July 18, 2024
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Introduction: Welcome to the True Sports Physical Therapy podcast with your host, Dr. Yoni Rosenblatt. Today, we explore the dynamics of growing and managing an outpatient clinic with Dr. Justin Lugtu. In this episode, we delve into the strategies, challenges, and successes of running a thriving physical therapy practice. Join us as Dr. Lugtu shares his experiences and insights from Spear Physical Therapy, discussing the key factors that contribute to the growth and effective management of an outpatient clinic. We cover topics such as patient care, clinic operations, team management, and marketing strategies that help build a successful and sustainable practice. Whether you're a physical therapist, Clinic owner or healthcare professional. This episode offers valuable knowledge and practical advice on navigating the complexities of outpatient clinic management. Let's jump right in.
Dr. Yoni Rosenblatt: Welcome back guys to the True Sports Physical Therapy podcast. Today's conversation is with Justin Lugtu.I met him by just walking into his clinic and I was really struck by his leadership, by how hungry he was to grow the clinic and to manage the clinic. And we dive into all of those things during this conversation. So be sure that you've shared this conversation with anyone interested in growing their own clinic, managing an existing clinic.They would love this conversation. Justin graduated from Rutgers university where he got his doctorate. Before that, he went to Kean university. He's also a CSCS as many successful sports PTs are. He's been out of school for a little bit over three years and has been managing one of the busier clinics for Spear physical therapy for the last six months. Without further ado, here's my conversation with Dr. Justin Lugtu. Welcome back to the True Sports Physical Therapy Podcast. We got Dr. Justin Lugtu with us today. I'm so excited to have you here and learn about how you rose the clinic director within Spear. Let's start by just telling us about Spear Physical Therapy.I know they're located up in New York, but tell us about what makes Spear special, and make sure you just hit on some of the culture, and what it is that keeps you engaged coming to work every day.
Dr. Justin Lugtu: Of course, of course. First of all, happy to be here. Thank you, Yorick, for having me. So, yes, I've been at Spear for three years now, and what I can say is, I think the thing that makes us different is we think of ourselves as a customer service company, happens to do physical therapy.So everything we do, patient first, uh, team first, the culture is very, say local, across the board, we all have that customer service mindset. It's the person in front of you, uh, that is your priority. And each clinic, I would say at its own level, has its own level of fun. I would say, what would you want to date?Day to day basis is fun. Uh, our priority is to have fun as a team, treat our patients well, and have that customer service mindset at all times.
Dr. Yoni Rosenblatt: Dude, that's, that's a, that's a beautiful mission and that's an awesome culture just by way of backstory. Um, I know the CEO of Spear for a long time. He gave me a huge break when he.Graciously allowed me to tag along with team Israel for the world baseball classic. And from that point on at every turn, his name is Dan Rutenberg. He has shown himself to be an outstanding human, a mint, as we call it in our family. Um, and he's been a great leader. Now I was just walking around New York on a food tour with my dear buddy, because it is the Mecca of kosher food in New York.And I saw a Spear sign and I just walked in. I'm like, I think I know who owns this place. Um, and I ran into you. And I, I was, I was greeted as if I was family. I mean, I was obviously a stranger just walking into a clinic and I felt at home immediately. Um, tell me how you rose to clinic director and what your career has been like in the three years you've been there at Spear.
Dr. Justin Lugtu: Sure. It's been a, it's been a journey for sure. So I would say day one on the job, I wasn't sure I wanted it. I wasn't sure if I wanted leadership, but now I was surrounded by the right people that helped me get to where I am today. You know, I spent about a year and a half as a staff therapist, learning how things operate in the clinic.And after that, I moved up to assistant director for about a year. And recently, as of February, I moved up to the clinical director role. And I would say, like, the major thing that Spear does is invest in their people. So, you know, we always promote within. It's not about tenure. It's about who's ready for the job.And I worked my way up, gaining experience here at 70 Pond. And here I am as director now.
Dr. Yoni Rosenblatt: Yeah, I love, I love that. So, you know, I walked in, I walked into, um, a very busy clinic. Um, a number of PTs working really hard with a number of patients. So tell me what it's like being a staff PT at Spear. Um, how many patients do you see an hour? How long do you have for evals and what types of patients are you treating?
Dr. Justin Lugtu: Yeah, that's a good question. So, you know, in our setting, our expectation is we see in about 12 a day, 60 a week. Within the hour, we book every 25 minutes now. Uh, so, you know, you could see anywhere between two, three potentially in the hour, that's a recent change.We used to be 30 minute blocks, um, switch to EMR systems as of January. And the major change there was for autonomy. We're trying to make life more flexible for our staff therapists. It was a bit of a struggle to, you know, meet your 60 a week. So having the more slots has helped us. Um, and yes, it does get busier.Earlier in the day versus, you know, midday, pre post work hours. Um, I would say the reality of being in a network physical therapy company.
Dr. Yoni Rosenblatt: Yeah. So, so how do you manage, um, treating patients on the 25? Give me some tricks because you're talking to a guy with serious ADHD. My head just spins thinking about trying to treat that many patients. How do you manage a schedule like that?
Dr. Justin Lugtu: It's a great question. Yeah. You know, of course, everyone's strategies are different, although it definitely starts with knowing your patients. There are a few that are a bit more independent, and maybe that gives you more leeway. But, you know, what we're trying to do is, you know, not catch our patients by surprise.You know, day one at the eval, we're establishing the fact that, all right, if you want to come at 8 a. m., just expect that it may be a little bit busier. Um, if so, you know, we can still schedule that time, but if you prefer a slower time, this is what's available. So we're always transparent as much as we can be when it comes to schedule our patients.That being said, yes, times do get busier. We do have a team of therapy technicians that just assist with the flow of each patient session. But for the most part we have, Lugtuily, each clinic is intentionally set up so it's open floor, there's mirrors all over the wall. So we always have our eyes on the patient and I think that's what allows us to see that volume.
Dr. Yoni Rosenblatt: And what's your best advice to a new therapist, um, who's walking into, let's say, two an hour, three an hour, what's the best way to make sure every patient is getting exactly what they need?
Dr. Justin Lugtu: I would say ask, you know, each patient has different demands. Some do want a little bit more one to one time. And others may be okay, you know, operating on their own. So my advice to that new graduate would be to get to know your people. It always starts there. You know, if you step out, zoom out from the realm of physical therapy, you know, it's always about the person in front of you and what they want. So even if you were giving a one to one session for an hour with the patient, that's not what they might want.So I think knowing what they need is super important. Um, so, you know, again, to that new grad, it's asking the right questions. Catering to the best of your ability to what they need and being transparent, being honest about how things will actually operate.
Dr. Yoni Rosenblatt: Yeah, I think that's totally worthwhile. Now, let's say high level athlete comes in or complex, um, patient presentation is in front of you and they say, listen, Justin, this is great. I feel like I need more time with you. I need more one on one time. How do you handle that conversation?
Dr. Justin Lugtu: Yeah, let's be real. It happens all the time and we're not looking to sacrifice quality of care. So in those instances, um, number one, we'll offer time slots, you know, for example, end of my day or beginning or end of my lunch, um, allowing that slot to offer in that slot to that patient.So they have a bit more time. There's no one scheduled. before or after them. You know, one thing we did want to promote was flexibility for our PTs, make a little bit stress or decrease the stress level for our therapists. So, you know, one thing we'll also offer is no documentation block. You can use that freely.So maybe I placed that before or after that patient and that's at your own discretion. As long as you're successful, you know, hitting your 60 patients a week. Um, we can also in turn be flexible in that way because of course, you know, quality of care. Is a most important.
Dr. Yoni Rosenblatt: Yeah. And, and then walking, um, the clinic that, that you run that your clinic director of is down towards wall street. Right. So, um, square footage is at a premium. What do you do with an athlete that needs to learn how to cut, needs to learn how to decelerate or, um, is working on some higher level athletic endeavors? How do you make best use of your space?
Dr. Justin Lugtu: That was my initial question. I walked into clinic day one as well, just from being in, um, you know, bigger clinics in Jersey. Where I had most of my rotations, so transparently, like, it's not feasible, you know, for some of those athletes where you do need a bit more space, you know, an alternative offer is, you know, we do offer other services like transitional care where, or even home care, where we can meet, you know, that patient at whatever facility and, you know, have the appropriate equipment environment to assess those things.But, you know, being full transparent, there are certain things you can assess. And certain things that aren't as feasible. So we do our best to, you know, simulate that environment.
Dr. Yoni Rosenblatt: Yeah. Now, now there's, I mean, you make a good point because I love talking about how our clinics are big and open and you have tons of turf that doesn't really, you don't come by that often in the middle of Manhattan.Um, the space just doesn't exist. And. And I say that because there is so much we do before, you know, running a 40 yard dash. There's so much we do that doesn't need this massive amounts of space, whether it be drilling, change of direction, whether it be working on deceleration or acceleration in small confines, which very often is the way these athletes are working.So I think there's a ton you can do. I love that Spear offers the ability to, Hey, I'll meet you on a field, or I'll meet you in your gym, wherever it is, you have space. To allow for that. So I think that's a, that's a great way to answer that. Give me the biggest challenge you have felt since becoming a clinic director.
Dr. Justin Lugtu: Biggest challenge I felt is definitely balancing the time between treating and handling more of the, you know, director roles. So, you know, managing team, PTO hours, um, that's being a manager in general. I still very much love treating and working one to one, one to one with my patients. So I have less of that.So it's just find a delicate balance of, all right, how much can I still be a staff therapist, do what I love to do, but still operate a clinic on the business side, which I'm also passionate about. So I would say just tug of war, like where I've spent my time wisely in both.
Dr. Yoni Rosenblatt: And so, so if that's the biggest challenge, what is the antidote to that challenge? How do you solve for that?
Dr. Justin Lugtu: The way I solve for that is just playing my week strategically. You know, maybe there's one day where I'm treating a little bit more heavily and another day where I have a bit more, you know, administrative time and knocking out some of those tasks that I have to do. So just time management, I would say is essential for what I do.
Dr. Yoni Rosenblatt: Yeah. And, and what's your, what's your split now? Clinical versus admin. Do you still have to see 60 patients?
Dr. Justin Lugtu: My expectation is a little bit different. Um, 36 a week. So, you know, about four hours treating four ish, maybe it's five. Sometimes the rest of the day, four hours of admin time, but it varies from day to day. Yeah, very much. So a lot of times I'm seeing a little bit more and that's okay.
Dr. Yoni Rosenblatt: So, and that's totally up to you. How many PTs do you have reporting to you right now? We have a team of seven reporting to me. Wow, dude, seven PTs. Yes. That's, that's incredible. And so walk me through the ladder of how Spear prepared you to be a clinic director.
Dr. Justin Lugtu: I love that question. Uh, I think Spear does a great job of offering that leadership pathway. I think the best way they do that is from day one, they are genuinely interested in, you know, what's your growth path with us, you know, it's on a piece of paper, the step by step outline, physical outline of how do we So I think it's just the right people in this organization that care about your growth and hold you accountable to it.And I was very surprised with the structure of how, you know, that growth path looks. And it's not just leadership and being a director. It's also clinical education or leading a general club, running a seminar. Everything is very structured. I think that's how things happen for you and how you tend to grow.
Dr. Yoni Rosenblatt: Yeah. So give me more of the nitty gritty of that piece of paper. Sure. What, like, what are the steps? How long does it take? Um, how'd they choose you to become clinic director?
Dr. Justin Lugtu: Yeah, it's, it's, it's different for everybody. Of course. Although, you know, I think it starts with one, you're directing, knowing your goals and two, showing that you can do your job effectively.You know, we all spend plates as a staff therapist. It's different things where we're doing it. We can show a level where we can do all those things. Efficiently. Um, yeah, that's, I would say that step one, like do your job effectively. Cause who wants to be managed by somebody that's not doing what you're supposed to do at a high level and outside of that, it's, you know, we have a leadership program within the company called SVLP, Spears Future Leader Program.I think that was a huge opportunity for me. It's like an MBA style, year long, uh, leadership crash course. So once you get to that level, once you apply for and get accepted, You know, you have quarterly in person seminars with the entire leadership team, other applicants and participants in that cohort, learn the ins and outs of the business, you know, not just, you know, business and operations, but also the soft skills and becoming a leader.So I think after that program, you know, you meet the right people and you know, your name kind of gets out there and you pick up the right skills and you slowly, slowly gain more responsibility within the clinic until ultimately you're. You know, familiar with what a director is supposed to be doing.
Dr. Yoni Rosenblatt: Now, did, did you were working in this wall street clinic?Let's call it, you were working in this exact clinic before you became clinic director. Yeah. 75th street. Okay. Okay. So, um, 70 pine. Pine. Yep. 70 pines. Fine. Okay. 70 pine. You got it. You got to live and die. 70 pine, obviously. That's seeping out of you. So that's awesome. What happened to the clinic director who was there prior? Like where do they matriculate to? And what if there's no clinic available for you to become a clinic director? What do you do with this? SFLP?
Dr. Justin Lugtu: Yep. Yeah. So our first director, when I first stepped in, he went on to open a clinic in NoHo. And then the staff therapist on the team already became the director. And, you know, this past year, he opened a clinic in a long Island where he's from. So that was his goal. So stepped in at February. And, you know, the question of what, if there are no clinics to open or places to move, uh, unsure, because right now it's, it's probably the most, it is the most clinics we're opening at one time currently.So we're strategically expanding and there's opportunities are more abundant than ever. I would say, you know, I was coming in 2021, but before then, you know, mid COVID, I'm sure things were slow. Um, you know, things are, I would say, never fully stagnant knowing the values and, you know, the pathway that we're looking to go as a company.I think those opportunities are going to be abundant.
Dr. Yoni Rosenblatt: True Sports Physical Therapy is growing like wildfire. We have 14 locations soon to be more. We are throughout the state of Maryland. We're in Pennsylvania, in Lebanon, in York, Pennsylvania, as well as in Delaware, in Newark and Wilmington, Delaware, like I said, so many more practices to come and we always need.Outstanding sports, physical therapists, our treatment style is unique. We are one on one with your athlete for 45 minutes, every single session, you do the entire treatment, you do the entire evaluation, and they are in state of the art facilities where you have room to run, throw and jump, and really get your athlete all the way back to on the field and better and stronger than they were.We also have outstanding salaries. Comp structures, bonus abilities, 401ks, as well as a very strong continuing education offering, including in house continuing education. And we're looking for you now is the time as we are growing like crazy. Just shoot your resume over to Yoni Y O N I at TrueSportsPT or shoot us a DM and we will hit you back.We will get you in for our unique tried and true interview process and really make the determination. That this is the right place for you to grow your career and get your athletes better than ever. We can't wait to hear from you. Yeah. Well, I mean, that speaks to Spear's success, right? And it speaks to the vision.Um, so that, that's awesome to hear and refreshing to hear. What if you, um, you're an outstanding staff PT, you're great interpersonally. You just don't want to manage other PTs. What other leadership roles are available within the Spear structure?
Dr. Justin Lugtu: I love that question because, you know, people automatically think, Oh, I have to become a clinic director or assistant director, but yes, going back to the fact that Spear outlines that for you and makes it clear, you know, you could go into leading our manual workshops.We have quarterly manual workshops for all NUVAD therapists that are required to go to. You could be an instructor for that. You can lead a journal club if you have a specialty such as, you know, uh, vestibular or BPV. You can lead an in company, uh, workshop. A lot of paths you can take, you become a CI. So, a lot of clinical education pathways and also involvement in our specialty programs.There's a role for everybody, I would say, depending on what you're looking for.
Dr. Yoni Rosenblatt: Yeah, that that's that's really awesome to hear. And then talk to me about, um, students at Spear. Where do they play in? How often do you get them? Etc.
Dr. Justin Lugtu: Yeah, yeah, for us, probably about one or two students a year. Uh, we, We only do it if that's per clinic, is that per clinic or per therapist?Per clinic, at least that's something you find, you know, it's a little bit different depending on what the school needs. Uh, we have a great relationship with Hunter Columbia. So we tend to see more of those students, but we don't take students unless someone on our team is interested in it. Like we would never force it upon somebody.So if someone has a passion for mentorship, awesome. Let's, uh, let's get you a student and allow you that mentorship opportunity.
Dr. Yoni Rosenblatt: Yeah, that that's, that's really awesome. And so you didn't do a rotation at Spear while you were at Rutgers. Did you? I did not. Yeah. All in Jersey. So how'd you, how'd you find Spear?
Dr. Justin Lugtu: It's a funny story. Actually. It was like 2015, a friend of mine was working at this, at this Spear, actually. 75. 75. Yes. Yes. Um, it was actually a few years before 75 had opened. He was, he was at a Spear and I remember seeing him dressing up with his team for Halloween. I was like, all right, this seems like a fun place to be.And, you know, I followed him throughout the years. He opened in 2017, and he moved over to that clinic. And when the time came, um, you know, April, year of graduation, I was looking around, trying to see where I wanted to work, and I thought of Spear. So, you know, like, fortunately enough, there was a virtual career fair for, um, New York outpatient clinics that I decided to attend.And Spear was my first interview. And knew right away, like, all right, this is the place I want to be. Because what? The culture. I think that post really impacted me. Like, seeing how much fun they have. And, you know, being a close friend that I trust. Sharing his feedback on his experience. But also just the excitement of working in New York.Now, that was always a dream of mine, being from a, like, more suburban town in New Jersey. I definitely want to come here and do random things like this. You never know who's going to walk the door. And here I am in a podcast with you, you know, the opportunities are endless.
Dr. Yoni Rosenblatt: Yes. Yes. Typified by one schmuck walking into 75 and it just turning into this outstanding podcast. So, okay. So you come to Spear and you're struck by the culture. Now, what do you do as clinic director? To make sure that you continue to, to grow that culture. And I love that question too. A lot of great questions. All of them. I am full of them. This is all I do is ask questions.
Dr. Justin Lugtu: The right ones, the right ones. Yeah, I guess so. I mean, I think that was the main, my main passion for wanting to become a director. I have a vision for the culture I want to set. Like I'll show you this, uh, this frame. When I first stepped into the role, my team made this for me. It says coach Jay. Love it. So, you know, I love basketball and.Now, I always thought that coach role would be awesome. Combine that with physical therapy, my other passion, you know, I, I think having a true team mentality where we can communicate openly, all support each other, uh, you know, hang outside the clinic is a plus. Lugtuily, all of us do get along to that level.But just having that team mindset, team oriented, um, connection is the culture I wanted to set here at 75.
Dr. Yoni Rosenblatt: Well, I mean, it's clearly working. And so now let, let me ask you two questions. Let's start with marketing. How do you then become patient face? And how do you drive more business to make sure that all of your seven PTs, that is so many PTs, that seven PTs have a full schedule with the type of patient that they want to sit.
Dr. Justin Lugtu: I'd say it's partly, I'd say fully your role with the support of, you know, internal structure within the company. So as director. You know, you should be networking with doctors and, you know, depending on the location, attending certain events and having a booth set up at, you know, whatever event is around.Spreading the word like that, you know, cold calls, dropping into random buildings, fires. So you know, boots on the ground type of marketing. How do you structure that? How do you, that, that falls on your plate to do that for 75? I would say it's part of your responsibility of. Again, building a business, making connections, it's not as if it's required, although, you know, I want to be successful, so that's, that's how I'll do, I'll do whatever it takes.Um, but we do have the support of a physician relation team, and that's our structured team within the company that is in constant communication with doctors. Building our network, meeting new doctors in the city, having a solid referral sources is super important for us and having the right ones.
Dr. Yoni Rosenblatt: And do you find that you get a majority of your referrals from physicians?
Dr. Justin Lugtu: I would say, I would say it's a bit of a bit of a mix. You know, we are ground level Lugtuily, so we do get a fair amount of walk ins. However, most of the referral source. Myself included. Yeah, I love it. I love it. What's the referral sources are going to be doctors that we have formed a relationship with.
Dr. Yoni Rosenblatt: So, so that's amazing that you're able to do that, especially as in network. I find it in, in Maryland. I mean, we're in Maryland, we're in Pennsylvania, we're in Delaware. I think, uh, a different approach. I find I strike out more with docs than I do with coaches than I do with athletic trainers or strength coaches.Hell, like when I started this thing, I started in Baltimore City. I was at Lululemon every weekend doing workshops. I was at Under Armour, I was at, I was everywhere except doctor's offices. Because doctor's offices own their own PT spots. I gotta imagine like HSS, um, or. Uh, Cornell, um, or whatever big hospital, right?Montefiore, whatever big hospital systems are throughout New York city, they have their own PTs. So why do they care about Justin lug to own 70 pine?
Dr. Justin Lugtu: Yeah. Yeah. It's, it's true to a, to a degree that, you know, these doctors already do have a PT in office or, you know, an established relationship with another within the network.So I think it just goes back to how strongly our leadership. From 1999 has been from 1999. You've been making these relationships when the company first opened now, Dan, and, um, you know, there boots on the ground forming these relationships and directors before me, you know, I think it's just the work put on in the early years that have really been paying off.Now we established relationships early on. I have maintained them. I think we're structured with maintaining relationships and that's how we're enabled to, you know, we can build solid.
Dr. Yoni Rosenblatt: So, so that's awesome. Is it to the point where Dan hands you like the Bible of like, Hey, here's Dr. So and so here's his birthday.Here's how many kids he has. Here's the last time we talked to him, you need to follow up this amount of times, or is it more of a crapshoot?
Dr. Justin Lugtu: We do have. You know, it's sort of a, a site where we can track certain things and have quick notes of certain doctors. So, you know, at your own discretion, almost like a Facebook wall to a degree.
Dr. Yoni Rosenblatt: Okay, it's there if you want to use it, um, and to leverage it. Are there, is there any streams of revenue or referrals that you've created outside of that? And how do you go about doing that?
Dr. Justin Lugtu: To be honest, it's mostly word of mouth around here. You know, there's just so many people. There's a lot of people.
Dr. Yoni Rosenblatt: Yeah, there are a lot of people. Okay, so you're doing tons of word of mouth. Are you doing when you say you're putting up a booth or things like that, tell me what types of events those are and how you're getting your foot in the door for those.
Dr. Justin Lugtu: Yeah, you know, I personally haven't done it, so I can't speak fully to it.
Dr. Yoni Rosenblatt: You gotta do it this week, dude. Put that on your schedule. Tell Dan, I said to keep that on your schedule.
Dr. Justin Lugtu: Um, you know, for example, we had a clinic open in Primus, New Jersey, so that's a bit of a different feel from the city. So let's say they have like a local event going on in the weekend, they'll be there, you know, something like that.Or, you know, for example, the New York marathon, we tend to volunteer for that, have a little booth set up for recovery. So getting involved in assorted events, you know, whether it's at a local level or more grand level.
Dr. Yoni Rosenblatt: And then how does, um, how does the staff PT at Spear, how are they incentivized to be at those events? Do they get paid for those events?
Dr. Justin Lugtu: So those again, unsure, cause I haven't personally done it. The incentive I would say is lies in a director. You know, I think it's super important to establish a team goal, you know, for a new clinic and we're opening up in this area, like, Hey team, let's, let's get to work, you know, let's build up our clinic.Let's, Let's put our names out there, and I think that's when it's incentivizes. I think more importantly, what Spear also wants you to do is not just work for the business, but work on your business. So it's also putting your name out there. You know, we want our therapists to grow personally and build up their own network and make a name for themselves. That's one way.
Dr. Yoni Rosenblatt: Yeah, I mean, that's a great way. Um, when do you guys decide, I'm ready. I need an eighth PT?
Dr. Justin Lugtu: Depends on clinic demands. Yeah. So of course the seasonality throughout the year. Um, we want to make sure the patients that are waiting at the door can be seen. So I would say it's a more of like a patient demand based on the past years, knowing when we expect to be busy this year, higher volume in the clinic.
Dr. Yoni Rosenblatt: Do you have a benchmark of what those numbers need to be like, Hey, if we're sitting at this percent of capacity, we need to bring on another?
Dr. Justin Lugtu: We do to a degree. Yeah. You know, again, I would say it depends on volume. So we're seeing. A clinic in a busy part of the city, you know, we'll know that we need to staff a little bit more and this is when so, you know, we plan as much as we can for that.I'm not too, too involved in the budgeting process. Of course, I knew it's the role, but, um, to my understanding, you know, previous years are a big factor into how we decide those things.
Dr. Yoni Rosenblatt: Okay, so, um, say your seven PTs plus you eight PTs, you guys are functioning at 85, 90% capacity. You can't get your post-op patient saying you need to hire a pt. What is the structure of that process?
Dr. Justin Lugtu: Mm-Hmm. So when a new referral, your patient wants to come in, um, we do have a call center team that will field those calls. Are they American desk? American based. Oh, wow. Okay. Okay. Um, so, you know, of course we'll consider location and availability. So that's also why we're trying to expand in the right areas is for this exact issue.One place getting too busy, this clinic's opening up and they'll have the space to see you. Um, we always book an hour for our evals, first initial evaluation. So that can also be a factor in how hard it is to get a patient into the door. Okay. Yep. So one thing we'll offer is, all right, you can get your initial evaluation in a year and then, you know, be seen at this clinic that's a bit more convenient for you, but I would say our answer, it really is just strategically opening in the right areas and making sure that we're maintaining the culture when we do open those clinics.
Dr. Yoni Rosenblatt: Okay. But talk to me about 70 pine. So 70 pine is at 90 percent capacity. You want to bring on a new therapist who interviews them?
Dr. Justin Lugtu: Mix of, mix of a couple of people on the team. Myself. Uh, we do have a recruiting team that they will be speaking to. So I'd say they will probably be speaking to about either one to three people before they come in.
Dr. Yoni Rosenblatt: Okay. Do you, do you bring them in to shadow for a day? Do you, how do you gauge their clinical acumen?
Dr. Justin Lugtu: We do. We do. So we'll get the, we'll, you know, reach out to the candidate, have them come in for a shadowing opportunity. And that's going to be three, four hours, three, four hours in the clinic. Okay. You know, on the floor, talking to patients, P.A. T. s, maybe getting involved here and there, showing an exercise. I personally love to run them through some clinical scenarios, case studies, you know, see how they respond to that. But, important that we're getting a feel for, you know, how they communicate with the team, with patients, and that, do they have a basic understanding of, clinical that we can throw at them.
Dr. Yoni Rosenblatt: Okay. What is the worst interview you've had in the last five months?
Dr. Justin Lugtu: Um, man, um, that's a good question.
Dr. Yoni Rosenblatt: I would say their name, Justin, do not say you can tell me this at all.
Dr. Justin Lugtu: No, it's not even that bad, but you know, I was with the PT and we went out to the floor. I had a patient at the time. So I said, Hey, go show them some T band extended rotation. And they just start going like some crazy band movement. And I'm like, Oh, you don't even understand that basic exercise. So that was a good example.
Dr. Yoni Rosenblatt: And they've been working for you for how long now? Did you hire them? You did not hire that person. No, we have to defer that one. Okay. Okay. So defer. I like it. Not reject, but that, so that's fair. But I think you make a good point and I, and I think it's worthwhile to, to the new grads that are listening, um, or even the students that are listening is I see a cardinal sin that people make when they come in and interview with me is they get way too fancy.It's like all you asked for was t band external rotation and they felt the need to hook a band to an ankle or something something ridiculous or put them on a BOSU when it's like, what is the point of the exercise? Don't get too fancy. Um, John Wooden, basketball coach, always used to say, don't be fancy, just be good, right?Just make sure you have those basics because I think that's how they really strike out. Hey guys, quick pause and a quick shout out to this new masterclass that we just launched here at True Sports Physical Therapy. Myself and Dr. Tim Stone put together a masterclass of ACL rehab and we call it From Table to Table To turf. And the reason we call it that is because it's going to teach you exactly how to get your athlete all the way from post op day one with the nitty gritty of regaining all of that range of motion with the tips and the tricks that we use here at True Sports Physiotherapy, that gets our athletes better, faster, and stronger.And that's early. And then how do you progress that athlete all the way onto the field with a ball in their foot or stick in their hands or whatever their sport is and teach them How to accelerate, how to decel, how to change direction, all the mechanics that go in there. What drills do we use to get our athletes exactly where they need to be back on the field and even better than before injury?And I want you to sign up for that class. Now you can find it on our website. You can shoot us a direct. Message and just say, Hey, send me the course it's right now on sale. So make sure you sign up now. It is fully accredited to get you all of your continuing education hours. Sign up for the true sports masterclass ACL from table to turf. Thanks guys.
Dr. Yoni Rosenblatt: Um, for sure. Now, what is your incentive to add more staff PTs?
Dr. Justin Lugtu: My answer to that is really like, you know, it's at the end of the day. It's a business. So. It's finding that delicate strike of, you know, of course, you're seeing higher volume, that's good on the business side, but how is that impacting quality of care?So, you know, just like every other business, you do have certain targets you're looking to hit. So my goal is really to hit those targets at with, you know, well, avoiding the expense of sacrificing quality of care. Now, to me, that's, that's forefront. So, you know, it's always. Striking that balance. I would say it can be difficult at times, I would say, but my incentive really is that my team is happy.And they feel like they can do their job effectively. Do they have the right tools? Do they have the right resources? And on the business side, are we being successful?
Dr. Yoni Rosenblatt: Okay. So when you sit down for your annual review or your quarterly review, what metrics do you and Spear leadership look at to measure, Hey, Justin's doing a good job as a clinic director.
Dr. Justin Lugtu: Few things I'd want to, you know, not be trans or fully transparent about, of course, but, you know, I would say generally, again, you know, obviously you're looking at the number of visits per year and how much revenue you're generating. So I think those straightforward things. But also what I've really, really enjoyed as I stepped into the role is how much we are measuring happiness, quality of care, retention.You know, I think our big focus this year is how can we make our team happier, you know, get rid of any barriers to, you know, hitting our targets, anything like that. And. Again, just making sure that our team feels like what they, they have what they need to do their job effectively.
Dr. Yoni Rosenblatt: Yeah. Now, now the first half of your answer I think is worth diving into because what we call it a true sports is profitability.And so it's awesome to have seven PTs working for you. It's not awesome to have seven PTs working for you if you have a caseload of that would fill five PTs. Because now your profitability is way off. You're losing money in that instance. Right? So I think PTs need to get comfortable with understanding what goes into profitability, profitability, happiness is really important.I can't have a therapist that's really happy and not profitable because there won't be a clinic next year for them to be happy in. If it's not profitable, right? So it's like, it's really like narrowing down your focus to the, to the management to say, here are the KPIs that we need to be profitable. We need to see this amount of patients.You, your staff needs to be making this amount of money for the entire thing to keep rolling on top of that. Let's put in happiness because that speaks to your retention. That speaks to your level of engagement of the therapist. Right. And that will ultimately. Speak to your profitability. Like if therapists are leaving left and right, you're going to lose your profitability is going to come down because you're not gonna be able to replace them.You're not gonna be able to have those visits seen. Right? So it's really layering those. It's something that we're working on really hard here at true sports is not being scared of the P and L of your profit and loss statement. Like I went a long time working for other people and even working for myself when we would dance around this idea of.Here's how much a patient visit is worth. Here's how much it costs us to provide that level of care. Those numbers cannot get out of black. Otherwise no one's happy. The company is not having the therapist isn't gonna be happy. Cause they're going to be working a pivot. They're going to be working somewhere else.Right? So it's like wrapping your head around those numbers is something that we've worked really hard here. I love that Spear speaks to this with their leadership. I mean, you described it as. Um, a mini MBA where they're, they're teaching you the nuts and bolts of how do you run the finances of a clinic?And I think that speaks to that, right? Yes. A hundred percent. So, so I think there's, there's a lot there. I love that they do that. I mean, what, one of the better conversations I've had with Root was Was on a plane to Korea, simply dissecting. How do you look at a profit and loss statement? Like, what are the metrics that we care about?How much does a clinic director, does a staff PT need to understand, need to know, um, so that they can work hand in hand and we don't just turn a blind eye to, to the numbers, I think we get in trouble when that happens. So I love that, that Spears kind of doing that, um, to begin with. What do you wish you knew coming out of Rutgers that you now know having been through Spear?
Dr. Justin Lugtu: I wish I knew how much the business plays into what we do, especially in this in network outpatient setting. You know, all of the numbers, finances, like, I wish I, I learned More of the business side of things in PT school, honestly. And I'm learning that now as I go.
Dr. Yoni Rosenblatt: You, what, what kind of resources do you use outside of Spear that are easily accessible to anyone listening to this pod?
Dr. Justin Lugtu: Nothing fancy, you know, audio books, podcasts, you know, I subscribe to, you know, the management tip of the day and little things like that, where it's just spread throughout my days. Also, I learned and just staying hungry. I think when I meet the right people. I will 100 percent take the opportunity to meet and pick their brain.And that's, again, going back to the reason why I wanted to be in New York. You get the opportunity to spontaneously run into people that, you know, you learned a lifetime from. Yeah, yes, that's awesome.
Dr. Yoni Rosenblatt: Yeah. And by the way, like, um, you have that, uh, that New York bias where it's like, you think it can only happen in New York, but wherever the hell you're from in Jersey, I guarantee you there's a business owner that was walking in with shoulder pain that you can glean a ton from what kind of audio books are you listening to? Give me specifics, Justin, don't hold out on me.
Dr. Justin Lugtu: I think they're more like, uh, no, not technically business oriented, but you know, I love Choco Willie. Who doesn't love Jocko Willant? Extreme Ownership, you know, Goggins, of course, both of his books I read through. I think those are two, like, huge books that changed everything for me.Uh, Shoe Dog by Phil Knight is another huge favorite of mine. I love Nike and basketball, of course.
Dr. Yoni Rosenblatt: So, I hear that. And I loved Shoe Dog. What was your big takeaway from Shoe Dog?
Dr. Justin Lugtu: Eh, from Shoe Dog, I would say it's, what's going to make you successful is your passion for pursual. And I also think, you know, you come across that big idea when you least expect it, so don't be afraid to take chances.You know, he came up with the idea of Nike from a random, you know, month, however long trip, just traveling the world and, you know, came up with that idea. So, I hope it's the same for myself.
Dr. Yoni Rosenblatt: Yeah, and he freaking ran with it, just like you're running with it, so You're, you're definitely embodying that. Um, I definitely took away that lesson.I also, I came away from that book thinking, how does someone start or run a multi billion dollar organization? And he's actually that good of a dude. I mean, he was so, I think he screwed over one guy. He talks about like his salesman that he sends to the East coast. Oh, he screws him over. Right. And like, he can't sleep because of it.I have a hard time believing he's that clean, but, but it's really impressive that he's even close to that. Um, I think it is nuts, um, that, that he was able to be that successful, but it was, it was a great takeaway that, that sometimes good people, you don't have to be a dick. I don't understand. You don't, you really don't.I would sum that up. Um, and. And I think like when I walked into 70 pine, I said the same thing about your CEO and it's like, it is astonishing that that level of success has not gone to his head. It's, it's really incredible. It's it's, it's a great life lesson. Um, did you, did you read you're too young to have as many kids as I have, but I love Jocko's kids books there.hey are awesome. Cause they talk about some of the struggles that, that I see as, um, I have younger generations of PTs or younger PTs coming in that are coming with a totally different mindset that I have. Um, as a ravenous entrepreneur, he talks about in his, in his kid books of like building toughness and resiliency in young, younger, um, generations.And I think there's such a divide between millennials and now Gen Zs and whatever it was before millennials is boomers before millennials, there's such a divide, right? Um, and how do you, how do you bridge that gap and how do you educate around that, um, I think are, are totally worthwhile. The, what do you say?The management minute. Um, the management tip of the day.
Dr. Justin Lugtu: The management tip of the day. Who puts that out? Um, let me look real quick. But, it comes to my email. Uh, right there. For me to view every day and You know, some of them are more relevant. Some of them are not, but you know, a quick other thing to, to look at, but that's out from a Harvard business review.
Dr. Yoni Rosenblatt: Okay. Nothing bad ever came out of Harvard. So that's, that's awesome. No, I haven't, I, yeah, very arguable. Um, I have enjoyed the, the HBR series. Like they put together a series with case studies that are business related, um, that I have found really helpful. To be awesome. So I think that's an awesome recommendation.Um, so I appreciate you finding that so everyone can kind of learn about that. Talk to me a little bit about, um, Justin Lugtu the person. Okay. Because, because you've been, how young are you on 28, 28, you're a freaking child. So clearly wise, wise beyond your years, um, in a serious management organization.So, so I would love to learn a little bit about what it is that makes You, you, um, and some of the lessons that, that we can hopefully pull from that. How many siblings do you have?
Dr. Justin Lugtu: Two siblings. So I have an older sister, one year, younger sister, about two years, middle child. And what are they doing? Uh, we're all medical. So my older sister is a pharmacist and my younger sister. Just finished PA school. She's also working in New York.
Dr. Yoni Rosenblatt: So it's in your blood. I love that you include us. I love that you included in medical. Cause one of my good buddies is a, um, he is an orthopedic surgeon and he calls me medical or orthopedic adjacent.He won't even call me like part of it. Yes. It's so degrading. So I appreciate, I appreciate you elevating that. Thank you very much. Um, okay. So what, what lesson did you learn in your upbringing that you bring to work every day?
Dr. Justin Lugtu: I appreciate you asking me first of all, but I think number one thing is don't let yourself get boxed in growing up, boxed in constantly.You know, obviously that stereotype, like, Oh, I'm that Asian kid, you know, it's like still five foot. Not growing much in high school. So I'm bigger than five foot. I grew a little bit, I grew a little bit thankful for that, but you know, I constantly had people like tearing away my confidence and, you know, I feel like I knew I wanted to be a leader in some way, but was surrounded by the wrong people.So, you know, here I am post PT school, first job surrounded by the right people. And even before that, of course, the PT school had some great friends, but, um, you know, not being afraid to. Look to your truth, I would say, know yourself, don't let anybody else tell you what you're supposed to be and pursue it and pursue it with authenticity.I think the way I lead is super authentic, keep it real with everybody. And I think that's what's made me successful in my eyes.
Dr. Yoni Rosenblatt: Yeah. And, and that, that surely comes across. I came across when I first met you. I'll tell you when else I really realized that it was, um, in those 11 minutes that I was inside of 70 pine, my first interaction was with, um, one of your texts, I think she gave me a tour of the, of the clinic as if she owned the clinic and then she said, you know, let me see.If our clinic director is available, you might have to wait a couple minutes, but her, her reverence and her respect for you, her reverence and respect for me, a Rando walking in was, was clear. And by the way, I mean, I'm sure she has her own backstory and life story, but your ability to support that and ingrain her with that culture and respect.Um, I think that speaks so highly on the company. It speaks so highly on your leader leadership, despite the fact that you're only 28, I mean, It's really amazing and leading a team of, of sports PTs. It's also crazy to hear a guy of your age with three plus years experience as a PT, how far this profession has come.So I've been a PT for 15 years. When I came out, dude, we were lackeys, like whatever the physician said. That's what we did. You know, they would check ultrasound. We would do ultrasound. They would check electrics. And, and now I'm talking to guys who are 20 years old, have been a PT for three years, who.Refer to themselves as leaders can talk, um, and articulate on good leadership on the way they're trying to model culture. It's, it's amazing how far this profession has come. What do you think the next step, how do we take this profession to the next level?
Dr. Justin Lugtu: So the next level, I think it starts in PT school, you get chiropractors and I think they learn a lot about the business side and how to sell themselves or, you at the very least advocate for the profession. And, you know, they're on Tik TOK and they know how to, you know, expand their audience. I don't think you still go on the street. You might go like four for 10 in terms of, do you know what physical therapy is? Yep. So advocacy is huge.
Dr. Yoni Rosenblatt: Yep. So advocacy is huge I think. So how, how do we actually do that? Cause I think you're totally right.I was gonna mention Cairo's earlier. They're awesome at that. They're awesome at understanding business and they're awesome, um, at marketing and marketing know how. Um, how do we advocate for the profession?
Dr. Justin Lugtu: I think it simply starts with an elective or a course in PT school that offers that mini MBA education and bring your awareness to the entrepreneurial side of things and, you know, making sure we're all equipped with that elevator conversation of, you know, what is physical therapy and how can it benefit you?And, you know, obviously getting more people involved with APTA and, you know, pushing for what's right for the profession. Of course, that's a. Age old question of how we do that, but we do need more
Dr. Yoni Rosenblatt: Age old question of how we do that, but we do need more of that. We definitely need more of that. Why do you think it's not in the graduate school curriculum? It's not just Rutgers.Um, I also went to a state school. It's not there. It's not, I mean, in so many, um, even, even universities, um, and academic institutions that tout themselves as number one in the country. They are not getting that type of education, but what is preventing it from being inside the walls? I have an idea, but I'd love to know yours.
Dr. Justin Lugtu: Yeah, yeah. I mean, of course, I think it starts with the staffing of the school. That's variable across the board. However, I just don't think people see that as a route of physical therapy right now. I think we're a couple of years behind Cairo, just as almost like OT is starting to become a more doctorate level now.We're trailing Cairo where we're starting to realize, Oh, I can go on Instagram and make a name for myself. And that's, we're seeing like the start of that. So I think a couple of years down the line, more people will have that mindset and see, you know, what is possible in the realm of physical therapy.
Dr. Yoni Rosenblatt: Yeah. I think I totally agree. What I was going to say was exactly what the first thing you said was, which was the staffing of PT schools. I was surrounded by academics. I was surrounded by people who had not run their own business to, to any measurable degree that work for the institution. And so when you work for university, you don't care about marketing.You don't care about a profit and loss statement. You, you may or may not see elite level athletes. That's always been my pet peeve is I got out of school, dude, I was ready to maybe, maybe rehab a total knee. I didn't know how to teach a box jump, let alone change the direction and deceleration and all those fancy things.So I wish, I wish these universities would include more schmucks like me and you, who could teach. Who could teach these, the next generation of PTs, what is it like in the outpatient ortho world? I'm fully aware that it's a small subsect of what it is that PTs do, but it is. It is a wildly popular subsect, and I think we are under underutilized.Like if I could tell you how many emails I've sent to institutions saying, dude, I would love to just come in and teach. I just want to talk to the next Justin lug to, and, and tell them about some of my experience or the, the mistakes I've made. Cause God knows I've made a million of them. I wish they would give us a little bit more of the opportunity.That's why I love bringing students in. So, um, As the great Colin Thompson would say, I digress because I could stand on that soapbox forever. Um, but, but I think it's worthwhile. Um, Justin, you, I'm so impressed, um, with, with what you've done at Spear. Um, I'm really impressed by Spear. Obviously I knew a lot about them before I walked into 70 Pine, but.Um, you are a great representation of what that company is doing. Um, and your clinic, like I said, from, from the front desk to the tech, to the other PTs, um, they, they obviously value what you do. So you're doing something really special. Um, and your time is insanely valuable treating that many patients an hour.So I appreciate you sharing a bit of, of all it is that, that makes outpatient sports PT awesome. So thank you very much.
Dr. Justin Lugtu: Thank you. And I want to quickly add to, I mean, on your end, Um, you know, that, that staff member that you talked to came to me yesterday and was like, Hey, who's that guy that came back, came by a couple of weeks ago. And he's super nice. Like, did you ever hear back from him? I was like, who are they talking?
Dr. Yoni Rosenblatt: Who are they talking?
Dr. Justin Lugtu: Oh, I was like, he's super, super nice. You know, I knew I was trying to go to PT school and I was being super helpful. So, I mean, kudos to you too. She remembered that interaction just as much as you did. I appreciate it.
Dr. Yoni Rosenblatt: Well, she better start working for true sports in about five years. She's obviously a stud. Um, Justin, tell us, tell this entire, um, audience how they can find you.
Dr. Justin Lugtu: Um, best ways to reach out and things of that nature. Come to 75th street. If you need physical therapy, come see me, but you know, I'm a social media at J a Y underscore L U G. That's a personal account. Um, I did have a, you know, an old Instagram physical therapy account that still exists, but. Not posting on that, but yeah, I mean, really, this is my passion right now. I want to make seven pine street, one of the most successful clinics at spear. So, you know, my Instagram email is J look to J L U G T U at spear center.com. Shoot an email. If you have any questions or, you know, would like to learn more about how we operate here.
Dr. Yoni Rosenblatt: I love it. I love it. I love it. Um, anyone looking for a job, reach out to Justin, anyone looking for outstanding rehab. Um, 70 pine, um, and, and spear is such an outstanding, um, institution. So that's really awesome.Justin, thanks for being here. Thanks for sharing your wisdom and knowledge. We'll do it again soon, man. Yoni. I really appreciate it. It's nice talking to you. Absolutely. Pleasure. Thank you everyone. As always, you can share your feedback, true sports PT on Instagram. Let me know what you loved about this interview.Let me know what you wish I would have asked Justin and we'll bring him back on and we'll run through those questions. Thank you guys so much for listening. Bye bye.
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