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

Most PT owners outgrow word-of-mouth long before they build a true demand engine. In this episode, Chad Madden breaks down the five levels of marketing awareness—from “I don’t need marketing” to running a predictable patient pipeline—and shows how to pick the right next step for your stage. You’ll learn where most clinics stall, how to avoid the DIY trap, and what a unified system looks like when it’s working.

👉 Learn more or book a demo: https://getbreakthrough.com

00:00 - Welcome & why DTC marketing now

02:54 - The 5-stage roadmap to predictable demand

03:56 - Level 1: Unaware — “Quality + word of mouth is enough”

08:34 - Level 2: Problem Aware — The costly DIY rabbit hole

14:36 - Level 3: Solution Aware — Channel dependence & algorithm shocks

17:40 - Level 4: Product Aware — The “duct tape” tech stack nightmare

20:34 - Level 5: Most Aware — One integrated, always-on system

28:48 - How Breakthrough helps & next steps (CTA)

Chad Madden sits down with Dr. Ben England, PT, DPT, FAAOMPT, to break down why adding treatment technology (laser, shockwave, direct current, dry needling, HBOT) isn’t a fad—it’s what today’s patients expect. We cover how to roll out cash-pay services, pricing, ROI, and the mindset shift clinicians need to recommend ethically and confidently. Ben also shares a turnaround story and how mentorship/accountability accelerate growth. Value-packed for private practice owners and clinicians who want better outcomes and better business.

YouTube Timestamps

00:00 - Intro & Ben’s PT origin story

03:00 - From hospital to private practice to all-cash

05:20 - Why patients want tech now (AI, biohacking, expectations)

07:45 - Rolling out cash-pay tech: training, pitfalls, integrity selling

10:50 - Evidence behind direct current, lasers & e-stim (Ben’s paper)

14:30 - Overcoming “sales prevention” and dosing mistakes

17:25 - ROI math, scheduling devices, and first-visit trials

23:40 - Mentorship, accountability, and building the Torrentia Tribe

30:10 - Practice turnaround case study + how to join

39:30 - Books that shaped Ben’s career & wrap-up

Book a free demo call and get a behind-the-scenes look at the exact systems, tools, and frameworks Chad used to grow from a solo PT to a $20M practice — and the blueprint he's using to reach $100M. https://getbreakthrough.com/demo/

Torrentia.com

Tribe of Millionaires - https://a.co/d/bjlyKdh

Financial Freedom Book - https://a.co/d/enf9G8E

Innerpreneur - https://a.co/d/0PKfKta

Private practice builder Ryan Christoff joins Chad Madden to unpack how he grew from one clinic to 26 in Western PA. He shares the two books that shaped his mindset, the sub-$500 tool that moved the needle, and the painful expansion mistake that became a turning point. You’ll hear practical hiring and retention tactics, why “foot on the gas” matters, and how AI will reshape scheduling, authorizations, and collections. Watch if you want battle-tested strategies to grow your PT practice and protect your time.

00:00 - Intro & why Ryan’s a special guest

01:18 - From one clinic to 26: Ryan’s background

02:52 - Game-changing books: The Strangest Secret & Rich Dad Poor Dad

04:24 - Best sub-$500 tool: two-way texting for D2C & reactivations

05:48 - Biggest mistake opening a clinic—and the turnaround

08:30 - Mantra: “Keep your foot on the gas”

09:32 - Best investment: time to think, partner smart, win-win deals

10:46 - Unconventional review process: staff self-assess wins & teamwork

12:18 - New mindset: you can’t please everyone (comp & balance realities)

13:55 - Starting a practice: legal/finance first, don’t rely on MD referrals

15:20 - Protecting time: say no, one needle-moving task per day

16:35 - Overlooked trend: staffing squeeze & creative scheduling

17:30 - What’s next: AI for auths & collections; faster changes than ever

18:16 - Closing advice to owners

Chad Madden and Dr. Ben Fung break down the behaviors that keep schedules full and graduation rates near 100%—from “left/right-brain” patient communication to always ending each visit on a win. They unpack UpDoc’s Corporate Quality Index (CQI), including intention-to-stay thresholds that predict retention, and why soft skills and on-stage presence matter. You’ll hear practical cues you can deploy tomorrow, plus a book rec that reframes patient experience through behavioral science.

If this helped, subscribe for more PT business and leadership insights.

00:00 – Why engaged patients graduate (and refer)

03:12 – Production goals vs. visits/units: keeping the schedule full

07:45 – Left- vs. right-brained patient communication (numbers vs. function)

12:10 – “End on a win”: structuring sessions for momentum

18:20 – What is the Corporate Quality Index (CQI)?

23:05 – Intention-to-stay thresholds & spotting flight risk

28:40 – Soft skills, stage presence & micro-behaviors that matter

33:15 – Resources, contacts & most influential book

Book a free demo call and get a behind-the-scenes look at the exact systems, tools, and frameworks Chad used to grow from a solo PT to a $20M practice — and the blueprint he's using to reach $100M. https://getbreakthrough.com/demo/

The Corporate Quality Index (CQI) 2024 Report

PT owner Chad Madden sits down with industry veteran Bob Kowalick to unpack what it really takes to scale beyond yourself. They cover the #1 book that shaped Bob’s approach, painful (and expensive) lessons on “trust but verify,” and why data. not opinions, must drive your systems. You’ll hear how to invest in yourself, innovate through experimentation, and the coming shift to PTs owning musculoskeletal health management. If you find this valuable, subscribe for more practice-growth playbooks.

Time Stamps

00:00 - Intro & guest setup

01:21 - The #1 book for scaling: Scale (Hoffman & Finkel)

06:11 - Biggest failure: trust—but verify (billing & IP lessons)

12:25 - Best investment: invest in yourself

13:12 - Unconventional edge: innovate & experiment

15:31 - What changed most in 5 years: data as foundation

16:43 - Advice to new PT owners (2024 realities)

24:28 - Bonus trend: PTs owning musculoskeletal health

Book a free demo call and get a behind-the-scenes look at the exact systems, tools, and frameworks Chad used to grow from a solo PT to a $20M practice — and the blueprint he's using to reach $100M. https://getbreakthrough.com/demo/

If you run a PT practice, you can almost feel the calendar tighten around Thanksgiving, January deductibles, or early summer. Schedules thin. Margins evaporate. Anxiety spikes. What if those same weeks became your busiest?

Most clinics brace for a slow season by doing less: pausing outreach, leaning harder on physician referrals, or trying to outspend big-box retailers in Q4 ad auctions. That combo leads to fewer evals, underutilized schedules, and profit leaks. Worse, it creates the illusion that slow seasons are inevitable.

Key Insights

1. Focus on the channel you own. Of the five New Patient Pathways—Reactivations, Word-of-Mouth, Physician Referrals, Partners, and Cold Traffic—only reactivations tap a list you truly control: your past patients.
2. Text beats everything. Start with SMS, then email. Response rates are faster and higher, especially when your message is clear and patient-centered.
3. Messaging is no longer the bottleneck. AI has crushed the cost and time of copywriting. Great subject lines, benefit-driven offers, and empathetic body copy can now be generated and refined in minutes—so bad messaging is no longer an excuse.
4. Conversion is about questions, not scripts. Move away from didactic monologues. Use calibrated “how/what” questions: What’s going on with your shoulder? How long has it been bothering you? What have you tried and how did it work? These open doors and build commitment.
5. Track everything and automate. Without attribution, you can’t scale what works. Marketing software and AI conversion agents (think an assistant who “works” nights/weekends) handle replies, keep conversations moving, and hand off to staff to schedule.

After two brutal Q4s—including a ~60% drop in new patients (October to December) and a six-figure loss—Chad asked a better question: What would it look like if Q4 were our busiest quarter? The team doubled down on the past patient list and launched a focused campaign: a half-day of free screens/rechecks in early November. They used direct mail plus email to invite former patients. Result: 73 reactivations in one morning and a seven-week waiting list that carried the clinic through year-end. Q4 flipped from a liability to their best quarter.

Putting It Into Practice

• Run the “Greatest Promotion Ever.” Offer a limited block of free screens/rechecks to past patients in early November. Cap slots to create urgency and protect clinical time.
• Cadence that compounds:
• Past...