Struggling with low margins in your physical therapy practice? Here are six ways to grow profitability by increasing revenue per patient. 

As a physical therapy private practice owner, increasing revenue is always top of mind. Insurance reimbursements are declining annually, inflation is at a historical high, and therapists are demanding higher salaries. These combined factors make it increasingly difficult to achieve healthy margins. 

There are numerous ways to address these financial challenges so you can become more profitable, grow your practice, and hire and retain staff.  In this article, we’ll explore six ways to grow profitability by increasing revenue per patient. 

Increasing Revenue in Your Practice: An Overview

There are many ways to increase revenue in your practice. One way is to see more patients. For instance, if you treat 100 patients today you can set an achievable goal to grow that number to 120 patients per week. To learn more about how to get more patients, check out this article: How to Get More Physical Therapy Visits. 

Some practices, however, have reached full capacity with their caseload. They either don’t have enough staff or enough space to serve more patients. Yet they may still struggle to make ends meet. If this sounds like you, you will likely benefit more from learning how to increase revenue per patient. At a high level, you can increase revenue per patient by:

  • Charging more per visit. If your average revenue per visit is $80, you could set a goal to increase your average revenue to $90 per visit. 
  • Adding more visits per patient. You can increase visits per plan of care. Or, find ways to get past patients to come back into the clinic for additional treatment. 

In this article, we’ll explore 6 ways to increase revenue per patient. Some of them enable you to charge more per visit, while others will empower you to increase the number of visits per patient.

Watch Chad Madden answer questions about making up revenue from low reimbursements:

6 Ways to Increase Per Patient Revenue

1. Add cash products and services

Many practice owners today are adding cash services to supplement income from insurance reimbursements. Numerous therapeutic devices and services exist that pair well with physical therapy. These options add value to your patients and can help them get better faster. At the same time, they generate cash income for your practice and increase revenue per patient. Examples of cash-pay products and services that are working today include:

  • Therapeutic lasers
  • Shockwave therapy
  • Traction / Spinal decompression
  • Massage 
  • Dry needling (covered by insurance in some cases, but not by all providers) 
  • Fitness classes/gym facilities
  • Online coaching or digital courses
  • E-commerce offerings such as nutritional supplements

Cash-based products and services like these can help you increase revenue without relying solely on insurance reimbursements.

How adding cash-pay services can help your physical therapy practice increase revenue per patient.
3 scenarios showing the difference between 1) relying solely on reimbursements, 2) relying on cash pay only, and 3) combining both reimbursements and cash pay services.

Some practice owners I’ve talked to express concern about their patients’ willingness to pay for cash services. The answer to this likely depends on the area you live in and the affluence of your local population. Yet dozens of practice owners in the Breakthrough community have found success generating strong ROI from cash-based products such as Lasers and Shockwave. 

One practice owner based in Gainesville, Florida recently shared that he generated more than $100,000 in additional annual income by adding LightForce® Lasers to his offering. He marketed those services through Breakthrough’s Patient Demand Platform.

When launching new cash services, it’s a good idea to develop a marketing strategy to get the word out and grow demand for your services. Breakthrough can help you develop a marketing strategy and implement it with pre-built email campaigns and done-for-you online advertising funnels.

“Breakthrough has helped us get the word out about our cash pay services with email campaigns promoting Lightforce Lasers. We’ve had patients coming in just for those cash-pay services that we offer and then they end up becoming physical therapy patients too.” -Tony Cere, Practice Owner

2. Reactivate past patients

Reactivating past patients goes hand-in-hand with adding cash-based services. When you add new services, you can market them to past patients as a way to attract them back into your clinic.  

It’s often easier and more cost-effective to reactivate past patients than to acquire new ones. Your patient list is your lowest-cost, easiest-to-use tool to quickly boost patient visits and increase revenue. 

I know PTs who have generated a dozen plans of care from a single email to past patients, even with a modest-sized patient list. Who better to focus your limited time and efforts on than those people who already know, like, and trust you? These are the people who are most likely to come back for additional treatment or another condition. 

A common mistake practices make when engaging their patient list is to send their patient newsletter via email. Unfortunately, this is typically ineffective at generating replies or inquiries. 

What works better is to craft email campaigns that a) provide “goodwill” value to your target patients and b) offer a call-to-action.

Watch: How to Reactivate Patients with Email

Balance “goodwill” emails (such as exercises they can try at home to lower back pain) with “offers” (such as an invitation to come in for a new service). You’ll build trust and credibility with your past patient list while providing them with opportunities to come back for additional treatment when they’re ready. 

Running campaigns to reactivate past patients helps to increase the number of visits per patient, which is a more cost-effective way of boosting revenue than acquiring brand-new patients.

Deepak Sharma, Owner of Primus Physiotherapy has been working with Breakthrough since he launched his practice in 2018. He uses Breakthrough’s pre-built email campaigns to reactivate past patients. Today, around 85% of his patient base are either past patients or referred by past patients.

“We know that if your primary base is your past patients, then they will never let you down,” Sharma said. He hit his 7-year growth goal in only 3 years and generates over $1 million in annual revenue from a single location. 

“We don’t do any other marketing,” he said. “All our marketing is through Breakthrough.” 

3. Reduce no-shows and patient drop-off

No-shows and patient drop-off can be a significant drain on revenue. 

Not only is it bad for business, but it’s also just plain discouraging to put effort into helping a patient, only to have them cancel last minute or even disappear altogether. This can leave therapists feeling disrespected and undervalued.  

By creating a Plan of Care for each patient, scheduling all appointments in advance, and implementing appointment reminders, you can help prevent no-shows and patient drop-off. 

These tactics are key for maximizing visits per patient. Ultimately, this will allow you to increase revenue per patient. 

4. Drop low payers or negotiate better rates

If you’re working with payers that reimburse at lower rates, dropping these payers or negotiating better rates can help increase revenue per visit. By focusing on better payers, you can increase revenue without necessarily increasing the number of patients.

If you can generate $120/hour instead of $90/hour, you could create a lot of lot more margin for the business. 

Something we see a lot is that practices are seeing patients that are capped at say $60/hr, while they have prospective patients covered by $120/hr payers on their waiting lists. 

You can avoid this by implementing a strategy where you cap visits below a certain revenue threshold and focus on attracting patients above your threshold. 

5. Expand insurance-based services

We’ve talked about adding cash services to increase revenue, but there are also some insurance-based services that can help to increase revenue per visit. 

For example, if you’re a physical therapist, there’s an opportunity to add Remote Therapeutic Monitoring (RTM) services. The RTM codes in the 2023 CMS guidelines offer generous opportunities for practice owners to add new revenue streams while potentially improving the patient experience. 

You can check with your payers to discover other services that may be covered under insurance and reimbursing at decent rates. This will vary by provider, but some that may be covered include dry needling and traction. 

It’s important to remember that if you rely solely on insurance-based revenue streams, services covered and reimbursement rates are subject to change. This can make revenue difficult to predict. In general, it’s a good idea to diversify your services and payer mix to hedge against changing reimbursements.

6. Build patient demand

It used to be that physical therapists could rely on a steady supply of physician referrals for patients. That’s no longer the case. Today, physicians are primarily sending referrals to hospital-owned and physician-owned clinics.  

This transition has been difficult for many practices, but to give up hope would be a disservice to our patients. Instead, practice owners must shift their thinking in terms of how to acquire patients. 

You have the power to go out and build patient demand for your services. To get patients for yourself, without relying on doctors to refer. Public demand for physical therapy is growing, largely due to aging baby boomers who are staying active later in life than previous generations. Practice owners need to get strategic about capturing the existing demand in their market. 

You can build patient demand through tactics such as online advertising, email marketing, or hosting educational workshops.  

Building patient demand enables you to focus on higher-paying patients. When you have a large following of interested and engaged prospects, you can drop lower payers and increase your revenue threshold. Plus, you’ll have an engaged group of followers that you can target when you have new services to offer. 

Patient Demand Is Key to Increasing Revenue Per Patient 

The more that you focus on building patient demand, the larger of a list you will gain, which you can continue to engage over time. With more people aware and interested in your services, you’ll gain the flexibility to:

  • Increase revenue per patient and treat better-paying patients
  • Rapidly create interest in new services 
  • Fill your schedules so you can hire and expand

One important note on hiring: A lot of practices are struggling to hire because they can’t keep up with therapist salaries offered by the competition. Keep in mind that a growing practice with healthy finances and a steady flow of patients will be able to pay better wages and will be more attractive to therapists. 

A key part of your role as a practice owner is to identify ways to build patient demand in order to create consistent patient volume, increase revenue per patient, and attract/retain clinicians. 

What questions do you have about how you can increase revenue per patient and build patient demand? 

Breakthrough - Increase Revenue Per Patient

Get your answers in a free consultation with a Breakthrough Patient Demand Expert. Schedule your free strategy call today. 

Whether you’re a cash based practice owner selling physical therapy, chiropractic, or integrated care services, you want to help as many people as possible. But with so many options for medical care, it can be difficult to stand out and attract new clients. If you run a cash-based practice, or you’re thinking of switching to a cash-based model, marketing is even more important.

Why Every Cash Based Practice Needs a Strong Marketing Strategy

Whether you’re a cash-based practice owner selling physical therapy, chiropractic, or integrated care services, you want to help as many people as possible. But with so many options for medical care, it can be difficult to stand out and attract new clients. If you run a cash-based practice, or you’re thinking of switching to a cash-based model, marketing is even more important. 

There are a few reasons why it matters so much for cash based practices to develop a strong marketing strategy. 

First of all, cash based practices or out-of-network providers need to put a big emphasis on marketing since they can’t get patients through insurance companies. 

Cash-based practices need to work twice as hard to convince people that their practice is the right one to meet their needs. 

After all, you’re asking people to pay for your services upfront and out of pocket. But if you can reach the right people with your marketing and effectively demonstrate the benefits of your services, you can run a successful cash-based practice. 

Top Marketing Strategies for Cash Based Practices

In this section, you’ll learn successful strategies for marketing your cash based practice. There are both online and offline strategies.

The Old School Way: Marketing Your Cash Based Practice Offline

Before the Internet, marketing was done differently. Think printed signage, direct mail, newspapers, radio, etc.

It’s great to bring some of those elements back into your modern-day marketing. But as cash based practice, it doesn’t make sense to spend a lot of money on branding that doesn’t generate measurable results. Here are some ideas that will go a long way in building stronger connections with your patients.

Mail Hand-Written Notes 

Hand-written welcome notes when a new patient joins your practice can go a long way in building patient loyalty and retention. You can also send hand-written thank you notes to referral sources to build continued goodwill. 

Yes, these things can take time. But, how much is a healthy and sustainable relationship with your patients worth? 

To save time, there are print and direct mail services that can write and mail hand-written notes for you. A quick google search for ‘Send handwritten notes’ will generate several options. 

Network with Referral Sources

Building relationships with other healthcare providers can be incredibly beneficial for cash based practices. For instance, if you’re a physical therapist, you can build referral relationships with chiropractors, massage therapists, local gyms, or local employers. Attend local events, join professional organizations, and offer to give workshops for referral partners’ clientele. 

The New School Way: Marketing Your Cash Based Practice Online

Online marketing is where you will want to focus the majority of your marketing efforts. Online marketing makes it possible to measure the results of your marketing and ensure you’re generating a strong Return on Investment (ROI).

Email Your Patient List 

A past patient list is your most valuable asset. These are people who already know, like, and trust you. With a little bit of outreach from you, they are likely to return for more treatment the next time they have any pain or conditions you treat. 

To save time and get the most out of email, you’ll need a software platform that automates email. With email automation, you’ll be able to: 

  • Send an indoctrination email sequence when someone becomes a new patient
  • Send nurture email sequences to your past patient list
  • Automatically trigger email conversations when someone interacts with your website or online content

Focus on Patient Education in Your Content

Across all your marketing channels, you want to focus on patient education. Patients who understand the benefits of your type of treatment are more likely to choose your practice over others. They’re also more likely to become loyal patients when you build trust and credibility by demonstrating your authority and expertise. You can create educational resources like blogs or videos, and share them on social or via email to your patient list. 

In educational content, use lay-person language rather than medical terminology. Focus on educating your patients about the different conditions you treat. 

One mistake many owners make is to focus on branding their clinic and talking about why prospective patients should choose them. The moment you shift the focus from them and their problem is the second we see most people losing interest. Instead of highlighting what you do and how good you are, keep your patient and their problem the focus of your messaging. Make it all about them and their paint points. You can create content that educates patients about their condition and learn how your services can help them get back to normal naturally. 

An example might be a video or article on the importance of a good posture whilst working from home and best practices to optimize the work-from-home setup. The goal is to provide value and educate. Again, this is a great way to engage your patient base and to make sure your practice is top-of-mind. 

Encourage Patients to Post Online Reviews

Encourage satisfied patients to leave positive online reviews about your practice. This can help you attract new patients and establish trust with potential clients. When a patient graduates from their Plan of Care, this is a great time to email or text them asking for an online review. 

Leverage Organic and Paid Social

Social media platforms like Facebook, Instagram, and TikTok can be powerful tools for reaching new patients. Share articles, videos, and testimonials about your services and interact with your followers.

Online advertising via paid social or Google is a proven way to attract new patients. You can test different types of ads and offers. The key is to ensure that you’re generating a strong Return on Investment (ROI). So you need to be able to track results from online advertising, from leads to paying patients. Use patient-centric language and direct response copy that includes a call-to-action (e.g. register for workshop, book an appointment, watch video). The goal of your ads should be to drive people into your clinic and generate new patients. 

Optimize Your Website

A professional website can help you showcase your services and reach new patients. Make sure your website is user-friendly, easy to navigate, and optimized for search engines. Again, keep the focus on educating patients and illustrating how your services can transform their lives. 

How A Patient Demand Platform Can Help

Adding both off- and online marketing strategies to your workload may seem time-consuming, but it’s key to running a successful cash based practice. 

Leveraging a Patient Demand Platform streamlines and optimizes every marketing touchpoint with your clients — from attracting new leads, to converting leads to patients, to reactivating past patients, and measuring your results. 

With a Patient Demand Platform, you can:

  • Reactivate past patients with pre-written, automated email and SMS campaigns with just one click
  • Reach your target audience with digital advertising campaigns
  • Attract new patients with educational workshops and online ads
  • Make it easy for your staff to follow up with leads at the exact right time with pre-populated task lists
  • Track ROI so you can do more of what works, with done-for-you reporting
  • Build your team’s marketing skillset with on-demand courses, training, and networking

It’s important to work through all the pros and cons as you decide whether to manage marketing yourself, hire a marketer, or invest in a marketing partner. Even if you do all the work yourself, you’ll ultimately need software to scale your marketing efforts. 

Interested in learning more about Patient Demand Software? Request a free demo. 

Remote Therapeutic Monitoring (RTM) offers physical therapists a new revenue stream and new ways to provide an improved patient experience.

Remote Therapeutic Monitoring for Physical Therapy

The healthcare system is evolving to offer more services virtually, and that extends to physical therapy. The 2023 updated Medicare rules from the  Centers for Medicare & Medicaid Services (CMS) include changes that expand Remote Therapeutic Monitoring (RTM) treatment options. 

Recently on the Grow Your Practice Podcast, Chad Madden interviewed Practice Manager Brad Saunders about his experience rolling out Remote Therapeutic Monitoring (RTM) in his practice. Watch the episode to learn the details of Brad’s experience with RTM:

Most of the recent changes in CMS guidelines (including a 4.4% reimbursement cut) are largely viewed as detrimental to physical therapists. However, the addition of Remote Therapeutic Monitoring (RTM) codes offers positive opportunities for physical therapists to add new revenue streams and improve the patient experience. Yet it is still relatively new, and practice owners are looking to understand how to adapt their practice to offer RTM services. 

Continue reading to learn:

  • What is Remote Therapeutic Monitoring?
  • What RTM codes can physical therapists use?
  • The benefits of offering RTM services 
  • One practice manager’s experience rolling out RTM across 10 practice locations
  • 7 steps for rolling out Remote Therapeutic Monitoring in your clinic 

What is Remote Therapeutic Monitoring?

Remote Therapeutic Monitoring is a way to contact, communicate, and monitor patients remotely outside of the clinic setting. It typically leverages the use of medical devices, apps, or online tools to monitor a patient’s progress using on-physiological data. RTM supplements in-person visits with follow-up conducted remotely via phone call or two-way audio-visual communication. 

It has become popular since updates to CMS guidelines have made it an affordable offering to patients that reimburses therapists well. There are a variety of vendors and startups that offer apps, online tracking and other ways to communicate with and monitor patients remotely.

Imagine one of your patients has a home exercise program to treat back pain— they document and track their progress through your RTM app. One day they report increased pain. You can provide feedback remotely on adjusting the exercises to meet that particular need.

Everything is transparent between you and the patient. You log the days and times you interact with the patient. At the end of the month, you can bill out the care they received.

Not only does this provide more revenue and growth to your clinic, but it also provides increased flexibility and treatment options for your patients. 

Remote Therapeutic Monitoring (RTM) Codes for Physical Therapists

According to a recent webinar where the CEO of Billing & Clinical Management Services shared 2023 Medicare changes, these RTM codes are payable for 2023:

  • 98980 Qualified Healthcare Provider (QHP) interactive session 1st 20’; billed at
    the end of the calendar month
  • 98981 QHP interactive session each additional 20’; billed at the end of the
    calendar month
  • 98975 Initial set-up and patient education
  • 98976 Device/supply-monitoring &/or alerts every 30 days Respiratory System
  • 98977 Device/supply-monitoring &/or alerts every 30 days Musculoskeletal

Important things to know about each code include:

  • Codes 98980-98981 cannot be billed for services < 20 minutes
  • Codes 98975, 98976 and 98977 can only be billed if the device used is
    defined by the FDA as medical device; it does not require specific FDA
  • Codes 98975, 98976, and 98977 will not be paid unless monitoring is ≥ 16
  • PTA/OTA Payment Differential applies only to 98975, 98980, & 98981
    All therapy licensees may provide RTM services, but CMS did not stipulate the
    supervision level for assistants

Remote Therapeutic Monitoring (RTM) Benefits 

Remote Therapeutic Monitoring offers all parties new opportunities and options. The key incentive for therapists is the ability to create a new revenue stream to augment your existing services. Other benefits include:

1. Create new revenue streams

RTM codes give you more services you can get paid to treat through Medicare and other payers. As Medicare cuts continue, RTM offers an important measure you can take to retain and grow revenue.

Additionally, therapists can see more patients when they meet with some remotely. 

2. Create flexible options

Remote therapeutic monitoring was initially created largely in response to the pandemic. When patients can meet virtually, the risk of spreading disease goes down. But there are other benefits to meeting remotely besides disease prevention.

Patients are busy. They work, travel, or don’t like driving to the clinic more than they have to. Remote Therapeutic Monitoring gives them more control over how they receive care.

Perhaps a patient decides to vacation for a few weeks. Or, a patient works so many hours and wants to spend their little free time at home. Now they can receive care remotely.

Flexible options open up more opportunities for patients and for therapists. This flexibility becomes a value add for your clinic that makes you more attractive to prospective patients.

3. Offer enhanced care

With RTM, patients feel a sense of security, and closeness with your care, improving the therapeutic experience. That’s because you can offer real-time responses to any questions or issues that arise. So even though you’re communicating remotely, you can provide more consistent care. 

Physical therapists can use the data collected to give them your best care and direction. For example, as they adjust exercises after communicating with a therapist on an app, they can experience progress faster.

4. Strengthen accountability

If patients aren’t motivated to heal, it will be impossible to see improvement. That’s why a therapist needs to encourage their patients and uplift them as they work to reach their goals.

RTM offers accountability. Physical therapists and patients have clear data that tracks exercises and follow-through.

5. Increase billable hours

Since a good RTM app or software can track and log hours, clinics can bill for more time spent on care outside of the clinic. With remote care, therapists are not limited to time and location compared to a physical location.

Physical therapists can provide documentation and transparent information on the care they provide.

6. Offer more affordable options

Not everyone can afford the amount of care they prefer. However, patients can now overcome many of these barriers, whether it’s an insurance limitation, financial, or an issue of time. 

RTM offers affordable and convenient options for patients. Therapists can increase accessibility, offering more care to more patients. As a result, they open their clinic to more billable hours and impact the community.

One Practice Manager’s Experience with Remote Therapeutic Monitoring (RTM)

When Brad decided to implement Remote Therapeutic Monitoring this year, at first he didn’t where how to start. It was fairly new, but he knew he wanted to do it after CMS guideline changes.

He said, “…we started in the springtime to investigate some different options… [for] an interactive communication with the patient after they leave the clinic.”

He led the charge to beta test 3 companies for RTM. Two were through an app and one was an online tool. An important factor he was looking for was ease of access for the therapist, to avoid overburdening staff.

With 90 team members across ten sites, he knew this would be a significant shift for everyone. He wanted to be able to offer RTM without making it taxing on the the therapists. He knew the benefits would outweigh the initial transition if he could find the right tools.

One option he found compelling had a special wearable device for patients that can track exercises and movements. But with associated costs, time, and logistics that come with a unique device, he shifted to something that fits his practice better.

Brad hired a licensed clinician remotely to support RTM service calls and two-way visual audio communication through the app. She ensures patients are compliant and she reports back to the clinic.

Since then, he has rolled it out to all 10 of his practice locations. A majority of patients, about seven out of ten, now utilize RTM care. It brings more clinic revenue, an improved patient experience, and helps grow the practice.

Through small steps, Brad and his team have used RTM to provide the physical therapy of tomorrow.

7 Steps for Rolling Out Remote Therapeutic Monitoring (RTM) in Your Clinic

Remote Therapeutic Monitoring is in an early stage within our field. However, if you adopt it now, you’ll gain a first-mover advantage and be able to increase revenue while providing more care and options to your patients.

That being said, rolling out RTM requires some creativity and research. Here are 6 steps to take to roll out Remote Therapeutic Monitoring in your practice.

1. Collect info from your staff and patients

As you’re researching RTM technology options, work with your staff to identify the criteria that will work best for your team. Ask questions, such as: Should you communicate on one app? What should you track? How often should you communicate, and with what boundaries? Write down a list of these questions and answers to identify the right app when it’s time to look.

Research what your patients need. What are their most common concerns? What is the popular positive and negative feedback you receive for the clinic? Develop an RTM program that can address these gaps. 

2. Is the program user-friendly?

Ensure you pick something your patients can navigate easily and get started without a steep learning curve.

The app should also be enjoyable to use. If there’s a lot of friction involved, users won’t spend too much time on it and will avoid using it again.

3. What languages do your patients speak?

RTM is a valuable care to add to your clinic because it provides therapy to more people. Whether it’s because of cost or time restraints, patients can choose your practice because it fits their needs.

If your RTM only serves those who speak English, you can’t help others who speak another popular language in your region.

If there are two contenders and one app offers other languages, you can care for more of your patients.

4. Do you need special devices?

Can the patients download it on their phones? If they can, is it available on most phones? Research and pick the app that provides service to most patients.

Phone apps offer many advantages, like using already-existing wearables. Imagine if your patients could use their smartwatches or phones to track the needed data.

If you choose a particular wearable, consider the additional costs and management. If your clinic decides to purchase devices, it also involves patients returning them on time if they’ve ended their care.

5. How will you make it transparent?

Since RTM is part of your care and, therefore, part of billing, everything should be documented and trackable. 

Great RTM software gives you the tools to document your care. When patients see the record, they can reference interactions. You can provide a more positive experience when patients visit a tangible logbook of what you’ve provided.

6. How does it fit with your billing?

Remote Therapeutic Monitoring is another revenue source that can grow your practice. Analyze your current organizational model, like how you bill and your primary sources of revenue.

Then, find the best pricing structure for your RTM. Ensure you review insurance requirements and consult your billing company for the best strategy.

Afterward, pick a few apps that fit your model. Ask for demos and test each app out. Be very specific and ask any questions or scenarios that come to mind. It’s the best way to get a feel for the apps before you commit.

7. Market your new RTM services

Once you implement RTM, you’ll want to spread the word to drive patient visits.

Adding new services is a great way to increase patient visits. Run marketing campaigns that promote your new services to past, present, and prospective patients. 

The Growth Advantage

Those who adopt new technologies will always be at the forefront of innovation. When a clinic leads the charge, they reap the rewards. Patients spread the word about your care. And through word-of-mouth, you can grow in your region.

Not only can your practice thrive because of high satisfaction, but also from additional revenue streams. Remote Therapeutic Monitoring is an exciting method of care that benefits everyone.


RTM monitors non-physiological data as therapists communicate with and monitor patients outside of the clinic.

The care offers many benefits, like more billable hours, remote team possibilities, better data to provide the best care, and increased patient visits. Physical therapists have more information to provide real-time guidance to their patients. And their patients benefit from direct access to their clinic from the comfort of their homes.

As clinics pursue Remote Therapeutic Monitoring, they can research the best apps and find one that fits their needs.

Once you launch RTM, use a patient demand system to easily market your new services.

Want to start generating consistent patient visits today? Learn how Breakthrough’s Patient Demand System makes physical therapy marketing easy.

Schedule a demo


Dr. Dan Sullivan explains why uncovering your own personal story is the key to chiropractic marketing. Learn how to use storytelling to get better results from your chiropractic marketing efforts.

How to Use Storytelling to Attract Patients

If you’re like most chiropractors, you’re responsible for not only treating patients but also running your own practice. To successfully run a long-standing practice, it’s essential to master chiropractic marketing.

Whether you marketing your practice through Instagram, TikTok, Google Ads, email, or Facebook, you must develop a compelling story. Your story is foundational for chiropractic marketing success. A story that connects with your target patients and the problems they’re trying to solve.

In a recent podcast episode, Chad Madden spoke with a master of chiropractic marketing, Dr. Dan Sullivan, aka the Chiropractic Advocate.

In this article, you’ll learn how to craft your story to achieve better results from your chiropractic marketing efforts.

Why Storytelling is the Key to Chiropractic Marketing

“Story is everything,” Sullivan said. “[We] have MRI studies that show how impactful the story is. It connects you with me and me with you differently than facts or information.” That’s why storytelling is a core competency for chiropractic marketing.

“As a professional, as a licensed clinician, to be able to walk into a room and build a level of trust — it’s not only possible, it’s necessary,” he asserted.

Sullivan’s recommendations are based on two years he spent learning from pre-eminent neurologists.

“The thing that separated the good from the great is — across the board — because you feel understood by them,” Sullivan concluded. “And the greatest way to do that is with the power of the story.”

Pro Tip: You can do chiropractic marketing well even if you’re an introvert. “If you’re an introvert and you use extroverted sales strategies, you’re going to exhaust yourself,” he explains. “You’ve been taught that the only way you can ‘sell’ is by coercing somebody. But when you become yourself and you nail your story,” you communicate with data, facts, logic, and information that persuades.

7 Steps for Using Storytelling to Market Your Chiropractic Clinic

A good story fuels your practice’s chiropractic marketing.

“Everyone’s got a story,” Sullivan said. “We’re all unique as clinicians.” And that’s the secret sauce to growing your practice just like it was for him. “The needle-mover was being myself and telling my story.”

Here’s how to develop your story and leverage it in your chiropractic marketing.

1. Find the Elements of Your Story

“Here’s the crazy part about a story,” Sullivan said, “It’s not about the external event. “The story is about the internal event. The attractiveness of your story is not what happened in it, it’s who you became because of it. The very reason why you’re doing what you’re doing is because of your journey.”

The best journeys feature obstacles the storyteller has to overcome. “If there’s no conflict, there’s no story,” Sullivan said. He cited research from McMaster University that shows that we process stories in our brain’s “theory-of-the-mind” network, which is stimulated by the storyteller’s intentions and motivations, beliefs, feelings and actions.

Sullivan developed the Impact Story Formula to help you pinpoint the elements of your story. There are 4 parts to the Impact Story Formula:

  • Your upbringing: where you come from and how you are just like your prospect
  • Your test: A point in your life that you encountered conflict or challenges that help you to relate better to your prospect
  • Your search: How you addressed that conflict or challenge, including your feelings, doubts and the breakthrough that brought you to where you are now
  • Your triumph: When and how you accomplished and overcame your test

Learn more in his book, The Trust Formula.

2. Uncover Your Unique Selling Proposition

By constructing your story, you identify what sets your practice apart from others. This is your unique selling proposition (USP) — the aspects of you and your practice that are yours alone. No one else can sell to those.

A well-structured story contextualizes your USP. “It gets somebody to be like, ‘Wow, I see why you’re so passionate about this, and you’re different than anybody else I’ve been to’,” Sullivan said.

3. Relate to Your Audience

Knowing even a little bit about who you’re talking to — whether that’s educated guesses or information from your intake form or their medical history — helps you connect with them.

“Simon Sinek, in his book, Start with Why, says it’s not about doing business with people who need what you have,” Sullivan continued. “He says about doing business with the people that believe what you believe, and the only way that you would know that as they know your why. How would they know your whys? You tell your story! You can essentially make anybody sitting across from you feel heard and feel understood.” And when prospects feel that connection, they’re more likely to want to work with you.

4. Attract Your Ideal Patients and Repel the Rest

A strong story that reflects your journey and your values appeals to your ideal patient and won’t resonate with the others.

“You repel the people who just love their drugs and want to go do that,” Sullivan says, because they know that’s not how you practice. Meanwhile, the people who are ready to pay and commit to going long-term are compelled to work with you and are more likely to comply with your treatment recommendations.

5. Speak to the Negative

Getting attention in an information-saturated market can be tough. “If you’re going to create something that’s going to cold traffic, speak to the negative because the majority [or our mindset] is already negative,” he explained, citing research that the average human’s daily thoughts are 80% negative.

For example, you might share a short blog post or video on “The 3 Things You Absolutely Never Want to Even Think About Doing if You Have Sciatica.”

6. Create and Distribute Educational Content

Storytelling is effective fodder for engaging your audience with educational content. Here are some examples of effective chiropractic marketing strategies that leverage content:

  • Lead magnets: Engage prospects with a relevant and useful product, service or piece of content that can be consumed in 5 to 10 minutes that requires them to share contact information.
  • Videos: Show what you know with short videos sharing stretches/exercises or advice for current and prospective patients.
  • Workshops: Establish yourself as a trusted expert, connect with attendees and motivate patients to take the next step.
  • Paid advertising: Reach people where they are with targeted advertising on Google and YouTube, Instagram and Facebook, or TikTok
  • Organic social: Share your story on channels you control and use lead magnets and other content to establish a reputation and build a loyal following that shares your content.
  • Email and text marketing: Reach out to prospects and current and past patients with relevant educational information like case studies, trends you’re seeing in your practice, advice and tips to stay connected and keep your practice on their minds.

7. Manage Your Chiropractic Marketing in One Place

Patient Demand software is a unique tool that enables chiropractors to perform email, text, and advertising campaigns that attract leads, convert patients, and deliver measurable results. All in one, easy-to-use platform.

Learn how Patient Demand can streamline chiropractic marketing for your practice. Schedule a demo today. 

Learn about the process of operating a cash practice. Discover the advantages and disadvantages of running a cash practice for your physical therapy or chiropractic clinic. Understand the steps for getting started with a cash practice model.

Why Run a Cash Practice?

It’s not a secret that physical therapists and chiropractors alike run into issues dealing with insurance payers. Insurance is a major headache for many practice owners. Therefore, many practices are considering switching to a cash practice model or offering more cash-based services in their practice.

Each year, insurance reimbursements go down. In 2022, CMS implemented a 3% cut on physical therapy services and a 15% cut on services rendered by physical therapy assistants (PTAs). In 2023, another 4.4% cut is planned.

These circumstances threaten profitability and leave many private practice owners worried about the longevity of their practice and the future of the industry. 

Switching to a cash practice model can be a great alternative for some practices.

In this article, we break down how Aaron LeBauer started one of the earliest cash practices and why he created the Cash PT Blueprint. In the second part of this article, you will learn how to create your own cash practice for physical therapy, chiropractic or integrated care.

Aaron LeBauer’s Cash Practice Story

Cash-based practices aren’t entirely new: They are already active in the chiropractic space, where insurance benefits have been cut at an earlier stage. As a reaction, many chiropractors already converted their practices to the cash-based model.

In the PT space, this hasn’t been the case until more recently. 

Two major events catapulted Aaron LeBauer on his path to change the PT industry.

First of all, Aaron recognized that patients often weren’t treated as humans anymore. Treatments are often built around what type of insurance the patient has rather than what the patient actually needs. Coming from a traditional, old-fashioned group of physicians (he grew up surrounded by them), he knew that couldn’t become the standard for him.

His goal became to treat patients like real humans and design their treatment based around their real need. He chose to take the time to ask the right questions and build a relationship to treat the patient as well as possible.

Before going to physical therapy school, Aaron worked as a massage therapist. When he became a PT, he was able to see what business practices massage therapists were doing better than physical therapists. It was astonishing how little pay physical therapists accepted given the amount of education and training they have. So when he moved into the PT space, he knew in-network practice wasn’t for him.

He set out to go a different road: He built his own cash practice, and then shared his learnings with others.

He created the Cash PT Blueprint. A course and book for PTs who want to convert to a cash-based practice or take their cash practice and scale it up. Even if you’re in network, you can learn how to add cash-pay services to your practice. 

This is how it works.

How to create your own cash practice

With insurance reimbursement going down and physical therapists requesting higher salaries, shifting to a cash-based practice can be an appealing alternative.

You don’t have to hire people to file claims and complicate your business. As a result, you can have a higher profit margin, generate more income, and keep more revenue.

Steps to setting up or switching to a cash practice

You can’t rely on insurance companies, or in the US, Medicare to find patients for you. You have to put measures in place to make sure those patients are still coming through the door. And, once they’re in: It’s all about making sure that these people are better off than when they arrived.

To successfully set up your own cash practice, there are a couple of important steps to take:

1. Identify your target market

As most patients are familiar with the traditional, insurance-based payment system, you’ll need to define which part of your market is comfortable paying for the service upfront. There may be some regions where a cash-based model makes sense, while others where it is less feasible. Today, it is more common to see cash-based practices in urban areas or regions where the average income level is above average. 

2. Price your services properly

To run a successful cash-based practice, you want to set the right price for your services. To determine this, you’ll need to take overhead costs, an ideal profit margin, and an indication of what the market will pay, into account.

3. Provide fitting payment policies

As you’re not relying on traditional insurance policies, the payment procedure has to be clear for all parties involved. Does payment occur upfront or afterward, and is it done in full or in parts? Usually, those terms are recorded in a policy and procedure guide for billing and collection. 

4. Develop a marketing strategy

Since you’re not relying on insurance companies to drive patients to their in-network providers, you’ll need to put a bigger emphasis on marketing. But this gives you more control over your practice growth and reduces the need to rely on physician referrals. In this article, we break down how you can market your cash-based practice to generate the best results.

Challenges of Running a Cash Practice

Creating a cash-based practice may be the right option for some clinicians, but it’s not without its challenges. 

Here are two of the most common challenges physical therapists and chiropractors face when they start.

1. Convincing patients that they’re getting a better deal with cash-based services

The majority of patients are used to having their insurance pay for treatment and are unfamiliar with the cash-based model. This lack of understanding often results in fear of having to pay more for treatment, than they would have done through the traditional model.

According to the Wall Street Journal, this isn’t completely true. “Patients who pay upfront in cash often get better deals than their insurance plans have negotiated for them.”

If you’re starting up a cash-based practice, convincing patients that the cash-based model is better for their wallet is a conversation you’ll have frequently.

One of the best arguments to make for the cash-based approach is that the quality of the session can be much higher than the traditional sessions because you’re not dealing with the rules and restrictions that insurance companies require.

Practitioners in the cash-based space don’t have to stress about declining reimbursements or changing their sessions to maximize their billings. Instead, they can set a price that covers their costs and makes sure they have a healthy profit. As a direct result, they can put their full attention on the patient.

2. The risks for Medicare patients and cash-based physical therapy

This only applies to US practitioners and patients.

Medicare, a government national health insurance program, has some conflicting elements with the cash-based practice. In fact, it’s not possible to accept cash payment from a Medicare patient for physical therapy services, that’s only possible for non-covered services. Legally, physical therapists cannot opt-out of Medicare, which leaves cash-based services for Medicare patients forbidden territory. The American Physical Therapy Association (APTA) supports legislation that would change this, allowing Medicare beneficiaries to select the health professional of their choice through private contracting. 

The Advantages of Switching to a Cash Practice

Despite the challenges, the advantages of switching to a cash-based practice may be worthwhile to some. At the very least, it is worth considering how you can add more cash-pay services to your practice. 

1. Get to Know Your Patients

This model enables more flexibility around how you structure your time with patients and can deliver higher profit margins for your practice.  

To start and grow a successful cash-based practice the right interaction and attention are required: Slow down the conversation, ask the right questions, and get to know the patient first. 

2. Customized Plans of Care

The second element of running a cash-based practice is that you’re able to create customized programs for patients. This speaks to most practitioners who turn to this model as it allows them to focus on a journey of health and wellness, not just a quick fix. Plus, you don’t have to deal with the pressure of keeping up with the administrative costs of submitting insurance claims.

The transparency and clarity are unrivaled as both parties know that the charges are coming out of the patient’s pocket. No more “We’ll send to insurance and see what they pay” when the treatment ends.

3. Inclusivity

The cash-based model is inclusive.

As payment is by cash, patients aren’t rejected because of the limitations of their insurance. The cash-based model is designed for self-pay patients who are free from outside interference. This allows them to address their circumstances and needs of themselves, not what their insurances deem allowed or necessary.

After all, the cash-based model places the control back into the hands of the practitioners and patients.

4. Attract More Loyal Patients

The fourth advantage of a cash-based practice is that it attracts more committed patients.

In general, it’s safe to assume that patients who pay out of their own pocket are far more dedicated to their treatment plan. This is because they have paid their hard-earned money for it and thus, are more invested in a steady way to recovery.

5. More Time with Patients

Finally, it’s a big advantage that sessions don’t have a maximum duration and there’s no need to worry about insurance approvals.

This makes a thorough assessment of strengths, weaknesses, and imbalances possible. Which gives you a full picture of the potential issues of the patient. As a result, you’re able to work on the right areas and ensure the patient is pain-free again. 

After all, that’s your biggest goal. Right?


Both PTs and patients benefit from a cash-pay model for physical therapy and chiropractic services.

Many owners are incorporating more cash-based services because of the level of freedom and flexibility the traditional systems don’t allow. This way, they stop having restrictions with third-party payers, which prevents them from helping their patients in the best way possible.

It’s important to work through all the pros and cons of your decision of starting and growing your own cash-based practice. This will help you to understand if it’s the right option for your business goals and your patient population.

Mary Daulong, Founder and CEO of BCMS, discusses the final rule of the 2023 CMS Physician Fee Schedule.

Medicare reimbursement cuts for physical therapists have been finalized for 2023.

On November 01, 2022, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the Medicare Physician Fee Schedule (PFS) and other Medicare Part B issues, effective on or after January 1, 2023. Here’s what we know. 

To help physical therapists and practice owners understand the final cuts to Medicare reimbursements in 2023, we’ve reassembled last year’s panel which discussed the 2022 Medicare Cuts.

Chad Madden, co-founder of Breakthrough, Mary Daulong and Alicia Mahoney—CEO and COO at Business & Clinical Management Services (BCMS)—linked up once more to discuss the 2023 changes to the CMS Physician Fee Schedule. They hosted a live Q&A with hundreds of interested practice owners and therapists. 

When you next have time, we highly recommend checking out the webinar recording

A summary of that conversation, including the key things you need to know about next year’s Medicare Cuts, is documented in this article.  

Q: What are the key changes proposed for the 2023 medicare payments?

A: In a nutshell…

  • The CY 2023 fee schedule conversion factor is $33.08, a 4.42% decrease (or $1.53) from the CY 2022—the lowest since the 1990s.
  • The Assistant Payment Differential (APD) is here to stay.
  • Assistant supervision is scheduled to expire at the end of 2022, but Medicare is proposing to extend the ability for therapists to conduct general supervision.
  • Therapists are still not on the permanent list of telehealth suppliers/providers.

Q: How can we minimize revenue reductions caused by the APD?

A: As much as many of us would love for this not to be the case, Assistant Payment Differential (APD) is looking more and more like it’s here to stay. When we look at our neighboring professions, we see how they have been dealing with it in a similar way for years. The good news is, there are actionable steps we can take to minimize revenue reductions caused by APD. These include:

  1. Avoiding co-managing a visit with an assistant. It lessens the administrative burden of counting time, which saves money
  2. Do not use assistants to help with evaluations and re-evaluations, as it will decrease the fee paid by Medicare
  3. Use assistants to perform the objective elements of Progress Reports, as this is not billable to Medicare

Q: Will Assistant Supervision rules be adapted or changed in 2023?

A: As many of you will know, during the pandemic therapists were allowed to conduct ‘general supervision’ of clients and patients which allowed for audio-visual supervision to take place as opposed to direct supervision. General supervision however is scheduled to expire at the end of 2022, although Medicare is proposing that it continues—despite not providing a clear target on the calendar. We will update our community as soon as we have a clearer consensus.  

Q: Are there any changes about who can and cannot provide Telehealth in 2023?

A: Therapists are still not on the permanent list of telehealth suppliers/providers. However, the House has passed the Advancing Telehealth Beyond COVID-19 Act. This bill that would extend the CMS waiver permits for telehealth by therapists until December 31st, 2024, regardless of the status of the Public Health Emergency (PHE). This is a great opportunity to write or call your state representatives and senators to see if they can take this further than 2024. 

Because of the PHE—as mentioned above—there is a temporary public health emergency waiver that allows telehealth to continue through the year that the PHE ends (currently set for 2023) +151 days. After these 151 days, practitioners will be required to use the following updated POS indicators for telehealth services:

  1. POS “02” – This code will be redefined if finalized as Telehealth Provided Other than in Patient’s Home
  2. POS “10” – This code would be redefined if finalized as Telehealth Provided in Patient’s Home

There are still geographical laws and regulations that must be abided by at a state level. For example, if you wish to provide telehealth to a patient in Florida whilst you’re in New York, your practice act must permit you to perform telehealth in both states.  

Q: What are the most common causes of Medicare audits and compliance costs?

A: Being routinely compliant across the board can save your business large amounts of money. This is especially important in today’s climate, as Medicare audits have skyrocketed and many private practices are getting stung simply by being underprepared and unorganized.

For Medicare, the most common audits were Post Payments, Supplemental Medical Review Contractors, and TPE audits. The most common HIPAA violations in 2021 were Illegal Access to PHI, Lack of Security Risk Analysis, and failure to have a Risk Management Process. OSHA violations that tripped up private practices included Failure to Provide Respiratory Protection, effective Hazard Communication, and PPE. 

Q: As practice owners, how do we deal with rising inflation and cuts to Medicare reimbursements?

A: A 4.4% decrease in Medicare reimbursements paired with 8-9% inflation (with a possibility of going higher) will be costly. Practices need to plan for a counteroffensive if they want to stay open and maintain profitability. The good news is, there are lots of tactics one can employ to improve profit margins, save on expenses and survive trying times such as these. You can: 

  • Optimizing staff schedules
  •  Minimize unnecessary overheads (like unused rental space)
  •  Attract patients — new and past patients

Q: What are 3 ways to increase our practice’s topline revenue?

A: In theory, it’s remarkably simple…

  1. Attract new patients
  2. Increase per patient revenue
  3. Reactivate past patients

It’s the execution that is the hard part. 

Breakthrough’s leading Patient Demand Platform makes it easy. Designed specifically for physical thearpy practices, the tool offers pre-built campaigns and automation that generate consistent, predictable revenue growth. 

Click here to schedule a demo.

Q: In our electronic medical records, why can’t both names show on the progress report document, or have a statement describing the exact involvement of the therapist and PTA?

A: Both names can appear on a Progress Report document, but the exact involvement of all parties from a regulatory perspective must be extremely clear so that when Medicare audits you, everything is above board. There must be proof the PTA has not done more than what they are allowed to. This is particularly important to do when you cannot simply eliminate your PTA from signing the report altogether. This doesn’t have to be a complex legal dissertation every time—it could be a previously written succinct statement that’s used universally throughout your clinic.

Q: Will we require an order from an MD in order to be paid from Medicare?

A: No. In short, to be paid by Medicare, your patient’s certified plan of care just needs to be laid out and accepted by their physician. It is always worth double-checking the legislation in your state of practice though. 

Q: How often are progress reports required, and does a Plan of Care certification need to be completed every 90 days? 

A: A progress report is required every 10th visit or less—there is no specific time frame attached to how often this is on a time/calendar basis. Plan of Care certification on the other hand, is on a time basis, and must be re-certified every 90 days

Q: How can we get reimbursed for treatments rendered if a patient self refers and begins the 10 sessions Medicare allows, but doesn’t get sign-off from their physician?

A: It is rare that a patient’s physician doesn’t sign the Plan of Care, as the physician has to comply with Medicare regulations. But in the rare case a patient’s physician doesn’t sign the Plan of Care, a Technical Denial occurs and the financial liability is then passed onto the patient. This is why it is really important to inform the patient that you are operating under a Plan of Care to avoid placing them in this financially vulnerable situation. If the physician still refuses to sign, speak with your patient and let them know that they will need to contact their doctor and request signature for the rest of the Plan of Care to continue under Medicare. 

Still unsure how you will navigate your business through the proposed 2023 medicare cuts? 

With proven tools, tactics, and strategies, the experts at Breakthrough can help you boost your profit margins, streamline your private practice and get you through 2023 and beyond. 

Schedule a call with our team today and we’ll plan your next step together.

During the 2022 PPS event in Denver,  Breakthrough co-founder, Chad Madden, gave a presentation on How to Generate Consistent Patient Demand by Marketing Across All Stages of Awareness. 

In the presentation, Chad revealed how physical therapists could generate consistent demand for their services by marketing across the 5 Stages of Awareness.

Keep reading to learn more about Chad’s session at the event and information on how you can get involved in a national campaign to make PT the first choice for people in pain. 


The Current healthcare System is Broken

Right now, the US healthcare system is number one in the world in terms of cost. In 2021, we were spending $12,956 on healthcare per person for a total of $4.3 trillion annually. 

And over the past 40 years, health spending as a percent of GDP has risen dramatically—from 9.9% in 1982 to 13.2% in 1997 to 19.7% in 2021. In comparison, the average health spending as a share of GDP amongst the OECD countries was only 9.5% of GDP

The vast majority of US health expenditure goes toward prescription medications, surgeries, and hospital care.

You’d think that with such a steep price tag, the US would have top scores for health in categories like longevity, suicide rates, maternal mortality, and satisfaction.  But the opposite is true:

The US ranks at the bottom of nearly every major health statistic.  

According to Robert H. Schmerling, MD of Harvard Health Publishing, “Our investments in healthcare emphasize technology and specialty care, and we overemphasize procedures and drugs. Our healthcare system is not sustainable.”

Increasing Patient Demand

What’s clear is that this trend is not going to get better on its own. 

As practitioners, we need to do a better job of marketing direct to the consumer and educating patients about the benefits of PT. 

And the most effective way to do this by marketing across all the stages of awareness to increase patient demand for physical therapy.

5 Stages of Awareness

The 5 Stages of Awareness is a marketing  framework first popularized by Eugene Schwartz in his book Breakthrough Advertising.

The basic idea is that it’s no longer enough to simply provide a great service or to have all your marketing talk about how great you are. To succeed in today’s healthcare economy, you need to meet your potential patients where they’re at, in their current frame of mind.

On one end of Schwartz’s spectrum you have the people who are highly Aware of you, your company and your services. They like, know, and trust you already. 

On the other end, you have people who are completely Unaware of you and how you can help them. This is where most of the general population is at when it comes to Physical therapy. They don’t realize that PT can often provide better results than surgery. As a result, far too many patients end up addicted to painkillers or in debt from repeated surgeries that often cause more harm than good. 

Patient Demand is educational marketing and business strategy designed to increase awareness for your practice and conservative care as a whole. It meets people where they are at. Whether they know nothing about PT or they are a current patient, it strategically engages them.

It puts you in the driver’s seat and helps your community better understand why PT is important. The goal is to educate patients about their options and drive more people in your community to PT, rather than surgery, medications, or injections. 

Take the PT Pledge and Increase Demand for PT

At PPS, Breakthrough launched a major industry  initiative: The Physical Therapists’ Pledge.

The pledge includes:

  • A commitment to educating the public about the truth of the US Health System, and the solutions that conservative care provides, 
  • A commitment to building patient demand and putting the choice of care in the hands of the patients themselves.

Once we have 1000 Private Practice clinics in America committed to the pledge, our goal is to a national tv campaign exposing the truth of the US Health System and the solution that Physical Therapy provides. 

We got off to a great start at PPS, with more than 100 signatures. 

Help us hit our goal of 1,000: Visit to participate in this National Campaign for a healthcare system that is affordable, accessible, and effective.

The Remarkable Practice with Dr. Stephen Franson: How to run a successful chiropractic business and lead a great life at the same time.

How to Run a Profitable Chiropractic Business (And Still Have a Life)

In a recent episode of the Grow Your Practice Podcast, Breakthrough co-founder Chad Madden sat down with Dr. Stephen Franson, a chiropractic business coach, author of “The Remarkable Practice: The Definitive Guide to Building a Thriving Chiropractic Business,” and host of The Remarkable CEO for Chiropractors podcast. 

They discussed how to run a successful practice and live a great life.

Most chiropractors who launch their own practice do so to have more control, autonomy, and flexibility. But between caring for patients and ensuring a consistent flow of patients in the door, it’s not uncommon, several years in, to find yourself overwhelmed.  There may be little time or energy left over to spend with your family, friends, or yourself. 

Franson says having a remarkable practice and a remarkable life is possible. But you must get clear on what you do and why you do it. He also explores marketing and staffing strategies to grow your practice. The final nuggets of wisdom he shares are 5 counterintuitive opportunities you can take advantage of during economic uncertainty. 

The Remarkable Practice Encourages You to Strive for Alignment Instead of Work-Life Balance

As a chiropractor practice owner, undoubtedly one of your most significant challenges is having enough time. Your days are devoted to caring for your patients, but you must also find the time to market and grow your businessAnd without much time left over, you end up sacrificing quality time with your family or your physical, mental, and emotional health. 

“You should be building the business that will support your remarkable life and not compete with it,” Franson said. 

Although most business owners are constantly looking to strike a work-life balance, there will be seasons when that’s simply not possible, so a better goal is to achieve alignment between your:

  • Core values: what’s most important to you
  • Vision story: what success looks like to you
  • Behaviors: how you choose to invest your limited resources which include time, energy, focus, and money. 

Take the time to consider your personal core values, vision story, and the behaviors you aim for. Once you’ve assessed these, you can  ask these two questions of yourself and/or your family: do you think it’s worth it? And are you with me?

“When you can do that as a human, as a couple, or as a family, that’s where success lives,” Franson said. 

These Alignment exercises will help you develop a Mindset that allows you to recommit yourself to what’s most important to you, and cut activities or behaviors that may be limiting you or taking up too much time. 

The Remarkable Practice: Build the Right Team

One of the key aspects Franson touches on in his book, The Remarkable Practice, is about how to reclaim your time by building the right team. Likely, there are activities you’re doing today that could be delegated to someone else. This would allow you to focus your time on treating patients and growing your practice. 

Instead of striving to know and do everything in your business, you should focus on building a team that can do it for you. 

The best team-building formula is about getting the right people. In the right seats. Doing the right work. In the right way:

Right people: Those who share your core values and buy into your vision story about what success looks like

Right seats: An understanding of the roles, as well as the experience, expertise, and talent each requires 

Right work: Using tools that measure your team’s success such as a scorecard method with key performance indicators (KPIs) 

Right way: An investment in staff training and development

“This formula will give you the highest ROI of your limited resources,” Franson said.

The Remarkable Practice: Get Clear on Your Messaging

There’s no shortage of people who are sick or injured and will need your services. “In fact, at any given time, approximately 20% of people in your community will be actively looking for a solution to their problem,” Franson said.

The question is, are you cutting through the noise and reaching your ideal client? 

Before starting any lead generation program, it’s important to understand that the purpose of your business is to solve problems for patients. Then, you must get clear on your brand messaging so that all of your marketing has the right message and the right offer at the right time.

It’s critical to understand:

  • The problems you solve
  • What problems you LOVE to solve 
  • The type of people you want to attract to your business
  • Those people who aren’t the right fit

“You can’t be everything to everyone,” Franson said. You actually want to repel those who aren’t your ideal patient, so that you can serve more of those who are.

The Remarkable Practice: Center Your Marketing Around Your Unique Success Proposition

Once you’re clear on your messaging and your market promise, part of the promise should be focused on a unique success proposition. A unique success proposition paints a picture for your target prospect of the life they could have should they choose to work with you. 

Additionally, you need to have a way to set SMART goals for what you’re trying to accomplish through marketing. SMART goals require you to be able to track, measure, and objectively quantify your outcomes. 

You can segment your marketing initiatives, budgets, and metrics into internal, external, and digital. Internal marketing is leveraging existing patients to get referrals. External marketing is made up of marketing activities that are outside of your practice that are not web-based, such as partner workshops, networking, signage, and direct mail. Digital marketing is made up of your web-based marketing activities, such as your website, email marketing, online advertising, and social media. 

As part of your hiring strategy, you can determine if you need a marketing manager, or a marketing partner, or can delegate marketing responsibilities to your front desk. 

Employ these 5 Counterintuitive Opportunities to Combat Economic Uncertainty

With a 40-year high in inflation rates and fears of a looming recession, comes increased staff and supply costs along with uncertainty around patient demand.

Yet fortunes can be made in an economic downturn and Dr. Franson presents  several counterintuitive opportunities:

  1. Audit your brand positioning in the marketplace: Does your community know you exist, who you are, what you do, and why you do it?
  2. Ramp up your marketing: Many practices will reduce their marketing spend during challenging economic times. This is the exact OPPOSITE of what you should be doing. When visits slow, you need to ramp marketing up, not down. The fact that competitors are making this mistake presents a great opportunity for your practice to stand out, particularly with digital marketing. With fewer competitors, you can spend less than normal and achieve greater results.
  3. Hire the right team: Rather than laying off staff in an attempt to control payroll, work “above” your business. Take a three-year view and let all decisions be driven by it, which includes building a great team. 
  4. Increase your prices: Instead of reducing the cost of services, focus on value. Identify what the market will pay, and increase your prices. Most practice owners undervalue their services and don’t realize how much patients are willing to pay. Don’t make this mistake — especially during inflationary times.
  5. Build an enterprise: For owners that are highly entrepreneurial and have a high risk tolerance, uncertain economic climates may be the perfect time to consider acquisition. 

Having a remarkable practice and life at the same time is possible, but it requires a mindset shift, planning, and some key strategies. 

A patient demand platform is the simple, repeatable way to consistently grow your practice by attracting leads, converting patients, and measuring success.

Request a free consultation today.

Marketing tips for physical therapists and chiropractors from the Evidence Based Chiropractor on the Grow Your Practice Podcast.

How to Grow Revenue and Help More People in Your Community

In a recent episode of the Grow Your Practice Podcast, chiropractic marketer Dr. Jeff Langmaid shares his top marketing tips for chiropractors. 

Known as the “Evidence Based Chiropractor,” Jeff is devoted to increasing chiropractic utilization. His great-grandfather was a chiropractor who studied under BJ Palmer nearly 100 years ago. His goal is to continue that legacy as a chiropractor himself and by highlighting the power of chiropractic adjustment through research and marketing. He believes it’s time for conservative care practitioners of all types to step up and create a healthier world by scaling their unique healthcare professions. 

Chad and Jeff discussed the top marketing tips for chiropractors. Some of Jeff’s key principles are to start with your patient database, lead with educational content, and create monthly recurring revenue. By implementing these practices, owners of chiropractic clinics and integrated wellness centers can improve profitability and generate consistent visits. 

Why should practice owners care about marketing? 

Dr. Jeff shared an unfortunate approach that he sees many clinicians make. He labels it the “journey of professional indifference.” 

Every day in your community, there are people undergoing unnecessary surgeries, taking unnecessary medications, and receiving unnecessary injections that affect them and their families for the rest of their lives. Opioid addictions are by far the worst they have ever been, largely due to doctors overprescribing opioid painkillers after surgery. 

The “journey of professional indifference” describes the approach where a practice owner passively waits for patients to come to them. These patients may have already undergone surgery or another intervention. They could have been referred by their physician or found you as a last hope. 

Whether you’re a PT, OT, or DC you are an integral part of a patient’s journey. You have the ability to get in earlier in a patient’s journey and help them take their health into their own hands. So they can avoid the fate that so many people in your community fall into. 

“If you care about the health of the people in your community, you need to get out there and tell your story,” Langmaid said. “You have to be proactively answering the questions people have about their health. The more you can build trust and rapport, the more you can help people in your community avoid the fate that so many have fallen into.” 

So you want to help more patients. Where to start? 

Dr. Jeff and Chad both recommend that you always start with your warmest audience. These are the people you have already seen. People who likely already know, like, and trust you. Reach out to your existing or past patient database. Email them consistently to let them know you’re around. 

Share educational content in your emails and invite them to something to learn more. A webinar, a workshop, or an appointment. Avoid using jargon or overly medical terms. For instance, if you’re writing an email to educate about radiculopathy, use terms like ‘how to tell if your arm pain is coming from your neck’ instead of the actual term ‘radiculopathy.’ Use patient-centric language and offer something of value. Then invite them to come in if they’re still not seeing relief. 

The key is to engage with your patient database consistently. Being consistent is what most practices struggle with most. Patient Demand software can help you automate this process, enabling you to choose from hundreds of pre-written and customizable campaigns. 

Top 3 Marketing Tips for Chiropractors 

When it comes to getting started with marketing, the lowest-hanging fruit is marketing to your past and existing patients. But that’s not where your marketing should end. To reach a broader audience and help more people in your community, you eventually need to create demand beyond your existing list. 

Here are the top 3 marketing tips for practice owners:

1. Lead with Patient Education: Teach and Invite

Jeff’s core philosophy is to teach and invite consistently. If you show up and teach, engage, entertain, and then invite – and you do that consistently – then you’re going to see success. Lead with educational content, then invite them to something: Say give us a call, hop on the schedule, join the webinar, or come to a workshop. 

This methodology applies to all audiences: past patients, existing patients, and cold traffic (people who haven’t interacted with you before). As practice owners, we often have this resistance to sales and marketing. We think we’re going to provide high quality-of-care and evidence-based practice, then just grow by word-of-mouth referral. But we need to be getting out there and educating, building marketing systems, teaching, and inviting. The reality is that marketing is just educating people in your community and showing them how you can help solve their health problems. 

Most people equate marketing with paid marketing and discount advertising. That’s just a small piece. The majority of your marketing should lead with education.

2. Avoid Discount Advertising

Tens of thousands of providers are offering deep discount advertising on a regular basis. This is not a cost-effective marketing strategy. Why? Most often, patients that come in because they saw an ad for a discounted service are not the people that are going to stay, pay, and refer. They are deal shoppers. And what do deal shoppers do? They shop for deals! So when they take advantage of that offer, you’re going to notice that there’s a small percentage of them that actually stick around. You’re going to get dramatically fewer visits from someone who comes in from discount advertising compared to someone who comes in through educational content. In most cases, Jeff recommends sticking to the teach-and-invite methodology over discount advertising.

When IS it okay to offer discount advertising? If you’re doing it to keep your doors open in the short term, that may be appropriate for you. Or, if you’re already doing everything else right, and you want to sprinkle on some discount advertising, that’s fine. But Jeff recommends first leveraging free or lower-cost options. This includes marketing to past and existing patients, teaching and inviting, and leveraging retargeted online advertising. 

3. Create Monthly Recurring Revenue

There are ways to create monthly recurring revenue and this is a great way to diversify your income stream. You can make your practice more durable and less vulnerable. The goal is here to create monthly recurring revenue that meets your minimum viable monthly expenses each month. If you can have recurring revenue that meets your expenses, working in your practice becomes a lot more fun and way less stressful. 

This does not mean changing your business model or giving up patient care. This is about diversifying income streams, reducing stress and increasing revenue in a patient-centric way. Dr. Jeff and his business partner Jason identified three primary ways that most clinicians can implement this in a way that makes sense:

  • Provide ongoing services

    This can look like a monthly movement assessment, a monthly check-in, or any type of maintenance care that makes sense for you. After your patients complete their plan of care, have them check in with you once a month. A majority of the time this is warranted and is not overtreating. Your patients come in because they have a problem and they come back for accountability. It’s better for the patient and better for you. Many of us have movement-based facilities that can be leveraged for a monthly check-in, but most of us don’t do it. A monthly check-in is a great way to increase patient visits and create monthly recurring revenue.

  • Open an e-commerce store

    Sell items that supplement your services. Supplements are a great example of what you can sell in an online store. We know that between 50 to 70% of people going to conservative care providers take supplements each and every day, whether it’s a multivitamin, Vitamin D, Omegas, etc. Other options could include exercise props, therapeutic heating/cooling devices, and ergonomic products for sleep or work as examples. The key here is to create auto-recurring revenue to have an online store that drop-ships direct to your patient. This way, you don’t need to have the inventory and utilize space in your clinic. Better for the patient, better for you.

  • Offer online coaching

    This could look like anything from telehealth all the way up to lifestyle coaching. For many providers, this may feel like very new territory, but there’s an avenue there to create monthly revenue by providing value on an ongoing basis. This can be leveraged at scale online. You can create courses that can be sold online without actually requiring significant amounts of your time on an ongoing basis.

Summarized Marketing Tips for Chiropractors

Practice owners wanting to grow revenue and help more people in their community can start by: 

  1. Consistently engaging your past and existing patient database. Lead with patient education. Teach and invite. 
  2. Avoid overusing discounts in your online advertising. 
  3. Come up with a strategy to create monthly recurring revenue. 

Would you like to be able to automatically create educational campaigns for your patients and community, without much effort? Patient Demand software can help. 

See How It Works. 


How to get more patients: Fix your funnel. Get more patients out of your advertising spend.

Recently, Breakthrough Co-Founder Chad Madden and Customer Success Manager Daniel Mina hosted a webinar on the biggest marketing mistakes made in private practice physical therapy and chiropractic clinics. And how to get more patients by fixing a leaky funnel. 

The majority of practice owners — although they often don’t know it — are losing money spent on marketing. Usually, the culprit is not the marketing tactics themselves. The mistake is in not setting up and maintaining an ineffective follow-up process on marketing leads. This mistake creates a leaky funnel. 

What is a Leaky Funnel?

A leaky funnel is the secret killer of new patient opportunities. In a perfect world, when you get a new patient inquiry (whether through online advertising, referral, your website, etc), someone follows up with that lead by phone within several minutes of the patient inquiry coming through. The person handling this could be your front desk or office manager. If they’re adhering to best practices, they have a good conversation with the individual and follow up as many times as necessary (up to seven times) until that lead comes in for an initial patient evaluation. It’s then your clinician’s job to sign them up for a plan of care. 

The marketing funnel is how a marketing leads becomes a paying patient in a physical therapy or chiropractic clinic.

But what happens when this process is not followed closely? You start to get leads falling through the cracks — your funnel becomes leaky. While a lot of practice owners *think* this process is working perfectly for them, they lack the visibility to know that something is wrong. They end up missing out on a lot of patient opportunities. For most, something is going wrong at some step of that process and this creates a leaky funnel. We frequently see practices that don’t realize they have a problem!

The fact is, most practices generate  leads that never get followed up on. Some leads get followed up with too late, and some aren’t followed up with enough times. Ultimately, an ineffective follow-up process produces numerous drop-offs amongst would-be patients. 

What’s the Impact of a Leaky Funnel?

By now, you probably get the message: A leaky funnel is incredibly common and most practice owners don’t know it’s a problem. You could be losing out on dozens of patients each month and not even realize it. 

If you have a leaky funnel, you’re wasting money and getting a lower return on investment (ROI) on your marketing spend. Plus, you hurt your own brand reputation by not following patient inquiries all the way through to a plan of care. Those leads may go elsewhere to your competitors. Worse yet, those would-be patients of yours never get treated and their problem gets worse until they need surgery, injections, or pharmaceuticals. For the sake of your practice and the community you serve, it’s important to be able to identify and fix a leaky funnel. 

How Do I Know If I Have a Leaky Funnel? 

As a practice owner, it may not be obvious that you have a leaky funnel. It’s unlikely you get into the weeds around tracking leads and their follow-up. Most practice owners have poor visibility into metrics around lead follow-up. They’re usually not involved in lead follow-up on a day-to-basis. And if your team is working out of spreadsheets, it’s near impossible to pull out  learnings from the data. 

There are warning signs you can watch for to help identify a leaky funnel. Here are the warning signs to watch for, and helpful tips for fixing your leaks:

  • If the front desk or marketer seems busy and has a very hard time keeping up, then make sure you have a clear process for following up on leads. 
  • Alternatively, it may seem like things are in control, but if there’s no accountability for those who are following up on leads – or if you don’t measure this – then follow-up can often be delayed or skipped completely.
  • Best practices are for your marketer to follow up on a lead within a few minutes of lead creation by giving them a call.
  • Many leads that could be patients never convert if you only call leads a couple of times before giving up. Inefficient processes like these result in a lower ROI on your marketing spend.

How to Get More Patients: Fix Your Funnel! 

Most practices miss out on potential new patients by thinking their funnel ends when an individual in need responds to an ad. But conversing with potential patients, giving them workshops or assessments, and reviewing the results are also crucial steps toward enrolling patients or members.

Poor calling practices reduce the number of appointments scheduled from a given number of leads. Poor follow-up processes reduce the share of scheduled appointments that are kept. Some owners think email blasts are enough, but email is for driving patient interactions – not for sending people to the homepage of your website for the first time. 

What Your Staff Needs to Know

  1. Follow-up conversations turn interested individuals into actual leads.

    Do confirmation calls within five minutes of signup. If at first you don’t succeed at connecting, keep trying! Seven attempts is the power number, so aim for that. After 7 failed tries, connection becomes very unlikely. But hit ‘em hard in the first few days following their signup, and be sure to use multiple channels – like text, phone, email – for best results.

  2. Never say “If…” on a follow-up call.

    From hundreds of hours of call tracking data, we’ve identified a key trend that does NOT perform well. Ending on “If” statements. What we’re talking about are statements like: “If you’d like to schedule an appointment, just let me know.” At the point that “If” statements are used, a lead has typically already inquired about your practice and demonstrated interest. So instead of saying “If you’d like to come in,” you can assume they want to schedule an appointment. 

  3. Have Patient-Centric Follow-up Calls.

    What should you train your staff to say instead of ‘If’ statements? After a short introduction, ask your potential patients questions about them and their pain. What’s their health concern? How long has it been going on? What have they tried for treatment? Patient-centric conversations turn leads into patients; talking about how great your practice is doesn’t. After plenty of discovery questions, your caller can ask, “Do you want to get that taken care of?” “When’s a good time to start the healing process? We have time on Monday at 11am or after 3pm, what time works for you?” 

  4. Use Initial Evaluations and Free Screenings as a Conversion Mechanism.

    The goal: to raise awareness and increase patient respect for the treatment plan. A killer exam begins by asking what their pain is stopping them from doing. Next, consider their history, including whether they’ve had PT before. Then test, treat, and re-test their issue. Help them understand the cause of the problem in lay language. Afterwards, formulate a treatment plan agreement, along with a financial plan and schedule for their treatment. Track who among your staff is best at converting new patients at this stage, so you can work to get your whole team to that level.

How Breakthrough Can Help 

Breakthrough offers a complete, all-in-one Patient Demand Platform that empowers practice owners and their staff to:

  1.  Attract patient leads through proven, top-performing marketing campaigns 
  2. Track leads through the funnel and easily identify stages of the funnel that need improvement. Plus, access hundreds of hours of training content to help your staff more effectively turn leads into patients.
  3. Gain visibility through measurement and intuitive dashboards.  Do more of what’s working and less of what’s not. 

A patient demand platform is the simple, repeatable way to consistently grow your practice by attracting leads, converting patients, and measuring success.

How would you like to have a team of experts audit and fix your funnel to fill up your practice?  

Request a free consultation today.