Michael Silva

Yeah, no, there's. There's the whether you, whether you believe in like energy or vibration or chemistry, whatever it was. I felt it with him and it was like it was. It was absolute gold. He coined a term that I use and I still now when I'm working with clients. I use a term that you know healthcare is not isolated to the treatment room or the gym. It begins with the first phone call, begins in the waiting room, begins at the front desk. And he's literally put that in my ear because when you know insurances started changing and all we're talking about people deductibles, co-pays, co-insurances well, you're going to reset in January. Do you really want to spend that money here? And we're helping people navigate this really confusing health insurance system. He came up with the Germans like listen, our care has to start well before they get in with the PTs. And I was like yeah, you're right. 

And I just took that and went with it and I that's part of my philosophy when I work with clients I'm like it's the care has to be well before. Like what are these touch points before that you can deliver. You know amazing hospitality and customer service before they even get in to see the PT. So thank you, justin, man Still, you still influence me to this day. I love it so powerful. 

0:43:36 - Mark Henderson Leary

Look, man, we've covered a lot. I could, I think, we have more conversations in the future, and let's make sure we do, cause I knew when I was coming in I thought this conversation might something amazing, cause I know we just kind of clicked and so, um, what have we missed? Anything you want to make sure we include in the conversation? 

0:43:52 - Michael Silva

I don't think we missed much, but yeah, there's definitely some future conversations for sure. But you know, if I had to do like the, the, the takeaway, um, just to reemphasize how important I think surrounding yourself with good people are and do not wait to get help. Like things are, there's very few people in life that become successful on their own. Like see where you need the most help, seek it out, empower people around you. Like it's all about people. Can't say that enough. 

0:44:24 - Mark Henderson Leary

Yeah, 100 agree, and I think to really maybe even add some safety. Hopefully, listen to this conversation you would. Someone would hear the difference between one of those working out well and and not. But getting help not from just anybody, from people who really you can hear, and whether that's oh, there's my little thumbs up on the screen Did not mean to do that Somebody, somebody you can listen to. And if you can't listen to them because they're not the right person, not the right context, not the right solver for the, for the, the, the season you're in in your life or in your business, make a change, like, get those people into your life that you need right now and if that's not who you have right now, make a change and do that. Flip side back to the people. 

And I love sort of this crystallization, hearing your description of this and I hear a lot of this and I really try to drive this home that when you have those diamond in the rough experiences, they are amazing. Uh, you can't, you can't really force it. No, you gotta pan for gold. Hiring, building a culture, is an ever ongoing panning for gold experience and you gotta know that there's been gold and fools gold and there's lots of that and really, when you find the right gold and in the or the diamond, in the rough or whatever precious metal gemology metaphor you want to use, really holding onto it and leveraging it and investing in it, but also being aware of when it's fool's gold and being aware of your desperateness and your sort of I'm going to try something, I don't understand what's going on and I'm going to hire some people. 

That just that doesn't work. If it doesn't feel like it's going to work, it's probably not going to work in that capacity and especially in healthcare. There's a lot of strata of people who and I love that point healthcare gets so mentally weighted at the point of care. That's where the magic is, and we've all had that experience seeing this great doctor. And you get to that front desk and you're like is this person here to abuse me? Is this person here to make sure I I never come back? 

it so it's and that's tolerated that's tolerated, unfortunately yeah, right yeah, it's so frustrating. 

0:46:45 - Michael Silva

So real quick on point, like a lot of the work I do now helping other practices. I was very I was very good in the clinic and I have really good clinical skills. I don't teach clinical skills, I'm teaching like Justin inspired, like like unbelievable patient experiences go well beyond me mobilizing your fibula or putting a dry needle in your butt, like there's so many more things involved with the successful outcomes and I and I preach and I've done so many um, like webinars and talks about improving the client experience is going to improve their outcomes. It's going to improve your bottom line in the business and how and just teaching that it's that's where the magic happens. Yes, you need good clinicians, you need to get outcomes, but there's so much more to an overwhelming patient experience and getting raving fans are going to be built in marketing for you and that starts with the first phone call and it starts with a guy like Justin at the front desk greeting you. 

0:47:38 - Mark Henderson Leary

Awesome man, awesome conversation, so privileged to spend some time with you. 

0:47:41 - Michael Silva

Same here. 

0:47:41 - Mark Henderson Leary

I really appreciate it, and we'll do this again, for sure. If somebody wants to continue the conversation or see what you're up to, how does somebody find you? We'll obviously put your information in the show notes, but something easy to remember would be what. 

0:47:54 - Michael Silva

Yeah, michaeljsilvacom, and it's Silva S-I-L-V-A, even though I am from New England, there's no E-R and I forgot to use the R because I didn't park my car in Harvard Yard. That's funny, michaeljsilvacom. And if you put that into LinkedIn, I'm not uber involved in social media but I do some stuff on LinkedIn. But you can find me, you can connect with me through that website. 

0:48:19 - Mark Henderson Leary

Awesome man. Thank you, super grateful. Same here, Michael Silva, everybody. So that's our time for the day. We'll see you next time. Before we do that, of course, a reminder that if you're stuck, if you're feeling like you want this amazing practice that's high value and you can't, you're stuck. You want this amazing practice that has high value, gives you the life you deserve. Please reach out, don't stay stuck. Practicefreedomcom slash schedule. Obviously, folks like Michael Silva are great resources as well. If this was helpful to you and you think somebody else might find it helpful, please share it. Get the subscribes going, get the shows people who can use it, because this information is not helpful if people don't know about it. We will see you next time, though, on Practice Freedom, with me, mark Henderson Leary.