Monday, May 21, 2012


It seems that the news, politics,  marketing, compliance, consulting, and even charity have all become the slaves of an EMERGENCY mentality! Watch it live as it unfolds.

All demand immediate attention and action it seems. ACT NOW! We careen along from one emergency to the next led by headlines, tweets, and shouting.

Get caught up in the emotion of the moment. No time for thoughtful reflect. Forget the analysis. Someone will interpret it for you. Don't understand it - just label it. Here today gone tomorrow - that's the news.

Well that's not how permanent change and long term value creation happens. Its how mistakes are made and unnecessary risk is taken.

Emergency management is no way to run a business. Its no way to grow a business, ...or trust for that matter.

Most things are not nearly as urgent or critical as others would lead us to believe.

Perhaps the proverbial window isn't closing - maybe its opening instead; and the glass isn't half empty but rather filling to overflowing.

When all one has is a fleeting snapshot, trajectory, speed and acceleration can't be judged.

Take a deep breath. Step back a few moments. Look around. Ask questions. Choose your own path.

Perhaps its time to replace emergency with cogency... focusing instead on relevance, rigor, validity, and credibility. Seek first to understand. Practice prudence and patience. Don't make decisions that don't need to be made.


(c) 2012
Performance Builders

Wednesday, December 21, 2011
As we watch another year wind down and celebrate the Christmas season and the beginning of a new year, I want to extend a simple thank you to friends and clients (they are one in the same) for another satisfying year of business challenges opportunities and friendships. It has been my privilege to contribute to your success and to have grown together.

Over the past 18 months I've been working with a select group of PT private practices from around the USA in a new business collaborative called InVisage. It is a close knit group that is quietly redefining how physical therapy is practiced and the opportunities that build on our competencies. If you are a PT private practice owner you might be interested. 

Because of my time commitments to the InVisage practices and other select physical therapy and personal training clients, I'm finding less and less time to blog for "public" benefit. Instead, my daily blogging and twice a week webinars are be directed toward creating prosperity for the committed few. Doing so also protects my personal time with family and friends.

The several hundred timeless blog posts that are contained here have been gathered over the years and are here for your exploration and use - I'm confident you will find benefit as a practice owner and countless others. I would particularly call your attention to the Matrix series (see select post topics in the lower left column).

 I'll be back from time to time with posts as time allows. In the meantime, feel free to contract me if I can be of service.

All the Best,

(c) 2011
Performance Builders

Friday, October 7, 2011

Welcome Gray Institute Live Symposium Participants

I have the privilege to speak at the Gray Institute Live Applied Functional Science Symposium in Chicago today. There will be dozens of speakers presenting on one stage with hundreds of therapists, trainers, and coaches participating. WOW!

My topic topic is "Tweakology ...Consider the Possibilities"

There are just 3 primary colors - red, blue, and green; yet when combined they produce infinite color possibilities - think rainbows, sunsets, and art. And, that's just the visible spectrum that our eyes can see... there is also the infrared and ultraviolet portion of the spectrum. The visible spectrum represents our body, the infrared our minds, and the ultraviolet our spirits - all three are a part of the spectrum and a part of life.

So too, exercise involves 3 primary elements - a person, a task, and an environment that engage 3 primary variables - movement, force, and time. When combined, they too produce infinite possibilities that touch body, mind, and spirit - that which we see and that which we don't see.

These elements and variables are what put the Magic in the 3-D Matrix.The possibilities are endless.

In preschool children are given a blank piece of paper and crayons (affordances) and invited to color. They predictably choose their favorite color (attractor well) and scribble (emmergent patterns) randomly across the paper (environment). Over time kids learn to draw lines, shapes and images (constraints). They learn to color (move) within the lines with purpose. They learn to mix (integrate) color and to introduce shading, texture, and perspective. Every child is unique. Every drawing is a unique reflection of the child who drew it.

So too it is with exercise. People tend to choose a few favorites and apply them randomly and even recklessly. But exercise like color can be evolved, refined, and customized to reflect the unique needs and aspirations of any person at any time.

As therapists, trainers, and coaches we are artists. We don't paint on canvas but rather sculpt in the flesh and bones of our patients, clients, and athletes.

Tweak! ...Put the magic in the matrix. ...Put the magic in living!

Enjoy this celebration of kids, color, and movement and remember you have the power to create perfect exercise for each person you engage... The Crayola Song (~4 min.). 

Consider this Matters That Matter Reflection "Creatures" on the art of sculpting movement.

Search for the magic! Become the artist you are meant to be!

All the Best!


(c) Copyright 2011
Performance Builders

Thursday, September 29, 2011

Vote Yourself Off the Island

I talk to a lot of Private Practice Physical Therapy Owners every week. Most describe feeling like a cast-away alone on a desert island, under the hot sun of regulations without shade, insufficient resources, and surrounded by sharks (declining compensation, rising costs, staffing challenges, productivity issues, moneyed competition, an un-level playing field, and more...). It seems the harder they work the less they have to show for it. Time for family, friends and the rewards of success continue to erode.

As long as PT practice owners continue to play a defense game alone, they WILL continue to lose and lose BIG!

It's time to take control, team up and go on offense!

All The Best!


(c) Copyright 2011
Performance Builders

Tuesday, September 27, 2011

We're Breaking-Out...

The practice of physical therapy is controlled by payers not patients and professionals. Insurers (private and government) define PT practice. When you play a game defined by someone else, on their field, with their equipment, rules and referees, who do you think is likely to win? For decades PT has built walls to protect the interests of consumers and qualified providers. Today those walls are feeling less like a castle fortress and more like prison walls.

It's time to break out!

All the Best!
(c) copyright 2011
Performance Builders
Sunday, September 25, 2011


The following from Seth Godin crossed my desk this morning and I thought it worth sharing...

Marketing of the placebo: Everyone gets their own belief

"The placebo effect isn't a lie. In fact, if you believe something is going to help you get better, it may very well do just that.

This very same effect works with stereo equipment, wine, politicians... just about everything where our belief intersects with reality.

You can believe that Ford is better than Chevy, that California reds are better than French ones and that your particular tribe is right (and that everyone else is wrong.)

Marketers love the placebo effect because it opens the door to stories and fables and word of mouth and varied perceptions. It gives marketers room to sell more than price and features. The first cultural byproduct this benefit creates is the notion that everyone is entitled to believe what they believe, and it’s rude to question it.

The second, is a real problem, though. If you spend enough time experiencing your own take on reality, you come to believe that what works for you might actually be a universal truth. Marketing plus psychology might equal science, it seems.

For the placebo to work, you have to believe it, but sometimes believing requires suspension of your connection with verifiable fact.

When that happens, we might believe that we’re entitled to believe things that conflict with demonstrable truth and an understanding of reality. With enough internal spin, you can believe that the moon walk was a fake, that levitation is possible and that the world is only 6,000 years old. You are welcome to believe that aqua metals will improve your sports performance and that z-rays will cure your arthritis, but only until it collides with things that are actually true. Placebos are a good thing, and everyone is entitled to their own beliefs, but they're not entitled to their own science.

We now have to deal with the fallout from personal science. We've so blurred the lines between stories we tell ourselves and our perception of the outside world that it's easy to be confused and easier still to confuse others if it advances your cause...."

As the saying goes, "The problem is not in what we don't know, but what we do know that just ain't so." Where is the placebo affect holding back your performance, career, practice, relationships, potential? What is it that you believe that just ain't so?
Saturday, August 13, 2011

InVisage InVitation

Over the past few months I've hinted about a group of progressive physical therapy practice owners that have come together from across the country to redefine competitive advantage and in doing so create new possibilities and prosperity for their practices. They are clear-eyed professionals who understand one does not take the lead by playing follow-the-leader or running with the crowd. 

When everyone is zigging there's a lot of value in zagging. They are zagging - big time! 

Maybe you should too...

Each has purpose, autonomy, and mastery in their clinic practice, business operations,  marketing, and in themselves as leaders. Each is practicing differently, each is practicing better, each has taken control of their own future and reward is seeking them out. 

Times have changed. Old patterns of practice are no longer adequate.Old patterns of professional association have lost potency. The playing field is not level and will not become level. Risks are greater as are their consequences. The rules and economics of practice have changed forever.

This coming together of like-minded private practice owners is called InVisage. It is doing together what no one practice could do alone. InVisage is a game changer. It is an exclusive collaboration of premier practices in exclusive markets that are innovating fast, gaining momentum, and getting results. InVisage is not out to change the profession; but rather to progress beyond the profession. Its not about surviving. It is about thriving.Invisage is for progressive physical therapy private practice owners who belief there is more, much more, than the tightening constraints and frustrations of traditional PT practice.  

Interested? Contact me. 

Perhaps InVisage is in your future...

All the Best!


(c) copyright 2011 
Performance Builders
Friday, August 12, 2011

You are the Gold

"Recent fluctuations in the stock market have driven the price of gold way up. Many people believe that when currency weakens, gold is a standard that you can depend on.
 I’m not an economist, so I cannot say if this approach is correct. Yet whenever I hear about people flocking to buy gold, I remember the advice I once heard a spiritual teacher give a student who could not seem to get a handle on prosperity. “You are the gold,” he told her.
We all like the idea of what money can do for us, but few of us recognize what we can do for ourselves. Spiritual guide Bashar predicts that, at some point, our economy will shift from a standard based on commodities such as gold or oil, to a standard based on the value of people and the skills and talents we have to offer. We will cease to trust in stuff and begin to trust in spirit.
This makes a lot of sense to me. There is much strife in the world as people fight over commodities with limited resources. Meanwhile, human beings are the ultimate renewable resource. The most successful people are those with good ideas, which are infinite and eternal. Stephen Jobs, for example, has commandeered ideas that have revolutionized the computer, audio, and PDA industry. He is wealthy, not because of what he gathered from outside himself, but because of what he brought forth from inside himself.
 Buy gold if you want to, but don’t overlook the gold inside you. You are precious and powerful beyond measure and not at all subject to fluctuations around you. Bashar suggests, 'Take stock in yourself.'" - Alan Cohen

All The Best!


Performance Builders
Monday, August 8, 2011


David, in response to your question about negotiating compensation...

Fair question... here are my thoughts.

The underlying principle is fairness - win/win. When a one time transaction is involved, the issue of fairness is transient and short lived. But when the transaction is ongoing as with employment or service contract, the matter of fairness is always on the table and is likely to shift due to changing circumstances - what was fair yesterday may no longer be fair going forward. Thus periodic review is warranted.  Employment is about mutual exploitation of value. When the value is no longer mutually beneficial or overly constraining it will end.

Compensation is all about contribution. At the heart of mutual value exploitation is the fairness of compensation relative to contribution. Increased compensation assumes there is a proportional increase in the creation of value. If one desires more compensation, one must be willing to contribute more value creation. Since one's compensation is assumed to be economic (i.e. not just heart felt gratitude), then one's contribution must also be economic. Just because someone is handsome, really liked, and smart does not mean they contribute economic value. The value of knowledge is proportional to its fruit. I frequently see GIFT Fellows who expect higher compensation because of the knowledge they have acquired. That knowledge is worthless in an employment situation unless it is translated into economic value - more clients, more revenue, better profit. That's just the way it is.

Professionals are not motivated primarily by money. Compensation needs to be adequate but it is not what drives knowledge based workers. In fact, financial incentives only work in manual labor. Financial incentives actually have a negative impact in knowledge based work. Professionals are motivated primarily by Purpose, Autonomy and Mastery. 

Tenure has little economic value in employment. People are not worth more simply because they have been with a company for a long period of time. Their value is determined by their current level of contribution. As such annual increases make little sense unless they correct a market inequality or contribution has increased.

The first responsibility of a business owner is the survival of the business. Employees who demand too much compensation can and often do undermine the vitality of the business, reduce job security for all who are employed, and reduce the company's ability to serve its customers. 

So with compensation there is the matter of contribution and business vitality. 

Shift gears...

If I'm an employee and I want to earn more, first I must demonstrate incremental, or even better, exponential financial value creation. That is what justifies higher compensation. I need to be willing to give it before I get it. I need to prime the pump. Oh, and I also need to practice good loyalty, team work, and good company citizen ship. Employees with low productivity, who are  high maintenance, demanding, or generally a "pain in the ass" are in a poor position to negotiate anything.  

Next I must find out what I'm worth in the market place. To do that I can: ask around, seek other job offers, and research compensation databases (many available on the internet and through professional associations). This is all about benchmarking - where do I stand in comparison to others and how do I contribute in comparison to others. Keep in mind that compensation involves wages, benefits, working conditions, growth/advancement opportunities, flexibility, etc - compensation is the whole package. There is always variation across employment situations. Sometimes these are negotiable and sometimes not. Employers do have certain legal and practical fairness obligation. 

As to actual negotiations, I'd recommend stating what financial compensation you want and why you deserve it - value creation, economic contribution, comparative compensation, commitment/loyalty, and willingness to share financial risk Then talk about the time line for achieving your financial goals - it may not be possible tomorrow, but can you at least launch on on a favorable trajectory. Be creative - what can you substitute for dollars, how else could you contribute, how much risk are you willing to accept in exchange for greater opportunity? For instance, would you be willing to risk a 20% reduction in compensation in exchange for a 20% upside opportunity depending on your financial contribution to the business?

One thing is for sure - if you go into a compensation negotiation with attitude, anger and threats it will backfire eventually. Conduct your negotiations professionally and respectfully. Be factual. Be creative. Be accountable. Be patient. Be fair!

I hope there's a nugget or two in all of this that you can use.

All the Best!


(c) copyright 2011
Performance Builders
Sunday, July 31, 2011


It's been a tough week to escape the federal financial debate, no correct that, "Debacle". The country is less faced by a debt ceiling than by a leadership deficiency. At the heart of every conversation is the issue of entitlements. Nearly half of Americans pay NO taxes, but all want what is "entitled" to them... think social security, medicare, medicaid. The federal government more than doubled since 1965 - of course state and local governments have also grown. None of this is a surprise. The financial implications of baby boomer retirement has been well documented for decades by the Menniger Foundation and foretold by Kotlikoff in his book The Coming Generational Storm (2004). But somehow the inevitable is conveniently pushed aside.

There is another entitlement issue. It is one faced by nearly every physical therapy practice in the country. It is the entitlement of compensation driven by labor shortages but supported by third party reimbursement. Over the past 2 decades, I have had the pleasure of working with over 100 hospital systems, and several hundred private practices. Interestingly, I've never found a hospital based PT service that knows what its profit margin is - yes they know how they compare to budget with all its arbitrary and rationalized allocations but not whether they in fact are creating economic value or even covering their own expense. Likewise, it is rare indeed to find a private practice PT owner that can simply answer the same two questions. Then there are employed PTs... are they creating financial value for their employer and for their own job security? Is that value proportional to their compensation? 

The US federal government will be paying over half of the entire US health bill by next year - that's even before national health insurance (2014). Do you think that the federal government solvency might impact Medicare spending? Do you think Medicare spending might impact PT provider reimbursement? Do you think PT provider reimbursement might impact PT compensation? 




Are you entitled? Think again!

All The Best!


(c) Copyright 2011