A recent post referencing Nick Saban stopped me in my tracks—not because it was profound, but because it was painfully familiar.
Saban calls them The 5 Enemies of Greatness:
If you’ve owned or led a physical therapy practice for more than a few years, you’ve encountered every one of these—not in theory, but in real decisions, real hires, and real outcomes.
What’s dangerous is not that these enemies exist.
It’s that they often masquerade as “good intentions.”
In clinics, entitlement shows up quietly:
At CEP, we learned this the hard way:
Compensation must always be an exchange—not a promise.
This is why we moved to pay-for-performance with mentorship, not volume for volume’s sake, but value tied to outcomes, engagement, and execution.
Most practices don’t have a talent problem.
They have a discipline problem.
Discipline isn’t punitive—it’s liberating.
When expectations are clear, good people thrive.
This is exactly why we invested heavily in status sheets, onboarding pathways, and 90-day ramps. Not to create pressure—but to remove ambiguity.
This one shows up as:
Vision-driven clinics adapt.
Circumstance-driven clinics react.
Vision says:
We’ll build systems that work regardless of conditions.
That’s how cash-pay pathways, tech-enabled care, and readiness-based models are born—not from comfort, but from conviction.
This is subtle—and dangerous.
It sounds like:
In reality, lowering standards protects no one.
It delays truth—and makes the eventual fallout worse.
Great leaders don’t avoid hard conversations.
They have them early, clearly, and humanely.
The moment a clinic says:
“We’re good enough.”
Growth stops.
Culture erodes.
A-players leave.
Complacency isn’t laziness—it’s loss of intentionality.
This is why we revisit:
Every year. Every hire. Every season.
The Real Takeaway
High standards don’t create therapy mills.
Lack of purpose does.
Structure without context feels transactional.
Structure with why feels like leadership.
The best clinics I know don’t chase volume.
They build teams capable of delivering value—consistently.