Entrepreneurship Podcast post

A Different Business Model with Dr. Aaron LeBauer

George Grombacher March 6, 2022

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A Different Business Model with Dr. Aaron LeBauer

LifeBlood: We talked about creating a different business model, the problem of insurance and healthcare, how to help patients actually get better, and how to make your business profitable while maintaining your professional and personal ethics, with Dr. Aaron LeBauer, Physical Therapist, author, podcaster, and coach helping other PTs scale their practices without relying on insurance.  

Listen to learn four keys to succeeding in business!

You can learn more about Aaron at AaronLebauer.com, Facebook, Twitter and LinkedIn.

Thanks, as always for listening!  If you got some value and enjoyed the show, please leave us a review wherever you listen and subscribe as well. 

You can learn more about us at LifeBlood.Live, Twitter, LinkedIn, Instagram, YouTube and Facebook or you’d like to be a guest on the show, contact us at contact@LifeBlood.Live.

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Our Guests

George Grombacher


Dr. Aaron LeBauer

Episode Transcript

Come on one level, this is George G. And the time is right welcome today’s guest strong and powerful. Dr. Aaron le Bauer. Aaron, how you ready to do this?

Aaron LeBauer 0:19
I’m ready to George. Thanks for having me.

george grombacher 0:21
excited to have you on Dr. Aaron is the host of the cash PT lunch hour podcast. He’s the author of cash PT blueprint. He’s a speaker. He’s helping physical therapists scale their time impact in income without just relying on insurance. Aaron, tell us a little about personal life’s more about your work and why you do what you do.

Unknown Speaker 0:43
Yeah, I think personal life wise I have, you know, family wife, two girls, and I love skiing riding bikes, vintage cars and scooters. And like, yes, I’ve done I’ve done a lot of different jobs in my life, you know, let’s see what I do for work. We do two things. We own a physical therapy clinic where we help active people in Greensboro Stay Fit healthy and strong without pain meds, injections or surgery. And after building that business, people asked me, How do I do it. And we we built that business without relying on insurance companies for reimbursement because that creates a lot of times it creates a conflict of interest in what’s right and best for our patients. And so I started teaching people how to grow their business and do that. And so I have a consulting business that helps physical therapists and other health care providers create six figure or launch six figure businesses and scale them to multi six figures in multiple locations to help so that we can help 1000s and even millions of people avoid unnecessary surgery and expensive imaging. And the main reason is, because as a therapist treating patients for over 20 years, people keep coming back with the same stories like I wish I never got this surgery, or you’re the first person that touched me where I hurt, or I was told never to lift 35 pounds ever again. How am I going to get back to picking up my baby washing my dog or even doing CrossFit? And there’s a lot of misinformation, miscommunication. And I believe a lot of it happens because healthcare providers don’t have any time to sit and help you understand what’s going on. And that’s what we’re able to do.

george grombacher 2:28
Nice. I appreciate all that. Tell me more about the scooter part. Aaron.

Unknown Speaker 2:33
Yeah. Well, I used to raise bicycles, right. And I lived in San Francisco, and I started working with a coach and I was trained really hard and but I had to commute to work. And I think Man, I’m too tired to you know, ride across town to go to work and and I was working as a massage therapist. So I mean, I was expending a lot of energy. And so I was like maybe I’ll get a motorcycle like, you know, Marissa was big. Let me check out the scooters and there was a big vintage Vespa and Lambretta seen, these are metal bodied scooters from Italy, from the 60s and 70s. And it’s really big in San Francisco. And I wrote one and I fell in love. And so I got one to commute around town on and then moved to North Carolina, where the you know, there’s probably a dozen or two dozen people here with vintage scooters, maybe maybe there’s more, but like, you know, I know of like two dozen people Max. I’m like one or I’m like the only person in Greensboro who actively rides and I had to be resourceful. And when someone break, I had to figure out how to fix it. And I and I’ve, since in the last 15 years, rebuilt multiple scooters, rebuilt multiple engines, you know, bought them, fix them up sold, I bought them for you know, $400 sold them for 2300. You know, like, yeah, it’s it’s really cool, but it’s something I can do with my hands and create something, see some work, enjoy it and even pass it along to the next person.

george grombacher 3:57
That’s awesome. Yeah, love it. Nice. Alright, so it strikes me that it is I wrote down problem of insurance. Yeah. Where it’s a problem, because so many people rely on it. And it’s a problem, because we think that it’s just the way that we did healthcare is through the insurance company. And, and probably a lot of the practitioners you’re working with doctors you’re working with are sort of locked into it trapped. Yeah. Is it better to start with the end in mind? I’m not going to take insurance. And is it possible to unring the bell and to unwind and detach my practice from an insurance model?

Unknown Speaker 4:38
Yeah. You know, like, if someone’s getting started, I think it depends on your philosophy and the scale you want. Right? I think it is. So number one, it’s I think it’s better to start without insurance because insurance reimbursements are going down. They’ve been going down for 20 years. plus years, they’re not going to go up. And so what that means is, in order to pay the bills, we have to see more people per app. Or whether we know it or not, they’re geared towards generating revenue, which isn’t a lot of revenue. It’s just we have to generate revenue to pay the bills. And so we start, I feel like shortchanging most patients, not all patients, some people, it’s a perfect model, because that’s what they need, and others, they just need more. Yes, it can’t You can’t unring the bell, I’ve worked with dozens of clients more than dozens, probably at this point who were insurance based. And their basically, their cost to treat a patient is $80. But their average reimbursement is $72. You know, so So we’re negative $8. For most of the, you know, most of the patients, so they have they can’t stand business and continue to accept in insurance at, in really, what it means is, the practice has signed a contract with the insurance provider like Blue Cross Blue Shield, to provide services at a specific rate. A lot of times people don’t understand what that really means they’ll sign this contract. And that rate is lower than their cost of operations. So the cost to run the business cost to pay the employees. And a lot of owners end up taking a pay cut or hit on their personal income as they have to pay their staff salary. So yeah, that’s the sort of the real problem is that what I see the real problem from a perspective of the therapist is, do I do what’s right for my patient? Or do I do what I know is going to generate revenue so I can pay my employees? And I feel like that’s a ethical question. I don’t want to have to I shouldn’t have to answer in healthcare. And other people see it as well. People have insurance, they are entitled user insurance, probably because I have insurance, I should be entitled, you should accept insurance. Well, if the math isn’t right, you know, like, I mean, the math just doesn’t work. So how can I help people if I can’t stay in business?

george grombacher 7:15
Yeah, well, that, when when you lay it out like that, it certainly does. I was gonna say it makes sense. But it doesn’t make any sense at all. Why? Why? Why would I sign a contract with an insurance company that’s gonna pay me less than cost me to provide the care? I guess that’s probably a whole nother podcast. But let’s, let’s, let’s let’s talk about the way forward and how you were able to do it differently.

Unknown Speaker 7:44
Yeah, I think the number one thing that I think your audience can get out of this is the way that we do it differently is through customer service and sales, not marketing. Yes, marketing, we market differently. I do more direct response marketing than most, you know, like traditional clinics, but it’s about the sales and enrollment. So if I’m a physical therapist, and I believe that my treatment is exactly what you need, because I’ve asked you questions and done it, done a short like examination, then it’s my ethical obligation to sell the service to you. Because probably most people here listening, have heard of physical therapy, some of you have said, Oh, physical therapy doesn’t work. You know, or I tried physical therapy, or it’s only for, you know, if I get a surgery, physical therapy can help me well, thing is, is, you’re right, no one knows what physical therapy really is. You know, physical therapy means so many different things their physical therapists do wound debridement, you’ve got a, an necrotic ulcer, like as dead tissue, like as a physical therapist, I can breed it and clean the wound for you. I can do what’s called electrophysiology testing, I can do testing to see are your nerves transmitting signals correctly. And there’s, there’s so many to women’s health and orthopedics. And then there’s like, I mean, there’s, there’s, there’s education, there’s so many things. So if I know I can help this person, I can’t try to give them physical therapy, I have to sell them the transformation that they want to make in their life. And if I can help them do that, you know, like, it’s my obligation to sell it. And I’m not selling you something you don’t need. Like a, you don’t need a Porsche 911. You can get around into Hugo, I mean, if there any still left on the road, right. But, but a lot of healthcare providers, like how could we possibly do that? That’s unethical to sell. Well, selling isn’t coercion, selling is asking the right questions. Right. As business owners, we know like in order to sell our services, I have to find out do you actually need it? And that’s, that’s the main thing that we do differently is we take the time to ask you questions what’s going on? On, how long has this been a problem? What? What issues? Is this causing in your life? And a question like, you know, George Sega snap your fingers and produce one outcome working together with us in the next 90 days, what would it be? And how would it change your life? And do this back

george grombacher 10:18
to start stop hurting? And they would change everything?

Unknown Speaker 10:22
Yeah. And then I would ask you why? Why is getting your back to stop hurting important?

george grombacher 10:26
No, I could get around without pain. I could play with my kids. I could exercise again.

Unknown Speaker 10:31
Yep. And why is playing with your kids and exercising again, important to you?

george grombacher 10:35
But that’s, that’s what made me happy. Yeah. Great.

Unknown Speaker 10:39
And are you able to do that now? I can’t. Right. Okay, if I could help you get back to playing with your kids and actually getting so you feel happy? You know? Do you think that, you know, would you like to work with us? You don’t like I would for sure. Right? But most people are going to come in and say, Okay, you can’t touch it, you’ve got this limited range of motion, you’ve got this diagnosis, let’s do this back pain protocol. You know, like, you get the back pain protocol on YouTube or Instagram. You know, let’s see if it works. But if I’m, so this is a sales conversation that I took from my coaching programs, like I learned how to enroll people into my coaching programs. I was like, wait, I should be doing that in my clinic. You know, and at the time, we allowed us to raise our rates $100 per visit. But we don’t sell physical therapy per visit, we sell programs, if that makes sense. So I sell you an outcome is going to take 12 weeks, and I’m going to see you eight times in those 12 weeks. It does,

george grombacher 11:37
it makes perfect sense. I mean, it talking about the outcome versus just feeding people on a conveyor belt of, of therapy, like, okay, you’ve got, you’ve got number four. All right, you you go over there, and you’re gonna go through that makes perfect sense. And it also makes perfect sense why a lot of the physical therapists and other practitioners in different fields, I’m sure that this is a very, a pretty common problem among anybody that’s working with insurance in medicine, that they don’t have the sales skills, they don’t understand the the mindset, the perspective that you’re talking about. And so it’s hard to bridge that gap,

Unknown Speaker 12:18
right. And it’s very different than me saying, like, let me sell you a surgery that may not be necessary, like physical therapy is a very low risk interview, we call it an intervention, it’s a low risk, you know, option for treatment of pain and injuries. Like the highest, the highest risk you have is getting burned by an ice pack. You know, like your skin can be burned by an ice pack, because you can’t factor why can’t feel it? Well, you know what, in our clinic, we don’t do ice packs. Because we spend time with you, we don’t leave you alone. And so there’s really no risk, you know, other than you wasting some time and maybe some money, like it’s not a health risk versus surgeries where you can get an infection, you can die, you can lose feeling in the leg and limb, you know, you I mean, there’s a lot of, you know, like, you can get an ulcer from eating too much out Advil, because the rock eats Advil on his show, you know, they they crunch opioids, you know, Jason Statham, the rock, every movie, they have them crunching some opioids. You know, like this super high risk to that. Oh, so we’re selling something that has very little risk. A lot of upside.

george grombacher 13:30
I’m what I’ve never thought about how, how action stars are popping pills and movies and the impact that that’s having on us. Interesting. That’s a whole nother podcast to Aaron. All right, but but, and the departure here is now I need to get my patients to come out of pocket for this service versus having it paid for by insurance.

Unknown Speaker 13:51
Mm hmm. Exactly. So a lot of our patients have already been somewhere else. And they were like, that didn’t work. Or that wasn’t the experience I wanted, you know, or expect. I mean, people said I could Dr. Bower, you know, I could do those exercises at the gym. I’m like, Yeah, I know. Yes. You know, you can do those at the gym. Because they’re, you know, and and then and then there’s people who don’t know about physical so it’s a small subset of people have already been in PT, I really want to do is reach the people who’ve never experienced it, and what and that’s where the marketing comes in, where we’re talking about talking them specifically, and about their needs, wants and desires, not about physical therapy. And what we have to do is we have to show them you know, that we can help them and then if if we feel good working together and we can help you you feel like like this is the right place to reach your goals. Like here’s what will lay out a plan. And, you know, there’s plenty people that say no to us because they’re like, well, I need to use my insurance and it’s absolutely they can help So you do that. Too few people. There’s a few people come in, I say too few, because I think a lot of people like, check their ego and don’t come back. But there’s a few people come back, say I should have come to see you in the first place. Like I went to the other place, I wasted a bunch of time. I should just come back here in the first place. I think a lot of people are afraid to come back, because they are that means they’ve made the bad decision. Actually, the bad decision is making no decision. Right. So you know, I think that’s, to me, that’s my biggest fight is how do I, how do I bridge that gap earlier on. And I think as insurance reimbursements continue to decrease. We’ve got a new regulation. Now you have to provide a good faith estimate for health care services, as people start seeing those from traditional places that like, wow, that’s, that’s a lot. You know, and that’s going to start starting to change the landscape. A little bit fascinating, what

george grombacher 15:58
just jumped into my mind is, what if there was some kind of program or insurance that paid for somebody to have access to financial education because they’re financially sick. And if they were to go through the insurance, they would get, you know, A, B, or C kind of a thing? And what that experience would be like, and then what a financial adviser would say, Well, this is the benefit you’re going to get from working with me and coming out of pocket pain, and it’d be just a completely different experience. And potentially, it’s actually going to solve your problem and get you on the path to the life that you actually want.

Unknown Speaker 16:35
Right? Yeah, no, that’s interesting question, it brings up two thoughts. Number one, I just want to be clear that our patients do file self claims for insurance, and then it is covered, we just don’t file the claim on their behalf. They pay us first and they can choose to file a claim. Most people’s deductibles are so high that even with two rounds of physical therapy, they won’t reach there to physical therapy and a surgery, they won’t reach their deductible. And the second part is having this money conversation with people like hey, you might you will probably actually save money working with us versus going somewhere else isn’t really a conversation that works. Because it’s to logic, logical people buy on emotion. And, you know, then what happens is if I get into this conversation with you and say, Hey, George, you know, eight visits with us is going to cost you $2,000. But if you go over here, you’ve got your, you’ve got your copay, plus their billing $350 per visitor unit, like, there’s no way for me to know what they bill, right? It’s like, but they probably do, you’re gonna come out paying more, but now people are thinking, But wait, why am I paying for insurance when it’s going to be more so that doesn’t make sense, it feels like it should be free or covered. Okay, so if I choose you, then I’ve definitely made a bad decision, whether it’s about choosing physical therapy, or choosing an insurance plan, somehow I’ve been duped so they’re not gonna come in and see us. Because now I’ve broken down it way too logical, and someone’s, someone’s doing something wrong. And so but they’re not going to come choose us is because it’s too logical. And I think that, as consumers, like my personal health insurance, like I have like a five or seven, I think we have a $5,000 individual deductible. And as a family, we have a $15,000 $20,000 family deductible max out of pocket Max. It’s basically insurance is catastrophic insurance so that we won’t go bankrupt because someone in my family’s in the hospital rather than it. It’s not something that covers oil change, right? Which is like physical, it’s a bad analogy as a physical there is like the mechanic. But in essence, pain is like your check engine alarm. And insurance doesn’t cover you getting new tires in an alignment every three years.

george grombacher 18:55
I think that’s great. Makes sense. Well, Aaron, people are ready for your different speaking tip. What do you have for them?

Unknown Speaker 19:02
I think the number one thing I think as a business owner that makes the biggest difference is asking for help being quick to ask for help. So whether that’s asking your current mentor for help, or finding a mentor, business coach, taking action and implementing what you learn, whether it’s something your business coach tells you to do or something, some strategy you learn, you have to take action on it. Otherwise, it’s not. It’s not gonna you know, like, you’ll never you’ll never succeed because you know, like, I think Wayne Gretzky said, you miss 100% of the shots you never take. And then you have to be you have to share your wins and your lessons. The only reason I’m here talking to you is because I started sharing what was working well for me. And so those are the big three things that at least make our Platinum mastermind member successful and I know make most people successful, is ask for help. take action quickly share your wins. And then the fourth thing or like the real main thing, that’s on the back of my sweatshirt today but you can’t see it. It’s 80% is good enough as business owners it doesn’t have to be perfect. It just has to work. You know?

Unknown Speaker 20:19
80% of businesses is enough. It’s good enough because perfection will kill your business.

george grombacher 20:26
Well, I think that is great stuff definitely gets come up. I love it. Those are solid. Aaron, thank you so much for coming on. Where can people learn more about you? How can they engage with you?

Unknown Speaker 20:40
The best way to find me is over on Instagram at Aaron Lauer. It’s a rln le B as in boy, au er, Instagram at Aaron Lauer, or you can go to Aaron labeller.com

george grombacher 20:51
Perfect. Well, if you enjoyed this as much as I did show and your appreciation and share today’s show with a friend who also appreciates good ideas, find Dr. Erin at Aaron lebauer on Instagram and then Aaron Lowry calm that’s a RONLEB a Yu er and a link all that to the notes of the show. Thanks again, Aaron.

Unknown Speaker 21:11
Thanks, George. Appreciate it.

george grombacher 21:13
And until next time, keep fighting the good fight. We’re all in this together.

Transcribed by https://otter.ai

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