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 our next article, we break down how you best 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 PatientDemand.com 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 are 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 physical therapists and 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 and physical therapists. 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, physical therapy practices 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 Physical Therapists and 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 leverage 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 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 its a multivitamin, Vitamin D, Omegas, etc. Other options could include exercise props, therapeutic heating/cooling devices, ergonomic products for sleep or work as examples. The key here is to create auto-recurring revenue is 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 Physical Therapists and 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.  


How to get more patients with Google advertising and YouTube ads. Physical therapy marketing to get more patients. Chiropractic marketing strategies to get more patients.

Do Google and YouTube Ads Work for Attracting Physical Therapy and Chiropractic Patients?

Whether you’re a private practice physical therapist or a chiropractic clinic owner, you need to get more patients coming into your practice on a consistent basis. Consistency is the key. The alternative — busy periods followed by significant slow-downs — is simply not sustainable. Whether caused by seasonality, macroeconomic conditions, or changes in your marketing, this type of rollercoaster scenario makes financial planning for the future nearly impossible. 

Online advertising can help bring stability to your practice by increasing demand for your services in your community. Regardless of how marketing savvy you are or aren’t, you can get started with Google advertising and YouTube ads to reach people in your community who need your help. These platforms offer some of the most effective marketing plays available to you today.

Getting Started with Online Advertising 

Advertising can be overwhelming at the beginning and does require some management and upkeep. You can reach a massive audience with the click of a button, but it will burn money very quickly if you aren’t careful with your targeting. 

In this article, we will share the do’s and don’ts of online advertising to help you get started. We’ll go over why you might choose one platform over another. Our focus will be on two of the biggest advertising platforms: Google Ads and YouTube. They’re both owned by Google, and they leverage respectively the largest and second largest search engine in the world. 

Hundreds of millions of people visit these websites every day, and among them, are those who need your services. Thus, knowing when and how to use these platforms will give your practice a consistent patient flow. That way, you can focus on growing your business, rather than hunting for patients.

How to Choose Your Advertising Platforms

Picking the right advertising platform is a challenge in itself. Choices abound, and all of them offer powerful features that make reaching the right people a breeze. 

What you want from an advertising platform is:

  • People who need your service
  • Targeting option that lets you connect to these people
  • Reach them when they are interested in buying from you

The first step in choosing where to allocate your marketing efforts is understanding who uses these platforms, and how

Let’s take Facebook for example. It is very likely that at least some of the people on it need your service, if not now in the future. But most of them are scrolling their feeds looking for entertainment. They will see various ads during their scrolling, but they probably aren’t looking for a solution to their problem while on Facebook. 

These people might notice your clinic’s ad, and even take a mental note of it, but the chances of them scheduling an appointment through a Facebook ad are lower than other platforms. Unless you are doing retargeting advertising on Facebook, this audience will likely be less familiar with physical therapy or chiropractic care. 

In contrast, someone conducting a Google Search for ‘chiropractic care near me’ indicates a much stronger awareness level and demonstrates higher intent to move forward with care. 

YouTube is similar to Facebook in that people use it primarily for entertainment. But it has advantages, such as being video-based. Videos tend to be more memorable than image or text. 

All three platforms can be effective tools for advertising your practice. To learn more about Facebook advertising, check out our earlier post on Facebook Marketing Strategies.  

Read on to learn more about how to get more patients advertising on Google and YouTube.

Why Advertise on Google?

Google is the world’s biggest website. With 45.41 billion monthly visits (November 2021), you can expect basically the entire population to use it. Between 90% and 95% of online searches are done through Google. 

But the wide reach isn’t the main reason we suggest using Google Ads. What makes this platform so valuable is how you can target keywords that highlight a specific intent. For example, when a user types in the search bar “physical therapist near me” you know that—most of the time—they are looking for a PT to visit them.

Compare this with TV or Facebook advertising. You’re interrupting people’s activity (enjoying a movie or scrolling through their feed) to market your service. People who see these ads most likely don’t need your services at the moment, so you won’t see much new business as a result.

Not to say that these advertising methods don’t work, because they do; they just achieve different goals. 

With Google Ads, you can reach the people who are looking to buy, and present them with the solution they need. 

Why Advertise on YouTube?

YouTube is a completely different beast. It’s the world’s 2nd most used search engine, with over 126 million unique users just in the United States. 

Advertising your clinic on YouTube offers a unique set of advantages over other platforms:

  • Videos are more memorable than text or images
  • It’s cost-effective
  • People can see who is actually going to take care of them
  • People can get a feel for the experience they’ll get in your clinic

Advertising on YouTube is also more challenging than on other platforms. Good videos are harder to produce, but this is an advantage if you think about it. How many other clinics are willing to invest in video production? You have way lower competition on YouTube.

Common Advertising Mistakes 

Creating performance ad campaigns is a mix of art and science. It’s also quite complicated when you’re a beginner, but even beginners can start seeing results by knowing the common pitfalls of online advertising.

The most common advertising mistake we see happen over and over is a lack of direction. We’ve seen clinics set campaigns that target everyone, and therefore they ended up targeting nobody. 

You need to know exactly who your ideal customer is, and how to best reach them. When you’re creating a campaign, do it with a specific target in mind. Targeting everyone will exponentially increase your costs and make you miss a lot of clients. 

The second most common mistake we see is making the ads all about you/your service. People don’t really care about you or your clinic. They have a problem and want it solved as quickly as possible. Writing patient-centric copy is crucial to getting people interested in your service. If you’re doing video ads, then start with a strong hook, don’t try to sell your service immediately.

Last, we see people who don’t test new ads regularly, or who give up too early. Your first few ads will most likely perform poorly, you need real-world data to adjust your messaging and see what resonates with your patients. 

This might seem complicated at first, but creating an advertising campaign that gets you sales is easier than you think.  

How to Get More Patients: Online Advertising Best Practices

If you want to build a campaign that will grow your practice, you need to follow a few simple steps:

  • Spend a lot of time on keyword research: Keyword research is the most important step in creating online campaigns. Put yourself in your patient’s shoes. What would someone with their issues search on Google/YouTube? And of those searches, which ones are likely to bring you a sale? For example, if someone types “why does my back hurt” they’re most likely looking for exercises, not for a physical therapist. If, instead, they type “who can fix back pain” they’re way more likely to click on your ad.


  • Use geo-targeting: A person who lives far away from you is unlikely to come to your clinic. Keep the advertising targeted around you. Also, think of what issue you’re dealing with. Someone with knee pain would rather get to the closest physician possible, and someone with shoulder pain would most likely avoid driving. 
  • Set up a sales funnel: Ads are only a small part of the customer journey. You can’t rely on them entirely. Make sure you have a system that takes people from not knowing you to becoming a loyal customers of yours. Your ads should get people to your clinic, and once they’re there, get them into an email/texting funnel. Another thing to consider is retargeting: not everyone who clicks on your ad will buy immediately, but if you keep poking at them, eventually they will. 
  • Tailor your messages for your ideal customers: You can’t please everyone. When you write your copy or video script, make sure it’s custom-made for your ideal customers. Don’t use generic ads like “We’re the best clinic in [location]”. Think about your customers: what do they need help with? Always create your ads with your ideal customer in mind.
  • If you follow all of these steps, you’ll create a strong marketing campaign that will bring in leads. But you must be careful, as Google’s ad guidelines are way more stringent when it comes to healthcare.

How to Avoid Setbacks and Ad Rejections

Google has a strict set of regulations regarding healthcare advertising. And every ad that doesn’t follow these regulations gets rejected, losing you money and visibility. 

Before publishing an ad, make sure it follows these guidelines. The main things to keep in mind are:

  • You aren’t allowed to hint at knowing the user has a certain medical condition, as it’s private data. Even if Google knows it, it can’t use it to target these people. Avoid asking things like “Hate your [condition]? Here’s how to treat it”.
  • You can’t promise results. Even if you are 100% certain your treatment will solve the user’s pain, you aren’t allowed to say it. You can say you’ll help them with managing pain, or alleviating the symptoms, but 
  • Do not, under any circumstance, mention chronic medical conditions. Words like diabetes or cancer should never ever appear in your ads.

An important thing to note is that Google, unlike Facebook/Instagram, also scans your landing page (where users end up when they click your ad) in your ad’s evaluation. This applies to everything in your landing page, including testimonials. So, make sure your landing page also follows these guidelines.

How to Turn Advertising Leads Into More Patients

Once the right people have interacted with your ad online, they’ll schedule an appointment with your clinic. This is where your staff’s qualities have a chance to shine. People will get to your clinic, and interact with your front office and doctors. 

You want your physicians to be top-notch and care for their patients. If a patient feels like they’ve received great treatment, they’ll gladly come back. They’ll also tell their relatives and friends about you. 

Want to create a constant patient flow through online advertising? Request a demo today to harness the power of online advertising and marketing automation.

What to know about the No Surprises Act and Good Faith Estimates. How to prepare for medical audits.

No Surprises Act, Good Faith Estimates, And How to Prepare for Audits

In a recent podcast episode, Breakthrough Founder Chad Madden, MSPT speaks with Mary Daulong, PT, CHC, CHP, President at Business & Clinical Management Services, Inc. (BCMS). Chad and Mary discuss what you need to know about the “No Surprises Act” and Good Faith Estimates. Mary and her team have worked hard on providing resources to help PT practice owners comply and thrive in the new regulatory landscape. 

Who is Mary Daulong?

Chad: Mary is the Queen of Compliance. She has more than four decades of private physical therapy practice experience. And I want to compliment and thank you for keeping us legal, compliant, and ethical.

Today, we’re talking about the “No Surprises Act,” which became effective as of January 1st, 2022. It’s being discussed in all of the online group forums at essentially every physical therapy or healthcare provider website that I’m on. There’s a lot of confusion about this new legislation amongst owners. Can you give us a summary of what it is?

Part 1 of No Surprises Act: Disclose Out-of-Network Charges at In-Network Care Facilities

Mary: Well, the “No Surprises Act” was a surprise, right? When it was first contemplated, it really was to protect patients from having “surprise” bills. Say they went to an in-network hospital for surgery, but there was an assistant surgeon or maybe an anesthesiologist there who wasn’t in-network. And as a result —surprise — the patient gets billed at out-of-network rates. That’s what part one of the “No Surprises Act” addresses, and I’m in favor of that. But it has kind of ballooned from there.

Part 2 of No Surprises Act: Application to Private Physical Therapy Practices

Mary: The idea in itself is good, but the dispute resolution system really doesn’t lean towards the provider. So if the patient complains about the bill in this process then you have arbitration, where someone decides what the fair amount is that the patient should pay. And that doesn’t always turn out to be favorable for the provider, as you might guess. Also, we have a lot of PTs who are out-of-network because they accept cash, and we don’t have any clarification about whether this will implicate them, but it could.

On “Good Faith Estimates”

Mary: This is the part where we’re all pulling our hair out and saying, you gotta be kidding me. Recently, I got a text from one of my dear clients that said, “I’m just going to sell my practice. I provide the services, I do the billing, I do all the administrative tasks. I can’t add this to my things to do.” And we’re hearing this all over. People are very frustrated. 

So, what does it mean? Basically, therapists have to tell patients who are uninsured—as well as those who are insured but choose to self-pay—what our best estimate is for how much the service is going to cost. And because we have repeat services, that makes it very, very complicated.

How to Make this Information Public

Mary: One thing we do know absolutely for sure is that we have to post a notice with all the information about good-faith estimates, timelines, and dispute resolutions. And that’s the easiest thing we have to do. The notice needs to be posted in your clinic in a prominent area, where a patient would be likely to see it. It needs to be posted in areas where you collect for services rendered or do billing. And it needs to be posted on your website. (CMS provides a standard form for good-faith estimates here and details on what should be included in the notice here.)

Chad: What exactly does the notice need to say? 

Mary: The notice is for people who are uninsured or who were not using their insurance—with the exception of federal payers. It basically says that we’re required to tell them what the services for episodic care are expected to cost. I’d suggest basing it on a plan-of-care period, because you might change things at that point. And you can certainly charge them less than that. But you have to tell them that if the estimate is exceeded by $400, they have a right to dispute it. And you have to tell them how to dispute it, and who to contact. So it’s a simple notice; that’s the most clear thing. What becomes unclear is it doesn’t apply to patients who have benefits with federal payouts.

So as healthcare providers, we have to post this notice in all our clinics. It should be in the waiting rooms with licenses or certificates of occupancy or something like that, in prominent display. If you’re an owner and you don’t have it, you can contact BCMS for a template. Medicare also has a template on its website. So you can go to cms.gov and they have a “No Surprises Act” webpage and their own template as well. Number one on everybody’s checklist is we have to get that done.

How to Train Your Staff on the No Surprises Act

Chad: The next thing is that we really have to train our staff, especially reception. If somebody asks how much this is going to cost, we have to be able to tell them.  Regardless of whether they’re in-network or out-of-network. Is that true?

Mary: That’s right. First, we ask if they’d like to file insurance. If not, we’re required by federal law to give them a good faith estimate for the services that we would render for this condition.

Chad: At my practice, we’ve been doing cash pay. I’m guessing our rate is exactly $100. It might be $104. And we’ve always said, $100 per visit. Is that sufficient? Or do I need to say, you’re coming in for an ankle sprain, and that’s likely going to be six visits, so $600. Or: you’re coming in for a whiplash injury or something like that, and that’s going to be 16 visits, so that’s $1600.

Mary: Right. They created “required elements” for the good faith estimate form. So what you have to do is tell them how much it’s going to cost. If you’re flat-fee, or if you do fee-for-service, or whatever, you’re going to have to make sure your estimate gives you enough latitude to not go over by $400. On the form we have, it will give you some options. The thing is, you have to identify what you’re doing. This is the hidden consequence that we’re going to have to deal with. For years, we’ve tried to discourage third-party administrators and payers from saying they’re going to authorize X number of visits or X number of CPT codes. Are we supposed to always have a crystal ball to know exactly how we’re going to treat them? We don’t, so that’s problematic for sure.

Good Faith Estimates Should Mirror Your Plan of Care

Regardless of how you’ve set up your estimate, you’ll have to do some prognosticating about what you’re going to need from the patient. So the more inclusive you are, the better. But the important thing is that the good faith estimate really mirrors your plan of care. If they’re going different directions, that’s a problem. And if you decide the patient isn’t responding well, and you want to change things dramatically, then you have to go back. But if you’re under your estimate, that’s not a problem.

When you evaluate somebody, that’s when you determine how you’re going to treat them. So it necessitates two good faith estimates. There’s one for the evaluation, and then you have to create another one because you have to give it to them in advance of treatment. Now, is there a consequence for not giving it to them in advance? If the patient says, “I want to be treated right now,” then it shouldn’t be a problem. Also, we don’t know yet what the penalties are because they’re not anywhere to be found. We don’t know if it’s fines, penalties, or administrative sanctions. But it’s the law, so we have to comply.

Show Intention to Comply

Chad: In your SIPA summary, you mentioned the importance of the intention. As business owners, we need to show that we’re attempting to comply with the law. What do you mean by that?

Mary: Well, there are some providers who totally defy what’s logical. When HHS tells you what should be in the notice and you choose not to include it, that’s pretty purposeful. You have to tell the customers that there’s a dispute resolution if it goes over by $400, and that applying for this costs $25. Those things have to be in the notice, or else you’re not compliant.This is especially for all of those who have been audited or are thinking that they want to protect themselves.

Green Envelopes: What to Do When You Get an Audit

Chad: So let’s switch over to the Supplemental Medical Review Contractor (SMRC) audits. What is that?

Mary: The notice comes in a notorious neon green envelope. Typically, it comes in the middle of an episode of care. It’s not uncommon for auditors to request one day to service records, maybe 30 or 40 charts. We’ve been flooded with people asking what to do for their initial evaluation.

Chad: Got it. So I get one of these fluorescent green envelopes in the mail. What should I do?

Mary: First, pull up all the resources in the SMRC packet. It tells you exactly what to do. We have one that says how to respond to a payer’s request for records. It’s quite lengthy, but it has some graphics, so it’s not terrible reading. Do not throw the envelope away. Read the letter, then read the letter again. Look at who’s sending it to you. Go through the SMRC packet step-by-step. You want your submission to be organized, legible, and easy to follow.

At BCMS, we produced a template for a table of contents. We have a template cover letter and a form for identifying the billing personnel they asked for. We also have provided some clips from the Medicare benefit policy manual that says we don’t have to have long-term goals. If you need further support, you can email Alicia at [email protected]

Chad: Mary, Alicia, and the BCMS team have put together other training sessions for you that are highly recommended on billing and coding, and also on documentation. So if you’re looking for any of the resources that we’re talking about, you can email Alicia and she can set you up with that. And if you  contact Alicia, they’ll also get the FAQ for the SMRC audits, which is pretty extensive.

What’s Changes Can We Expect in the Future?

One final question for you here. And thank you for extensively reviewing the good faith estimate and also the SMRC audits, because I know a lot of owners are paying attention to those two things right now. Is there anything else in store for us as private practice owners in 2022 that you see coming down the pipe? Is there proposed legislation or anything like that on your radar right now?

Mary: Well, we all know the PTA payment differential is a killer, but I want to tell you, it’s not going away. Sorry if I’m the fun sponge on this, but our colleagues, the nurses, PAs, all of them have been dealing with this for years, if not decades. So it’s going to be very hard for us to say, “hey, this shouldn’t apply to us.” 

So let’s put our endeavors where we’re gonna get the least resistance. Let’s get rid of the plan of care certification. Let’s get general supervision across the board. Then we won’t have problems with somebody signing something that they’re not enrolled in. I’d encourage everyone to look at some of those important things. That’s my little soapbox.

Chad: I appreciate the look into the crystal ball, Mary, and into what’s coming down the pipe for us in the future as private practice owners. Another quick reminder: if you’re looking for any of the resources that Mary mentioned in this episode, you can email Alicia Mahoney, at [email protected]. You can also check out the BCMS website, BCMScomp.com. 

Well, Mary Daulong, Queen of Compliance, thank you very much for being here and helping us as private practice owners.

Looking for more resources to help you manage your practice? Visit Breakthrough’s Resources Hub for free content on marketing, hiring, financing, and more.

PT marketing strategies to fill your new hire's schedule

Conquer hiring fears with PT marketing strategies that create a steady stream of new patients.

As a Private Practice Owner, there are several tell-tale signs when it’s time to hire. 

  • You consistently have a full patient load
  • Or you spend all your time treating and not enough time working on your business
  • You may even have a waitlist (this could mean it is far past-time to start!) 

Yet even when the signs are apparent, many practice owners still harbor doubts when it comes time to hire. 

You may wonder if you can attract enough clients to your clinic. Or think that your patients have grown attached to you and your current staff. That they wouldn’t want to be treated by someone new. You may fear the costs of hiring would exceed the increased revenue.  

Many practice owners experience these fears of expanding their business. But there are plenty of successful practice owners who are able to grow, hire, and expand each year. Their secret? Implementing effective systems and repeatable processes to consistently produce a steady stream of new patients. 

In this article, you’ll get a blueprint for how to never run out of patients. The strategies in this article will help you consistently attract patients, scale your business, hire more, and keep growing your practice. 

Once you build a system that works for consistently getting more patients to your clinic, you can hire without fear. You can even open new practices and use the same tactics to grow them.

The State of PT Hiring in 2022

Before diving into PT marketing strategies, let’s look at the the hiring landscape for physical therapists now and in the future. 

At the macro level, an aging population and advancements in medicine are helping people live longer. This creates increased demand for physical therapy and other types of conservative care. Physical therapy is also becoming more accessible as more states open up for direct access

As a result, The APTQI estimates that the US will need 27.000 new physical therapists by 2025 and the Bureau of Labor Statistics projects that by 2030, there will be a 21% growth in PT job openings. Currently, there are around 13,000 people graduating with a physical therapy degree in the US annually. 

What does this mean for your practice? A couple of things:

  • The demand for physicians will keep growing for the foreseeable future. 
  • Because of increasing demand, the job market will become very competitive (it already is). Finding new hires that fit your needs will get harder.
  • With increased demand, salaries will go up. This means that each clinician you add to your staff is more valuable than they were a year ago.
  • A competitive job market means you’ll have to attract the best clinicians. You’ll face stiff competition by the hospital system.

How to Compete in Today’s Hiring Market

The key here is to make your practice an appealing place for people to work. More patients equals the ability to deliver higher salaries and better benefits. A demonstrable track record of consistent patient demand will show potential hires that they’ll have job security. You also want to be able to paint a clear picture of future growth. This motivates future and current staff members. 

Being able to quickly and consistently attract patients and fill a new hire’s schedule helps make your practice attractive to potential hires. In fact, you should start attracting new patients even before onboarding new staff.

When Should a New Hire Have a Full Schedule?

The timeline for having a full schedule for a new hire depends on various factors, like your practice’s location and popularity. Many successful practices follow a timeline such as this: 

  1. 90 days before hiring: If you’re not already at full capacity, this is a good time to implement a patient demand system to create a steady stream of patients for your new hire. A patient demand system includes solutions for marketing across platforms such as online advertising, email automation, and two-way texting.
  2. First 90 days after hiring: Once you’ve hired someone, it usually takes about 90 days to fully onboard a clinician.  This includes getting the PT used to their operations, acquainted with the front office, and taught to deliver the standard of care expected from the clinic. It’s normal to have a new PT work at lower capacity during this time.
  3. After 90 days on the job: After this first probation period, the new hire should be working at full capacity (or close to it). They should be integrated with the system, and visit as many patients as possible. A great way to structure your staff’s schedules is to have experienced clinicians seeing existing patients, and to fill your new hire’s schedule with new patients from cold traffic. 

PT Marketing Strategies for Attracting a Steady Flow of Patients

You have way more control over the client acquisition practice now than in the past. Back in the day, clinics relied on word-of-mouth and referrals to keep their practices working. These tactics are great to keep in the mix, but should not be relied on for all of your business.  

Nowadays, a complete recipe for growth goes beyond referrals and word of mouth. It includes a plethora of channels and tactics for reaching potential customers, including online and offline strategies. 

Typically, growing practices should budget around 10% of revenues for marketing. Marketing includes strategies to engage existing and past patients, such as automated email blasts, two-way texting and direct mail. It also encompasses advertising (both online and offline) for cold traffic. You can advertise online on platforms like Facebook, Instagram, Google, YouTube. A comprehensive direct-to-consumer marketing strategy should also include automated lead management and follow-up to ensure a strong ROI for your ad spend. 

 Creating a Successful PT Marketing Campaign

It may feel a little overwhelming at first, but with the right processes and system in place, you can generate a constant influx of patients. You can avoid the dreaded feeling that you are continually reinventing the wheel each month by implementing plug-and-play campaigns that repeat throughout the year

Here is a 5-steps process for creating a successful marketing campaign:

  • Start by defining your audience. For example, if your clinic serves an older demographic, you’ll want to focus on means of communication favored by older folks. Things like snail mail and phone texts can yield amazing results for you. Conversely, younger audiences are easier to reach with digital marketing. 
  • Your messaging should be patient-focused. Most of your patients don’t know what latissimus dorsi is, or that they have tendonitis. They know they have pain, and only care about fixing it. And that’s how your marketing messaging should be. Make it patient-focused by using everyday language. 
  • Identify the channels you’ll start testing for both cold traffic and past patients. Different media types can be appropriate for different stages of the patient journey. For instance, Facebook and YouTube ads are great for cold traffic. They help educate a large, unaware audience that you have a solution for them. Google is more appropriate for advertising to a more aware audience that is already looking for physical therapy clinics in their area. Email, direct mail, and two-way texting are great tools for engaging past patients. 
  • Design a compelling offer. “Attend a workshop on solving back pain.” “Give the gift of a free screening to a friend or family member.” “Schedule an appointment easily online.” These are examples of call-to-actions, or compelling offers, that you can promote in your campaigns. Each campaign should highlight one clear call-to-action. For cold traffic, workshops are an incredibly powerful offer to promote online. This strategy lets you showcase your clinicians’ expertise on the workshop’s topic. Instead of telling people you can solve their health issues, you get to show them. And you enhance efficiency by driving multiple potential patients into your clinic at once. 
  • Measure how your campaigns are doing. Set targets for each of your campaigns, and ways of tracking how they are doing. This is all data that you’ll use in the future to refine your marketing strategies and prove ROI. A patient demand software like Breakthrough will have easy-to-understand reporting and dashboards built-in. 

Patient Demand Systems for Consistent and Predictable Growth

You can’t rely exclusively on referral marketing anymore. If you want your practice to thrive and grow, you must build a system that takes people from being unaware of your services to paying customers. 

In marketing speak, this is called a funnel. Patients are either unaware of your service, aware of it but unsure if it’s the right one for them, or ready to buy. The perfect marketing system gets people from all of these places, and gently accompanies them to the bottom of the funnel, which is purchasing a care plan. 

That’s why here at Breakthrough we built an all-in-one platform that does the heavy lifting for you. Its beauty lies in how it sustains itself. It starts by giving you the right tools, like our powerful online advertising tools and done-for-you campaigns to attract clients to your practice. Then, through email automation, two-way texting and lead management tools, it converts them into paying customers. This process generates lots of data you can then use to optimize your messaging throughout the customer acquisition process and beyond.

Do you want to learn more PT marketing strategies for consistently increasing patient growth? Request a demo today. 

See how our platforms can help you create a self-sustaining marketing system that makes filling a new hire’s schedule easy.