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Before you go: 13 of your 17 summit speakers wrote a chapter of the same book.

Titans of Private Practice PT

Every wall you are hitting, someone else already got past.

101 leaders from across private practice PT sat down and answered the same 14 questions. What broke them. What they would do differently. What they would never do again. Read what they did, then go do it.

The summit gives you one day with thirteen of them. The book gives you all 101, on your desk, the next time you hit a wall at 9 PM on a Wednesday.

Buy the book

$45 plus shipping. Hardcover first edition. Estimated delivery end of December 2026.

Titans of Private Practice PT, the hardcover first edition, on a hotel lobby table

95Chapters

101Leaders

14Questions each

800+Pages

Carl Mattiola & Chad MaddenFirst Edition, 2026

Read this part first

The hardest part of owning a practice is that nobody tells you the answer.

You made a decision this week that you were not trained to make. Maybe it was a hire you were not sure about, or a payer contract you could not tell was good or bad, or a number on a report that did not look right and you did not know who to ask.

So you guessed. You have been guessing for a while now, and mostly it has worked, which is its own kind of problem, because you still cannot tell which of your guesses were good ones.

Here is the part that stings. Every single one of those decisions has already been made, badly and then correctly, by someone who owns a practice just like yours. They already paid for the answer. They paid in staff turnover, in a bad lease, in two years of revenue, in a partnership that ended in lawyers.

You just have no way to ask them.

You are not stuck because you are bad at this. You are stuck because the answers live inside other people, and nobody ever writes them down.

So we wrote them down

We asked 101 of them the same 14 questions.

Practice owners with one clinic and practice owners with forty. The people who built the software you use, the lawyers who fix the contracts you signed, the ones who sold and the ones who never will. 101 of them, 95 chapters, and not one of them saw anyone else's answers.

Then we put their answers side by side.

What comes back is the thing you cannot get from a conference stage or a podcast episode, because a stage rewards the polished version. Asked the same fourteen questions in writing, people tell you about the failure instead. The number they got wrong. The advice they followed for six years that turned out to be nonsense.

It is modeled on Tim Ferriss's "Tools of Titans." You are not meant to read it front to back. You open it to the person whose practice looks like the one you want, and you find out what they actually did.

Who is in it

95 chapters. 101 leaders.

Thirteen of the people you just signed up to hear wrote one of these chapters, so they come first. Tap or hover any face for what that person covers, or open the full list and search for someone you already follow.

Speaking at Titans Online

Chapters 1 to 50 are practice owners. Chapters 51 to 95 are industry leaders and partners.

You are not the first

Somebody in this book already had your worst week.

These are real chapters. The point is not the disaster. The point is that each of these people came out the other side and then wrote down exactly how.

Thirty team members, three locations, a new baby, and eighty hour weeks. His body shut down and he was tested for cancer, Crohn's and celiac before he understood what was actually wrong.

An insurance audit left her pediatric practice roughly $150,000 in debt. She borrowed from her parents and cashed out her and her husband's retirement accounts to cover the rest.

He handed a location manager complete trust and no oversight. They used it to open a competing clinic down the street and tried to take his location down with it.

His clinical director was arrested. He was called before the state board and asked 156 questions about how he ran his business, and he had almost no documented systems to point at.

He took the common advice and signed every insurance contract he could get. The schedule filled up. A large share of those visits reimbursed below what it cost him to deliver them.

His top referring surgeon moved to Alaska. There was no contingency plan. It is the reason he now says no single referral source should ever exceed a quarter of your new patients.

How to use it

Open it to the person you want to be. Do what they did.

Find the practice that looks like yours

Skim 95 names and titles. Solo owner, multi-site, cash-pay, hybrid, about to sell. Somebody in there is two years ahead of you and had your exact problem.

Read their answers

Same questions every time, so you can hold two owners side by side and see where they disagree. That disagreement is usually the most useful page in the book.

Steal the part that applies this week

The wisdom is concentrated. The application is yours. One chapter is a fifteen minute read and most of them contain something you can change on Monday.

The fourteen questions

Everyone in the book was asked the same questions.

Read the list and notice how many of them you have quietly wanted to ask somebody for years.

01What is the book or resource you have recommended most to other practice owners, and why?
02What practice management tool, system, or purchase under $500 has had the biggest impact on your success?
03What was your biggest failure or setback as a leader that ultimately led to breakthrough growth?
04Do you have a personal go-to mantra or favorite saying that guides your business decisions?
05What has been your best investment in your practice, whether time, money, education, or energy?
06What is an unconventional approach or "weird" habit that works surprisingly well for you?
07In the last five years, what new mindset or system has most improved your performance and your quality of life?
08What advice would you give a PT about to open their first practice, and what conventional wisdom should they ignore?
09What are the worst pieces of advice you commonly hear given to practice owners in our profession?
10What have you gotten better at saying "no" to, and how do you protect your time and energy?
11When you are overwhelmed by the demands of running a practice, what do you do to regain focus and clarity?
12What trend will influence private practice in the next five years that owners are not talking about?
13Who is doing something in our industry that is novel or wildly successful, and what are they doing?

Straight from the pages

A few lines from inside.

Clinical excellence is the floor. It is non-negotiable, but it is not a growth strategy.
Josh Funk, PT, DPTFounder & CEO, Rehab 2 Performp. 151

If you don't build the system, you become the system.
Pratik Shah, PT, MPT, DPTOwner & President, iMotion Physical Therapyp. 376

Most owners are flying without instruments.
Stacey Schatz, DPTFounder & Regional Director, Professional Physical Therapyp. 364

An empty slot is the most expensive thing in your building.
Carl MattiolaCo-Founder & CEO, Breakthroughp. 689

Reimbursement is not coming to save you.
Josh Funk, PT, DPTFounder & CEO, Rehab 2 Performp. 153

When a physician tells you they'll send you referrals, divide that number by two, then divide it again by three.
Ryan Christoff, PT, DPTPresident & Owner, The Physical Therapy Institutep. 101

Tenure is not a performance review. Longevity is not loyalty.
Brandon SeigelPrivate Practice Consultantp. 757

Equipment depreciates the day you buy it. The return on a person compounds for years.
Deepak Sharma, BPT, MPTFounder & Director, Primus Physiotherapyp. 390

Clarity is kinder than rescuing.
Carrie Hall, PT, MHSFounder, SISU Physical Therapy & Mentoring Servicesp. 622

You can grow yourself into bankruptcy one visit at a time.
Pratik Shah, PT, MPT, DPTOwner & President, iMotion Physical Therapyp. 383

The best clinician in the market with no visibility will lose patients to an average clinician with a strong online presence and a real marketing plan.
David Straight, DPTCo-Founder, E-rehab.comp. 801

Ambiguity is a tax that compounds.
Michael Mayrsohn, DPT, OCSCo-Owner, Metro Physical & Aquatic Therapyp. 290

What changes

What you walk away with.

A straight answer on the reimbursement question, from people already building for the other side of it.
The delegation mistake almost every owner makes, described by the people who made it and what it cost them.
What to stop doing yourself, and the exact point in a practice's growth where continuing to do it starts costing you money.
Which three books are worth your time, decided by consensus rather than by a bestseller list.
What the owners one stage ahead of you would undo if they could, in their own words.
The unglamorous systems that actually moved the numbers, including the ones that cost under $500.

Buy the book

$45 plus shipping. Includes the Titans Vault.

Included with the book

The book gets you into the Titans Vault.

Every copy comes with access to the Titans Vault, the resource hub behind the book. It is built from the same people as these pages, and it keeps growing: new material is added as the contributors keep sharing it.

Playbooks
Step by step guides to the problems that come up in every practice: reactivation, opening a new location, moving to cash pay, finding the leaks in your funnel.
Tools
Calculators, scorecards and checklists you can put your own numbers into and get a straight answer back.
Trainings
Short, practical sessions on one thing you can change this week.
Interviews
Long-form conversations with the owners in the book, on how they actually did it.

Ever growing. More is added as it is made.

Who put it together

Carl Mattiola and Chad Madden.

Chad built and scaled his own practice before co-founding Breakthrough. Carl has spent his career working with practice owners on the business side of the clinic. They did not write this book so much as assemble it: find the people who have already done the hard part, ask everyone the same questions, and stay out of the way of the answers. Both of them are on the Titans Online lineup too.

Before you order

The things people ask.

I already own a stack of business books I have not finished.

So does everyone in this one. That is why it is not built to be read front to back. Each chapter stands alone and runs about fifteen minutes. Open it to a name, take the one thing that applies to your week, put it down. It is a reference, not an assignment.

Is this just theory from people selling something?

No. Every chapter is one named person answering the same 14 questions on the record, and the questions were written to surface failures rather than highlight reels. Section one is practice owners. Section two is the industry leaders and partners who work with them: attorneys, association leadership, and the founders of companies you already use.

My practice is different.

It probably is. That is the reason for 95 chapters instead of one author's opinion. Solo owners, multi-site groups, cash-pay, insurance-based, hybrid, rural, urban, and several people who have already sold. You are looking for the two or three whose situation rhymes with yours.

How much is it?

$45 plus shipping. One price for the hardcover first edition, and it includes access to the Titans Vault.

When does it ship?

Orders are filled from the first print run, with an estimated delivery of the end of December 2026. You will get an order confirmation from Breakthrough by email.

What is the Titans Vault?

The resource hub behind the book: playbooks, tools, trainings and interviews from the people in these pages, in one place. Access comes with every copy, and it keeps growing as new material is added.

Who is it actually for?

People who own or run a physical therapy practice, or are about to. If you have never had to make payroll, most of this will not land. If you have, several chapters will feel like they were written about your specific week.

First edition

Somebody already solved it.

95 chapters of people who got past the thing you are stuck on, and wrote down how. Every copy includes the Titans Vault.

Buy the book

$45 plus shipping. Hardcover first edition. Estimated delivery end of December 2026.

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Mon, Oct 19

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Tue, Oct 20

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