In this episode, Chad Madden shares the behind-the-scenes origin story of Breakthrough—starting with a cold email in 2012 and a call with Carl Mattiola (then at Tesla). You’ll hear how private practice marketing evolved as physician referrals declined, and why direct-to-consumer strategy became essential. Chad breaks down the shift from courses and newsletters to a unified, three-channel marketing system built for private practice growth. Subscribe for weekly best practices to help you grow your clinic with more time and financial freedom. If marketing feels complicated and your schedule isn’t as full as it should be, Breakthrough gives you a simple, proven system to attract and follow up with new patients automatically—book a demo here: https://getbreakthrough.com/demo 00:00 - Welcome to Grow Your Practice 00:21 - Why this episode: the Breakthrough origin story 01:02 - 2008–2013: physician referrals decline & the push to DTC marketing 03:44 - The cold email that started it all (November 2012) 05:41 - Carl’s Tesla background + interviewing 300+ owners 09:01 - From Clinic Metrics to marketing referrals (and early stumbles) 16:12 - Webinars, “green ink letter,” and the early courses 19:27 - Evolution into ads + a purpose-built CRM and 3-channel system 26:43 - Market–Message–Media Match + how AI changed copywriting

Private practice owners: feeling stuck in the clinic and stretched thin? In this episode of the Grow Your Practice podcast, host Chad Madden interviews Jamey Schrier on moving from burned-out clinician to true business owner. You’ll hear the pivotal moments (including a literal clinic fire), the mindset shifts around identity and ego, and a practical first step to reclaim your time. If you want a self-sustaining PT practice that doesn’t require you every day, this one’s for you.

If marketing feels complicated and your schedule isn’t as full as it should be, Breakthrough gives you a simple, proven system to attract and follow up with new patients automatically—book a demo here: https://getbreakthrough.com/demo

00:00 - Welcome & guest intro

02:30 - The fire that forced a reset

05:45 - Personal low points: stress, family, and wake-up calls

12:10 - Stages of a practice: clinician → operator → entrepreneur

14:50 - First step out of the trap: the “activity organizer”

17:45 - Ego, identity & letting go of control

29:40 - Lifestyle by design (not default)

37:40 - Profit vs. revenue in today’s reimbursement climate

43:55 - Where to start: assessment & next actions

Chad breaks down the 2026 state of private practice across four pillars: people, finance, operations, and marketing. You’ll hear hard numbers on the DPT shortage and debt, why reimbursement + inflation equals a ~29% hit since 2019, and how cash-pay services are stabilizing margins and improving outcomes. He also shares systems to streamline ops and a playbook for always-on marketing—even when you’ve got a waitlist. Subscribe for weekly strategies to grow a resilient, patient-first practice.

00:00 - Welcome & why this matters

00:44 - The four pillars of private practice

03:00 - People: DPT shortage, debt & salaries

09:05 - Finance: fee schedule declines & the 29% squeeze

15:04 - Cash-pay services: what works and real numbers

20:55 - Team buy-in & rollout pitfalls

22:36 - Systems/ops: EMR, integrations & AI

24:28 - Marketing evolution, reactivations & waitlist trap

30:50 - Key takeaways & next steps