Ep 5: Building trust and mobility in allied health with Tristan White

Michael Dermansky

Hi everyone and welcome to the show that explores with allied health business owners and managers what’s important about being in allied health business today. I have a special guest in our show today, Tristan White. Welcome to the show.

Tristan White

Hello, Michael, nice to be here. Thanks for the invitation. I’m looking forward to having a chat.

Michael Dermansky

What? Well, I’ve been looking forward to having a conversation about your business for a while and I forgot to introduce myself. Like my name is Michael Dermansky. I’m here. I’m a manager director of MD Health and we have a health business in several parts of Melbourne and Brisbane as well. And I mean, we’ve known each other for quite a while now. And we’ve talked business many, many times before. But can you tell the audience a little bit about yourself, who you are, what you do? And then we’ll go from there.

Tristan White

Yeah, sure. Sure. So look, Michael, I’m a qualified physiotherapist. Uh, uh, dad of four married, live in, uh, in Gippsland in Victoria is the, um, these are sort of the background, but, um, I qualified from, um, Melbourne uni in 2002 and, um, I’ve thought I was heading to a journey in private practice as a, as a physiotherapist. And I’ve had a few twists and turns, which involved, um, uh, trial improving practice, starting to work in sports physio for a while.

And then moving towards working with older people. Uh, I really did, um, enjoy working with older people and I’ve, I’ve started working for myself and I started working in nursing homes and over time, Michael, I, um, I got some clarity and I grew a team and a business that was, had a very clunky name for a start, Michael was called TJW physiotherapy services. Uh, there’s a, um, there’s a, there’s a long, uh, egocentric name for you, but, um, uh, my goal for the last 20 years has been to provide physio for older people to help them stay mobile, safe and happy. And, uh, we now, I now own an operator business called the physio co. And, um, it’s got a long history of working with older people in many parts of Australia, but it started from just me in a spare bedroom in the suburb of Baldwin in Melbourne, uh, in 2000, early 2004, it’s February, 2004, the physio co was born and it’s February, 2024 right now, uh, Mike. So we’ve been around for 20 years.

Michael Dermansky

That’s pretty amazing because I think I incorporated MD Health in February, 2004 as well.

Tristan White

Ah, there you go, connection.

Michael Dermansky

2004, I think incorporated the same, almost the same month. Um, I remember filling that out recently too. So there you go. But let’s go through that journey a little bit more detail as well. So exactly that too, you thought you were going to go to sports physio, but you started in the age care. I know the stories in your book, uh, culture is everything book too, but, um, from your words, let’s just, let’s talk a little bit more about the story. You started working in one nursing home and that developed into a business. Tell us a bit more about that.

Tristan White

Yeah. So, so look, Michael, the, um, I started working with, um, with sports in private practice and sports to me, it felt like I was helping healthy people become healthier and just didn’t have the right, the right, um, connection or the right purpose for me. And so I decided to work with older people and, but because of my interest in, and short experience in private practice, I really wanted to bring a private practice quality service to older people in their own homes. And so the first iteration or the first steps of what is now the Physio Co was something that’s progressed from TJW Physiotherapy Services to TJW Physio with the tagline dedicated home visit physiotherapy. Now there’s another mouthful of a line, but my goal in the early days was home visit physio. It worked when it was just me in the first year or so.

But I couldn’t figure out how to get consistent home visit work for myself and then to build a team around me. The commercials, I just couldn’t, couldn’t figure it out. And so, uh, I started working with older people in another environment being nursing homes. And, um, and I started working in one nursing home in Preston in the Northern suburbs of, of Melbourne. I gradually built relationships with other nursing homes and at the end of 2004 and into 2005, I had more work for myself than I could handle. And I started looking for some help as in another physio. And I’ve been adding members to our team and growing a team since early 2005, which grew into a business which was very focused on residential aged care. And that was definitely the focus for the next 15 years or so Michael a big a long run of helping older people stay mobile safe and happy in residential aged care facilities is where the physio co progress to from there 2004 all the way through to about 2019 2020 was a big focus on residential aged care.

Michael Dermansky

Right. I mean, it’s interesting that you build a business and you’ve talked about this before that, you know, you started with one contractor because of the quality of the service being produced by the physio. You got another contract, another contract, another contract till it became, you know, a nationwide service, which looked after quite a few residential facilities.

Tristan White

Yeah, look at these Michael and look, I would say that some years on now, Michael, I’ve been in business for 20 years. I’ve done an MBA. I’ve done all sorts of study and experience and the like. And, and I would say that business at the physio co in the early days was a B to B business, a business to business approach to, to it, but it was a people business, we’re all in people businesses and it was connecting with the older clients, helping them feel safe, feel felt like someone believed in them that I could actually help them to be more mobile, safe and happy. That was one connection and skill that I had to get better at, but also building connections and skills and relationships with the managers of nursing homes was the next step. And I worked hard through that over many years and build relationships and ask, are there any other places that you know of that could benefit from an energetic, consistent, reliable physio service for older people?

And that grew over time until Mike, until in the beta B world of business to business, I, I met a new category of people that I wasn’t familiar with in the early days. That’s for sure. And, uh, and Mike, that’s, that’s the procurement manager of the large organization, the large, um, uh, age care organizations. And that was, uh, it was a different type of, uh, of relationship building activity code because procurement managers are often about reducing costs or managing costs for their organizations.

And that was very different to the quality-based, trust-based relationships that I’d been building for with nursing home managers for a long time.

Michael Dermansky

That’s really interesting too, because I mean, as a health business owner, usually we deal with the customer and then, and you did B2B to the manager. And then, you know, that next level of corporate relationships as well. A lot of us, that wouldn’t even been a radar of, of things that we learned as well. I mean, we don’t, you don’t do big 10 years. You don’t do big, big contracts as well. There can be multi-year, multi-site, multi, you know, all those things that take time that you had to plan, plan a lot of head and it evolves forward and back negotiations. It’s just, there would have been a really different learning curve for you.

Tristan White

Michael, I never imagined that I’d be understanding contract negotiations and relationship building off with CEOs and COOs and procurement departments and or purchasing departments, whatever they might be called. It’s very different and so different from where I started with a passion to help older people stay mobile, safe and happy. And that was one of my challenges for a little bit of context for people listening. The PhysioCo between 2004 and 2019, it grew from myself to just myself working in the northern suburbs of Melbourne. And in 2019, we had over 150 team members in over six states of Australia. And so it was a significant growth, which I had to learn how to be a better leader, a better communicator, a better networker. But at the same time, I had to be able to zoom out to that sort of activity and zoom back in.

Are we helping older people stay mobile, safe and happy in each of those 150 or so locations around the country? Of course, I didn’t do it on my own. I had a team and I do have a wonderful team, but it’s certainly a very different from the early stages of my career and what I initially trained in, that’s for sure.

Michael Dermansky

I mean, that’s very interesting because you’ve got very different competing needs. You’ve got the needs of the recipient of the service, which is the, the resident of the aged care facility to the, to the manager, to the corporate sort of procurement manager or whoever’s making decisions as well. And their needs are very, very different. And how did you balance them? The learning to manage different incentives and different customer needs very, very can be often opposing.

Tristan White

Yeah, well, I don’t think I’ve ever got the balance. All that perfect, Mike, I think it was always a blend. It was a blend of, of what’s right for the older person, what’s right, what’s the organization looking for? What is the, the care staff need? What are the nursing staff need? What are the managers of the facility? What are the owners of the of the aged care organization? Understanding, I think one of the things that I’ve learned over a long time, Michael, I’ve made plenty of mistakes on this, but leadership is communication and communication is leadership. And so for me to become a better leader of our business, I become a better communicator and then to be a better communicator, uh, it’s actually about the, uh, being interested and listening closely to what each of those people are saying and what they need and want. And when I got better at realizing that communication was very, very high on the list of things I need to focus on and then, um, being interested in others using those skills really did help me. It’s still a work in progress. I’ve got fine tuning to go on all those things, Mike, but that’s some of the ways I went about it.

Michael Dermansky

Was it, um, so just one more granular step without one, two, in terms of being interested in other people and listening to them, what was some of the things that shift that you learned that shifted your thinking when dealing with some particular manager that were, Oh, I didn’t expect that, but now let’s change the approach here that really shifted a position for your business that you noticed.

Tristan White

Well, look, I think maybe one of the best stories that I can tell about combining the two, Michael, is I forget the time period, I’m gonna guess it was around 2014 or thereabouts, 2015. And I headed out to a nursing home to meet with the manager of a nursing home who was looking for a new physio provider for their 80-odd bed nursing home in the Western suburbs of Melbourne.

And I went out and I, I met the manager and, and I had a chat. We had a chat about the service we could provide. And I had a chat about the, the residents and what they were looking for. And then the manager said, would you like a tour of the facility? I said, I’d love to, I’d love to have a look around. We would, um, and she was very proud of this nursing home that she was a manager of and Mike, we were walking around and saying hello to a few people. And then we walked around a corner and I actually bumped in to an older person, a resident of the facility was walking along with their walking, walking frame. And I was chatting to looking one direction and chatting and I bumped in this person and I very quickly had to recover and, and I grabbed, grabbed the person and just, I didn’t, I wouldn’t get a fall over, but I sort of just grabbed them and smiled and made sure they’re okay. And we had a quick chat to that older person. And, um, and then we went on with the tour and I didn’t think much more of it. But a week later, I got a call from the manager and she said, we’d love you and your team to come and work here at our facility. And I said, thank you, we’d love to. I said, what made you choose us? And she said, it was that moment. It was the moment that we went on the tour. Firstly, I had three other possible clients come and want to deliver the service. None of them were interested in going on the tour. And then secondly, the way you interacted with that resident of ours, that showed that you cared. And it was about the connection that we had when I muck something up, to be honest with you, Michael, I shouldn’t go and bump it into the older people in a nursing home, but that’s the basics. So I think, Michael, finding connection with people, whatever level they are in an organization, finding common ground and being humble and respectful. And if you make a mistake, own it. Some of the skills that I learned from that, from that particular story.

Michael Dermansky

That’s pretty interesting. So let’s go back more towards the people side as well. And so you develop the culture as everything system.

Tristan White

Mm-hmm.

Michael Dermansky

a lot of those things in the business here as well. Why did you develop it? Why did you need to build this system?

Tristan White

Yeah. So, so Michael, I, as I said, I stumbled into growing a business or starting a business 2004, and then I started employing some physios in 2005. And it was really freaking hard to attract people to come and want to work with older people in nursing homes, in a startup business with no track record, some young fellow who thinks that, that he knows what he’s doing sort of stuff. And so I did what I thought was right. And that was, I think that we should build more great places to work in the world. I didn’t know the language or I didn’t even know what culture was in those days, Michael, but, um, but I worked really hard to build a organization, which was. Caring, it was connected. It was appropriate level of training and challenge and all those types of things. But it wasn’t enough. We had to go deeper. And so I become obsessive about learning about what, what is a workplace culture? What is a team culture? What’s involved.

And then I was a student and I was an action taker and I applied many, many things that I learnt and that helped us to, to start winning some awards. We were, we got ranked as one of Australia’s 50 best places to work way back in 2009 and that was quite a shock to, to win that first award, but then we doubled down on how can we keep becoming one of Australia’s best places to work, how can we get better at building a team culture? And that was a long journey of obsession of building a strong team culture, learning it, applying it, and then writing the cultures, everything book, uh, was a, a accumulation of all the, all the things that I learned along the way and the physio co became one of Australia’s 50 best place to work. 11 times we’ve made that list, which is quite phenomenal. And, um, and so the answer was by necessity to underpin how we could build a strong team of physios working at older people, but it was also based upon my belief that, um, that work should be a positive part of people’s lives.

Michael Dermansky

around, fantastic as well. I mean, we know we’ve implemented those systems as well. Here, we, a lot of, we had a list of things to work on and we had a few of those things with that, but we didn’t have all of them and particularly the recognition and the fun part as well. We brought into our business as well. And I know we’ve spoken about this before, but the unlimited budget for flowers as well. I mean, we’ve done that for both customers and like when something happens to, um, with, with staff members, just something that makes them feel a bit more special. Um, it, it feels like, oh, this is an extra cost, but the, the reality of the cost is, is very little. I mean, you had an unlimited budget for flowers. Do you remember exactly how much it really meant?

Tristan White

Look, we had, I’ve got a member of our team, her name is Jess, she’s an important part of our leadership now still, and she’s been part of our team for a long time. And part of her responsibility was to find an opportunity to connect with a client or team member or team member’s family once a week, and send a bunch of flowers as deemed appropriate most weeks, so once a week. And so I reckon those bunch of flowers might probably cost us between 60 and 80 bucks at a time and you multiply that by 50 weeks of the year or thereabouts and we’re talking about three grand is the summary. But the number of smiles, the number of connections, the number of lasting memories we got from the $3,000 spend is a phenomenal return.

Michael Dermansky

Yeah. And we’ve seen that too, when we’ve done things like that in our organization as well, where the real cost of it is, I mean, the real cost is minimal is so small on the radar, but the effect it has on building a culture, building a team, you know, how much people feel like they’re, they’re just, they’re valued and see as human beings and not just the person that is billable hours is enormous. It just, it completely changes the feeling of the organization.

Tristan White

entirely. And Mike, I think that’s, you’re talking about the show more love part of the culture is everything checklist. And I think that says that is an important part of it. And I think you’ve done a wonderful job of applying that in your business. For people that aren’t familiar with it, or don’t know about it. I’d simply encourage them to consider the little book called The One Minute Manager that I know you’ve read, Michael and all listen to, and the premise of The One Minute Manager or the new One Minute Manager that which is, as it’s now called is find a way to catch people doing something right, as opposed to only communicating as a manager or a leader when things aren’t meeting your expectations. It really can be as simple as that, as a starting point to show more love to people in your team and in your community.

Michael Dermansky

Great. I mean, I didn’t mean to sell anything here as well, but if they haven’t gone to your website and looked at your, um, culture is everything book, I really highly recommend downloading it or asking for a copy because it’s a short book, but, and it’s got some really easy steps you can do to improve into your organization as well. Um, I mean, we had core values. We had goals, everyone really, we talk about them all the time and we are high based on those as well. And it’s, you know, it’s a no on those core values from some team members, it’s a no from us. We don’t hire. And every time we haven’t been stringent about hiring our core values, it really hurt our company. Um, and you know, whenever I’ve had a question, Mark, I’ve gone back to what you wrote about that too, and said, no, we need a high baseline score values. And if we don’t, it’s going to hurt us more. And when we don’t, it hurts us more. Um, and so it’s been a really big part, but I highly recommend worst case scenario, download the list to one pager and it gives you the basis to do list as well. It’s fantastic.

Tristan White

Thank you, Mark. The culture of living checklist. Yes, the 19 steps to building a great place to work markets, some something I produced a quite a few years ago, and it still lives and is useful today. So yeah, do check it out. I think that’d be useful.

Michael Dermansky

So let’s go, you know,you, you’ve talked about where your business has gone to 2004 to, to …, 15 years. But a few years ago, you had to make dramatic change in the business. This is a really big deal where you’ve got a successful business. It’s this is the direction it’s gone for so long. You’ve won 11 awards in a row of being the best place to work. And then you have to shift. Now that is tough. Talk about, let’s talk about that.

Tristan White

Look, I’ll quickly tell that story, Mike, I think I think the important part of the story as well, we don’t need to get into all the detail, but in 2015, I sold part of the shares to physio Co. And so I was in partnership with that with another business partner between 2015 and 2000 and mid 2020. And during that time, we had a growth plan as to where we’re headed to continue to grow our business and, but there was there was some patterns that I was seeing. There was some trends happening in our industry and there were some changes happening, which were quite challenging for the direction that we had set without, with our business partner. And the core purpose of the physio co is to help seniors stay mobile, safe and happy, and the places we’d been doing that were in residential aged care facilities. The problem was that we were finding more and more and more that we weren’t able to deliver on our promise of helping seniors stay mobile, safe and happy, because the residential aged care industry was changing significantly. The funding was changing a hell of a lot. And the needs and wants of the owners of the aged care facilities and the managers in the facilities was less about the care for the older people and more about completing forms, getting appropriate funding and, and contributing to the financial sustainability of the organization, as opposed to the mobile, safe and happiness of older people. And so our core purpose was challenged. Um, and Michael that challenging our core purpose, uh, is part of the culture is everything system that you spoke of before team culture is underpinned by core purpose, core values and of the, of the future. Um, however, what I’ve learned in recent years is that there’s more to a sustainable culture of an organization than simply the team culture fundamentals. Uh, there is also the leadership culture and there’s the money culture. And one of the other challenges at that point in time was the money culture part of our business. And what I mean by that is it was getting more and more competitive in residential aged care facilities and in physiotherapy for residential aged care. And so it was going harder and harder to make a profit and therefore to reinvest in our team to pay our team appropriately to reinvest in our culture in our learning all those types of things. And so for a few reasons, including a challenge on purpose, a challenge on the commercials, we made a big decision. And that was that we were going to continue to help seniors stay mobile, safe and happy, that we weren’t gonna focus on residential aged care. We’re gonna help people in their own homes and pivot to a community focused aged care. Sorry, let me put those words back in my mouth. A community service seniors physiotherapy service.

Michael Dermansky

Right. Okay. I’m, you know, that it was a huge change in how the business looked. You didn’t, the stability of the income was going to be different. Um, the number of staff members, it was going to be different as well. Um, the margin is going to be different as well. And what your life is going to be different as well. What did you go through internally to make the decision? And then what did you, some of the things you had to do to be able to take, take your life at such a big change in direction.

Tristan White

So, I had to come to grips with the possibilities myself. I had to work through it with our business partner, with our leadership team, with our coach. There were many, many conversations and possibilities to consider. And building, growing, and maintaining a strong connection with people and a strong culture is at the heart of who I am and what I’ve learned and applied at the PhysioCo. And so the decision we made, was that we would make a change to working, to helping older people in their own homes. But we would, doing what we say we do is really important. And it’s one of our, it’s part of our core values. And so what we did was we continued to fulfill our obligations to our existing contracts with our nursing homes or aged care facilities. And we slowly but surely didn’t renew the contracts when they came to their ends. And there was a big one in mid 2019. We had grown from, it was just me way back in the early 2000s of one facility of this large national chain. And over those 15 years we’ve grown and we were delivering services in more than 50 locations at that group around the country. Multiple millions of dollars of revenue from that one client per year.

And we decided that we wouldn’t be continuing to work with them. It didn’t fit with our, uh, our purpose, our values, our vision, and the culture we want to build. And so we, we let them know that we wouldn’t be continuing and we communicated as clearly as we possibly could, as humbly as we could with our team to let them know that was what was happening. If they’d like to keep working with the physio co then we would support them and help them and find a solution for them. If they’d prefer to keep working with the older people they already had relationships with in the communities in the nursing homes already at, then we would support them to move to a different employer to continue doing the work they wanted to do. And that was the first significant change. And we continued to do that through, that was 2019 through 2020 through 2021. And the very last of the work we did in residential aged care finished in as in a contracted provider, finished in early 2022 was the way we went about it.

Michael Dermansky

Wow, okay. How did you feel?

Tristan White

stressed. That was the at the time it was it was a difficult, challenging time. But it was a courageous decision that I felt very strongly about. I felt very strongly that we want to help older people stay mobile safe and happy. Building a sustainable organization is key to that. And I didn’t see a sustainable future for the physio co in residential aged care.

I didn’t see a sustainable future for our business, for our team members, and therefore for the finances or the stability of our family as well. And so when you think about it like that, why wouldn’t you make a change? Uh, and, but it was very difficult. I had to have, I worked through all sorts of financial modeling, all sorts of difficult conversations with a business partner, with our accountants, with our, with our team, with our leadership team, um, all sorts of challenges, but you know what, uh, Michael, we are now in early 2024, I lead the physio coach is a much smaller team about 30 odd of us now, helping older people in their own homes in Melbourne, Sydney and Adelaide. And I feel like we’re doing the best work of our lives. I feel like we’re doing the best work of our lives. And I’m excited about the future growth of what we will be able to do have an impact on more people, more older people, very different type of impact, very different type of business model, very different team, but still driven by the same purpose and the same goal of a sustainable business, which does something great in the world, and is a great place to work. And so I’m feeling pretty good about it. But man, it’s been it’s been a long, hard change, but one that I’m very proud and pleased that we did make the move.

Michael Dermansky

Well, it’s interesting. I mean, I’ve got to come in here for making such a brave decision. And it, you know, it comes out of. But combination necessity and, um, and, you know, being true to what you want to do, cause I mean, you got to show that, you know, what was your take the money and we’ll do this. I know it’s not at our core value, but you know, the revenue is coming in and we’ve got to pay our bills. We’ll deal with it, but you make the brave decision to say, no, I want this. I don’t believe in this. I don’t believe that this is where I want my life and my business is not what I want to stand for. And he made the hard and stressful decision saying, okay, our life is going to be more uncertain for a while. And I’d rather take the risk to be different than to be the same and do something I don’t believe in. That’s a pretty tough decision.

Tristan White

Yeah, it was tough, Michael, but I’m very, I’m surrounded by some wonderful people. Some great advisors, some great friends, some great team members. My wife is a wonderful supporter of mine and all those things considered made it to be the right thing to do. But I can tell you what one of the best things to come out of the whole thing, Michael, and we’ve got a long way to go with the Physio Co and I think we’ll do better work than we’ve ever done in the future.

But I’m a better person. I’m a better leader. I’m a better communicator. I’m a, I’m better at so many things by choosing to do that hard thing, uh, by choosing to, to make that big move in our business has been amazingly challenge, challenge challenging, but I’m a, I’m a better person. I’m a better leader. I’m a better communicator. And I think I’m happier with the work that we do. And I’m happier that we’ve worked through those big challenges. And so all things considered, it’s, it’s a great result. Could we have done things differently and better? Of course we could have, but that’s life and that is business.

Michael Dermansky

So before we finish up any final thoughts you wanna tell the listeners before we finish up for today.

Tristan White

Any final thoughts, Mike is, I think, believe in yourself, believe, believe that doing great work is the important part of being a business owner, and that money is important. But money is the output, money is the result of the of the great work that you do, as opposed to money being the driver of all decisions that we that we do. So that is probably my last my last final thoughts.

Michael Dermansky

Yeah, fantastic as well. I mean, it’s interesting you say that to me because I mean, out of all of the entrepreneurial courses, books, stories we’ve heard is when people start chasing the money as the outcome is that it’s not sustainable because there’s so many ways to achieve that. And it’s so hard to go through. But if you have a particular goal, if you want with your life and your business and where you want to go, you, it’s more likely you’re going to get through that when you have a larger purpose than just the financial goal, the financial ends up being the outcome of the work that you want to produce in the world.

Tristan White

Michael, I agree with you entirely. And don’t get me wrong. The physio co has served me and my family very, very well. You’re not only as a phenomenal place to do the best work of my life, but I’ve been paid very well and we’ve got done very well financially, but that’s an output of the work that we’ve done. That’s the result and that’s not the driving force.

Michael Dermansky

It’s an output. It’s an outcome, yeah.

Fantastic. Well, Tristan, thank you very much for being a great guest on the show. I think there’s some great learnings there for everyone as well. And, um, I mean, I, I’ve, I commend you for the brave moves you’ve made, both what you did to grow the physio code and saying to yourself, I don’t know what to do here, but I’m going to put the effort into learning it. And then saying that I don’t like where we’re going. We better fix this, even though it’s going to be hard.

Tristan White

Thank you, Mike. It’s in hindsight, it sounds like the right decision and it was, but when we were going through it, it was really darn hard. So great to be here to have a chat with you about it. And thank you for having me on as a guest.

Michael Dermansky

Great. You’re very welcome. And we’ll gladly, we’re going to be listening to another story next time on the Business of Health podcast. Thank you very much.