How to Expand Your Therapy Practice Without Losing Your Mission with Avani Shah

It's a multidisciplinary therapy clinic based in North Carolina . They just opened their second location and so she's a speech therapist my first on the show which I'm super excited about because you'll get a slightly different angle of private practice in a way that will serve us .

And so Avni is growing , and she doesn't just do PTO , tslp for her pediatric company . She also provides ABA services and psychological evaluations , mental health . It's a full gamut . She talks about which groups that she's used to help her grow , but the main focus of this discussion is how to grow .

What is the benefit and value of knowing when , how and where to grow ? So guys sit back and enjoy the show . Where to grow ? So guys sit back and enjoy the show . So , avni , I am so excited to talk to you today . You obviously are a successful private practice owner in the rehab space .

You have a multi-discipline practice that we'll get into unpacking here in a minute , but you just recently expanded to your second location .

And this space , the new space that we have , is bigger than our current space and we're super excited to help more children in a newer area and are loving our space . We're about 75% of the space is ready to go and we've already started seeing children there . 25% is a gym space and that's still under construction .

First of all , what was the criteria for you to decide it was time to expand ? How did you know it was time to open and expand to a second location ?

We had started to meet our goals with the number of children that we had planned to help and the number of staff that we had wanted to hire . Space was the only thing that we didn't have and in August , this space fell in our . We had been looking for a space to expand , just the right kind of the building .

Right , because we were looking for a space that is a standalone building that we can do modifications , a standalone building that we can do modifications we can build gym as well as it has some outdoor space for children to go out and enjoy the nature too .

So you know it was hard to find the right space and this space just fell in our lap at the right time and we're very excited to be there .

. The first is that growth was a decision of aligning with her values . Oftentimes , I think as entrepreneurs , avni , we get kind of scarcity mindset about growth because it's like if we're not growing we're dying , and maybe we even have a vision of wanting to impact the world and we get over our skis a little bit of growth .

But your first thing was like you had a set number of what your goals would be in order to impact the community . The number of children helped is how you set it . So I think that's beautiful , that the first thing you guys did was set a plan in place before you knew expansion even looked like to help more people .

And then the second thing I noticed that you said was that you guys were pretty capped out on your space already . You didn't go expand a second location until that first location was fairly full . Do you know how busy or how full was your first location before you decided it was time to open a second ?

So it came to the point where , you know , one of us had to work from home on scheduled days so that we can finish our calls . Us had to work from home on scheduled days so that we can finish our calls .

But you know , just to just what I said earlier , like it's important to like , you know , we set the goal with the with , with the thought of making a difference . So anybody like who's starting to get into doing the business , you know the important thing is don't start it with the thought of , like , just making money .

You know , do it with the thought of making a difference and then , you know , everything else will fall in place .

But in our case , when we talk about wanting to increase our impact first , as you've done , then it becomes a lot more of a passion project . I can feel your excitement over this new location and what it means for your vision . If I can ask , what is your vision for your company ?

And , as an employer , our vision is to be the company of choice for all children that we can help with , and , as an employer , our vision is to be the company of choice where they want to work .

So when you decided to open this location , how did you let your team know about that in a way that didn't overwhelm them ?

I also believe in a lot of manifestation . So , like I'm manifesting , I'm telling you that this is going to happen in future . I don't know the exact time and date , but this is going to happen in future . So we told them that .

And then , as we started looking for office spaces , like , we started taking their feedback on you know what would what is an ideal location , like you know what would you look for . So they all had their . You know , the excitement was building because they all had a say in it .

And then , finally , when we got this space , like the leaders , the executive team has , even before we put in the offer on any of the spaces , they came and saw the space and either loved it or said , nope , this is not the space for us . And after that , as a team , they work together to design the gym . Like the gym is beautiful .

Once it's done and ready , it'll be very impressive .

But what you did that I think is so great and rock stars pay attention is that any major change in our company , as much as we can , has to be pertained to or connected to a vision . And so when you created that vision as the visionary of your company , you announced it to your team early and you're like guys , I want to go up into practice .

I don't know when or how , but this is what we're doing . And everyone's like cool , because then they can think about it from a place if it doesn't really hurt them . I've done this before where I've made big changes in my company and I tell them , hey , guys , we're rolling this out next month and I need your support . And they're like what the crap ?

Versus ? Like , hey , one day I want to create this , or this year I want to do these things , and here's why . And people go .

That makes sense because they can be open to it when they're not like super burned out , already thinking there's more work for them to do , because I'm guessing this new clinic probably created additional work for different people at different times .

But when they knew it was coming and they knew why and they even got a chance to help create some of it right Like then it becomes this team effort thing . So I just think that's brilliant how you were able to help get them bought in early by sharing the vision before anything else started .

You know that it's their vision that's coming true right , like they are putting in all this work that you are acknowledging , validating and that you really value their feedback .

That's such a cool way of , because either we're growing or dying , and if we do it right , it becomes fun and engaging and provides growth opportunities for our other team members as well . So let me ask you this , avni what are some of the challenges that you're currently facing as you're expanding ?

So hiring is our biggest challenge and hiring the person that aligns with our values and our mission is even more challenging . Again , you know , as an entrepreneur I have learned this the hard way . You know it is hard to find people and so when you have somebody applying , you want to almost hire everybody that has the degree .

Amen , oh , she has the degree , she'll be , she can do it . You know we can train her teacher , but I've learned it the hard way that you know that's not the way to do it . You know , hire slow , fire fast if it does not work for your team .

I kind of knew the nightmare people before I hired them . I kind of could sense and I pushed past that just because I doubted what I my instinct . I mean , who was I to know ? How have you dealt with that ?

Like you feel like , okay , it's all going to be all right till they come on . And then all the reality comes out . So , yes , I agree , it is . You know it's important to spend to have the children wait on the wait list versus hiring and having to go through transitions .

Often You're going to lose those children and those families if you constantly have a revolving door of therapist .

We want to make it work for our clients , we want to help more people and , to be honest , we're probably a little bit burned out , like we don't want to do more work ourselves because we've already done more than most . So we make that mistake of bringing people on and so it's a . It's a , like you said .

If we do that , we open that revolving door and you know people just come and go and I get a sense , avni , that your , your team culture is phenomenal . I already know this based on some of the things that you're mentioning , as I've worked , if I interview all these people .

So in your case , do you use your team at all in the recruiting process to help you vet your people ? Or how does your existing amazing company help you when you're recruiting ? How do you use them ?

Second would be when we have a process of interviewing where the HR talks to them , then we bring them on site and the lead will meet with them and then they do a working interview where they've been given the goals of the child and then they jump in to see how they're working with that child right , and so it's like three to four people meet with them

before they even finally meet with me .

But then , secondly , what's really cool is that , from a recruiting perspective , a lot of these therapists they've got like 30 different jobs , so they're getting mostly that ma and pa one interview . Do you want to join Versus ? Like those layers that you create , multiple team members can tell the same story , which creates conversion for people .

They go wow , what a wonderful culture . I want to be a part of this , and so , yeah , I think that's powerful . You know , one of the things I know about your culture as well is that it's very diverse . You have a diverse culture . Would you mind speaking a little bit about that ?

The triad is very famous for having a diverse group of families living here , so our team definitely is able to work with families with varied cultural backgrounds and it definitely brings , like perspective , you know , wealth of ideas , insights and solutions that enrich the therapeutic experience for every family we serve .

What is normal in their life For many children , just because of the complexity of the Indian food , families feed their kids up till a certain age , right , and so as an outsider , I may think , oh she , you know , this parent still feeds their child , but it's as a if I knew that that it is normal and they are doing it because they you know a lot of the

families . One are vegetarian . Two , the food is complex . You know , you have the roti , you have the dal , you have the sabji , you have three , the roti , you have the dal , you have the sabji . You have three , four things that you have to mix together to make sure that , one , they're getting their veggies in . Two , they're getting their protein in .

Uh , so you know it just gives the more you know , the more you know about other cultures . It gives you that acceptance and then that way you are , you know you form a good relationship with the family . They know that you're understanding them and then that way you are . You know you form a good relationship with the family .

They know that you're understanding them , and then they are able to listen to your suggestions better .

What you just said around how we could leverage diversity within our own team to create a greater knowledge base of how to help . I love that , and it's one thing I really get about your company too , avni , is that you guys are really big on going a mile deep with people .

So , like this diversity team , this diverse team that you have helping this diverse population helps you understand what's needed and wanted . But above and beyond that , you have a different model . Like you obviously have PT , ot and SLP for PEDS , but you have a lot of other services too .

Could you share a little bit about those other services that help your company , help people , like all the way down in those patients core ?

Like , what does that look like from a parental support ? I'm not in the PEDS world , so what does that look like ?

They were hustling their children from school to another service , to another service , from one you know in different locations , and they kept coming and saying , hey , when will you add ABA ? And so there are standalone ABA providers that are just ABA and we have . We used to go to ABA buildings to provide services speech and OT .

However , the collaboration never happened between the speech and the OT Like we did what we wanted , we thought was appropriate , they did what they thought was appropriate and you know , everybody was in all in different directions versus working on one thing for the child , right .

And so then , after a lot of thought , we decided yes , we're going to start ABA and we love it . It's like magic for our kids .

A speech therapist will introduce something and with the intensity of the services that the children get in the building , the ABA providers are able to carry that on throughout the day and within a span of a week to two weeks , the child has mastered that skill and you know we can now introduce something else .

So it's like it's magical how much difference the children are making in a short time , because as a speech therapist and an occupational therapist , you only see the child one time , one to two times a week for 30 minutes to an hour . So with this intensity in the building itself and the collaboration that you know the team does , it's amazing .

I mean , we've only been open , we've been doing ABA for almost a year year and we already have two graduates . So it's very exciting .

I think one of the biggest mistakes we make when we're doing business is and I want to hear what you think some of the mistakes that maybe you've made you could share , avni , but what I was thinking in my case is , as an entrepreneur , I think we oftentimes get really excited about lots of options to do things , to grow Like I could open five locations , I

could also do specialization in mental health , all these things . But what I have learned , and what you've done so beautifully and I want the rock stars to pay attention to , is this idea that your focus was creating maximum value for your ideal client .

Sure , so instead of it being about what we can do to make money , it's how we could maximize the experience that patient has on reaching outcomes .

My favorite book of all time is a book called the Speed of Trust by Stephen Coveney , and it's like the idea that when we can produce results for people , it's the quickest way to build trust and that's where growth comes from a company , which is what you've done . You looked at your ideal avatar , your pediatric patient .

You create a mission statement around that individual . You build your services . You listen to your patients . The parents were saying , hey , we need help in these areas and you invested your time and resources to grow with their needs in mind . And now you've expanded to where you can't handle any more patients and so you've opened a second .

Then you've opened a second location . I think we oftentimes get the cart before the horse on that . Until we've dialed in our offering , it's still in work , always in work . But until we get that offering dialed in , we can't really go expand to multiple locations . But now you can confidently , and obviously you've done that very well . So what are ?

If you were going to give advice to someone who's you know getting started in this journey or looking to expand , what's some advice that you'd give them , or even some mistakes you would tell them to avoid ?

So make sure that whatever service or product your customers that you are providing is solving the problem for your customers . So that's one of the things that I would highly , highly recommend . The other ideas would be to just , you know , get out of your . It's not easy .

You know , when I started I'm a speech therapist when I hired my occupational therapist , it was not easy to decide who to hire , right , like so just getting out of your . Anything that you do new is to get out of your comfort zone .

And only then , only when you get out of your comfort zone and go in your growth zone , that's when you are really going to be able to really grow . If you are always fearing things and , you know , worried about things then it's going to be hard to just take on the next step . So just take the leap of faith and trust the unknown .

So she sits outside the room , watches them through the camera and trains the parent over the phone saying , hey , now this has happened , this is how you do it Really . Parent are a big part of our success because they are learning these techniques to transition them every day at home .

Wow , you know , every time we add a new location , you know there are so many ideas , there are so many things out there that we can and ways that we can help families right .

So one of the other things that we had started to offer earlier this year was aquatic therapy , where we had partnered with a local swimming aquatic center to offer that services , where our therapist went in and provided the services . So there's so many I mean .

So our goal is one center , one clinic every year in a new location where we can now help another service area in the community , and then also looking at the need of what is needed . So again , adding other disciplines and or services to help the community better .

Water is just a tool , but at the same time they do much better in water and we had a wait list of children that wanted aquatic therapy . So that's our next thought that , hey , you know , in our next clinic maybe we'll have a pool where we can offer aquatic therapy on site .

So we're always looking to do better and improve on the offerings that can help children .

So instead of going after every possible solution , oftentimes I go to these conferences where there's vendors and they're like you should try this new red light system and you should try this and that . And it's all very exciting , because they'll tell you stories about clients who are making all this extra money and all they have to do is spend 20 grand .

And you know everything that we do for our company is going to take a time investment and it's going to be a risk Like . But in your case , you're not so much sold on just the flashiness of growth as much as you're looking at it from a place of what do they want ? And listen to what she said .

She guys , rockstar , she talked about asking her clients frequently what else can we do to help you ? So , obviously , not all the clients are going to know . Sometimes people don't even know what they need , right , but you are at least listening to the things that they said that they do need and then watch what she's doing .

Guys , she's listening and watching as she grows . When they put in aquatics there was a wait list , oh , they like this . It was a pilot program for future growth .

So I'm sure Avni , your clinic , your company , when it has 10 clinics , is going to look very different than what it does now because you're constantly evolving , but it will feel similar because you're doing it in the same way , which is really powerful . So , yeah , that's really exciting . What else do you see in terms of growth ?

You know you're listening to your clients , your your , those types of items . Do you have any other ideas for different programs and things you want to implement ?

However , we do have a lot of children with cerebral palsy and other motor delays coming to the clinic , so I've considered this Again . This is a goal for future . If parents wanted to even offer hypotherapy , so sky's the limit in the therapy world , right ? Like you know , there are so many options out there .

You just have to weigh what works best for the population that you're serving and you know what else can you do to accelerate that progress .

I'm wondering with all this growth that you're doing , have you found that it creates job opportunities for development within your own team ? Is this something that you're you're able to use to help people grow in leadership or in other specializations ?

We have an org board and we have hierarchies in there where every five team members under a clinical mentor , and then certain number of clinical mentors under a lead , slp , and then so every under a lead , and so every role comes with the opportunity to grow and be able to teach the skills to your mentees .

So a growing company like yours that's looking at creating additional training , certifications , leadership developments with an org board I think that's one of the keys to retention that I've seen in successful companies like yours that I just want to highlight for the people listening , because growing centric to our clients' needs but then using that growth as opportunities

to help our team grow , is the magic formula . All we need is just more people Like that's a totally separate thing here . You can use it , of course , to recruit , but obviously , like in your case , that's going to be something I'm guessing you're going to be bumping up against as you continue to open locations is getting the right people involved to do that .

You know we are often as leaders , we think we do we . Nobody else can do something better than us . So well , we have to give an opportunity to everybody . Everybody has different strengths and just give them . Give them a chance to lead and they will do well .

I ask other successful business owners what they are doing and you know , just like me , they're always happy to share what mistakes that they've made , what not to do and you know what how can you improve Right . So , so like meeting other people , like-minded people . They'll give you a lot of energy . You know it'll give you a vision . Oh wow , she's doing .

She's doing this . You know so well . You know I can do it too . So that's one of the things . So forming that , finding those right people , reaching out to successful business owners that you idealize to be your mentors , would be one of the things that I would say as a speech therapist .

I'm a part of a private practice organization called American Association of Speech-Language Pathologist it's called ASPA . I would highly recommend people to join that group . We often have roundtable once a quarter where we go through issues that we as business owners always face , and people are , you know other business owners are talking about how they've handled it .

The other group that I really learned a lot from is Survival Strategies .

I didn't work with them personally , but I worked with a similar company called Measurable Solutions when I was a PT practice owner and it was just phenomenal . Measurable Solutions still exists , but Survival Strategies is so owner and it was just phenomenal .

Measurable solutions still exist , but survival strategies is so great and they're really heavy in the PEDS space right now .

And once you have learned how to do things , it's like now you can just duplicate . You know , and they've taught us how to do it .

I'd love to stay in touch and maybe have you back , if you're open to it , to help kind of just update people on your growth , and I'm sure there's a lot of people out there wanting to learn from you , whether it's a provider looking for a job or another business owner or future business owner who wants to network with you .

How can they get a hold of you ?

. So , avni , thank you again for being on the show .

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