Chad Madden, MST, Author at Breakthrough

Learn 5 ways to create practice growth and make up for lost revenue in 2023.

5 Ways to Make Up for Lost Revenue in Your Clinic

Are you a physical therapy or chiropractic clinic owner looking for ways to increase revenue and create long-term practice growth?

Many of us are in the same boat. Today’s market conditions have created downward pressure on revenue, upward pressure on costs, and shrinking margins for many private practice physical therapy clinics. A lot of practice owners I’ve talked to recently are wondering how to grow revenue.

So what do you do in this situation?

We need to figure out how to make up for lost revenue in our clinics, and for physical therapists, we need to make up for the recent 4% Medicare Reimbursement Cut.

Here are some of the ideas to help you think through this, get your mindset right, and make meaningful changes long-term that create practice growth.

1. Avoid the Urge to Pull Back — Instead, Focus on Practice Growth

For most of us (95% of the population), we’re wired so that we usually pull back whenever there’s any sort of danger or threat. This is how our lizard brain works to make us feel safe.

Robert Kiyosaki shares a story in Rich Dad, Poor Dad that’s relevant here: As a helicopter pilot, one of the key things he was taught was that if you get hit in wartime, you should push forward rather than pull back.

Although it can be counterintuitive, the same is true for practice owners. When things get tough, we need to double down and develop creative business solutions to create practice growth rather than pull back and get small.

But that’s easier said than done.

I’ve been through it myself. Early on in private practice, when I would take a loss or lose money, I would pull back my marketing. I’d try to minimize our costs and somehow think that was going to help me come out on the other end.

It never worked.

Usually, I’d go a few months before I figured out that I needed to course correct.

After surviving that a couple of times, I eventually figured out that when there is revenue loss, when we’re in the red, and when we have more costs than we have income coming in, it is very easy to pull back.

The only way to get out of it is to go forward. To figure out a way to grow your revenue.

Financial Analysis of a Hypothetical Physical Therapy Clinic

To show you why it’s important to continue growing revenue, let’s look at some hypothetical numbers.

Let’s say you have a clinic producing $100,000/month in revenue, with $95,000/month in costs. In that situation, it’s very difficult to create margin.

What if your revenue goes from $100K a month down to $97K in a month?

You had a $5,000 margin per month, now it’s $2,000. So you had a 60% decrease in margin.

That’s a pretty big deal.

A lot of owners, at least when we’re being reflexive and reactive, we’ll try to shrink costs down. We think that we can somehow go from $95,000 in costs down to $50,000 or something like that and create margin again.

That’s not how it works.

Instead, we have to think about how to take the $100K that went down to $97K, up to $110K or $120K. It’s a better way to business problem solve.

So that’s the first thing to work on in terms of creating a practice growth mindset. You’re almost never going to be in a situation where pulling back and clamping down on costs helps you succeed.

2. Aim to Fill Space and Fill Schedules

The second thing for creating practice growth is to understand the game and the scoreboard that we’re playing.

We’ve invested in space. That’s a fixed cost. We should aim to fill the space.

If we have 3,000 sqft and we’re seeing 100 visits/week, then we have way too much space.

We can either choose to fill the space or cut down on space.

Let’s say we estimate the capacity for the space to be 300 visits, right?

Then we need to ask the question, “What do we need to do to create enough demand for my services that we’re seeing 300 visits a week in this space?”

If we can’t get visits up or don’t want to, then the next time our lease is up, we can cut back. Maybe we bit off more than we can chew and we need to adjust. That’s fine.

But eventually, we need to get to a point where we can control the space that we’re in and can maximally fill it.

In addition to space, we need to fill schedules. If we have four full-time clinicians and each clinician can see 50 visits a week, then our capacity is 200 visits a week.

Let’s say we’re at 130 visits/week today. Then the game we’re playing is to get up to 200 visits/week.

We need to create enough demand for our services that both our schedules and our space are full.

3. Don’t Be Afraid of the Waitlist

When I talk to practice owners, I often hear some variation of this story:

“I don’t have a problem of not having enough demand for my services. I have a waitlist. My problem is keeping therapists and hiring. I recently lost a therapist who was with me for years. They went to work for the local hospital system.”

This is a very real pain. But if you think through it further, you realize the solution really comes back to building demand for your services.

Let’s say your space was full, schedules were full, and you had a $20,000 margin instead of a $5,000 margin. In that situation, you’d be able to compete better with the hospital system on salary and benefits.

It’s hard to have that conversation without talking about payer mix as well.

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

How do you do that if the schedule is already full and you have a waitlist?

You increase revenue per patient.

Bob Kawalick has talked about this, saying something like, “We’re seeing patients covered by $60/hr capped payers, while we have prospective patients covered by $120/hr payers on our waiting lists.”

I’ve heard some owners talk about the waitlist as a bad thing.

But if we’re created enough demand that we have a waiting list, it might be time to consider either a) adding cash pay services or b) going out of network with those lower payers. In both cases, we’re increasing revenue per patient and generating more revenue without increasing our capacity.

So don’t be afraid of the waitlist and consider optimizing your payer mix.

4. Increase Per Patient Revenue with Cash Pay Services

This one is a must in today’s financial climate. There are a number of cash pay services you can add to your practice that both provide value to your patients and provide more cash flow to you. By adding cash pay services you can charge more for a plan of care and create more income to support your traditional services.

Examples of cash pay services that are working for many practices include therapeutic lasers such as the Lightforce Laser, electrical stimulation such as Neufit, dry needling, fitness classes or facilities, e-commerce (e.g. supplements or other relevant products), or coaching.

Adding cash pay services is a key way to create practice growth.

5. Develop Ownership Mentality and a Practice Growth Mindset Within Your Team

The final way to create practice growth is something that was a really big error for me in the beginning. And I’ve talked about Jack Stack and the great game of business and also stake in the outcome. They’re essentially the same book. The Great Game of Business is the one that I prefer, but it’s how to be. So most of us, if we have very thin margins, we’re like hiding that from our staff. So they’re not even sure what the score of the game is.

And that’s not healthy or good. It means we’re internalizing and carrying all the stress with us.

The team doesn’t understand exactly where we’re at as a company. They don’t know the scoreboard and we’re not being transparent.

In the Great Game of Business, Jack Stack talks about how he made that transition back in the 80s and he developed owner mentality across everybody in this company. From the C suite the whole way down to the Janitor and everybody else in between in their organizational structure, everybody had ownership mentality.

When I made that transition, it was a significant for us. It was a game changer. It took a lot of pressure off of me.

Now, when we have a bad month or a bad quarter, we’re asking ourselves better business questions and getting to a solution more efficiently rather than me having to create the solutions for 100 plus team members that we have here. That’s impossible to do.

We have very competent, smart people on our team, so I don’t need to carry all the weight of the company. I’ve empowered my team with transparency and they are going forward, producing solutions, creating new policies, and developing new procedures that help our business across the board.

Cultivating a Practice Growth Mindset

So we’ve talked about mindset and we’ve talked about some specific strategies you can implement for practice growth.

I hope you got something out of this that helps you shift your mindset and generate some ideas for you so you can increase revenue and create forward practice growth in 2023.

Interested in learning how Breakthrough can help you increase revenue and create practice growth? Request a demo.

How to increase physical therapy clinic revenue. Learn 7 ways to boost physical therapy revenue in 2023.

How to Boost Physical Therapy Clinic Revenue and Increase Margins

Physical therapy clinic owners nationwide are feeling the financial pressure of declining reimbursements and historic inflation. As you plan for 2023, you’re likely focused on how to grow physical therapy clinic revenue and cut costs. This article will share 7 ways to increase physical therapy clinic revenue in 2023. Incorporate these strategies into your 2023 practice plan to make more money in your physical therapy clinic.

Recently, on the Grow Your Practice Podcast, we talked with owners about 2023 financial planning. The key takeaways are included in this article. If you’d like to watch the full episode, press ‘play’ on the video below.

Wondering How to Increase Physical Therapy Clinic Revenue? Start by Designing Your Annual Physical Therapy Practice Plan

Like any business, the key to a thriving private practice requires a well-thought-out plan with measurable and achievable goals and an all-in mentality from every team member regardless of their role.

For physical therapy clinics, your Practice Plan should include:

Your biggest long-term and annual goals
Vital practice metrics (e.g. new patients, visits, revenue, attendance rate) this year and projection for the year ahead
Financial assessment from this year (revenue and costs) and plan for next year
Marketing assessment from this year (what worked and what didn’t) and plan for next year, including key metrics to track
Personnel assessment from this year and plan for next year

A private practice growth plan ensures predictable performance and consistent growth not only next year but over the long term.

Should You Increase Revenue or Cut Costs?

The threats of declining reimbursements, a competitive hiring market, and rising costs for space, personnel and equipment are reducing physical therapists’ already slim margins to dangerous levels. There are two main ways to combat these challenges:

Increase top-line revenue
Reduce costs

Most of your competition will approach this problem by seeking to lower costs. But you actually have less control over costs than over revenue, and cutting costs usuallys lowers revenue, particularly when it comes to marketing. There is much more upside and growth opportunity available to those practice owners who focus on increasing top-line revenue rather than decreasing costs. Therefore, the suggestions we make in this article focus on increasing top-line revenue.

7 Ways to Increase Physical Therapy Clinic Revenue

In this section, we’ll explore 7 ways to increase physical therapy clinic revenue without a significant increase in costs.

1. Decide on Your BHAG (Big Hairy Audacious Goal)

Before you develop your practice growth plan for the year, look ahead and think about what you envision over the next 5, 10, 15 years, and beyond. If you had a magic wand and could make anything possible for your practice, would would it be?

This is how you can determine your Big Hairy Audacious Goal (BHAG), an idea popularized by the book “Built to Last,” by Jim Collins and Jerry I. Porras.

Your BHAG is something that is long-term and achievable but at the same time, makes you feel a bit uneasy that you’re even considering it in the first place.

It should be inspirational, motivational, and something that is frequently shared with your team.

Here are some examples a BHAG for a physical therapy clinic:

Become the number one physical therapy provider in your region
Help 20% more people in your community YOY
Open a new clinic every 3 years
Become the most popular physical therapy clinic to work at in your area

Note that your BHAG should not be a revenue goal. It’s important to have revenue goals, but your BHAG should be something motivational, inspational and compelling that makes your entire team proud to work at your clinic.

Your annual goals should be designed to support your your BHAG.

For example, if you have a BHAG that has to do with increasing your volume of patient visits, you’ll need to develop your annual goals to ensure that you have a plan in place for driving more visits, have enough space to accommodate more visits, and enough clinicians to serve additional patients. Depending on your situation, you may decide to open additional locations or hire more staff.

2. Break Down Goals By Quarter, Month, and Week

One of the biggest mistakes private practice owners often make is developing an annual plan and then shelving it for the year. Without a concerted effort however, you simply won’t be able to grow your practice.

Therefore, you must be specific and set goals for each quarter, month, and week. This strategy allows you to understand what’s working and what needs to change so ultimately, you can meet your annual goals.

3. Add Cash-Pay Services

Think about ways that you can provide more value to your patients and generate more revenue by adding additional services to physical therapy. Many physical therapy practices are supporting their revenue by adding cash-based services such as therapeutic lasers, massage therapy, or dry needling. Some practice owners are even adding gym or fitness facilities on to their practice and charging for membership or fitness classes such as pilates or yoga.

4. Be Transparent With Your Staff

Keeping the lines of communication open, and sharing metrics, high-level finances, goals, and achievements with your staff gives them ownership, builds morale, and helps to retain and attract staff. .

For starters, your staff should have full transparency into your expenses, marketing budget, reserve, and profit. With this data, they’re able to get an accurate and complete financial picture of the business. Staff will want to know that the practice is stable. When finances are tight, it gives them a better understanding of why their salary is what it is.

As long as your staff is behind the mission of your practice, your BHAG, and the culture of your practice, they are more likely to stay on for a lower salary than what they could potentially get elsehwere.

During weekly meetings, start with wins and recognize staff members who have gone above and beyond to help your patients or solve a problem.

Then, each staff member should share their accomplishments for the week, such as the number of visits and attendance rate, as well as what they’ll work on the following week.

This not only builds accountability, but it helps staff recognize that they’re working as a team to achieve a financially stable environment, grow the practice, and ultimately, help more people and leave a bigger impact on the community.

5. Create Monthly Recurring Revenue

Earlier this year, we spoke with Jeff Langmaid on the Grow Your Practice Podcast about how to grow practice revenue. One of his main suggestions for diversifying your income is to create 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,” Jeff said.

He offered 3 models for creating monthly recurring revenue:

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. 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 to creating 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.
Offer online coaching or digital courses
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 requiring significant amounts of your time on an ongoing basis.

6. Explore Remote Therapeutic Monitoring

Most updates in the 2023 Medicare ruling further squeeze revenue for PTs.

But there is one area that actually presents an opportunity to GROW revenue: Remote Therapeutic Monitoring (RTM).

Remote Therapeutic Monitoring is a way to contact, communicate, and monitor patients remotely outside of the clinic setting. RTM solutions may leverage certain medical devices, apps, or online tools to monitor and communicate with patients. RTM is often used for follow-up conducted remotely via phone call or two-way audio-visual communication.

Many therapists are recognizing the opportunity to augment their services with Remote Therapeutic Monitoring to increase reimbursements.

7. Build Patient Demand to Create Consistent Patient Visits Year-Round

Private practice owners are often unsure about how to get started with marketing and which tools and platformsthey should invest in.

The best (and most affordable) place to start is with your patient list and email marketing.

Email can help make your practice more valuable, and increase reactivations and build patient demand for your services.

Once your email marketing is in place, you’ll want to think about online advertising. However, it’s important to recognize that not all channels are created equal and what works for one practice may not work for another.

Talk with your patients first and find out what types of media they’re consuming to figure out which channels would be the most effective.

Breakthrough offers a complete, all-in-one patient demand platform that provides a simple, repeatable way to consistently grow your practice by attracting leads, converting leads into patients, and measuring success.

Our team of marketing experts has years of experience working with hundreds of private physical therapy practices and delivering guaranteed revenue growth.

Find out how to physical therapy clinic revenue and generate consistent visits year-round.

Request a free consultation today.

Wondering how to get more physical therapy visits? This article gives you 6 ways to generate consistent visits year-round.

Eliminate Your Slow Season and Create Consistent Patient Flow Year-Round

If you’re reading this article, you’re probably wondering how to get more physical therapy visits scheduled.

In an ideal world, your physical therapy practice would have a steady flow of clients coming in the door all year long. Yet the reality is that most practices have slow seasons, usually around the winter holidays or in the summer months, when they experience a steep decline in visits. During your slow season, you may start looking for ways to get more physical therapy visits — and fast.

Many practice owners I’ve talked to feel like they’re on a roller coaster throughout the year. There are times when they can’t seem to keep up with the high number of visits, and there are times when visits slow down substantially.

I’ve experienced personally how a slow season can result in as much as a 20% loss in annual revenue. This is far too common in our industry.

The revenue loss that practices experience during these slow seasons can make it challenging to predict hours and pay staff. It can also have a significant impact on the practice’s long-term profitability and ability to stay afloat.

During these slower times, it’s critical that practice owners change their approach to marketing. Yet what we often see are two common scenarios:

Accept slow seasons as inevitable and do nothing to change it.
Continue with status quo marketing. Essentially, they continue with the same marketing they’ve been doing or they even cut back on marketing, which makes the lack of patients a self-fulfilling prophecy.

How to Get More Physical Therapy Visits: 6 Proven Strategies

In this section, we explore how to get more physical therapy visits and prevent drops in patient flow during historically slow periods. You will learn 6 proven strategies for creating predictable, consistent growth all year long.

Identify Your Slow Season and Target Past Patients

The first step to getting more physical therapy visits is to determine when your slow seasons are. For most practices, it’s between Thanksgiving and New Year’s and during the summer months when kids are out of school and people are away on vacation.

By identifying when visits slow down, you can avoid working nine months out of the year only to lose profitability within a few months.

The next step is to look for ways to reconnect with past clients and encourage them to come in again.

Your past patient list is the lowest-hanging fruit for your marketing activities. This is true not only in private practice; but in about any business in just about any industry.

Why? Because the people who have done business with you in the past, if they are satisfied and if they are happy, are much more likely to buy from you in the future.

Over time, your past patients will be more likely to respond and return for additional care and services, than any other group you could market to.

This is especially true during the holiday season when the price of advertising to cold traffic goes up and physician referrals often slow down.While various marketing channels can be effective, it’s important to first identify your audience personas and use channels that target those specific populations to achieve the best ROI.

Plan Your “Greatest Promotion Ever” To Increase Plans of Care

One of the best ways to get more physical therapy visits throughout the year is to plan a large, “greatest promotion ever” campaign, such as a day of free assessments or exams.

This approach is an effective way to net you a backlog of patients and plans of care to treat during your typical slow season.

By doing this, I have turned the slow season at my practice into the busiest time of year. And through my work with Breakthrough, I’ve helped hundreds of other practice owners do the same.

Below are a few keys to success for your promotion:

Before launching the campaign, double-check you are staying compliant with your local practice act. You can tweak the name of the service as needed, e.g. ‘assessment’ or ‘exam’ to remain compliant. I checked with Paul Welk, a health law attorney who focuses on PT, to ensure compliance.
Announce it to your past patients as a celebration of something. That could be a celebration of a milestone in your practice such as an anniversary of a certain number of years in practice. Or it could be a celebration of a staff member’s life event, such as a wedding. Keep it authentic and genuine. Past patients will be more likely to attend to celebrate and congratulate you.
Launch the campaign in the weeks leading up to your slow season and be sure to target past patients in the right channel (see #1).
Run these campaigns only twice a year. This ensures consistent patient flow without overwhelming patients with the same promotion over and over again.

Prioritize Email Marketing

Scheduling automated emails at least once a week, every week, is a good rule of thumb. It becomes especially important before and during your slow season to promote reactivations and word-of-mouth referrals.

Emails can include promotions for events and workshops, as well as educational content with a blog post, new report, or video. Be sure to balance promotional content with goodwill that purely delivers value through education.

One of the most effective types of emails is the single-question email. It’s a short email that poses an easy question to reply to, such as “Have you experienced back pain in the last week? Let me know.”

The goal is to start a conversation with past patients. If a majority of people say yes, for example, it’s important to think about how to respond to them in a way that delivers value and ultimately converts them to patients.

One of our clients who sent 500 emails with a single-question email received more than 60 responses and generated 11 plans of care.

Once you discover an email is effective, put it into a regular, annual rotation.

For new practices who don’t have established lists, compiling a list of 150 or so friends and family in the local area and promoting a grand opening, a one-year anniversary celebration, or a new location can be a great way to get patients in the door.

Deploy Direct Mail

A marketing misnomer is that direct mail is dead, but nothing could be further from the truth.

In fact, a recent report by The Association of National Advertisers found direct mail has a 112% ROI, higher than SMS (102%) and email (93%).

When you plan your “greatest promotion ever” campaign, also use direct mail to your past patient list.

Once a month, you may also consider sending a simple print newsletter to your patients with a mix of personal stories, education, and promotions.

Invest In Online Advertising

If you would like to expand your reach beyond your past patient list, market your “greatest promotion ever” to cold traffic via online advertising channels such as Facebook, Instagram, and TikTok.

We recommend running ads a few weeks before the slow season.

For one of our clients, investing in online advertising for a free event netted 67% of all attendees and resulted in 70 plans of care.

Create a Marketing Calendar

For any marketing campaign to be effective, you need a plan. Creating a marketing calendar for each month can ensure your team is organized and accountable.

Be sure to include all marketing campaigns and tasks for every target market, including past patients, the general public, partners (for instance, large employers in your area, or a local gym or yoga studio), physicians, and other referral sources.

For your big promotion events, schedule direct mail and email campaigns 6 weeks prior to the launch and include a series of social posts in the weeks leading up to the event.

It’s also important to carve out time in your schedule and / or your staff’s schedule every week to devote to marketing to ensure results.

With a consistent plan in place and a multi-channel marketing strategy, you’ll get a clear understanding of which tactics net the best ROI, and where you’ll need to focus your efforts to have a consistent flow of patients every month.

As you continue to reactivate past patients and attract new ones, you’ll be able to hire more team members or increase staff hours.You’ll be able to invest in growing your practice and gaining more market share.

How to Get More Physical Therapy Visits with Breakthrough

Our team of marketing experts has years of experience working with hundreds of private physical therapy practices and delivering guaranteed revenue growth.

Find out how to get more physical therapy visits and generate consistent visits year-round.

Request a free consultation today.

Physical Therapy Marketing Flywheel: How to attract patients, convert them, and measure results for consistent growth.

Physical Therapists Have Become Masters of Adaptation

If there’s one thing we’ve had to become really good at as physical therapists, it’s how to adapt.

The list of changes we’ve adapted to is long. Here are a few:

The way we treat patients has evolved over the years as new research comes out.
We’ve incorporated new types of treatment and medical devices into our practice.
We’ve had to learn how to compete with hospital-owned and physician-owned clinics.
Every year, we see changes in reimbursement policies and compliance.

One of the biggest adjustments for private practice owners has been the transition from a complete reliance on physician referrals to direct access. As a result, we’ve had to figure out how to balance time spent treating patients with time spent growing and marketing our business.

The technology sector has not always kept up with the changing healthcare sector – in many ways, healthcare gets left behind in the traditional technology sector. Many marketing software platforms are not a great fit for the changing needs of private practice physical therapy.

In this article, I’ll share my understanding of how physical therapy marketing has evolved over the years. This pulls from my own experience as a private practice owner and from what I hear working with hundreds of practices at Breakthrough. I’ll share how I think about physical therapy marketing today and what to look for in physical therapy marketing software. You’ll learn about tools that help you create consistent growth and adapt in our ever-changing field.

The Old Way: Physician Referrals

Over the last decade, customer acquisition in private practice has changed dramatically. When I started my practice in Central Pennsylvania twenty years ago, the name of the game was physician referrals. In order to get new patients, I was driving around to doctors’ offices, visiting physicians several times a week to drum up business.

At my practice, physician referrals peaked around 2008. I was generating 154 physician referrals per month and nurturing 200 referral sources in a year. No physician represented more than 4% of total referrals. I had mastered physician referrals!

The New Way: Direct Access Ends Reliance on Physician Referrals

The next year, everything changed. Between 2009 and 2011, referral sources started drying up as competition from hospitals and healthcare systems increased. At the time, 90% of physical therapists in the US relied on physician referrals and almost none were marketing direct to the consumer — yet.

For decades, the APTA focused legislative efforts on increasing customer access to physical therapy care. And throughout the 2000’s and 2010s, direct access legislation passed widely in states across the country.

While direct access opened up a wider market for practice owners, it completely changed how we had to go to market and acquire customers. We no longer had to rely so heavily on physician referrals. But we had to learn marketing — something they never taught us in PT school.

The Transition to Direct-to-Consumer Marketing in Private Practice

For many, the shift to direct access happened suddenly, over a short period of time. By 2011, I was spending much less time visiting physicians. Like many other practice owners, I was forced to become a student of marketing.

Today, no matter where you are in the country, your practice has to dedicate resources towards marketing.

To help practice owners learn the ins and out’s of marketing, Breakthrough launched the first Killer Marketing course in 2016. We taught skills like email marketing, online advertising, promotions, and how to host workshops. Hundreds of owners and their staff went through the course and implemented its strategies. They implemented tools like CRM, automation, landing pages, and advertising across multiple channels. They captured new patient demand throughout their communities.

But even the best of us have found marketing to become more challenging over time. Privacy changes have made advertising online more complex. It seems like there are always more platforms to learn about. Loads of marketing automation platforms and engagement tools are available, but they’re often overly complex and bulky. Practice owners find they’re not getting their money’s worth because they simply don’t have the staff time or resources to use these tools.

The Future of Physical Therapy Marketing

In his book Good to Great: Why Some Companies Make the Leap…And Others Don’t, Jim Collins presents the flywheel concept. The concept is based on his observation that successful companies found their success in a series of gradual actions that built momentum over time.

Unsuccessful companies frequently launched new initiatives, chasing the shiny object — the one big move — that would transform their business. Successful companies, on the other hand, built momentum over time through a series of repeatable processes.

The main premise behind the flywheel is once you get it moving, it requires very little effort to keep it moving. It builds on itself.

At Breakthrough, we believe the future of physical therapy marketing will be built around a flywheel that enables private practice marketers to create repeatable processes that: Attract patient prospects, convert them, and measure the results.

This is how we think about private practice marketing today and in the future.

1. It Starts with Attraction

When marketing our practices, first we must Attract potential patients with our advertising.

One of the most effective ways to buy market share in an area is to begin with online advertising. Specifically, Facebook, Instagram, Google, and YouTube. (I’m not seeing consistent, repeatable results on other platforms…yet).

Rather than just advertise for the sake of advertising, we see direct-response campaigns working the best. This allows for full coverage of all awareness levels, from unaware to solution aware to aware of your practice.

This includes capturing the information of ad responders so we can communicate with them over time and nurture the relationship potential. We do this with proven landing pages and compelling offers.

2. Next, We Convert

Once people respond to our ads, we must have processes to convert them from ad responders to a plan of care.

Back in 2011, when I started posting YouTube videos, we started receiving emails and phone calls literally from all over the world – 5 continents – requesting more information, etc.

After a few months of trying to answer every one, with frustration setting in, I simply started to ask, “When can you fly to Harrisburg?” It was a big ask. And it started to work.

The lesson: conversion is the key. Marketing activities, generating patient demand, are not worth 2 cents, without conversion.

Conversion can include automation (and increasingly does). However, all roads eventually lead to a human-to-human conversation. It’s worth your while to master this as an organization.

How do we do that at Breakthrough?

It starts with Lead Management. If you’re truly generating patient demand – and the ad responses that come with it, sticky notes and spreadsheets aren’t going to cut it. There’s too much wasted time…too many dropped balls. That’s where Lead Management saves the day. Your staff will know exactly who to call or email and when. You’ll be able to update a contact with one click and automatically send reminders.

Then we have email automation. Email automation done well provides value, establishes your authority, celebrity, and expertise, and ultimately increases the likelihood that the lead has a human-to-human conversation with your practice. Included in the automation are pre-built email sequences you can pick and choose from to save time on follow-up.

Rounding out conversion is Two-Way Texting. Why? Some people prefer email, others are collecting thousands of unread emails in their inboxes. Almost all who don’t prefer email will respond to a text message. We want to get through.

3. Finally, We Need to Measure It

As this Attraction and Conversion is happening, we must Measure what is happening, so we can do more of what works, and less of what doesn’t.

This means ROI Intelligence. Which platform are we advertising on that is generating the most plans of care? Where are we having drop-offs or leaks in our processes?

Benchmark Insights – What’s a solid conversion rate in a workshop? What % of the First Appointments (free screens, IEs or Discovery Visits) result in a plan of care – broken down by each clinician? These are variables we want to benchmark so you know where to focus your energies.

Training and Coaching – What are the workshop closes that work the best? What should we say to the registrant who’s already tried PT and failed? This is where a collection of best practices start with a coach walking you through the learning curve.

What’s next?

As your team improves their skill sets and competencies, you buy more market share, and the cycle repeats, beginning with Attraction. This is the exact process I’ve used to open our new locations and build to 5 full-time clinicians within 18 months (now 3…almost 4 times).

The Attract / Convert / Measure flywheel is the key to consistent growth. The flywheel will be the backbone of private practice marketing today and in the future.

How to Make Next Year the Best Year Ever for Your Private Practice

The holidays are approaching and we’re all looking forward to a much needed break and time with family. But before closing out the year, I highly encourage you to spend time building your 2022 private practice growth plan. With patient visits starting to wind down, now is a great time to get clear on what you want to achieve next year.

We recently hosted a Webinar on this exact topic, so this video will walk you through the entire strategy and plan!

Why Create a 2022 Private Practice Growth Plan?

Because if there’s one activity I’ve seen that separates successful practices from struggling ones, it’s this: Setting measurable objectives and creating a practice growth plan that gets you there. An astounding number of practice owners don’t go through this process. And they’re usually the ones left wondering what went wrong.

As healthcare practitioners, we face many challenges associated with a broken system. But with a bit of planning and strategy, you can take control of your own destiny and build a legacy that lasts.

It’s always important to have a clear plan, but this year it feels even more urgent. With high inflation and a competitive hiring market, our costs are higher than ever. There’s not much we can do about it. That means we need to get very strategic about what we can control: The amount of revenue we bring in. Follow the practice growth planning process below to develop your strategy for increasing top-line revenue.

How to Create an Annual Practice Plan

To do this process right, you should dedicate around two full workdays to building out your practice growth plan. If you have a leadership team, you can work through this process together.

I’ve created a tool to help guide you through annual planning: The Ultimate 2022 Planning Tool. Download the tool and sign up for the 2022 Planning Webinar, where I’ll walk you through how to best use the tool for your planning process.

For any private practice, there are 3 pillars of successful practice growth. An effective way to begin is by assessing each of these key areas and determining what’s needed to achieve your goals in each one.

3 Pillars of a Practice Growth Plan

1.Financial Plan

What are my projected revenues and costs? Do I need to make changes to increase top-line revenue?

According to Greg Crabtree’s book, Simple Numbers, Straight Talk, Big Profits!, service-based businesses in the healthcare field typically have profit margins between 10 to 25%. The average margin in physical therapy is 14%.

I prefer to aim for the high side of that range, and regularly see margins upwards of 20% in my practice.

If your earnings are 10% or less, your business is at high risk. If this is you, then developing a strategy to improve profitability should be your #1 priority if you want to stay in business.

To calculate your profit margins, subtract your costs from your earnings. Start by calculating these numbers for 2021, then project out to 2022.

You can calculate total gross revenue by multiplying the number of treatment plans with treatment plan value.

Expenses are derived from personnel, billing, marketing, space, office expenses (e.g. office supplies), and clinical expenses (e.g. medical devices).

Once you’ve calculated 2021 earnings, it’s time to forecast 2022 profitability. Ask yourself questions like:

How many treatment plans do I expect?
Has the value of a treatment plan changed?
How can I increase the value of each patient?
Do I need to make any personnel changes?
What is my marketing strategy and what ROI can I expect?
Are there any changes in financial expenditures?

2. Personnel and Hiring Plan

Do I need to make any personnel changes to grow profitability?

If you have a full schedule, a waitlist, and space, then guess what — it might be time to bring on another clinician. Bringing on more clinicians enables you to serve more people in your community and increase profitability.

It’s a competitive hiring market, and there are a lot of changes in supply and demand in the workforce right now. This doesn’t mean you shouldn’t hire right now. You likely only need one or two new clinicians. Even in a competitive market, it’s very possible to find a great fit.

Follow best hiring practices: In your job ads and interview process, be very descriptive about what you’re looking for in the role. Make sure it’s a good culture fit and paint a picture of growth at your practice. Learn more about hiring mistakes and best practices in the upcoming 2022 planning webinar.

3. Private Practice Marketing Plan

What strategies and systems will I use to increase revenue?

Your marketing strategy is your biggest lever for increasing top-line revenue. When evaluating what changes you want to make to your marketing strategy for 2022, I recommend asking yourself the following questions:

How will I attract more patients?
Can I increase per patient revenue?
What’s my plan for reactivating past patients?

As you answer these questions, consider: What goals do you want to achieve in each area? Which tools, systems and channels will you use? How much ROI can you expect from each strategy?

To keep your practice profitable and growing, you should spend around 10% of your total revenue on marketing. For established practices, you can split your marketing budget between attracting new patients and reactivating past patients. Newer practices (under 2 years old) will want to allocate the majority of marketing budget towards cold traffic and spend a smaller amount on engaging past or existing patients.

Ready to start planning for 2022? Let’s chat about partnering and automating your patient demand: head over for a free consultation

When talking to potential patients, most Physical Therapy practice owners focus only on their programs and products. They spend all their time talking about the PT services themselves, but by doing so, they’re neglecting a huge piece of their marketing strategy: the takeaway.

In other words, what is the audience going to take away or remember about your message? What knowledge will they gain? If there’s nothing adding something worthy to their lives, they’re not going to act on your message, and they’re likely not going to remember it.

You don’t want to get hung up on the details or start talking in professional terminology that only someone in the industry would understand, but this is the reality for a lot of PT practices when they’re trying to market themselves. It’s hard for them to step outside of the office and look inward from a patient’s perspective to develop messaging that speaks to the patient’s understanding of their own needs.

How can you shift from Physical Therapy Medical talk to delivering tangible, honest value to prospective patients? It starts with creating your unique value proposition and learning how to translate it into every component of your marketing strategy. Let’s dive in.

What is Patient Centric Marketing? What does it mean to be truly Patient focused?

Patient centric marketing flips the script and prioritizes value to the patient. Instead of talking about you, it pulls the patient into what you can do for them. You’re not just sharing content or creating workshops that will help the patient; you’re also trying to put the benefits into a perspective that the patient can understand, digest, and decide if it’s right for them.

Patient Centric gives a nod to fully immersing the patient in the experience, from their first click to the website experience to the way you navigate them through the funnel. It ensures that the view of your brand will be all about healing and helping the Patient recover.

Physical Therapy Medical Talk vs Patient Care

Promoting a Service vs. Promoting Value

Before we get into specifics, let’s visualize a quick example:

If you’re shopping for a car, and the salesperson is telling you the car has a powder coat paint finish, you might politely nod in agreement. But when they tell you that the powder coating is more resistant to chipping, scratches, and wear and will keep your car looking like new for longer, then you might start tuning in.

It’s a similar story with physical therapy marketing. PT practice owners tend to focus too much on the service side of the business rather than the education.

And it’s through education that your audience will start to connect their own dots, draw their own conclusions, and decide to take action without you having “sold” them anything.

Physical Therapy clinic owners often invest in self-serving marketing. They try to promote a program, a Physical Therapy workshop, or a new product, and even though these things will benefit the patient, the messaging is ultimately focused on the practice.

To do this well, PTs need to first identify their value to the patients. You can help them eliminate pain, avoid expensive surgery, live a better quality of life, heal from an injury—there’s a lot of value in working with a Physical Therapist over another type of healthcare professional.

But first and foremost, you need to translate this value in a way that patients can relate to.

Finding Your PT Practice's Value Proposition

Finding Your PT Practice’s Unique Value Proposition

By definition, a unique value proposition (UVP) is a clear statement on the benefits of what you offer, how you solve your patients’ needs, and what makes you different from the competitors. These are what make your PT Practice truly patient centric.

In physical therapy, every practice should have two value propositions:

The first is what sets them apart from other healthcare options, such as surgery, a general practitioner, or a chiropractor. In a recent webinar, I asked our attendees (who were all physical therapists) where they thought people would go if they had back pain. Around 90% of them said a chiropractor, and that’s a big indication that we haven’t done a great job in building the value of what we do to become a go-to choice for the conditions we treat.

The second value proposition that PT practices should create is what sets them apart from other PT practices in the area. People have options, and the few that do choose PT as their treatment of choice will need to know why they should select you versus a POPTs or HOPTs practice, or even another private practice nearby.

Take time to flesh out ideas that not only make you unique but also valuable in the eyes of your patients and prospects. These ideas aren’t necessarily something you’ll show to the public, but you can use them when developing your marketing messages and test your content against them.

If you find that your Physical Therapy marketing isn’t reflective of your value propositions, then you’ll know you need to do some tweaking.

4 Ways to Promote Your Value in Your Direct Access Marketing

We’ve given value a face and a name, so now, let’s explore some ways you can make your value tangible for your patients. Remember, the typical audience isn’t going to understand PT terms and procedures the same way you do. It’s not their background, so they need an easy way to put your benefits and value into perspective from the outside looking in.

Here are four common Patient Centric PT marketing tools that are ideal for highlighting value:

Physical Therapy Workshops

Seminars, webinars, and workshops are too often synonymous with sales pitches, and that shouldn’t be the case in physical therapy.

Your overall goal, of course, is to get more people to learn about your practice and the services you provide. But ultimately, the seminar itself is about the patient. You’re sharing information about a problem they’re experiencing, tackling potential causes of that problem, helping them understand ways to prevent the problem from recurring, and most importantly—proposing a clear solution that will solve their problem.

Your seminar should be designed so that no matter how many people sign up for a program of care or call for more information, every person will be able to walk out of your doors with something helpful, insightful, or important and not feel like they’ve wasted their time listening to a sales pitch.

Content Marketing

Content marketing is the collective term for blog posts, social media posts, videos, e-books, and all the other content you create and publish to promote your practice. This is by far the easiest and most effective way to promote your value because your content doesn’t have to say anything about your practice or services.

The main goal of content marketing is to position you as the subject authority in your area. People who read your content will learn from what you’re sharing, and they’ll know who to turn to if they ever have a problem you can help them solve.

Added benefits include increasing brand recognition, improving relationships with your patients and community, building trust, and giving you something to use to start conversations with your prospects.

Good content isn’t overly salesy in nature but rather focuses primarily on the educational aspect of marketing. Let people draw their own conclusions from it, or include a call-to-action that encourages them to reach out for more information.

Online Reviews and Testimonials

Online reviews are powerful in patient centric marketing. Studies show that 84% of people trust online reviews as much as a referral from a friend or family member, while 82% of consumers read reviews before making a purchasing decision.

The interesting part here is that your patients are the ones who are delivering your value proposition; not you. They’re sharing their own experiences with your practice, how you helped them, why they chose you, and why they’ll do business with you again.

Patient Retention Marketing

Retaining Physical Therapy patients is only possible when you’ve done a thorough job of promoting value throughout their experience. When you start a patient retention or reactivation marketing strategy, you should continue sharing valuable content and education that will remind them of how much you helped them in the past.

Similar to the influence of online reviews, patients who continue to seek your services after completing a program are living proof of your value. They achieved great results, they’re living a higher quality of life, and they won’t hesitate to visit you if they get injured again or experience a new problem.

In Closing

The biggest takeaway in pivoting is that you not only need to show your prospects how you’re different but also why that difference is important. They’ve been sold enough by doctors and other providers, and this is your chance to step up and show them there’s a better way.

For more direct marketing access insights and patient centric marketing strategies, head over to our Physical Therapy Marketing & Business Resource Center to check out our newest online training.

If you’re reading this, then the chances are that you’re either a physical therapy private practice owner trying to wear ALL hats or the single marketing person in a practice that’s trying to get new ideas…but you have one burning problem around solving the physical therapy marketing mystery.

You want new and innovative ways to market your PT practice, get net new patients to convert into plans of care, and you want to grow the overall valuation of your practice…

You want

more referrals
more direct access patients
more business from your past customers

If that’s the case, then you’re in for a treat.

In this article and the video below you’re going to find out some of the best ideas I’ve found over the years in physical therapy marketing for my practice.

Ideas which grew Madden PT 600% in 30 months.

We even have great podcast (video) episodes you can watch directly related to PT marketing including:

The 3 Physical Therapy Marketing Target Areas

There are three “target markets” that you can focus your efforts on to get more patients. These are…

Marketing To the General Public

This is simple.

You market to members of the general population.

People who’ve never heard of you, who are coming across you “cold”. You could try any DIY marketing channel from SEO, to Google my Business location and reviews, to Google Adwords, to dipping your feet in the water on Facebook…go to where you audience is!

And then become Direct Access patients.

In spite of all the recent trends, we’ve gone from starting out with no Direct Access…to having over 80% of our patients be Direct Access.

This can be a powerful marketing strategy if done right.

Marketing to Past Patients

If there’s one axiom in business it’s this:

Your best future customers are your past customers.

And in private practice, your best patients are your past patients.

You’ve already built a relationship with them, they already trust you, and they already know the quality of care they’re going to get.

So why not market to them?

Marketing to Physicians

Yes, there are industry trends which are pushing referrals down, such as POPTS practices opening up and local hospitals doing all they can to kill referrals.

But that doesn’t mean you should ignore marketing to physicians (only that it’s unwise to rely on it)..

Back in 2007 we hit a high of 154 physician referrals a month.

More recently we hit a low of 29.

We went from 154 to 29. Which admittedly is not great.

But guess what?

Even though this is a decrease, that’s still about 350 referrals a year.

350 people who were in pain and got help naturally.

And as you and I both know, those referrals can lead to lifetime customers that will never leave your practice.

The Proven Physical Therapy Marketing Strategies

Okay, those are three areas you can target to get more patients. But how do you go about doing this? What can you specifically get started on?

Well here are my #1 strategies for each of those markets.

1. Using Workshops to Get More Direct Access Patients

Workshops are the #1 most powerful tool I’ve found to get Direct Access patients.

Over the years we’ve had patients fly into Harrisburg, Pennsylvania from Montana, California, Lexington, Kentucky, Atlanta, and Georgia to name a few.

You can have the same results by throwing your own workshops.

How?

Well, I’ll give you an example.

We ran a Facebook advertising campaign (not easy, but doable) for a live Back Pain and Sciatica Workshop.

Guess how many signups we got?

35.

Yup. 35 new potential Direct Access patients. All from one workshop.

Fast-forwarding to this weekend, we have another one scheduled and we have 43 people registered to attend.

So if you’re looking for a silver bullet to attract new patients from the general public, this is it.

Master the art of throwing workshops and you’ll have a source of new patients for the lifetime of your business.

2. Using Newsletters to Maintain the Relationship with Your Past Patients.

Your past patient base is your most valuable asset. These are people who’ve been treated by you, who like and trust you, and who are more likely to come to you again.

But how do you tap into this asset? How can you utilize your past patients for future business?

Well…there are two ways your past patients can help your business.

The first is them returning to you for additional care.

For example, maybe they came in for back pain a year ago, and now they’re coming to you for a total knee replacement.

Now this is not really under your control, however what is under your control is providing quality care, as that’s why they’ll come back.

But you’re probably doing that already.

So what can you do to get more referrals from this asset?

Well…the second way they can help is by referring other people to your practice.

Your past patients know and trust you, they benefited from your help, so when they find out a friend or colleague of theirs is in pain, and it’s the easiest thing for them to recommend you.

But you can’t just sit back and wait for that to happen. What can you do to aid this process?

The best method I’ve found is to use a newsletter. I’ve been doing a newsletter for over 12 years, and have invested over a million dollars in newsletter printing.

This stuff works. When it comes to newsletters I put my money where my mouth is.

Without a newsletter, we’d have never been able to weather the storm of POPTS practices springing up in our area, and 3 local hospitals employing more than 70% of our referral services, making it hard to build a relationship with local physicians.

This would kill most private practices, but because of our newsletter we were able to survive that crisis.

3. “Top 3 Program” for Physicians

Like I mentioned before, physicians are still a great source for referrals. If you’re not tapping into this source, you’re losing hundreds if not thousands of potential patients.

But what if your local hospital won’t let physicians refer patients to you? What can you do then?

There has been times where I’ve not been even let through the door to talk to physicians I’ve treated.

So how can you get referrals from them?

Well this is by using something we call our Top 3 Program. By using this you can fly under the radar of the hospital, add value to the physicians and their patients, and get referrals.

We surveyed some physicians and asked them

“If I came in for back pain, what would you do for me?”

“Well, we’d hand you an exercise sheet.”

And they handed us this exercise sheet, and I was couldn’t believe my eyes.

It was an old ancient pamphlet that was out of date.

Specifically it was a 1977 AMA handout printed on pink paper with 9 lower back exercises on it. Almost every physician in our area had this.

It was out of date, wasn’t visually appealing, and had no form of differential diagnosis.

I know this because I asked the physicians,

“If I had stenosis which exercise would you give me?”

“Uh…well I’d tell you to do all of them.”

Really?

Just to clarify, this exercise sheet had 3 William Flexion Exercises, appropriate for stenosis or arthritis.
3 were for SI joint and pelvic instability involving core strengthening exercises.
The last 3 were mainly extension exercises, which in particular seemed to be for disc herniation.

And if I was a patient and came in for stenosis I’d have to do all 9 of them?

Talk about overkill.

This was a problem that needed to be solved. The physician didn’t know enough to do a differential diagnosis, and the patient needed specific information that would improve their quality of life.

So we came up with an idea. The conversation with the physicians went like this:

“Hey, what about if I created a brochure that you could hand out to the patient who is older than 50, has pain standing and walking and gets relief from sitting, and they likely have stenosis on an x-ray….would that be beneficial?”

“Of course”

And that’s what we did.

We created 3 different brochures with the top 3 exercises for each problem:

The Top 3 Exercises for Lower Back Pain for Arthritis, Disc Degeneration and Stenosis.

The Top 3 Exercises for Lower Back Pain, Pain Bending Forward, Herniated Disc and Sciatica.

The Top 3 Exercises for Lower Back Pain, Pain with Sitting, Getting In & Out of the Car and Rolling Over in Bed, SI Joint Pain.

But wait…why would we want a physician handing these out? Surely this removes you from the equation?

Well, not really.

First off these physicians aren’t referring us as many patients as they could.

Second, we’re looking to build a relationship with these patients. We want them to feel like they stumbled upon us more than the fact the physician referred us.

Why? Because in our area making referrals is not really what the physicians are strong in.

They’re unlikely to make a referral, but they are likely to hand out a brochure.

But how does this brochure drive us business?

Well at the bottom of the brochure we have a clear call to action to learn more about their condition. And that opens a whole other conversation.

This method is amazing, because not only is it a value add for the physician AND the patient. It also flies under the hospital’s radar.

If for example, you’re in an area where hospitals won’t let you in, doctors can still hand these out and won’t get in trouble. It’s not a referral, it’s a brochure to help their patients.

In Summary

These are the top 3 physical therapy marketing methods we’ve used to grow our private practice in the three different sources of business.

There are quite a few other ideas you can use to market your practice, such as writing reports and books, which you can find more about in the video and below.

However, if you want the best bang for your buck, the three strategies I mentioned will start boosting your private practice:

Hosting workshops to attract the general public and get more Direct Access patients
Writing and publishing a newsletter to encourage your past patients to return and send you referrals.
Top 3 Programs to encourage physicians to discreetly market your practice.

These ideas have helped our private practice weather many storms, and ensure we have a constant source of revenue, despite local market conditions.

If you’re interested in learning more about Direct Access Marketing, be sure to check out this free training:

How To Attract Over 60 Direct Access Patients Each Month With Predictability

This training reveals the full “Patient Attraction Engine” System that I and over 179 other practice owners are using to attract 50+ patients from the internet every single month.

Also be sure to visit our PT Marketing and Business Resources with Courses, Podcasts, Books, Cheat Sheets, and More!

*Updated: Original Publish Date 3/4/2020 / Latest Version changed 7/14/2021

Many owners go into private practice Physical Therapy with the goal of having more than one location. At Breakthrough, we’ve worked with a number of owners who have multiple locations in their home state and are opening up de novo clinics continuously.

At my practice, Madden PT, there’s a process that we follow to help us think through the opening of a de novo clinic location. We just opened our third clinic about a year ago, and we made it to the break-even point by our second full month. And now, we’re operating at about 100% capacity with two full-time PTs and two full-time PTAs.

If you have the time, I actually recorded a video to walk through this subject!

This is a huge difference compared to when we opened our second clinic about ten years ago. We didn’t know how to do it the way we would today, and we struggled for a few years before getting it up to speed.

We’re planning to open two new locations in the next few months, and we plan on using the same process we used a year ago to max out these locations quickly.

3 Keys to Consider When Opening a De Novo Clinic (New Location)

Before you start to open a new location, there are three core things to think about that will guide your decisions:

Location – It’s a tired cliché, but location really is the most important thing when choosing a new location.
Pro Forma – Your numbers need to make sense before you decide to open a new location.
Next Steps – You need a plan to hit the ground running when you open the doors to your de novo clinic.

Let’s look at each of these in more detail.

Location

When choosing a location, you’ll want to look at three things:

Where people live – This is the location of your target market. Ideally, your target market is a female aged 45-64 who is likely making appointments for herself, her husband, her children, and maybe even her parents (about 70% of all healthcare appointments are made by someone fitting this demographic).
Where people work – Most people want service providers that are close to their work or home.
Where people shop – The closer and more visible you are to where people shop, the more impressions you generate.

To gain more insight into a location, we use the USPS Every Door Direct Mail map. Enter whatever ZIP code you’re considering for your location and see who lives in that area. This map tells you which areas are residential vs. commercial, the average age of household members, the average household income, and other details. We can also pull a FREE full area assessment for any location using our internal tools that will give you an idea of total addressable market by demographic in that specific area.

Once you learn about the people in an area, you can figure out where they work and shop and strategically choose your location.

Pro Forma

De Novo location success is also a numbers game. You’ll first want to look at the potential income vs. expenses of the new clinic, including the cost of the space – a Pro Forma for your Physical Therapy Practice. Next, you’ll want to calculate a target six months from your opening that will get you past the break-even point.

Now, step back and think about what you need to do to make those figures a reality.

We surveyed more than 300 private practice PT owners who were considering an expansion and asked them how many months they expected it would take to get an ROI on their de novo space. The first answer we got was from a practice owner who expected to invest anywhere from $50,000 to $150,000. That’s pretty expensive, especially given that we’ve opened new locations for less than $50,000 and done very well. This might make more sense if you’re in a large city instead of a place like Hershey, PA, where we are.

Whatever investment you decide on, the ultimate goal is to go from liability to asset as quickly as possible. As long as you’re still waiting to break even, your new location is a liability. But once it becomes profitable, it becomes an asset. We recommend making six months your target for turning your liability into an asset.

Once you go through the numbers, you’ll start connecting what you need to do to reach your target.

Here’s a sample breakdown:

Pro Forma for your Physical Therapy Practice

Once you’ve calculated your six-month break-even point and potential earnings, you can work backward to connect the dots.

Immediate Next Steps

We run the numbers first so we know exactly how many patients we need to reach our financial goals. In the example above, if we calculate that our potential is 900 patients a month and the average plan of care is about ten visits, then we could say that we need about 90 new patients a month to reach that goal.

Now, your job is to figure out how to get 90 new patients a month. You’ll want to hit the ground running even before your doors open. We do “seeding” workshops before we open the practice to ensure we have patients in our facility on the first day.

We also use the Market Message Media Match Triangle, in particular the Media aspect. If there’s a daily newspaper or other local publication, we want to try it out. EDDM campaigns is another outlet to try. We’re testing different media with bullets (and then cannonballs) to see what gets the best response in that location.

The other thing we do is Facebook Targeting with our automation team. They research specific areas for us and help us figure out more about our location and audience. This helps us decide what might work for that audience, but it also shows us where we might be overlapping with other owners that are part of the Breakthrough family. (By the way, this is something that we do for all of the owners we work with.)

In Summary

We’re huge proponents of systems and processes here at Breakthrough, and that’s because they give us a better chance of repeating our results once we discover what works. We’ve used the framework outlined here to open additional de novo clinics for Madden PT and help other owners do the same.

Reach out to chat with our growth team or for more PT practice insights and resources, head over to our free resource center.

Direct access marketing is opening some pretty big doors for private PT practices. In most places, PT practices can market directly to patients rather than waiting on referrals from physicians, which gives you a whole new customer base to tap into. But new potential also means new codes to crack.

The term “direct access marketing” alone can stir fear because it’s new and different. Doing something different means changing what you’re doing, and change is uncomfortable and scary!

But change is also necessary if you want to get different, better results in your PT practice—namely, increased patient satisfaction and higher revenue.

Let’s take it step by step so you can understand where we are with direct access marketing and recognize the value it can bring to your practice.

The Current State of Direct Access Marketing in Private PT

In the past, private PT practices were dependent on physician referrals. If you failed to build good relationships with doctors and hospitals, you didn’t have a shot at keeping your doors open. That’s not easy work, given how busy doctors are and the overwhelming number of practices and providers to market to.

Direct access marketing is breaking these boundaries and creating a direct path to the patient in the process.

Currently, all 50 states have some form of direct patient access, but many states remain limited.

But despite the headway that’s been made, only about 10% of practices are actively seeking patients directly. Web PT tested this by calling 50 clinics in Arizona, a state that’s had direct access since the mid-1990s, and asking if they could make an appointment or if they needed a physician referral.

Here’s the clincher: 45 out of the 50 clinics they called said they needed a referral, even though they could have taken the patient directly! That’s like saying, “Hey, we’d love to have you as a patient, but first, you need to go spend time and money with a physician.”

This is a huge market that most practices are underutilizing—don’t you think it’s time to stop ignoring it?

Why Shift to Direct Access Marketing?

Direct access marketing isn’t just a way to get more patients through your doors, though that’s enough reason to shift focus. Practices that are already using direct marketing notice changes in the type of patients they treat as well as the impact these patients have on their teams and culture.

Here’s a look at the top success drivers of direct access marketing:

1 – A Better Patient

You walk into the examining room with a new patient. “What brings you here?”

“My doctor told me to come here.”

That’s a weighty sentence.

This is a standard scripted scenario you’ve heard a hundred times. That patient is saying that the doctor chose this course of action; not the patient.

Now, let’s say you walk into an examining room, and instead of the patient following the doctor’s orders, they say something along the lines of, “I’m having shoulder pain, and I saw your Facebook webinar on rotator cuffs and thought you could help me.”

Which patient do you think you’d rather treat?

There’s a huge difference between “my doctor sent me here” patients and “I’m choosing to be here” patients.

Patients that are following a doctor’s directive aren’t in your office because they want to be treated by you. They didn’t choose to have you solve whatever problem they are facing.

Patients who do choose to be there are typically more invested in their care. They’re confident in your abilities to help them—otherwise, they would go somewhere else. They keep up with their visits and do the home exercise program. And they also know that if their care were to plateau, the accountability would fall on them; not you.

That’s the type of patient that graduates PT—the one who has a better connection to you and your practice as well as an overall better experience.

When patients get that optimal experience, it opens a direct referral source that isn’t dependent on physicians.

2 – A Better Team Culture

Are you hunting in your practice, or are you being hunted?

Before direct access marketing became widespread, most private PT practices were largely hunters. We were chasing referrals by catering to doctors and trying to get just five minutes with them because that was our only lifeblood.

It’s exhausting to operate this way—not only for the PT but also for the team. Acting out of desperation for referrals isn’t healthy for the team culture and ultimately doesn’t allow your players to perform their best.

But being sought out by patients rather than clamoring for doctors’ attention flips the script.

When patients have a choice, they overcome the barriers of time, money, and distance. They want to be in your practice and will do what it takes to get the care they need.

As patients start coming to you on their own, authority and community become natural byproducts. They position you as a valuable service and information provider in your area that they can confidently refer others to.

Think about what that does to your team morale. Imagine the pride your front desk, PTAs, and marketing team feel when patients are actively seeking you out. It’s the makings of a significant culture shift that will ultimately be healthier and more productive for everyone on your team.

Now, if you’re crushing it with physician referrals, there’s no need to stop doing it. It’s working for you, it’s bringing in revenue, and your team members feel confident that the office doors will be open and the lights will be on the next day. You can still add direct access marketing to your mix to grow your practice even more.

But if you’re breathing heavy chasing the time-consuming, brain-draining work that it takes to get referrals, you’ll be glad to know that referrals aren’t your only option to grow a thriving practice.

3 – Marketing and Financial Stability

The most recent IBIS report broke down PT practice expenses and found that, on average, practices spend 1.2% of revenue on marketing and 19% on a category labeled “Other,” which is mostly bad debt.

What would it take for you to switch those numbers?

While I don’t believe that we have to invest 19% of our revenue in marketing, investing more than the current 1.2% would help combat the percentage that’s currently going toward debt.

YOU are your best investment, and putting more money into your opportunity to grow gives you a way to take control of your patient flow.

Tuning up your marketing vehicle crash-proofs you against insurance changes and physician-owned or hospital-owned PT practices. If you need more patients or are adding PTAs, just give it a little more gas to keep going. If you’re booked eight weeks out, ease off the accelerator. Your vehicle is still running in optimal condition, but YOU’RE controlling the speed and direction—not insurance or other practices.

Are There Pitfalls to Direct Access Marketing?

For many practices, direct access marketing is an end-all solution. However, there are a few considerations you need to be aware of.

The first is a low graduation rate, which is usually because of holes in your sales funnel. If you have a large influx of patients coming in but not completing care or meeting their goals, this is a problem.

Direct access marketing focuses on plugging this leaky funnel before you start bringing in direct access patients.

The second pitfall is a misconception on automation. There’s a mentality that you don’t have to do anything with automation, but the reality is that there’s still work to do. For example, Madden PT recently hosted a rotator cuff workshop, and we used print ads, online advertising, and direct mail to fill our seats. We had to call those patients after they registered, which is a ton of work.

Automation brought the leads in. We had to host the workshop, schedule appointments, and handle those leads with care. Hands-off automation is a fallacy that must be remedied quickly if your marketing is to survive.

And finally, the front desk assumes a greater role beyond order taker. In the old model, your front desk person had a script for when they received an order from the physician.

In the direct access marketing model, the front desk needs to have the people skills required to handle calls directly from patients. This requires more thought and action to get people excited about PT and confident they’ve made the right call.

Put Predictability into Practice

Direct access marketing is the future of private PT, especially if all 50 states adopt some allowance of direct patient access. The priorities will be to systematize your marketing as much as possible and ensure your team is prepared to handle not only the big, scary changes but also the valuable financial and cultural results that come with direct access marketing.

Want a closer look at how direct access marketing works? Download our ebook to see how to attract over 60 direct access patients!

Each quarter, Breakthrough hosts a live event featuring training sessions focused on private practice growth.

Our most recent event was the “Increasing The Value Of Your Practice Virtual Summit” where we brought together the best from within the Physical Therapy Industry to address how you can find opportunities in the current market.

Here’s a breakdown of the day and key takeaways from each session.

Click here to access all the recordings from the Summit.

The State of Private Practice PT with Chad Madden

Key takeaways:

Being “the best” and offering the highest quality is not a sustainable business strategy for private practice owners.
Patient-focused marketing is the biggest opportunity for practice growth right now. PTs going directly to the consumer is more important than ever after the pandemic.
Don’t ignore the importance of “conversion conversations” to turn more of your direct access leads into paying patients.

Relying on doctor referrals vs going directly to the consumer.

Getting the Most Out of Your Space & Team with Ryan Christoff

Ryan is the president of the Physical Therapy Institute and his session focused on space and personnel utilization.

Key takeaways:

Complete a pro forma prior to expanding into a new space and forecast your expected expenses and revenue.
EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization) is the key metric to look at when trying to determine the value of your practice.

Take the time to watch the replay of this session to see the math Ryan uses for looking at space and personnel utilization.

Practice Value in Today’s Marketplace with Chris Reading

Chris, the president of USPH, shares how practice valuation has changed because of the pandemic.

Key takeaways:

Hiring strategically can help you diversify the services offered at your clinic in an intelligent way that doesn’t distract from your core offer. It’s better to hire someone who is already passionate about a new service instead of trying to start from scratch yourself.
There’s a lot that smaller PT practices can learn from corporate practices. Don’t dismiss good ideas because they come from a corporate setting. Instead, find ways to adapt and adopt them into your smaller company.

3 Things Driving the Value of Your Practice Today with Paul Welk

Paul Welk is a PT and transactional attorney at Tucker Arensberg, P.C. In his session he covers the the top 3 things driving practice value in the current economy.

Key takeaways:

While your 2020 financial numbers may not accurately reflect the true value of your practice, resiliency – the ability to bounce back to pre-COVID numbers – is something that potential buyers will look for.
“Never let a good crisis go to waste.” Use hard economic times as a forcing function to fix issues in your practice.
One of the largest assets in your practice is your staff and company culture.
Having systems and process in place at your practice makes your business more attractive to potential buyers.

Grow Your EBITDA with Robert Kowalick

Bob Kowalick built a very successful private practice before transitioning into revenue cycle management at CRS. And in his session he shares some actionable insights on maximizing EBITDA.

Key takeaways:

Many private practices are leaving money on the table and not achieving the highest amount of revenue per visit.
Data points to pay attention to: revenue per visit, Average Days Outstanding (ADO) score – how long is it taking you to get paid, and billing process efficiency.
In general, a good margin for PTs to aim for is 20%.

Opening De Novo Clinics (New Clinics) with Dave Del Vecchio

Dave is the Regional Director of Operations at Professional Physical Therapy and he has a very unique perspective on opening de novo clinics.

Key takeaways:

In some cases, sellers can use a projection of EBITDA for a de novo clinic to increasing the value of their practice.
On average, Dave expects de novo clinics to become profitable in 3 months.

“How Can I Scale My Business In The Next 4 Years With Direct To Consumer Marketing?” with Kathy Borkoski & Carl Mattiola

Kathy Borkoski, the Head of Product at Breakthrough, and Carl Mattiola, Breakthrough’s CEO, share the steps involved in creating an end-to-end direct marketing strategy at your practice.

Key takeaways:

Many practices have a solid foundation with physician referrals, past patients, general marketing (website, email, SEO), but have not figured out how to attract people with musculoskeletal issues who don’t know that PT can help them.
Free screens and workshops (both virtual and in-person) are the best converting offers to use with cold audiences.
Improving the ROI from paid advertising must involve taking steps to properly nurture and convert the leads generated from ads. This process involves following up with the people who engage with your ads, presenting a strong close at the end of workshops, and using standardized conversion techniques during free screens.

There is a right way to grow a practice, especially during a time of crisis like we’re experiencing now. Watch the full session replays from the Virtual Summit for free when you sign up at the link below.

Take A Tour

Industries

News & Resources

Company

5 Ways to Make Up for Lost Revenue in Your Clinic

1. Avoid the Urge to Pull Back — Instead, Focus on Practice Growth

Financial Analysis of a Hypothetical Physical Therapy Clinic

2. Aim to Fill Space and Fill Schedules

3. Don’t Be Afraid of the Waitlist

4. Increase Per Patient Revenue with Cash Pay Services

5. Develop Ownership Mentality and a Practice Growth Mindset Within Your Team

Cultivating a Practice Growth Mindset

Interested in learning how Breakthrough can help you increase revenue and create practice growth? Request a demo.

How to Boost Physical Therapy Clinic Revenue and Increase Margins

Wondering How to Increase Physical Therapy Clinic Revenue? Start by Designing Your Annual Physical Therapy Practice Plan

Should You Increase Revenue or Cut Costs?

7 Ways to Increase Physical Therapy Clinic Revenue

1. Decide on Your BHAG (Big Hairy Audacious Goal)

2. Break Down Goals By Quarter, Month, and Week

3. Add Cash-Pay Services

4. Be Transparent With Your Staff

5. Create Monthly Recurring Revenue

Provide ongoing services

Open an e-commerce store

Offer online coaching or digital courses

6. Explore Remote Therapeutic Monitoring

7. Build Patient Demand to Create Consistent Patient Visits Year-Round

Find out how to physical therapy clinic revenue and generate consistent visits year-round.

Request a free consultation today.

Eliminate Your Slow Season and Create Consistent Patient Flow Year-Round

How to Get More Physical Therapy Visits: 6 Proven Strategies

Identify Your Slow Season and Target Past Patients

Plan Your “Greatest Promotion Ever” To Increase Plans of Care

Prioritize Email Marketing

Deploy Direct Mail

Invest In Online Advertising

Create a Marketing Calendar

How to Get More Physical Therapy Visits with Breakthrough

Find out how to get more physical therapy visits and generate consistent visits year-round.

Request a free consultation today.

Physical Therapists Have Become Masters of Adaptation

The Old Way: Physician Referrals

The New Way: Direct Access Ends Reliance on Physician Referrals

The Transition to Direct-to-Consumer Marketing in Private Practice

The Future of Physical Therapy Marketing

1. It Starts with Attraction

2. Next, We Convert

How do we do that at Breakthrough?

3. Finally, We Need to Measure It

How to Make Next Year the Best Year Ever for Your Private Practice

Why Create a 2022 Private Practice Growth Plan?

How to Create an Annual Practice Plan

3 Pillars of a Practice Growth Plan

1.Financial Plan

2. Personnel and Hiring Plan

3. Private Practice Marketing Plan

Promoting a Service vs. Promoting Value

Finding Your PT Practice’s Unique Value Proposition

4 Ways to Promote Your Value in Your Direct Access Marketing

Physical Therapy Workshops

Content Marketing

Online Reviews and Testimonials

Patient Retention Marketing

In Closing

The 3 Physical Therapy Marketing Target Areas

Marketing To the General Public

Marketing to Past Patients

Marketing to Physicians

The Proven Physical Therapy Marketing Strategies

1. Using Workshops to Get More Direct Access Patients

2. Using Newsletters to Maintain the Relationship with Your Past Patients.

3. “Top 3 Program” for Physicians

In Summary

3 Keys to Consider When Opening a De Novo Clinic (New Location)

Location

Pro Forma

In Summary

The Current State of Direct Access Marketing in Private PT

Why Shift to Direct Access Marketing?

1 – A Better Patient

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