If you look at how Private Practice Physical Therapy has changed over the last 2 decades, it’s easy to see why so many owners feel frustrated about their business.
The rules for growing a successful PT practice are very different than they were 20 years ago.
It’s important to get a look at how our industry is evolving so that you can stay ahead of the trends and put an end to needless frustration over how to move forward.
Below are the top trends owners need to be aware of.
Physician Referrals are Dying a Slow Death
There may be a few owners in the US who can comfortably rely on physician referrals, but that number is on the decline.
Even those who are hanging on and surviving with such a limited marketing arsenal (physician only) now recognize they must diversify their new patient sources into their past Physical Therapy patient list and the general public.
PT Practices and companies who have not embraced the “direct-to-consumer” model will struggle to survive in today’s healthcare economy.
The good news is that “direct-to-consumer” marketing not only gives owners more control of their numbers, it also brings in a better patient.

Direct-to-Consumer Marketing
Picture this.
You walk in Exam Room A. You ask the patient, “What brings you in today?”
She responds, “I’m having trouble with my back. My doctor sent me here.”
Next you walk into Exam Room B. New patient. Same question.
She responds, “I’m having trouble with my back. I read your book. Came to your workshop. I know you can help me.”
Who would you rather treat? Yes, nearly 100% of owners agree it’s the patient in B.
We know she is significantly more likely to meet her goals, complete her plan of care, graduate, return to Physical Therapy for additional care in the future if she needs it, AND refer her friends and family to us.
The problem? Going direct to the consumer is relatively simple…but not necessarily easy.
What I mean by that is, anyone can make a Facebook page for free and spend a few dollars on ads. The advertising platform on Facebook makes it very quick to get started (especially compared to something like advertising on television).
But…what happens after that? For most business owners…nothing. They run their ads and maybe a couple of hundred people see it.
Maybe a few of them even “like” it.
But how many new Physical Therapy patients are generated? Zero.
And so, in this example we are technically advertising directly to the public.
Just in the wrong way.
Want to see the “right” way? Head on over to our Physical Therapy Resources for some free direct access marketing training.
From Clinician to Business Owner
A few decades ago, a Practice Owner may have been able to run their business off of word-of-mouth alone.
Usually because they were the only PT in town.
However, those days are gone. Most markets are competitive now – increasingly competitive.
The Self-Employed Mentality of providing high quality of care and growing through word-of-mouth, managing finances via checking account balance, and hiring PTs and staff by posting a simple ad?
This does not work today.
It is NOT a problem should you want to remain a small practice with a handful of staff. However, if you’re choosing to grow and build a true Private Practice Business, then you’re going to have to learn operations – the creation of processes and systems – for your marketing, finances, personnel, billing, etc.
Working More for Less Money
When I look at the amount of documentation our PTs are putting in for one visit…it’s unreal to me.
In general, we are doing way more documentation as clinicians. Frequently, we’re doing this for less or capped money. It’s alarming how fast the healthcare GDP is growing…$3.3 Trillion per year. That’s $10,300 per person per year in the US.
However, we are not getting healthier for those dollars. We’re actually getting less healthy!
Yikes.
So, the answer is to make it more cumbersome on the conservative care clinician…and ultimately have decreased access to care.

Rising Cost of PT Degree and the Scarcity Mindset
When I graduated PT school, the maximum student loan I was allowed to borrow was $24,000.
Today, for many graduates, it’s that figure PER YEAR.
A quick survey of recent grads revealed student loan amounts of $160,000-$240,000. Never mind the exorbitant costs of education.
So, the student debt plays out to be a $1,000/month payment for the next 30 years. That’s a mortgage payment.
There are a limited number of PT graduates each year. Many, pressured by financial stress, will be forced to work in higher paying environments, such as the hospital systems (where reimbursement is 3x what we receive in outpatient PT for the same services).
Because of the reliance on physician referrals in the past within the PT industry…that scarcity mindset is still present. Scarcity mindset = I win, you lose. However, a handful of forward thinking, outside-the-box owners are paving the way with Out of Network and Cash Pay Models.
This is BIG and worthy of your attention. In the end, those companies have adopted an Abundance Mentality. This sets them up to hire the best new PT grads accordingly. Letting owners stuck in the old mentality to fight over the remaining students.
If you’d like to learn even more about these new models for Private Practice Physical Therapy, check out our newest free training – How To Double Your New Patient Visits In Less Than 12 Months