The Client Experience Nobody's Building On Purpose with Jerry Durham

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Jamey Schrier: Why do some practices create loyal, raving fans, while others deliver good care and still struggle to grow?
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Jamey Schrier: Welcome to Freedom by Design, I'm Jamey Schrier. This is the podcast for practice owners who are ready to think differently about their business, take ownership of what's really holding them back, and build a business that actually sets them free.
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Jamey Schrier: Today's guest has spent years helping practice owners rethink something most clinics completely overlooked, the client experience.
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Jamey Schrier: After owning a physical therapy practice in California, and later relocating to Philadelphia, he went on to build a company focused entirely on helping healthcare businesses create experiences that drive loyalty, retention, referrals, and growth through the front desk.
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Jamey Schrier: Joining me today is Jerry Durham, the one and only. What's up, man?
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Jerry durham: Howdy, Jamie. Thanks for having me on. You know, yeah, and I always love when people reach out to me for podcasts. I'm like, you sure you want to take that risk? So, I appreciate you reaching out and, giving me yet another megaphone to yell through about the stuff I've been yelling about for about 15 years.
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Jamey Schrier: Absolutely, and you know, you and I, just for people listening, you and I go back a little bit of ways. It's been at least 15 years, maybe…
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Jamey Schrier: Maybe longer? You know, you get older and you realize that the journey has been a winding and twisty turning. It's not just a nice upward flow, is it?
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Jerry durham: Oh my god, no. It's that picture where you see that, right? What everybody thinks it's like, and it's, like, that nice, steady arc versus just the scribble, like, that looks from an Etch-it, or from an Etch-A-Sketch yet, type design.
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Jamey Schrier: Which, of course, you and I would know what an Etrosketch is, so… And nobody else, right.
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Jerry durham: So we just separated… we definitely dated this, the people on this call, so that's good.
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Jamey Schrier: So, I, want to start with, let's just go back a little bit, because I always like to know people's backstories and stuff. So, when we first met, you had a private practice, I think multiple locations, you had a partner, and you were in California, I believe in the San Francisco area, and then, all of a sudden, I'm seeing you.
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Jamey Schrier: in Philly. We run into each other, at, at this, speaking, really cool event. I'm like, dude, what are you hearing? He goes, I live a couple, you know, a couple blocks away.
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Jamey Schrier: Tell me just about that… that… where you were then, the practice, and then you moving out here. What prompted all that? I'd love to just get a little backstory.
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Jerry durham: Sure, I want to… yeah, so I want to touch one… so that… had that business with a partner for 18 years that I was in it. And really, the jumping-off point for all of this was we went out of network in about 2007, 2008. So, I'm gonna say it again, before it was cool.
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Jerry durham: And it should have always been cool, because it was a business decision, so let's bring it back to what we're going to talk about, Jamie. Yet, I didn't… I knew it was a business decision at the time, but I didn't really…
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Jerry durham: Realize the extent of what we hadn't done.
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Jerry durham: up to that point, that needed to be done, and should have been done in something that I was calling a business. And I just take ownership of this from my side. So we go out of network.
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Jerry durham: And I remember my… and we were… we were working towards it, so it was the easiest decision, seriously.
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Jerry durham: I mean, it sounds like a huge decision, and it was, but because of all the work we had done, it literally was like, we gotta do it. Cool.
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Jerry durham: When do we have to do it by? January 1. Cool. We had, like, 3 months.
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Jerry durham: I remember my gut response, I'll never forget this, Jamie, which leads us into where I am today and what I've created, is I remember going, hmm, we have to start talking to people on the phone differently when they call into schedule. That was all I remembered, because we were going from in-network to out-of-network. So now let's fast forward. So I spent all those years
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Jerry durham: Figuring out what the hell that meant.
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Jerry durham: And that statement, who would have thought that a statement like that would lead to the journey I've been on?
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Jerry durham: Where it then turned out to building out a front-end cell system, right? That pre-arrival phase, of which I had no idea what I was doing.
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Jerry durham: And then realizing… by the way, so I was…
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Jerry durham: if you want to say this, completely out of the clinical space, I was working with the front desk team, I was working with the initial phone call, I was working with what happens when they show up. All the work to win, then the provider walked out and greeted them.
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Jerry durham: And making sure that continued, but really focusing the work there. So the more time I spent in that, the more I realized how much I loved it.
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Jerry durham: And really, that was my passion. I was like… I literally… I mean, we're all salespeople, we know it at heart. If we're physical therapists, we're salespeople. But that was really the moment in time where I went, holy shit, I love this sales thing.
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Jerry durham: And I love this part of the business. And I mean, I wasn't disconnected from the clinical, but man, I was spending no time in the clinical side of the business.
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Jerry durham: Was that pre-arrival, the front desk, and then, like, billing issues, and how are we managing cancels and no-shows. So finally, I decided that I wanted to do that more than I wanted to be in the business.
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Jerry durham: So, I left the business, yeah, and started a client experience company, and then doing exactly what you said. I found out it worked for us, I had helped some people.
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Jerry durham: do the same work, and I said, you know what, I think there's a lot of legs here in helping more people do this. And we could call it going… it didn't matter whether I said, do you want to go out of network? Do you want more arrivals? Do you want less cancels? It was all still the same work, I realized.
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Jamey Schrier: threats.
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Jerry durham: So, that's what then led me to being mobile. So, let's get to Philly, right? So now, I'd created this company, Working Consulting, so it didn't matter where I was for the first time, right? We… we grew up in a generation where there was only one choice of treating. It was in clinic.
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Jamey Schrier: border.
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Jerry durham: business, right? I was tied to wherever we… and you know what I mean by tied. I was, you know, I wasn't going to move out of state.
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Jerry durham: So after I got out of that, then we became mobile, and then my wife and I had said, you know what, we always want to go to the East Coast.
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Jerry durham: Let's go to Philly.
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Jerry durham: And so, that's how we ended up there, and yeah, I walked to the event, and there you were in the event, literally walked from my place. You'd flown 3,000 miles, or…
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Jerry durham: however many miles. Sorry, it probably wasn't that many, but I'd walk, like, 6 blocks to get there, so that was funny. And yeah, and so we, spent our time there. By the way, so I had this… I had this great office, right, because I was consulting at the time. My wife was going to the office, then COVID hit in there, and then magically.
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Jerry durham: my wife and I have been working from home together ever since. So, you know, that was a big transition, but yeah, it gave me some mobility, because
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Jerry durham: the consulting, whether it was pre-COVID even, was via Zoom or showing up in people's clinics, you know, COVID changed it a bit, but still, coming out of COVID, it was still the same. So, that's… that's how my journey has gone, and I'm gonna tack on one more. We came back to California about less than a year ago, so now I'm backing up.
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Jamey Schrier: Once you're back in California.
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Jerry durham: Yeah, full-time. Still at the place in Philly.
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Jamey Schrier: Where back in California are you?
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Jerry durham: So, we are in Southern California. I'm born and raised here, just.
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Jamey Schrier: Oh, okay.
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Jerry durham: Yeah, so both my wife and I were born and raised, and everything…
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Jerry durham: we're the only two ever left the state, which is kind of interesting when I look back at both of our families. So, it was great to have the base here while we were gone, and then was a big reason why we came back. The intent always was to come back.
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Jerry durham: That we knew at some point we would get back, but we wanted to embrace the East Coast. Man, I love the frickin' East Coast, and needless to say, it fits me well, with my…
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Jamey Schrier: Oh, I think Philly fits you perfect.
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Jerry durham: Yeah, it does… it really did, and dude, I used to go… I used to just go to Philly baseball games. I didn't care if my Giants were playing, right? I'd gone to Eagles games, right? I'd go down to that Xfinity Live. Yeah, I embraced it all. And I'm going to say, I hate the Eagles because of my Niners, 49ers, but I was there for the second Super Bowl win.
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Jerry durham: I wouldn't trade that for anything, so I got… I was physically in the city, in… I wasn't in the middle of it, but I was right.
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Jerry durham: Me, yeah.
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Jamey Schrier: Let me watch.
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Jerry durham: I should've written.
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Jamey Schrier: Let's get a fan through.
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Jerry durham: Yeah, oh, there we go.
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Jamey Schrier: We can share hating the Eagles all you want.
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Jerry durham: So, and I was pulling for the… yeah, yeah.
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Jerry durham: Yeah, I pulled for the Eagles, so when my Niners go, then I pulled for the Eagles, right? I'm, like, my heart team, my heart team. But yeah, now I'm back here, and I'm still doing the same work, and still loving it, and .
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Jamey Schrier: So let me ask you this. Obviously, you've been around for a little bit, as have I. You've seen a lot of the changes.
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Jamey Schrier: What do you think is…
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Jamey Schrier: What do you think is going really well right now in the world of rehab?
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Jamey Schrier: just the things you see, I mean, I know you're involved, I see you, you know, connected to a lot of people, commenting here, commenting there. You're not a loss for words for anything.
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Jerry durham: how much we had to.
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Jamey Schrier: makes a great guest, of course, but I wanted to start with the positive, because I believe in go big, B-I-G, beginning gratitude. So, looking at it in a good frame, what's going really well in this rehab industry, in your opinion?
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Jerry durham: Check this out. So I'm gonna kind of come through the side door on this, not completely the back door.
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Jerry durham: I truly believe what's going well right now, Jamie, and I think you can appreciate this more than most, is we're being forced, right? So I was able to start a business… oh, sorry, I don't even call what I created a business until about… we went out in that work. I was able to create something and believe it was something other than it was.
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Jerry durham: Because…
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Jerry durham: payment, what people call reimbursement, I call it payment. Payment was good, right? And it was easy to manage.
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Jerry durham: Just by the numbers.
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Jerry durham: And that's all we did. But then you get… you really get in the weeds on, man.
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Jamey Schrier: We got spoiled, basically.
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Jerry durham: Yeah, and then you… yes, and then we got lazy because we were spoiled.
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Jerry durham: I'm going to say it out loud, and because I experienced it. So anything I say poorly, I want to give a quick preference here. Anything I say poorly about business owners, about the profession, I was part of that. I did it 100%, and probably did it far more than most people. So I come from a point of not doing these things, and then… and then moving into this world going, what was I doing, right?
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Jerry durham: What I think is really positive right now, Jamie, is people are being forced to get their head out of the weeds. And by the way.
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Jerry durham: Owners.
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Jerry durham: managers and providers. Everybody get their head out of the weeds and go, what really is going on here in the business of physical therapy? I'm getting more inquiries than ever, as you are too, just people going.
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Jerry durham: Basically, the theme is something around, I need to change this, I don't really know what part of it, but I know I need to change it. So, to me, the change is coming.
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Jerry durham: whether it's AI, whether it's continued.
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Jerry durham: cut of payment, reimbursement, whether it's team, right, through Medicare, whether it's access, all of this, all of those things, I say the commonality across all those are people going, hmm, I may need to change something, hmm, I may need to learn more about the business side of healthcare, and I believe that's a positive thing.
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Jamey Schrier: So you're looking at this as a wake-up call.
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Jerry durham: Yeah.
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Jamey Schrier: You're like, this is a long-overdue wake-up call for people that have been…
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Jamey Schrier: more or less, sleep at the wheel. Obviously, there's always your ambitious few percent that have completely saw an opportunity and taken it, but for the rest of us, you know, reimbursements were not too bad. I know when I started my practice in Maryland, I know it from this day, it was $114.
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Jamey Schrier: Now, I think it might be in the upper 70s? Yeah. Or so. So,
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Jamey Schrier: people are asking different questions, and you and I both agree on this. You start asking different questions, you start to get to different solutions, and that's what has to happen. So, alright.
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Jerry durham: Yeah, that's my positive, that's my positive, is…
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Jamey Schrier: Well, let's go to the other side.
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Jerry durham: having to ask different, and I would say, better questions.
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Jamey Schrier: Yeah, for sure. So let's go. What is, and it's only a, you know, 35, 40 minute show, what is…
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Jerry durham: Sorry, I blocked out 4 hours.
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Jamey Schrier: What is the possible issue? We can go longer if we want, I don't care.
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Jerry durham: Okay.
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Jamey Schrier: I shall. What is… not going so well right now. Where, where do you find is,
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Jamey Schrier: The big trouble spots.
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Jerry durham: So, here, here's what I'll tell you. Here's what I don't think…
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Jerry durham: has changed, and I literally did a speech on this, and I still have a copy of it, and I did this, like, 8 years ago. The drivers of change in healthcare are actually the people we serve, not us.
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Jerry durham: We have done and continue, and this hasn't changed one effin' bit, we need to leverage the people who benefit from our services and what we do. We need to leverage them more, and by them, I mean their voices, their stories.
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Jerry durham: the impact we have created for people, if we truly want to drive advocacy change, payment change, all those things, we need to stop showing up en masse as a
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Jerry durham: as a, right, we have an invested interest. We need to let people who do not, who have experienced us, and get to say, I paid for these things, I committed my time, money, and energy to this, and this is how much better I am because of it. And if we engage the people we served.
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Jerry durham: more on social media, on advocacy, in PR, in advertising, in every sense of everything we do, then we truly see some change, I believe, in some of these other things.
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Jerry durham: But signing another… a bunch of PTs signing another petition on changing
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Jerry durham: reimbursement and payment, I'm like, how's that work for the last 34 years I've been here, right? So that's the thing that still frustrates me in all this.
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Jamey Schrier: I get you. So what's the real serious problem, then? What are you seeing on the horizon?
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Jerry durham: Yeah, is we keep doing the same thing, so we…
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Jerry durham: So, so the real serious problem is the 35th year of having payment go down. So, again, we can list out, Jamie.
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Jerry durham: just about any problem anybody's having right now in the profession, and I'd say that solution lies in engaging the people. So whether it's payment, whether it's access, right? I did a post on access the other day, and access means more than just money. It means having the capacity to serve, right?
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Jerry durham: If all of these things, if we want these things to change for the better.
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Jerry durham: Right? Why are only 10% here? This is interesting.
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Jerry durham: And you and I know where the first answer people will go. Why are only 10% of the people who need our help ever finding us?
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Jerry durham: Right? I believe the answer lies in engaging the people we have served.
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Jerry durham: and giving them a bigger megaphone, and that 10% would grow quicker than anything else. Now, mind you, we can then look at the flow, Jamie, of what the impact of 1%, 5%, 10% more of the population looking to use our services. And at the same time, I'd argue, as they're doing PR for us, they're also doing advocacy for us. So the overlap of these things where
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Jerry durham: We have Advocacy Day, and that's separate than the marketing we do, and that's separate than this.
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Jerry durham: I'm like, the people we serve could pull all that together and give us a bigger return on our investment, time, money, and energy, whether it's payment, whether it's access, whatever it is, right?
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Jamey Schrier: I hear ya. I, I, I, I agree with…
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Jamey Schrier: I agree with where you're going with that, that… our…
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Jamey Schrier: The people we serve, being the clients, being the patients, are the ones that have the voice. They have the pocketbooks. They're the ones that are paying us through the insurance companies.
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Jamey Schrier: And I thought you were going to say this, because you and I, you know, had businesses 20 years ago. I thought you were going to say, except for the technology part, the AI part, specifically the AI, the same problems we're facing today, they're the same problems we were facing.
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Jerry durham: Yeah, they are, yeah, yeah, absolutely.
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Jamey Schrier: We're facing HMOs and declining reimbursements, and guess what? Reimbursements, no one, nobody goes, hey, we should increase them.
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Jamey Schrier: Right? I mean, Medicare might, because of some rule we get passed for a hot minute, but generally, they just keep going down and down and down, because we are a red line in their expense sheet. Like, we're like, oh, God, we gotta pay Schreier again?
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Jamey Schrier: Man, let's see if we can run them through some, you know, more…
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Jerry durham: Got another 10%, what's another 10%?
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Jamey Schrier: Yeah, it's only 10%, it's only 2… oh, no, it's the 2%. What's another 2%? 1%. You know, half a percent, 3%, and all of a sudden you look, it's 18% that you have to make up.
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Jamey Schrier: A lot of clinics… I'm going to switch here a little bit. A lot of clinics focus on clinical outcomes, right? There's a lot of, you know, especially in the PT world, a lot of stuff that's out there. You're focusing on
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Jamey Schrier: the client experience. Dive a little bit more about your perspective around the client experience, and how…
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Jamey Schrier: I guess what people don't understand about it… first of all, you call it the client experience, not the patient experience. I don't know if that's intentional or not, knowing you.
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Jerry durham: as all hell, dude, right?
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Jamey Schrier: Yeah. Knowing you…
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Jerry durham: No one…
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Jamey Schrier: conventional. Give us a perspective.
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Jerry durham: When… you know what I love? You know why I called it Client Experience Company? Because I went through this and go, when do you call them a patient, and when don't you?
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Jerry durham: oh, we have a new patient scheduled. I'm like, no, it's not a new patient. They're not a patient until they show up. What are they beforehand? So, it was very intense.
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Jamey Schrier: Prospect.
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Jerry durham: And I believe… I believe in the power of words more than anything, and most of the work I do, and I was doing a lot of it this morning, because I have a company where I train front desk teams, right?
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Jerry durham: So, the training is so much the words we choose, right? So, yes, there's a process to sales.
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Jerry durham: yet how I present something to Jamie, right? I can present something to Jamie, someone next to me can present something to Jamie, we could both be presenting the same thing, it's just in the manner we
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Jerry durham: choose. So, words are really powerful. So that patient word… by the way, I did a deep dive into the term patient. It is one of the most passive words ever created.
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Jerry durham: Right? And it was about someone being in a hospital, is how it started. Well, so, an outpatient, they're… they're not in a hospital, they're not passive, they're going to work, they're doing their shit. So, yeah, that's why I called it client experience.
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Jamey Schrier: And does anyone really like being called a patient?
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Jerry durham: Dude, yeah.
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Jamey Schrier: I'm somebody's client, okay, and they're my client, but am I someone's patient? It sounds like I'm, like, in the lid, like, I'm incapable.
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Jerry durham: I've gotten pushback on a healthcare consumer, they're not a consumer. I'm like, are you effing kidding me?
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Jerry durham: They're a consumer in every…
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Jamey Schrier: consuming your services. If they're not a consumer, who's pushing back? Like, what are they pushing back with? They're not.
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Jerry durham: Yeah, well, I… you know, they start telling you they don't have choices, they don't have this, they don't have that. I'm like, I don't care what program you're on, everybody's paying for something, right? And by the way, here's the other thing, too, I want people to consider in this conversation.
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Jerry durham: if it was just about cost and just about insurance, then why doesn't every in-network clinic in America have a 100% arrival rate? The lowest arrival rates I've ever seen are all in in-network clinics. So, I'm just going to leave it at that, in a context of, this is what I'm going to say next, right? It's…
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Jerry durham: Arrival rates consistently, Jamie, the biggest impact I've made are with… everybody likes to say, oh, you're the out-of-network guy, you're the cash guy, you're the sales guy, you know, and I'm like, no, I'm the…
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Jerry durham: Patient, client experience guy who drives more rivals.
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Jerry durham: Because the arrival rates at the in-network contracted clinics are damn near unethical, in my opinion.
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Jerry durham: So, I don't remember the original question, but man, there's a lot of shit there to unpack.
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Jamey Schrier: That's alright. You know, I'm prepared for everything here, so I like what you just roll, man, it's always.
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Jerry durham: Yeah, I mean, all of that goes into, then, why the experience? Okay, so let me tell you this, and I think the origin story is important here. I was working with my clinical team
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Jerry durham: when, Bishop and Belosky started releasing their expectations research.
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Jerry durham: And what I found was people were leaving us and dropping off because of one big thing.
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Jerry durham: Right? And this is a whole separate story, but…
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Jerry durham: expectations were not managed properly. Either we didn't set them, or we didn't… right? We didn't ask them, or we didn't set them.
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Jerry durham: So, cool, so I'm meeting with all my providers and talking about how we should be doing this in the eval room. Then I start working upstream with the front desk, and one day it hits me that why the hell
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Jerry durham: Are we waiting?
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Jerry durham: We're taking a phone call.
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Jerry durham: We're scheduling someone 7 days out, we're doing all this work, and we do zero to set expectations. And we're waiting for them to show up in the clinic, drop their money, and then hope expectations are getting set. I took that same expectations research and built it into the front-end process.
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Jerry durham: Expectations, it was back about clinic, outcomes. Expectations. So if you want to tell me your outcomes-focused, expectations are the only consistent alignment with outcomes in all of our research. I said that out loud.
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Jerry durham: Let's say it out loud, everybody. Expectations align with outcomes. So if you tell me, Jamie, what has made you better in the past, if you tell me what you believe will make you better, then I've got to take that into consideration, because that's what's going to move you through your course of care.
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Jerry durham: To the outcome that you deserve.
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Jamey Schrier: a second, because I, you know, some of the stuff you're saying, I feel like you've gotten pushback on that.
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Jerry durham: Oh, ho, big time.
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Jamey Schrier: Of course, I'm listening, but…
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Jerry durham: Big time.
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Jamey Schrier: and I think a lot the same, so.
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Jerry durham: Buy it, big time.
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Jamey Schrier: We're two people just talking about, so… but not everyone's gonna think the same, so I wanna try… I wanna think like my audience, right? So…
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Jamey Schrier: what is the pushback happening, and what are you saying? Because you're talking about… I call it setting the stage. Anytime we're working with our clients, it's like, look, I don't care if you're speaking to someone, I don't care if it's on the phone for a potential client or a prospect, I don't care if you're speaking to a doctor, or you're in front of an audience.
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Jamey Schrier: You know, you set the expectation, you set the stage of what's gonna happen. A lot of times that reduces, you know, if they're anxious, if there's for time, yada yada yada.
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Jamey Schrier: You're teaching people to set the expectations. Here's what you can expect. Here's what's gonna happen. And then, of course, you follow up and do it, and then, of course, you told them what you just did. So, it's you tell them what you do, you do it, then you tell them what you just did. I don't know who came up with that, but I remember reading it somewhere.
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Jamey Schrier: Who the heck?
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Jamey Schrier: is pushing back on that. Like, where's… what am I missing there? Because you mentioned the… I guess it's the outcome people. What's happening with that?
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Jerry durham: So there's that difference between giving people what they want and what they need, right? That's where it starts to come from the clinical side.
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Jerry durham: Okay. So the clinical side, two things, and again, I want to set this context early.
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Jerry durham: when I get pushback, people talk about this moment in time. I'm like, nothing's moment in time that we do. I mean, it's courses of care, it's an ongoing relationship, it's a journey. So I always get this pushback, we shouldn't give people what they want, we should give them what they need. And I'm like.
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Jerry durham: But that's a journey, that's… I mean, that's marriage, that's dating, that's everything in life. And nothing is about saying, cool, Jamie, I can do all this unethical, low-value stuff for 12…
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Jerry durham: visits for 3 months, for 6 months. That's not what I'm talking about, right? Right? And you get it, you've already repeated it. It's about managing
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Jerry durham: an expectation. It's about setting an expectation. Yes, Jamie, we do have physical therapists who do hands-on care. Well, we all know what the research says about just hands-on care. I didn't say we just do hands-on care. But you know what I'm selling during that first step is
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Jerry durham: That meeting with the provider where you get a plan of care, which is your journey back to
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Jerry durham: the gym pain-free. Your journey back to picking up your grandchild pain-free, right? Whatever that desired outcome it is. But the next step, Jamie, the most important thing you can do next, is show up on Thursday at 10 o'clock, because this is what you're going to get during your hour with your expert, Dr. Jane Doe. And so I set the… I set this expectation. At the same time, I'm going to pass on
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Jerry durham: parallel, Dr. Jane Doe, that hands-on care has helped Jamie in the past. Jamie's had a bad experience with physical therapy, he didn't like being left in a gym to do his exercises on his own. I'm like, so if you fuck that… oh, sorry. If you mess that eval up.
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Jerry durham: That's on you 100%. But if you take that information and start building that clinical relationship with Jamie, you're gonna get to what they need more than what they want. So, that's my answer to that. Everybody sees this. Every time I get pushback.
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Jerry durham: it's… and it's funny to see the people that have come around, because I've never changed my tune on most of this stuff.
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Jerry durham: Anytime I get pushback, I say, this is about a journey, it's about a course of care. You guys are talking about one incidence of going, yes or no, we can do that for you. I'm like, nothing in life is like that, right? I'm like…
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Jamey Schrier: Yeah.
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Jerry durham: And so…
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Jerry durham: it's approaching it as managing a conversation, managing expectations, but I can't manage expectations, so I first learn yours. By the way, no expectation is the biggest disaster creator in
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Jerry durham: physical therapy that no one… it's the people who show up with zero expectations that flame out the fastest and biggest. So I'm like, just get the expectation, and let's start a conversation.
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Jamey Schrier: Yeah, I see where you're coming from. I… it's almost like…
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Jamey Schrier: You're combining the psychology of just who we are as human beings…
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Jerry durham: Got it.
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Jamey Schrier: You're adding in that marketing component, which is really just psychology. You got it. And you're saying that, look, that first person, and I've always said this, the most important person is the front desk. I've said it for 25, 30 years. You've taken it to another level, into a business.
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Jamey Schrier: Because that person is absolutely, persuading someone to do something that is good for them, which is my, definition of sales, which is adapted from,
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Jamey Schrier: Dan Sullivan. His was much longer, I just kind of short.
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Jerry durham: Yeah, no, I got… I like the Dan Sullivan stuff.
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Jamey Schrier: Yeah, it's like, you know, I'm persuading you to do something that I believe is good for you, that will help you. That should be what sales is. If we truly believe in what we're doing, I do think we have a problem of believing in what we're doing.
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Jerry durham: Yeah, there's that too, right? And that's… that's that. You know, it's funny, Jamie, you say that part, because I want to pile on.
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Jamey Schrier: Yeah.
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Jerry durham: when I go to… so, I can either, A, train someone's front desk, or bring a virtual salesperson, virtual front desk sales associate, I call them. Everybody always asks, you know, it's weird? It's weird in Heinz, I probably asked it a million times, yeah, because I used to do this, right? Oh, do they have healthcare experience? And to which I always say, why?
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Jerry durham: Why is that important to you?
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Jerry durham: To your point, because I find it's easier to train
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Jerry durham: good front desk people, based on the attributes they bring, not the best experience, right? Yeah, so it's interesting. So, to your point on that, now providers, that's a whole, whole nother horn in its nest to do.
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Jamey Schrier: Yeah, we get caught up in, they need to be healthcare this and trained. I go, you know, our biggest problem is we're too close to what we do. And the training and everything that we've gotten and the people we hang with creates biases, and we all have biases, we all have negative biases.
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Jamey Schrier: We all have, limiting beliefs, and my definition of a limiting belief, it's something you believe that is not helping you get what you want. So it's limiting
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Jamey Schrier: Helping you get what you want. So, we can only see what we see, right? Yeah, correct. The saying goes, Jerry, how you see anything is how you see everything. It's your lens, unless you.
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Jerry durham: It's so funny how we…
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Jamey Schrier: Change your list.
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Jerry durham: Yeah, and I go, you know, people's perception is their reality. Well, hey, that doesn't make it reality. I was like, I didn't say that.
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Jamey Schrier: their reality.
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Jerry durham: But yet, if that's their reality, and you don't acknowledge that, and you don't figure that out, that's… by the way, that's… by the way, all of this stuff is… the more I get, right, the deeper I get into the business side of it, the deeper I go on the personal side, and look back on my own relationships, right?
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Jamey Schrier: Right.
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Jerry durham: It's the world, it's humanity, it's the way we respond, and if we don't get to this stuff early on… and I'm not here, by the way, to change people. I'm here to… I'm here to have a conversation and let people know that I have a solution for them.
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Jerry durham: And here's how I can deliver it, and here's what the cost will be. Will that work for you?
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Jerry durham: Yeah. Right? That's my job, and it's based on what you need and want, and if I can't have that conversation, and if I don't believe that's most important, if I believe what's most important is I know what's best for you, by the way, most PTs will say that's not true, but when you sit in a vow, you're like, all you did was tell them what was best for them.
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Jerry durham: You never asked.
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Jamey Schrier: you know, It's so funny, I'm…
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Jerry durham: So, and again, moving this upstream real quick, moving this upstream, doing it earlier, and we're not doing a subjective exam. That's the beauty of coming from inside the clinic room. I understand what's needed in the clinical room. So I've built out these phone calls based on… based on building these steps, right?
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Jerry durham: So I'm not trying to take over the PT's role, I'm trying to… I tell everybody, the main objective of the pre-arrival process is to set the provider up for success. If you set the provider up for success, that means the patient said.
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Jamey Schrier: It's funny, I just literally had this conversation yesterday with a client, the exact conversation, and we were analyzing her business, she has a…
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Jamey Schrier: going on $6 million business, and we were diving into some of the weed stuff, and, you know, she realized she's in mental health, but she realized that the appointment scheduler is the magic. It's not…
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Jamey Schrier: It's not the counselor. The schedule is the… they're the salesperson. They're the most important person, and I was just asking questions, I'm sure you do. I was just like, well, what kind of training do they have?
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Jamey Schrier: And how do they, you know, set the expectations? How do they talk about, you know, whatever the person's having, and kind of move them through to make it just super, super easy for the counselor to see them? And the plan, I mean, in that industry, the plan's kind of already set.
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Jamey Schrier: And she was just like, Wow.
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Jamey Schrier: I didn't see… I didn't think of it like that, and I was like, yeah.
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Jamey Schrier: So.
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Jerry durham: all that time, money, and energy to get someone to show up, I'm like, you actually, I would argue.
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Jerry durham: Well, we could talk about ROI, we could talk about on the front end.
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Jerry durham: And, by the way, it's more than just marketing, it's the branding, it's the training, it's the systems, right? So take marketing, and then add in your training, your hiring of all these front desk team members.
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Jamey Schrier: Right.
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Jerry durham: it is not that difficult to get a significant bigger ROI on… right? So a bigger ROI
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Jerry durham: is a spend, right? Where are you going to spend it? How are you going to invest it, right? Because I believe for that dollar, you can get more out of a dollar on that front end than you'll ever get out the provider side.
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Jamey Schrier: Yeah, no, I'm not gonna argue with that one. I think that the…
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Jamey Schrier: What's interesting is that we don't have a clear picture of what's actually happening. If we saw what the
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Jamey Schrier: acquisition cost of a new… of a new client. If we actually saw what it's costing us, specifically for cancellations, for no-shows, for churn rate, if you really saw those numbers.
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Jamey Schrier: Look, I got nothing else, nothing against marketers, some of my best friends, or marketing companies, but for most people that I see, marketing is not the issue.
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Jamey Schrier: It could be part of the issue, but the issue is you're losing, leaking, you're leaking oil all over the place, and you're paying these people that hopefully have a passion for helping others.
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Jamey Schrier: And they're not as busy as they should be, as you expect them to be, but you're not holding anyone accountable, because you're not doing your part in creating clarity, and creating accountability, and knowing yourself what
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Jamey Schrier: You know, how many people they should be, and how they should actually communicate and engage and set the, you know, the values and the standards and stuff like that, so…
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Jerry durham: No other industry, no other industry.
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Jerry durham: Whenever I used to go to my… I belong to EO, a huge shout out to EO Entrepreneurs Organization, because they were definitely a tipping point in this that got me
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Jerry durham: Over the going out of network part.
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Jerry durham: I'm laughing, just thinking, when I used to go in the room and go, yeah, we're only converting 65% of our leads, all of them looked at me like, F you, because they're right, they're in the frickin' business world. They're converting 20-30% of their leads, and they're really excited.
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Jerry durham: really, that was the time, Jamie, when I stood back and I went, we are sitting in a position where we are wasting
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Jerry durham: our potential clients time, money, and energy, and are so disrespectful to the people who are raising their hand and saying they want our help, when everybody else is fighting tooth and nail to just find 2 out of 10, and we got
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Jerry durham: 8, 9 out of 10, of which, you know, then 7 are showing up, you know? I'm like…
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Jerry durham: Man, yeah, so it was really interesting to… and I called it disrespectful or disrespectful to people who are raising their hand and saying they want to do business with us. I want… I at least want to learn about your solution. What's your first name? What's your last name? What's your date of birth? Do you have a doctor's referral?
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Jerry durham: what's your insurance? And I was like.
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Jamey Schrier: I talk a lot about mindset. I hate using mindset, because it's… people, like, just to miss it. I use kind of mind shifting, or just… just thinking differently. What do you think
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Jamey Schrier: is… For lack of a better term, the mindset that we, as a collective.
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Jamey Schrier: Practice owners, private practice owners, have That is disturbingly wrong.
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Jamey Schrier: That's really causing problems, and what does it need to be from your point of view and your experience?
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Jerry durham: That we can leverage the providers more. That deliverer of the product.
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Jerry durham: Has more leverage left.
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Jamey Schrier: Providers are the therapists.
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Jerry durham: Yeah, providers, thank you, yeah, yeah, and that we can leverage them more, right? Through…
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Jamey Schrier: The mindset is, we don't think we can, because if we push them too much.
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Jerry durham: No, we still believe the leverage is the provider, and so I'm gonna try to squeeze, right, another… one more visit a week out of them. I'm gonna try to get, right, one more treatment out of them.
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Jamey Schrier: current mindset.
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Jerry durham: Yeah, current mindset, yeah. And whether it's… so my only… so let's go a little higher, Jamie, that the only opportunity I have to drive better in my business
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Jerry durham: Which is more revenue, is through the provider.
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Jerry durham: Right? Is the only… that's the only place I need to look. So I have the blinders on, so I'm going… and let me give you an example, my personal journey, right? Spending 8 years yelling at providers about their cancel rate, no-show, drop-off rate.
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Jerry durham: No, you gotta do better. No, you gotta do better. Holding people accountable, going, you're doing this wrong, you're doing this wrong, you're doing this wrong. Buying new equipment, and going, okay, you gotta now put people on this, right? So, that's all provider-driven, right? When you're getting new equipment, and they gotta see the provider for the eval, that's all looking just in one place.
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Jerry durham: And,
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Jerry durham: And I've proven this over and over, and you've seen proof of it in the work you've done, that the money I invested in the front desk team actually drove
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Jerry durham: the biggest ROI. So when I take a step back and go, I'm not going to yell at the providers anymore, I'm not going to give them more work, I'm going to allow them to be the experts they are, move someone through, you know, pitch a plan of care, then move someone through that plan of care, and mind you, their only accountability is to deliver a complete plan of care.
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Jerry durham: then I saw.
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Jerry durham: changes in everything I just mentioned. Revenue went up, cancels went down, no-shows went down, drop-offs went down, just by investing in the front end. So the mindset that's killing us is the only answers through the providers.
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Jamey Schrier: Interesting.
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Jamey Schrier: Man, I didn't expect that answer.
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Jerry durham: And by the way, Jamie?
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Jamey Schrier: Yep.
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Jerry durham: would argue…
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Jerry durham: When you… when you take the focus off the providers, then things like your billing, collections, first pass, all that stuff changes. So it solves even bigger problems. And this was a lot of my journey. I went to the front desk to do one thing, get more people to show up.
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Jamey Schrier: That was it.
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Jerry durham: when I saw the impact on the business overall, dude, I spent more time reinvestigating stuff, going, wait, how'd this just change? And I went, holy shit, the only thing I did was change the front desk. My providers aren't… my billings aren't doing anything differently, it was just… our focus was getting someone on the schedule.
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Jerry durham: ready to arrive, pay, and then stay. If you think about it, every single business metrics is in those three terms. So, arrivals are assigned to someone, payments assigned to someone, and staying is assigned to someone. So that… that gave me… you know, the, it's sitting right above me, the four disciplines of execution.
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Jerry durham: a book that the speaker one year at PPS was there, and I only bought the book because he spoke. That was the tipping point that got me to look, okay, what is everybody driving to? You mentioned this earlier. So I had… when I gave a talk on patient success.
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Jerry durham: The front desk is in the room, every provider's in the room, support team's in the room, billing people are in the room, because I show everybody
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Jerry durham: Because it forced me to define what patient success was, and I realized it's more than just people getting better. It was people, right? Go read my frickin' negative reviews for my first 5 years of my business. It's all billing-related. One-star reviews.
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Jamey Schrier: Right.
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Jerry durham: So, if I didn't have my billing team included, I wasn't going to have true patient success. So, again.
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Jerry durham: Back to your question, leveraging… there's nothing left there. Let the provider be the expert. They just spent $200,000 in 7 years in school. Let them be the expert they are. That's my statement. That's how we say, let the provider be the expert they are. Don't keep giving them more.
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Jerry durham: and train the rest of the team to create that experience that you want as a journey, not as a one touchpoint, right? Back to your mental health person, we're driving everything to that provider and not doing any work.
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Jerry durham: You know my favorite term, Jamie, you hear? Just get the patience in front of me. I do really well once they get in front of me. I'm like, oh, that is killing me.
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Jamey Schrier: Get him in front of me.
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Jerry durham: Yeah.
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Jamey Schrier: All right. Great stuff, Jerry. People want to reach out to you, obviously we'll have your thing on our show notes, but if they want to connect with you, you know, look more around your services, get help with their whole patient, you know, client experience, not patient, client experience, what should they do?
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Jerry durham: I think the best place to go, and we're…
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Jerry durham: This is 2026, mid-2026, go to LinkedIn. I treat all my DMs everywhere as text messages. Every… by the way, I tell everybody all the time, I respond to everything, even the robo stuff, even the bad stuff, I respond to it all. I'm like, how can you help me? But, you know, whatever. So…
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Jerry durham: If someone says, hey, you know, I saw your name, I respond to it, so DM me.
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Jerry durham: I tell you, the best two places right now are Instagram to see my content and get an idea of what am I pitching. Instagram and LinkedIn. Instagram is Jerry Durham.
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Jerry durham: LinkedIn is Jerry Durhampt, and if you DM me in either of those and tell me you heard me on Jamie's podcast, you'll get a real… you'll get a response regardless, but you'll get a quicker response.
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Jamey Schrier: Excellent.
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Jamey Schrier: Appreciate you, man.
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Jerry durham: Yep, awesome.
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Jamey Schrier: Oh, right.
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Jerry durham: Thanks for having me, Anna.
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Jamey Schrier: Oh, you're so welcome. This is fun, and I'm gonna have you back, because we can get into some more stuff, because, you know what's nice, before I kind of do my little outro here? Just real raw and honest, and I'm sure you get that, and, you know, I get that, too. Just being authentic.
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Jamey Schrier: You're not, you're not trying to be anybody but you.
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Jamey Schrier: Oh, real quick, I have to ask you.
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Jamey Schrier: Jerry is famous for all caps.
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Jerry durham: Oh, yeah, I do.
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Jamey Schrier: Real quick, where did that come from, and why are you yelling at everyone?
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Jerry durham: So check this out, the all caps and the exclamation points, right? And you're right, I get called out for it.
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Jerry durham: Here's what I start to do when people do that.
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Jerry durham: one of two things. I go, you've met me…
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Jerry durham: So, one of two things I do when someone does that. If they don't know me, I go, you obviously have never met me in person, because what you see here is what you get in real life. If it's someone I met, I go.
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Jerry durham: and I'll say it publicly, or I'll say it privately, tell me this isn't me. So a lot of times when I meet people.
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Jerry durham: So, it's me, Jamie. It's the stuff I get excited about. It's…
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Jamey Schrier: It's part of your DNA.
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Jerry durham: Yeah, and I'm just like, engage patients, right? To be our advocates, engage the people we've served. That's gonna be all caps. And yeah, if you envision me screaming that, it's because I am.
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Jerry durham: And it's my way to scream on social media to go, this is important. And I type out the F word, and, you know, in Instagram, you know, eventually, if you type out the F-word enough, they get tired of telling you, are you sure you want to send this? And they just fucking send it. So, fortunately, I've gotten past that with most platforms. So, when I meet people publicly.
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Jamey Schrier: I'm honest.
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Jerry durham: I've followed you on LinkedIn, I followed you on Instagram. I say, okay, in 5 minutes, I'm going to ask you one question. And then 5 minutes later, I'm going to go, so is the person you saw on social media exactly the person you're talking to right now? And they go, absolutely. And I'm like.
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Jerry durham: That's all I want to know. I want to be the same exact person, Jamie, everywhere. LinkedIn…
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Jamey Schrier: to be, you know, when I describe authenticity, it's the you that you could be if you could just be you.
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Jamey Schrier: And so much of us just can't be who we know we are because of the junk.
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Jerry durham: Yeah, the junk…
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Jamey Schrier: The shame, and all this other stuff that we Put on others.
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Jerry durham: Yeah, and I own the fact, look, we could check about 5 boxes here about why I had the opportunity to be that way.
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Jerry durham: I have my own business. It's make or break. I am the boss. I am the one signing the paycheck. So, I get that. I gotta check all these boxes, and I do understand that, but man, there's… there… one of my favorite podcasts I ever did was with Dave James. You guys can find him on,
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Jerry durham: LinkedIn. And we spoke to this professionalism and authenticity in healthcare and how important it was.
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Jamey Schrier: God.
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Jerry durham: Yeah, it's really good stuff, and we all have this opportunity to do it to some degree.
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Jamey Schrier: You know.
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Jerry durham: I see people type stuff, and I know them, and I'm like.
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Jerry durham: who the hell's typing their shit? I'm like, Right?
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Jamey Schrier: AI. Yeah.
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Jerry durham: Well, and that's the only way I know it's AI, is if I know someone. Otherwise, I'm just like, well, this must be who they are, right?
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Jamey Schrier: Yeah.
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Jamey Schrier: I love it, man, thank you. And if something resonated, which I'm sure it had to resonate, don't just listen, do something with it.
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Jamey Schrier: And if you want more clarity on where you are in your business and what to focus on next, then take the practice growth assessment. It'll help you better understand what's actually driving your business and what may be holding you back. And yes, the practice growth assessment, we do ask a lot about the front desk, which could be a perfect lead-in for Jerry. If this episode…
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Jerry durham: Nobody owes that to themselves to do your practice assessment, dude.
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Jamey Schrier: You know what it is?
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Jerry durham: You know what cracks.
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Jamey Schrier: mirror.
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Jerry durham: You know what cracks me up, Jamie? Is we're all physical therapists, and no one would ever ask for a solution, or sorry, anytime a patient asks for a solution, you go, well, I gotta see it first, I gotta do an evaluation, and you're giving it to people for free, so…
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Jerry durham: Why wouldn't…
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Jamey Schrier: Thank you. I've been saying that for everything. I go.
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Jerry durham: If you don't…
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Jamey Schrier: And I'm like, no.
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Jerry durham: early.
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Jamey Schrier: What's going on with your business?
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Jamey Schrier: How are you.
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Jerry durham: You can't take that first step in a journey if you don't know where you are.
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Jamey Schrier: Excellent.
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Jerry durham: Yeah, more so do that.
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Jamey Schrier: If this episode helped you think differently with talking to Jerry, it better have, share it with another private practice owner, share it with a clinical director, share it with someone who needs to hear it. Thank you so much for listening. I'm Jamey Schrier, and this is Freedom by Design.