In this episode of Physical Therapy Private Practice Secrets of the Top 10 Percent, host Brian Gallagher, PT, dives straight into one of the most common challenges facing private practice owners: identifying and addressing the root causes of poor performance in their clinics. Drawing on his 30 years of experience, Brian provides practical insights and proven strategies to help practice owners turn around underperforming operations. This episode is a masterclass in diagnosing issues, implementing structure, and fostering accountability—all aimed at transforming a struggling practice into a successful, high-performing business. Key Takeaways  Identify Root Causes - Common issues include staff misalignment, lack of accountability, structural gaps, inadequate training, and quality control. Implement the Five Divisions - HR/Admin, Marketing, Finance, Production, and Quality Assurance. Use Metrics for Accountability - Track Net Promoter Scores, visit adherence, and staff performance. Foster a Learning Culture - Invest in a learning management system to support continuous team development. Outsource for Efficiency - Delegate non-clinical functions to trusted professionals to focus on clinical growth.