In case you missed it, Diagnostics in PT magazine recently featured Breakthrough on its cover, along with a feature story where we dove deeper into some of the biggest issues threatening the PT industry.
Alongside Dr. Dimitrios Kostopolous of Hands-On Diagnostics, we pulled back the curtain on four of the most important lessons a private practice PT owner could learn and how these lessons can help to guide you through tough challenges like declining reimbursements, talent shortages, and practice autonomy.
Here’s a semi-quick summary of our feature story:
A New PT Model Is Long Overdue

Change is inevitable in any industry, whether it’s catering to shifting customer preferences, cutting costs, or making improvements to the way you work. But in the case of private practice Physical Therapy, there’s a growing need for a complete transformation of the revenue model.
Diminishing reimbursements, finding the talent, and remaining competitive among HOPTs and POPTs practices are just a few of the serious threats that are plaguing the PT industry. Many private practice owners already acknowledge that something needs to change, but very few realize the power they have to initiate it.
As a leader of a new PT business model, we’re focused on creating momentum that will lead to greater profits, more control, and increased predictability within the practice—so much so that traditional revenue streams like doctor referrals won’t matter nearly as much when those streams run dry.
Lessons in Leadership

No PT owner gets everything right the first time, and I wholly believe that it’s our mistakes that prime us for a role in leadership. Here are four of the biggest lessons I’ve learned along the way:
1. Failure Makes Perfect (Or Close to It)
In my first ten years of practicing PT, I lost my top referral source four times. I remember the first time this happened was just six months after I opened my practice. It was a scary, sinking feeling that I’ll never forget since this referral source accounted for 25% of my business.
This was the direst situation, but because it happened so early in my career, I think it made me more resilient and in tune with what would later become my objective with Breakthrough: diversified revenue streams.
By comparison, the last time a referral source left my practice, it only accounted for 0.5% of the business. That was a smoother pill to swallow—not because it wasn’t a lot of money, but because I had so many other ways to generate revenue because my earlier failures had shown me it was necessary.
2. Keep a Finger on the Industry’s Pulse
We all know that hindsight is 20/20, but there’s not a single one of us who can predict the future with absolute certainty. However, I’ve found that studying the PT industry’s trends can help me to make mostly accurate predictions and allow me to better prepare myself for what comes next.
Case in point: declining physician referrals. No one had to tell me that this problem wasn’t going to get any better, nor was it going to solve itself. With an influx of HOPTs and POPTs practices and PT failing to capture a large market share compared to other methods of treatment, doing the same thing and expecting the same results wasn’t going to cut it.
After looking at the State of PT report, it was clear that PTs were doing more work for less money. What’s more, private practice is having a tough time competing for talent when hospitals are paying $90,000 or more per year to grads who are eager to start repaying student loans.
This, of course, only presses profit margins thinner.
The only logical remedy is to keep a healthy stream of revenue that will allow you to afford to be competitive.
3. Disruption Wins
When you can’t “fix” the problem, I’ve discovered it’s best to reframe it. In the case of declining referrals, I decided that instead of trying to save a sinking ship, I would leverage direct-to-consumer access to diversify revenue.
When I first started going direct, there was no road map, no blueprint, no mechanism for me to do this. That’s why I created Breakthrough in the first place, and as a result, private practice owners are disrupting the PT industry as we know it. And we’re thriving.
4. Acknowledge the PT Model Is Shifting Because We Made It Shift
Advancements like Breakthrough or Dr. Kostopolous’ Hands-On Diagnostics are two of the biggest examples of an industry shift. Both of us decided that change was necessary in private practice, so we took action.
Other PT owners can also take the lead and force change in the industry. In doing so, we’re sending a message about the value of our service, our passion for our profession, and our desire to help as many people as we can gain the quality of life they deserve.
Diversifying Income Is the Key to Longevity

I mentioned earlier that our feature cover story was a joint interview with myself and Dr. Kostopolous. We’ve each experienced similar pain points in the industry, particularly the major declines in reimbursements and referrals. That’s why it was easy for us to agree that the unique challenges we face in the industry present a need to reframe problems and focus on better solutions.
The solution: diversifying your income sources.
This is exactly what we preach and teach here at Breakthrough, and we leverage direct access marketing to go straight to the patients who need your services. Direct access can take many forms, but we mainly focus on workshops for specific problems, such as back or neck pain, along with positioning yourself as the expert in your local market. Our goal is to turn our PT owners into local celebrities so that patients will see them as the obvious choice to treat their pain.
By doing so, you set yourself up for autonomous, resilient success that will not only keep your doors open but also help you maintain the spark that got you into PT in the first place.

You can read the full issue with Breakthrough’s Chad Madden on Diagnostics for PT here
Or check out the Breakthrough resource center for PT marketing training and tools.