how to get more patients

I need to get New PT Patients…NOW.”

This is the #1 problem facing the market right now. How to get more patients immediately…

Most of us risk insolvency if we can’t solve this problem.

For those of us who can solve it, we can gain market share at an unprecedented rate – with a flipped PT job market and rock bottom marketing/space costs.

In the past few months, the team at Breakthrough has experimented with new campaigns like Virtual Workshops.

But we’ve largely relied on a few fundamental marketing strategies to solve the problem of ‘how to get more patients’. The strategies themselves may seem simple, but don’t let that stop you. Actually implementing them will produce results and set your practice apart from most business owners (who have reduced and in some cases completely shut down their marketing efforts).

For example, here’s a story from an owner in the Breakthrough community:

Click to view at full size.

This is a pretty remarkable rebound.

But there’s a deeper story which can be easily overlooked:

  1. The people who made it happen: Deepak and his team.  Deepak is in my list of top owners ever in one significant category – Study. 

    He’s an amazing student and is genuinely interested in growing his practice and learning the best marketing methods to help with this.
  2. He and his team take action and implement.  When asked about the secret to his success – Deepak will frequently say, “I just do what I learned here” 

    Sounds simple enough, right? 

    Well unfortunately for most of us, we seem to struggle doing that.  Deepak implements the control first – then will adjust based on his metrics.  He and his team will start with the fundamentals, then progress as they learn, and update the technique to make it their own.
  3. They are successful in a nearly impossible environment.  In the greater Edmonton area, Deepak and his team compete with a free healthcare system (you can get physio for free down the street). 

Yes, Deepak is in Growth X and has access to software that automates his marketing.

But it all starts with taking action.

You can do the same. Here’s how…

How to Get More Patients NOW: 3 Effective Steps

  1. Market to your past patient list ASAP.  At Madden PT, we just ran a our Greatest Promotion Ever at all 5 locations.  The result of that was 50+ Plans of Care. Deepak mentioned calling clients personally, but you can also use email for this.  Your patient list is the most valuable asset in your business, but only when you nurture it and engage with the people on it. 
  2. Market to the general public.  Pick a niche – a specific target market – and make sure it’s someone who your clinic can treat profitably.  Host an in-house workshop that will appeal to this demographic.  One example would be a free event for back pain sufferers.
  3. Send a fax to physicians, NPs, PA-Cs letting them know you’re open.

An easy way to take action is with the Single Question Email. This one strategy can quickly produce multiple plans of care in only a few hours.

Not only that, but it’s a great way to engage with your email list in a way that past patients will appreciate now more than ever.

Click here to download the Single Question Email template for free. It shows you how to put together the initial email and also how to handle the replies you’ll receive.

There are three markets you can target to attract patients to your clinic and successfulyl grow your practice:

  • Physician referrals
  • Direct to consumer
  • Past or current patients

When it comes to marketing, most focus is put on external marketing – going direct to the consumer to get  brand new patients. 

However, internal marketing –  marketing to your current and past patient list – is a strategy that should not be overlooked. Here are five internal marketing campaigns you can use to market your practice and re-engage past patients. 

These campaigns are a great first step towards getting your practice  “back to normal” after COVID-19.

1. Green Ink Letters

Green ink letters are powerful marketing tools because they’re personal to the patient or referrer. It’s a one-to-one interaction that’s packed with personalized attention and value. 

At Madden PT, we send out green ink letters when a patient graduates a program. We also send them to physicians who refer patients to us at the beginning of the patient’s plan of care. We include how the initial evaluation went, along with a promise to keep them updated on their care. 

The benefit of using green ink letters is that you can write these any time. Make them personal to the patient using something you’ve discussed with them to strengthen that connection. Also, don’t forget to include a soft call-to-action to encourage engagement. This doesn’t have to be a sales message or asking them to book an appointment, but it should be enough to get them to take the next step.

Extend an open invitation to visit your clinic again if they have any other issues or simply let them know that you and your staff are available to help anyone the patient knows who may also be in pain.

2. Patient Newsletters

Some practices print newsletters to mail or distribute in the office, while others offer a digital newsletter. Our patients respond better to receiving something physical in the mail, but there’s no wrong way to go about creating a patient newsletter.

The important parts of a newsletter are:

Some of your content should have nothing at all to do with PT. This could be a staff member spotlight, a new hire, holiday traditions, or anything else your patients might find interesting. We’ve found our patients love to learn about our PT team and keep up to date with what’s going on in the practice. 

Relevant Content

Relevant content will have something to do with PT and your practice. It could be a patient testimonial, success stories, or an exercise of the month. Skip the scholarly articles on PT-related topics or anything you’d discuss one-on-one with a patient.

Call to Action

Every newsletter should have a call to action. We use a standing insert inside our folded newsletters. It’s an 8 ½”x11” page, front and back, that’s often used to highlight an upcoming workshop, free exams, free reports, or something else of value. We’ve found the freebie is most effective when people are getting information from it.

3. Patient Interviews

This is one of the most important roles of an internal marketer in your practice. Our internal marketer meets with every patient three times during their plan of care: once at the beginning, once in the middle, and once at the end.

The first goal is to establish rapport with the patient. The second goal is to ensure the patient is staying compliant with the plan of care set forth in the initial evaluation.

A lot of times, the conversation has nothing to do with PT. Talk about their interests and get to know them so you have a meaningful connection with each patient.

The second interview is your opportunity to get their feedback on how things are going and whether they’re seeing any progress. This is a great opportunity to educate them on what they can expect next in PT.

During this interview, we like to bring in cash pay services (we also do this during the first interview) to see if they’d like to continue with them. Some patients prefer these services after having gone through most of their plan of care when they know how things are progressing.

In the discharge interview, we get a picture of the patient with their team and celebrate the end of their plan. This is the point where we ask for referrals, online reviews, and testimonials since we’ve already built a great rapport with the patient. 

During the discharge interview, we also book a follow-up appointment for a couple of months later. Our purpose in doing this is to take measurements and make sure nothing has backtracked. But it also helps us keep the lines of communication open and stay top of mind with the patient since they’re not coming into the office as frequently, and we’ve actually reactivated a lot of patients this way.

4. GPE – Greatest Promotion Ever

Choose a day to offer free screenings to friends and family members of patients and past patients. We have five teams, so we try to do ten free screens for each time at a half-hour per screen. You’ll also want to plan for five weeks of marketing after the event with emails, newsletters, Facebook Live videos, and other content. 

5. Killer Testimonial Machine

Last but not least, we love the Killer Testimonial Machine, which is a wall of patient testimonials that new patients see when they walk into the clinic. This shows them how many patients have gotten great results and gives them hope for what they can expect. It also establishes celebrity, authority, and expertise for the PT to boost their credibility.

All of these marketing tips are excellent for bringing past patients back into your practice, and they’re easy to implement when you can hand them off to a marketing person.

Download my Internal Marketing scorecard to see how we utilize this position at Madden PT and how you can add an internal marketer to your team.

Consistently fill your schedule with new patients by creating a marketing calendar for your clinic.

One thing that private PT practices have in common is that they thrive on consistently filled schedules. You know you have a lot to offer your patients, but first, you’ve got to get them through your door. 

That’s where marketing comes in. This is your chance to spread the word about your practice and services and how you can help others get back to normal naturally. Using a marketing calendar to guide your efforts can help you plan out activities and ensure your schedule stays full. Here’s how:

What Is a Marketing Calendar?

Simply put, a marketing calendar is a written plan of your marketing activities for a given time period. You could create a calendar for the next month or even for a whole year at a time. 

Your marketing calendar should include all three of your target markets:

  • Physician referrals
  • Direct to consumer
  • Past or current patients

Why Do I Need a Marketing Calendar?

Much like any type of calendar, a marketing calendar allows you to work a few steps ahead and avoid having gaps in your PTs’ schedule—and, ultimately, your practice’s revenue. It also allows you to maximize the space you’re in to ensure you’re getting your money’s worth. Why pay for a 3,000-square-foot space when you only have 50 patient visits per week?

More patients = more revenue, which helps transform your liabilities (e.g., personnel, equipment, space) into assets. You’re already paying for these, so it makes sense to generate as much revenue as possible to help cover the costs. 

In addition, having a planned out marketing calendar ensures you’re not overlooking any of your three core target markets. For example, if you have a past patient list but file it away and let it collect dust, there’s really no value in keeping it. You might not give it a second thought for months or years. But having past patients on your marketing radar (and the calendar) can help you maximize its value and give you more opportunities to grow or maintain your practice.

Using a marketing calendar to target your three markets also allows you to divert your dependence on physician referrals. There’s no doubt that physician referrals aren’t what they used to be to a typical private practice. Designing marketing activities around other markets allows you to capitalize on more revenue opportunities.

Most importantly, once you create a marketing calendar, you can use it as a template for your entire marketing department and stop reinventing the wheel. This is part of creating a marketing system that will give you more time freedom, less guesswork, and better financial stability in the short and long term.

How to Build a Marketing Calendar

pt marketing calendar
Photo by Kaleidico on Unsplash

When creating your calendar, it’s best practice to work backward. Ask yourself: What do I need to do to fill my schedule, as well as the overall space? 

To do this, you can use your space’s capacity and availability to figure out how many patients you need to see in a given time period (e.g., the number of patients per day, week, month, etc.). This number should help to guide your marketing activity planning to ensure you’re meeting your space’s goals.

Once you know your goals, you can start planning activities that will help you achieve them. Here’s a quick breakdown:

1. Pick a Month to Plan

The best place to start is to look at the following month and start planning. Look for any holidays that could reduce appointment availability when calculating how many slots you have to fill.

2. Gather Larger Planning Pieces (Quarterly or Annually)

If you have a quarterly or annual calendar, you’ll want to review these pieces to ensure your monthly activities align with your greater goals. Annual and quarterly planning is usually more general, while weekly and monthly focus on more specific goals.

3. Choose a Market

Pick one of your three target markets to focus on for that month. Most practices aren’t investing a lot of time, money, or resources in marketing to physicians, so this will likely be your past patients or the general public.

4. Review Past Successes and Failures

Think about what marketing activities have worked well for you in the past—and which ones haven’t. What media did you use (e.g., Facebook ads, direct mailers)? What was the message that worked? 

5. Decide How to Execute the Campaign

There’s a lot that needs to happen to set your campaign into motion. Your goal is to break down those steps and figure out what you need to do to launch. For example, if you’re running a newspaper ad, you probably have to meet specific deadlines to get published in a specific run. 

6. Repeat Steps 3-5 for Other Markets

If you have the time, budget, and resources, repeat steps 3-5 for another market. Maybe you’re doing a workshop for the general public but also want to do a reactivation event for past patients. Once you start planning your marketing activities, you’ll have a better idea of how much time you realistically have to connect with prospects and bring them into your practice.

Campaigns to Choose From

Marketing activities are organized by campaign, with each campaign having its own steps to execution. Some of the ones we’ve found to be the most impactful are:

  • Patient & physician newsletters
  • Captured audience workshops
  • In-house & virtual workshops
  • The Greatest Promotion Ever (GPE)
  • The Single Question Email campaign

We’ve also tested other types of campaigns, like the recent in-house book signing we did for current patients. It’s best practice to review what’s worked and hasn’t worked in the past and double down on what you know will bring results.

You can download a free Marketing Calendar Template to use at your practice.

In-person workshops have proven to be the most effective way of converting the general public into direct access patients. 

During the COVID-19 crisis, many owners in the Breakthrough community have experimented with online PT workshops. Making the switch from in-person to virtual workshops isn’t as simple as you might expect, but the results have been similar. 

Here are some ways you can get the most out of your online PT workshops to make them even more successful and worthwhile:

1. More Engagement = More Appointments

Engaged audiences are more likely to become patients than passive participants. 

But holding someone’s attention is much easier when you are giving a presentation in front of them, face-to-face. With virtual workshops, attendees are at home watching on their computer screens and only one click away from checking social media or otherwise being distracted.

Giving simple directions like “Look at the screen” during your presentation can recapture their attention and pull them into what you’re talking about. Give them directives and keep them in the moment. 

2. Stick to the Format

It’s easy to go off course in an online workshop, which is why we recommend sticking to a format that logically moves you through each part. Download the free Online Workshop Template to discover a proven format for structuring your physical therapy workshops.

Practice it to get comfortable in teaching an audience that isn’t right in front of you. 

3. Focus on Your Final Five Minutes

No matter how long your workshop is, the last five minutes are always the most critical, as you’re giving your audience the call to action to move forward with you. The CTA should be clear so that people go right into scheduling an appointment with you.

Make sure your “next step” is congruent with the online format and avoid asking attendees to do anything that would require them to leave their computer. 

Other Ways to Set the Stage for Success

There are several moving parts to conducting a successful online workshop, and knowing these parts can help you get one step closer to your goal.

First, you need to have people in pain watching your workshop. This is where strong workshop marketing skills come into play. If you don’t have the right audience in seats (or the right eyes on your presentation), you’re not going to get the results you expect.

Second, you need to know what to say that’s going to trigger conversions. This is different from in-house workshops. It takes more engagement, more interaction, and more conversations to help people feel safe enough to come in for an appointment.

Also, you need a follow-up sequence to follow up with people who didn’t schedule an appointment right away. Again, this looks a little differently than it does for in-house workshops because it all takes place online. 

And finally, you need to understand the right levers to pull to get the most engagement from your workshop. 

If you’re like most practice owners, online workshops are new to you and you may be wondering how to get started.

That’s why we created a free Online Workshop Template that shows you how to create a presentation that will maximize conversions. At Breakthrough, we’re purpose-driven and want to help people get back to a pain-free life naturally, and the best way to do this is through private practice owners like you. 

Download the Online Workshop Template to get started today!

PT Hiring Process

Improve your management style, get your team aligned on goals, and create more time freedom when you start using scorecards as part of your hiring process.

Click here to grab a free copy of the scorecard used in this training. 

A scorecard is a personnel tool that you’re going to use in all of your personnel decisions. Hiring, incentivizing staff, firing, promotions, et cetera. 

Everything revolves around the use of this tool. 

Growing your practice beyond a certain point requires having the right team members on your staff. Autonomous, solution-oriented employees who get stuff done without hand-holding and micromanaging. 

Problem solvers who are fun to work with and who help your business hit new milestones and revenue goals. 

The ability to effectively hire is a skill most Practice Owners overlook. But its a skill that differentiates owners who are constantly stressed-out, overwhelmed, and time-starved…

From owners with an enviable level of time-freedom and the ability to take time off from their practice WITHOUT everything falling apart. 

The training above contains my “Scorecard” Method for hiring and managing PT staff. 

If you want to attract, train, and motivate rockstar private practice employees…

Who take problems off your plate and make life easier for you…

Then be sure to check this out.

And also download a free scorecard template to use at your practice. 

In the past, we’ve discussed the state of PT and our aspirations to Flip the Pyramid and make conservative care the first choice for people in pain – ahead of injections, medications, and surgery.

But the current state of PT looks a lot different than it did just a few months ago due to the COVID-19 pandemic and the chaos and uncertainty it’s created in the world.

The truth is that similar events and challenges have occurred throughout history. Case in point: just 12 years ago, the financial crisis of 2008 hit and shook PT practices everywhere. At Madden PT, we were already battling encroachment from HOPTs and POPTs practices and ended up losing $98,000 in a single quarter. Back then, we were focused on physician referrals, but that crisis made us realize the need to diversify our income and create systems that would put us in a much better position during a future crisis.

Understanding these events can help us to better shift our thoughts and behaviors that will allow us to thrive now and in the future.  

Exploring the Transition Curve

In the past, PT owners have typically followed a transition curve, where we start our PT practice with uninformed optimism that turns into informed pessimism when something goes wrong or business doesn’t come as easily or quickly as we’d hoped. Soon after, a crisis of meaning follows, where we explore what we really need and want from our practice. This leads to either crashing and burning or informed optimism, in which we are more aware of what it’s going to take to be successful and have new hope for the future of the practice. 

PT during Covid

But today, the transition curve looks much different. We’re now on a cycle of market emotions.

But now, just within the last week, we’re starting to see the bounceback. Patients are trickling in once again. They’re wearing masks and acting with caution, but we’re finally starting to see some hope for normalcy. 

Learning How to Pivot (and Pivot Quickly!)

Just two months ago, our goals at Breakthrough looked drastically different than they do now. As a rule, our goals have always been to help private practice PT owners become successful while helping our own patients get back to normal naturally and make PT the first option they think of when they’re in pain.

We haven’t lost sight of those goals, but we immediately shifted our focus so that we could help other owners and the PT industry at large survive this crisis. We’re doing this by focusing our content and training on things to do during the pandemic, such as where to turn for financial relief and how to stay connected to your team and patients (even if you’re not treating them at the moment). 

Just like we have four seasons in a year, we also have four “seasons” of the economic cycle in a given year. And it’s important to understand these seasons so that you can be in the best financial position when the market starts going up again. There will be an “end” to this pandemic, and when that end finally comes, PT owners should be prepared for the rebound.

The State of PT and the One Goal to Set Moving Forward

Bob Kowalick from Revenue Cycle Solutions shared some interesting stats with us recently on the financial state of private practice. His research found that about a third of practice owners are not in a financial position to survive this crisis. They’re in the same boat with about 43% of small business owners throughout the country that are saying they’ll likely not be able to reopen their doors when the pandemic is over. 

For PT owners, avoiding this situation might mean not taking a salary for a little while. You still need a staff, a facility, and a way to pay for these things, so you might have to make the ultimate sacrifice. 

Kowalick also found that almost half of owners only have a partial financial bridge. Of those, the majority are about 5% off their goal. If they need $50,000 in total to make it through, they are likely just $2,500 short of their goal. Some may be able to cut enough corners to come up with what they need, but if you can’t, your goal should be to do what you need to do to get into this next group of owners—the 19%.

Roughly one in five owners have a clear financial runway to the end of this crisis. Those 19% are at a major advantage because they’re going to be able to advertise and gain market share when the majority of their competitors cannot. They’re going to be in a better position to rebuild and hire the best staff and continue to grow their practice, both now and when the pandemic is over. 

For the remaining 81% of owners, it should be the goal to become among the 19% that can weather tough storms like COVID-19 and be in a better position to continue growing. 

For us to do this during the financial crisis of 2008 and the following months, we shifted our focus to three things:

  • Marketing direct to the consumer to become less dependent on physician referrals
  • Learning how to influence your payer mix and build a financial bridge
  • Building a better culture through personnel

When the pandemic conditions started rising earlier this year, these are the same three things we focused on. That’s because physician referrals have been in a tailspin, along with declining reimbursements. And since many people aren’t hiring right now, we’re using this opportunity to attract top talent to the practice to create an optimal patient experience.

PT practice owners can put these same ideas into motion to become one of the 19% (and ideally turn that 19% into 100% by the next time crisis strikes). To start, you need to know where you are right now, then understand where you need to go. 

We have tons of resources available at Breakthrough University that can help you take the necessary steps to connect your present situation to your ideal destination― learn more about Breakthrough University today.

This video is for Private Practice owners looking for strategies to get new patients in the current market.

Social distancing and quarantine measures mean that hosting in-person workshops isn’t an option for most practice owners.

And even as more and more states open back up, it will still take time for the general public to feel safe in group settings.

At Madden PT, my team and I have been experimenting with virtual workshops. The process was modeled after our traditional in-person events, and we invited people from our social media and email list.

We had about 60 register, and from that we had 10 people sign up for an initial evaluation.

I know a lot of owners are considering hosting online events, so I decided to create a short video training to share my tips for getting the best results from this new style of workshop.

I’m also making my Online Workshop Presentation Template available to download for free.

[expand title=”Click to Read Full Video Transcript”]
Chad Madden:
Hey, everybody. Chad Madden here with Breakthrough. This is simply attracting new patients with online workshops. This is specifically for private PT practice owners who want to grow in today’s marketplace with everything that’s going on right now. So essentially, we’re taking the offline, the in-house success that you’ve seen hundreds of owners do, all 50 States, 12 countries internationally, and we’re taking that and transitioning it to an online format to adapt with the times and be able to continue to attract new patients that need our help.

Chad Madden:
So some quick success here. You can see Luke and Ashton down at Texas adapting this already, and then in Michigan, Andrew Gorecki, Andrew applied this, did the online workshop, ended up with 17 free assessments. And by the way, Andrew is a pioneer in this, adapted very early on, took this, ended up doing his own stuff and did really well. So, our hope is that you can get the same exact thing out of this.

Chad Madden:
The purpose and our purpose here at Breakthrough is to help people in pain get back to normal naturally. The best way for us to do that is to work with practice owners like you in your community and help you do these online workshops. So, this workshop deck, where they call it a deck because it’s like a deck of slides, was designed with the same, exact six-step process that I personally use in my own online workshops. And another big point that you should realize is online workshops are different than in-house workshops. For example, we’re going to talk about engagement. Right? When I’m doing an online presentation, I can’t really see what my audience is doing. They could be texting on their phone, they could stand up and go to the bathroom, and come back, and I would never know that. Right? They could be watching a TV program with, I’m in the background. That’s not the case with an in-house workshop.

Chad Madden:
So, we want to be able to change our strategies for online workshops because it truly is different than hosting an in-house workshop or a live workshop. And also, I have training for you which will help you get the most out of this tool in your online workshops. We’ll talk about that here in a minute.

Chad Madden:
So, three tips to get the most out of your online workshops. Number one, we talked about this already, but more engagement equals more appointments. So, very important that you’re bringing people back to the screen. Pay attention to this, write this down. You’re giving them directives in terms of, basically, paying attention. And when you do so, when you get them to share, you’re going to be able to schedule more appointments. We learned that… Significantly, it was a huge change from our first workshop to our second.

Chad Madden:
Number two is it’s going to be easy to deviate when you have online, when you’re doing an online workshop, maybe you get lost in a story or something like that. You want to stick to this exact format that I’m showing you here. Six steps, very, very simple, and most importantly, in sticking to the format is you want to focus on and pay attention to, you want to practice this the most, what you say in the last five minutes because that is the thing that you must nail. You can’t deviate and go into answering questions at that point. You have to have a very call to action so that people are going right to scheduling an appointment.

Chad Madden:
And when I taught in-house workshops, and we’ve been teaching that for the last five or six years, again, with hundreds of owners from everywhere, when we’re teaching that, we talk about the last five or 10 minutes is the most important point. It’s even more so. It’s even more accentuated right now. There is more stress on this in an online workshop than there is in-house, and it was the most important thing, the primary thing to practice and focus on. And in an in-house workshop, it’s even more so important right now.

Chad Madden:
There’s some other things that you need to be successful. I’m going to give you four other steps here. Number one, you need people in pain that are actually watching your workshop. Right? So, you have some workshop marketing where, when we were doing this in house, it was called Butts in Seats. Right? Getting people in the room? Right now, you want eyes watching your presentation. Right? You want people watching your presentation.

Chad Madden:
Number two, is you want to know exactly what to say to increase engagement into conversions. It’s different than in-house workshops, especially during this time. We call it, the pay line has been pushed back. So in an in-house workshop, 60 days ago, 90 days ago, people would register for the workshop, and somewhere between 10% and 25% would schedule an appointment and a plan of care before the workshop even happened. That low hanging fruit is not there in these times right now. We pushed the pay line back. It’s going to take more engagement, more conversations for people to ultimately feel safe enough to come in, regardless of the area of the country that you’re in.

Chad Madden:
Also, you want a follow-up sequence after to convert those who did not schedule right away. That’s really, really important. And also, there are three key levers that you should be pulling to get the maximum leverage out of your workshops. And if you’re not doing these, yes, you can run an online workshop. You can check the box, but pretty good chance nobody’s going to schedule. You want to make sure you’re pulling these three leavers so that you’re getting the most out of your workshops.

Chad Madden:
What I’ve done for you is I created a special training called, How to Deliver an Online Workshop that Converts. And in this, we’re going to be talking about how to market your workshop. By the way, we have the former head of online Facebook learning, who actually worked for Facebook, walking you through this in addition to her, Kathy Borkowski, she’s also sharing and presenting with you in this training with Carl Mattiola, the co-founder here at Breakthrough who was the head of online sales at Tesla. So, they have huge experience there marketing your workshop. That is in this course, avoiding the most common work workshop mistakes. We talked through that as well in this training. And then a step-by-step guide and presentation so you know what to say and why you’re saying it for maximum conversions.

Chad Madden:
Now, normally, we would sell something like this for $500. We’ve sold trainings like this for a thousand dollars or more. But because of the times, because we want you to succeed and remember we’re purpose-driven, so we want to help people in pain get back to normal naturally. Again, the best way for us to do that is to work with you. Dedicate a private practice owner who’s helping people right now. So, we want to give this to you for free, and it’s free for everybody that joins Breakthrough University. What is Breakthrough University? It’s training and content, and it spans your entire organization.

Chad Madden:
The key thing here is that it’s not outdated, ivory tower philosophy, it’s not theory. This is what is working right now in the trenches of private practice PT. Just like you saw Luke, and Ashton, and Andrew sharing their wins of people that are implementing and applying right now. It’s the same thing here. It’s training and content that is up-to-date. This is what is working today. We have that for you at Breakthrough University. You also get access to a community of like-minded private practice owners. And right now, in this group, there are over 1300 owners, again, from all 50 States, 12 countries internationally. I know we’re all different. We all feel like our business is unique. However, whatever stage of business you’re in right now, there’s likely somebody in your area already learning in there and sharing, and they’re likely at the same stage that you’ve been at. Right?

Chad Madden:
So, you can find people that are at the same stage as you, whether you’re a startup or whether you’re a private practice vet, you’ve been in there for four decades. Or, there’s likely somebody that’s in your same marketplace or a similar marketplace like you somewhere else in the country or even somewhere else in the world. There’s also accountability. We have these inside circle implementation calls where we hop on with a group of owners, and we help you implement whatever it is that you’re stuck on. So again, they’re called the inside circle calls.

Chad Madden:
And in the big picture of marketing, what we’re really trying to do is we’re going from a trickle. We’ve all at least been affected in some way by our current crisis and situation, right? So we’re going from a trickle, and we’re rebuilding to a flood. There is an exact sequence of how we do that. And workshops are actually step number four. And online workshops fit in there as well. So, realize that this is part of a bigger picture for you, and we want to make sure you’re able to fill in all those gaps and ultimately, get the most out of, not only your online workshops, but be able to grow and leave an impact in your area, again, far beyond, far stronger than what you were before this crisis. Right? So, very cool stuff there. Again, this is Chad from Breakthrough. Thank you for watching, and I’ll see you in the next video.


On a recent Breakthrough webcast, we talked about flipping the pyramid in the healthcare industry to capture more of the spend on health services.

Right now, about 72% of what’s spent on healthcare each year goes to surgery, injections, medications, and diagnostic imaging. Just 2% goes to physical therapy, occupational therapy, and speech combined. We want to be the number one skilled healthcare expert of choice, and to do this, we must become the foundation of skeletal and neurological health.

The recent pandemic has thrown a monkey wrench into this mission. Many practices are seeing declining appointments and revenues, which means you may not be helping as many people as you can. But if we’re going to push the PT industry forward and continue our greater objective to help people get back to normal naturally, we must survive the current crisis.

Let’s look at how you can do this on three different levels and be better prepared to help others:

Step #1: Managing Yourself

There’s a reason why airline companies tell you to put your own oxygen mask on first in the event of an emergency. You can’t help others if you’re not in a position to first take care of yourself. 

The times we’re living in are unprecedented. Many of us are experiencing extreme levels of stress and added worry about the future. It’s changed our entire way of living, even if it’s only temporary. If you’re not taking care of yourself first, it can put you in a dangerous position if you try to reach out and help others.

Right now, there’s a common fear of what this increased isolation will do to us as a society in the long term. Some people may not be mentally handling these changes well. The best thing that each of us can do is take care of ourselves so that we can continue to reach out and be valuable to others:


Matthew Walker’s Why We Sleep is an excellent resource that talks about how sleep is a daily detox of the brain and the way it affects the rest of your health. Ideally, you can use this extra time away from work to catch up on sleep and build healthier sleep habits.

Eat Well

Prioritizing the right foods can help us take care of ourselves for the short and long term. Some resources to check out are The Switch, Boundless, and Peter Attia’s podcast.


Exercise and nutrition go hand in hand for a healthy lifestyle. Take this time to build more exercise and movement into your day, even if it’s “just” walking. At the very least, it can help combat the effects of stress eating.


Finding clarity and making mental space in your day can help promote positive feelings and crowd out any stress caused by the coronavirus. 

Socially Distance But Stay Connected

Socially distancing yourself doesn’t mean you have to cut all forms of communication. Stay connected with your employees, family, and even your patients via text, Zoom, phone calls, or social media to maintain the human element.

Step #2: Managing Your Family

We’ve talked about this before at Breakthrough, but if you’re not taking care of your family, you won’t be able to handle the highest responsibilities of being a practice owner. 

Staying on a schedule can help everyone in your home maintain a sense of normalcy. Also, showing your spouse, children, and even parents your love and gratitude can make a difference in the dynamics within your home. Gary Chapman’s The Five Love Languages is a powerful resource for helping identify ways in which we give and receive love that is well understood by others.

Step #3: Managing Your Business

When you and your family have put on your oxygen masks, you’ll be in a much better position to help your practice, employees, and patients. We talk a lot about the three pillars of a successful practice: Finance, Marketing, and Personnel. These pillars are just as important during the pandemic as ever, but the way in which you approach them may need to be adjusted.


You’ll want to focus on financial planning. How are you going to bridge gaps and survive until things get back to “normal?” Before the crisis, one of our top concerns was figuring out finances with declining reimbursements. Today,  a new challenge we have to factor in is what our income will look like based on grants, loans, and accounts receivables, as well as any new expenses you may have incurred due to loans, personnel changes, and potential vendor negotiations. One thing worth mentioning is that you may be able to negotiate some relief on your lease. Right now, not a lot of people are renting commercial property, and the last thing a landlord wants is to lose a tenant because they can’t afford rent due to closure.


Before the crisis, one of the biggest marketing concerns was declining physician referrals. Many PTs are diversifying by going direct to the consumer and trying to influence their payer mix.

Staying in touch with patients will be key. Some practices may even consider offering telehealth options to give patients another option. The virus hasn’t taken pain away. If anything, it’s probably caused a lot of patients who were undergoing treatment to regress. Continue to provide value to your patients to stay connected.


You should think through your current salary cap and how you can continue to employ your people and still be able to afford them. The PPP and the Cares Act offer some valuable help here, which we covered in an earlier blog post.

If you’ve had to lay off or furlough employees, you’ll want to consider how a reduced workforce will affect your ability to serve patients once you reopen. The good news is that not many people are hiring right now, so it should be relatively easy to build a pipeline of PTs and related personnel. Be transparent about your projections to rebuild and grow after the pandemic. 

We have a hiring course in Breakthrough University and other resources that support the three pillars of a successful PT practice. Visit to learn more about Breakthrough University.

Physical therapy practices across the country are facing unique working conditions during the COVID-19 pandemic.

Some practices are closed altogether, while others are operating under limited conditions. In either case, the situation is giving way to several employment questions and potential issues. In addition, the federal government has rolled out a stimulus package available to small businesses under certain conditions.

We recently spoke with Scott Leah, an attorney who specializes in employment law, to answer important questions that will help PT owners make sense of handling employment changes during COVID-19. 

What Are the Two Types of Paid Leave?

Two new paid leave types have been introduced by the federal government: paid sick leave and the FMLA (note: the FMLA isn’t new, but the rules surrounding it have been changed during the COVID-19 pandemic).

Paid Sick Leave

Paid sick leave provides qualified employees with up to 80 hours of pay if they meet one or more of the following criteria:

  • They’re under quarantine
  • They’ve been ordered by a medical doctor to stay at home for a certain period of time
  • They’re receiving testing for COVID-19
  • They’re caring for a family member who is getting testing for COVID-19 or is under quarantine
  • They’re taking care of a child whose school or daycare is closed due to COVID-19 concerns

There are a few differences to consider when it comes to the amount your employees will receive. In some cases, they’ll be eligible to receive their full salary. Under other circumstances, they’ll get two-thirds of their normal salary. Employees must have been working for you for at least 30 days to be eligible.

There’s a lot we still don’t know regarding this pay—such as how employees can apply for it—and more details will hopefully emerge soon.

There’s also a provision for employers to get a dollar-for-dollar credit on their payroll taxes if they provide this benefit to their employees. Again, there are still a lot of unknowns about getting this tax credit, so it’s a good idea to bring this situation to your accountant. There will probably be a special form to fill out and documentation to provide before taking advantage of the tax credit.

Family Medical Leave Act (FMLA)

The FMLA has also expanded to accommodate more employees. Historically, most PT practices didn’t have to concern themselves with the FMLA unless they have more than 50 employees in a 75-mile radius. 

The FMLA provides up to 12 weeks of paid leave under new circumstances:

  • Caring for a family member
  • Caring for a child under the age of 18 because school/daycare is closed

The first two weeks are unpaid, while the remaining weeks are at two-thirds of the normal pay. Under the new law, the employee can get paid during the first two weeks using the new paid sick leave (which is 100% or two-thirds of their salary). They can also leverage any existing PTO, vacation, or sick time (although you can’t require they use their PTO).

The amount paid during the FMLA is a refundable tax credit, which is significant for small business owners. This means that if you pay out $1,000 in benefits and owe $750 in taxes, you’ll get a net of $250 back from the government.

What Are the Two Types of Unemployment?

Many practices are facing tough decisions in choosing to lay off or furlough employees. These are dire circumstances we’re in, and while you want to do what’s best for your employees that take care of your practice, you also want to do right by your practice.

The government is helping to provide small businesses with funds that can help them avoid both laying off and furloughing staff, including a stimulus package (which we cover in another blog post) and paid leave requirements for employees. 

The problem is that many practice owners may not be able to afford to keep all employees on long enough to take advantage of these options. Yes, you get back the money you pay for leave as a tax credit, but you have to be able to front the money first. 

In this case, many owners wonder which is more beneficial: layoffs or furloughs?

In a layoff, the employee is no longer working for your company, and they are eligible to collect unemployment. Furloughs allow the employee to remain employed and work on a reduced schedule (even down to zero hours per week). They’re still eligible for the paid leave options and benefits, and they should also be eligible for unemployment compensation. Once the pandemic conditions lift, they can come back to work and handle business as usual. 

The one caveat with furloughing employees is to check with your insurance broker to see how many hours an employee needs to work to maintain their benefits coverage. In some cases, reducing them to zero hours may not save their insurance benefits.

Can You Qualify for Unemployment as an Owner?

Unemployment is largely state-driven, so each state will have its own rules surrounding eligibility for unemployment. In Pennsylvania, the general consensus is that business owners are not eligible for unemployment benefits. 

In essence, unemployment is designed for employees, not employers. The idea is that if employers could receive unemployment benefits, then anyone could start up a business, fail, and collect benefits. 

An exception would be someone who owns a small portion of a practice that doesn’t have much say in how the business is run from day to day. Alternatively, if you’re a C corp, you may be able to file, as you’re not technically the “owner” of the company. These are rare cases, but they do happen.

However, we’re in unique times, so there’s a possibility that some states may allow small business owners to file for benefits. The best step to take is to work with an employment lawyer who can look at the specific state requirements and help you support your case. 

Finding Ongoing COVID-19 Support

We know these are challenging times to be a practice owner, and we’re committed to helping you get answers to your most complicated questions and navigate new legislation. Join our free Facebook community – Private PT Practices: Standing Up Through Crisis for more resources.

As many practice owners continue to struggle financially during the COVID-19 crisis, the new Paycheck Protection Program may offer a ray of hope.

The PPP is part of a $1 trillion+ stimulus introduced by the federal government that provides a financial cushion for small businesses in the form of a loan—some or all of which may be forgiven.

As you explore ways to pull your practice through declining revenue, the PPP should be among your options. Here’s what we know about the PPP so far:

What Is the Paycheck Protection Program Intended For?

The PPP was introduced as part of the larger CARES Act as a means to help small business owners continue to keep employees on their payroll, even if they had to bring business to a grinding halt. The alternative, of course, is to lay off employees, which would allow them to draw unemployment benefits. The goal is to continue to compensate employees through the PPP, regardless of whether there’s work for them to do. 

What Determines Loan Eligibility

To qualify for a PPP loan, you’ll first need to determine what your payroll costs are on a month to month basis. Then, you’ll multiply those costs by 2.5 to get the maximum amount you’ll be eligible for. You will need to provide supporting documentation of payroll costs so that your lender can determine your eligibility. 

Nearly every bank and credit union is now approved to issue PPP loans, but your own bank is the best place to start. It’s advisable to apply wherever you already have a strong banking relationship, as most banks are not taking non-customers for this loan. 

How SBA Loans Relate to PPP

The PPP is part of the larger CARES Act, and many small businesses may have already applied for an SBA loan in addition to the PPP. If you’ve already received an SBA loan, you should be able to roll that loan into your PPP. For example, if your PT payroll costs are $50,000 per month, and you received a $25,000 SBA loan, then your total loan amount would be $150,000 ($50,000 x 2.5 + $25,000). 

How Are You Allowed to Use the Loan?

Once you receive your loan money, you begin an eight-week period in which you must spend your loan. This period is also used for comparative purposes to determine how much of your loan is going to be forgiven. Ideally, a large part of this loan will essentially be free money for PT owners. 

The allowable use covers payroll costs and other operating expenses, including rent, utilities, mortgage interest, and debt service. You’ll be required to provide documentation of these expenses. During the eight weeks, the amount of loan money you spend on qualified expenses becomes the amount that is potentially forgivable.

How Much of the Loan Can Be Forgiven?

Once you have a potentially forgivable sum, you’ll need to calculate how much of the loan can actually be forgiven. To do this, you’ll compare your FTE from February 15 to June 30 to this same period one year ago (another option is to review FTEs in January and February before the pandemic began). You’ll also need to compare how much you’re paying in wages during this time compared to this same time frame a year ago.

This goes back to the PPP’s intention: to keep people on payroll instead of cycling through unemployment.  

The forgiveness process has yet to be defined, but you will need to apply for loan forgiveness. It’s advisable to work with your accountant to help you accurately calculate payroll costs that can affect your loan eligibility and forgiveness.

You can watch Bob Kowalick from Certified Reimbursement Solutions do a full training on PPP in the free Facebook community, Private PT Practices: Standing Up Through Crisis.