In the latest episode of the Grow Your Practice podcast, we dive into the rich insights from our “Market for Profit” session at boot camp held in Harrisburg. This session was dedicated to uncovering effective strategies to maximize the use of clinic space, efficiently schedule patient visits, and ultimately drive up revenue. Here’s how physical therapists can leverage these strategies to optimize their practices.

Filling Schedules and Utilizing Space

During the bootcamp, we explored the correlation between clinic size and patient visits. For instance, a 3000 square foot clinic should ideally handle about 300 patient visits per week to maximize space efficiency. If you’re seeing fewer visits than this, it’s time to reevaluate your use of space. Here’s a straightforward formula we discussed:

  • Space Utilization: For every 1000 square feet, aim for 100 patient visits per week.
  • Clinician Capacity: Ensure each clinician can handle 40 to 60 visits per week, maximizing their potential within the available space.

Reactivating Past Patients

Reactivations are the lowest hanging fruit in practice marketing, requiring minimal expense and effort. A simple “how are you” message can re-engage past patients, filling your schedule quickly. Here’s the process we recommend:

  1. Identify Past Patients: Look at your records from the last 6 months to 2 years.
  2. Send Personalized Messages: A simple text asking how they are can reignite their interest in your services.
  3. Follow Up: Engage with those who respond to schedule appointments.

Leveraging Referrals

Referrals are a goldmine for practice growth. We discussed three main sources:

  • Word of Mouth: Encourage satisfied patients to refer friends and family.
  • Professional Referrals: Engage with physicians, nurse practitioners, and other clinicians.
  • Community Partnerships: Connect with local businesses that can promote your services to their employees, especially those offering favorable insurance benefits.

Expanding Service Offerings

To counterbalance the effects of low reimbursement rates from insurance, consider expanding your service offerings. Techniques such as dry needling, laser therapy, and shockwave therapy not only enhance patient care but also add new revenue streams. Here’s how to implement:

  • Evaluate Profitable Services: Determine which services can be provided within your specialty that also offer higher reimbursement rates.
  • Educate Your Team: Ensure that all team members are proficient in new techniques.
  • Market New Services: Promote these new services to both existing and new patients.

Building a Strong Brand and Community Presence

A strong brand is essential for attracting new patients and retaining existing ones. Know your community; understanding the demographics and needs of your neighborhood will help you know how to market. Then, use educational workshops and active digital marketing strategies to build trust and raise visibility in your community.

At the end of the day…

Adopting these strategies can significantly increase both the operational and financial health of your physical therapy practice. By focusing on efficient space utilization, patient reactivation, strategic referrals, service expansion, and robust marketing, you can ensure sustainable growth and success. Watch the full episode for the full learning experience.

Apply for Profitability Under Pressure today. You’ll learn even more keys to increasing profit margins, connect with like-minded owners, and achieve financial stability and growth. Extended deadline is June 7th at 11:59PM EST.

Apply to Profitability Under Pressure where practice owners will learn how to use text messaging for profit and patient engagement, optimize hiring processes

Breakthrough - Unlock The 5 Key Sources of New Patient Flow For PT Private Practice

5 Key Flows For New Patients

In today’s hyper-competitive healthcare environment, keeping a steady flow of patients is crucial for the survival and growth of your physical therapy private practice. But where do new patients come from? They usually emanate from five key pathways. These pathways are essential routes to patient attraction and growth for any healthcare practice.

With each pathway, use the strategy listed to see more new patients come in your doors.

Understanding the Five Key Pathways of Patient Flow

Understanding these pathways can give you the insights you need to target each one effectively and optimize your overall physical therapy marketing strategy. Let’s take a deeper dive into these pathways and explore practical strategies to maximize each channel’s potential.

1. Reactivations: Bringing Back Past Patients

Reactivations refer to past patients returning for additional care. Reactivating past patients is an efficient way to bolster your patient list, as you’ve already established credibility and rapport with these patients.

  • Strategy: Maintain regular interaction with your patient list through newsletters, email campaigns, text messages, or personalized handwritten letters.

2. Word-of-Mouth Referrals: Leveraging Satisfied Patients

This pathway involves referrals from existing patients. Fostering word-of-mouth referrals involves maintaining a high quality of care, establishing strong rapport, and encouraging your satisfied patients to share their experiences.

  • Strategy: Implement a formal referral program incentivizing referrals with exclusive benefits or rewards.

3. Physician Referrals: Building Relationships with Healthcare Professionals

Maintain good relations with physicians, nurse practitioners, and other medical professionals to facilitate their referral process.

  • Strategy: Provide regular updates about your services and capacities to healthcare professionals.

4. Partner Referrals: Leveraging Business Partnerships

Form partnerships with gyms, yoga studios, large employers, or any organization serving your ideal clientele to promote your practice.

  • Strategy: Offer special packages and conduct workshops that are mutually beneficial to local businesses – you’ll be able to offer your services to their patrons and benefit from their marketing efforts.

5. Cold Traffic Marketing: Attracting Unknown Prospects

This pathway involves tapping into completely unknown prospects who aren’t familiar with your practice. Creative online advertising and focused marketing campaigns are essential here.

  • Strategy: Build a robust online presence, invest in direct response ads, adopt SEO practices, and build funnels (ads, landing pages, & automated emails) to attract your ideal patients.

Conclusion: Maximizing the Potential of Patient Flow

Understanding these five main pathways of patient flow is fundamental to boosting your practice’s growth. Tailoring strategies to accommodate each pathway will allow your physical therapy private practice to maximize the vast potential they collectively offer.

Recalibrating your physical therapy marketing efforts to embrace these pathways to patient flow will not only enhance your current patient base but will also set your practice on the path to profitability and sustainable growth. 

Ready to unlock the potential of these patient flows to attract more patients and supercharge your practice growth? Sign up for a Practice Growth Strategy Call to learn how you can optimize your marketing strategy today.

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

How to Grow Revenue and Help More People in Your Community

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

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

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

Why should practice owners care about marketing? 

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

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

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

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

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

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

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

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

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

Top 3 Marketing Tips for Chiropractors 

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

Here are the top 3 marketing tips for practice owners:

1. Lead with Patient Education: Teach and Invite

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

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

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

2. Avoid Discount Advertising

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

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

3. Create Monthly Recurring Revenue

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

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

  • Provide ongoing services

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

  • Open an e-commerce store

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

  • Offer online coaching

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

Summarized Marketing Tips for Chiropractors

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

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

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

See How It Works. 


One of the alarming metrics I share about Madden PT (my Private Practice) is in 2009, we hit an all-time highest ever of 154 New Patients referred by physicians, in one month.


Due to the changing healthcare environment (Hospital systems, POPTS practice come to mind), that number shrunk to 30 New Patients for us in March.

So we’ve gone on a progressive decline from 154 down to 30 in physician referrals.

Yet we’re busier than ever before…

Our income is better than ever before…

We’re seeing more ideal clients than ever before…

Our patient compliance and graduation rate is better than ever before…

And we continue to grow…

So What’s the Deal?

A month or two ago in the “Breakthrough Marketing Strategies for Physical Therapists and Owners” group on LinkedIn…another owner stated:

“We need referrals from doctors to stay in business… if we don’t have that, we might as well join them.”

(I’m paraphrasing, and unfortunately not giving the full context in the space provided here, yet I’m sure you get the point).

I’ll politely decline to agree with the comment, and here’s why.

In spite of operating in one of the most competitive healthcare markets in the U.S., my Private Practice continues to grow (we doubled profitability in 2013, over any other year in business).

So what’s the BIG Secret of how we continue to grow and expand in spite of shrinking referrals?


Acres of Diamonds

One of my favorite stories of all-time is Russell Conwell’s “Acres of Diamonds” (you can Google it and read it later).

In the story, a farmer sells his land and farm in Africa and spends the rest of his life desperately searching for diamonds, and dies broke and a failure.

Meanwhile the land that he sold, the farm, later was discovered to be on top of the largest diamond mine in the history of the world…

I’m not sure if the story is true or not.

It’s a good one though.

And it illustrates a point I believe many of us Physical Therapy Private Practice Owners miss…

We’re sitting on Acres of Diamonds, and don’t even realize it…


BIG Secret Revealed

In my Direct Access Marketing Training, one of the first things I share is the value of:

Your Past PT Patient List (Your Acres of Diamonds)

These people already know you.

They like you.

They trust you.

And now you’ve discharged then and maybe even encouraged them to never come back again…

M-I-S-T-A-K-E (and one I made for years).

In any industry, in any business, the #1 Asset of the business is the customer list AND the relationship of that business with their customers.

And as in other businesses, you can choose to:

  1. Ignore your patient list.
  2. Send them generic, meaningless B.S. that portrays, we hope, that we care about our patients…
  3. Or send them meaningful communication that allows that patient to continue to feel connected to us.


What Meaningful and Valuable Communication Can Do For You and Your PT Private Practice

Two weeks ago we hit an all-time high here at Madden PT, 17 Returning Patients in one week.

That’s 17 New Patients just from our past patient list.

Our team was pumped.

And you can do the same…

Staying in contact with your past patient list does several things:

  • Keeps you top of mind for their Physical Therapy needs…
  • Establishes you as an Authority, Celebrity and Expert (A.C.E.)
  • Makes it more likely they refer their friends and family to you…

And my favorite benefit, if you do this the right way.

They’ll come back years later and talk to you as though they’ve never left.

It’s pretty cool…

Like they’re part of your family.

(I cover step-by-step how I’ve done this at Madden PT for the past 10 years, in my Killer Marketing Training, only open to Private Practice PTs unfortunately, the enrollment period for the latest group of owners is closed as of this writing… we’ll be opening another Direct Access Marketing Course later this year).

***As an aside, by far your greatest Return on Marketing Investment (ROI) should come from your marketing efforts to your past patient base…NOT the unwashed masses of the general public.  Write this down…and reread it until it’s etched into your subconscious business mind.***

So How Do You Stay in Touch With Your Past PT Patients?

Well you have quite a few options when choosing how to stay in touch with your past patients…

If you’ve been following my blog, you know by now I’m a huge fan of Direct Response Marketers, especially Dan Kennedy.

For years, Dan taught a concept called “Market-Message-Media” match…meaning for your marketing to work, you need to match the right market with the right message using the right media.

So for our past patients and considering “Media”, here’s a few options:

  • Email
  • Snail Mail (including postcards, letters, and newsletters)
  • Facebook and other Social Media
  • Fax
  • Texting
  • Phone
  • Live communication, such as at an event…
  • Smoke signals…

You get the point…

So, which “Media” is most used by your past patients AND are they most likely to respond to?

(That’s what I would use, and what I share in the Killer Marketing Training).

On the negative side I dropped my Twitter efforts years ago, because my Target Market is not using Twitter.


OK, You Picked Your Media…Now What Do You Put in There?  What’s Your Message?

Again, due to the limits of space and time, I’m going to touch on this briefly…

I can tell you what your message should NOT consist of, at least from experience.

100% PT Jargon-filled, condition-related advice…

You know what I’ve found to work best?

Yes. Donkeys.


Recently in a bulletin we sent out to our past Patient List (a touch over 7,000 people), we did a cover story on the 3 Mini Donkeys we have on our farm…and the story of how one ends up with 3 Mini Donkeys: Haley, MoonBeam and Peppermint Patty (who is expecting in August, so make that 4 Mini Donkeys).

A little quirky…

A bit different…

BUT Crazy effective at building long term relationships with past patients (aka customers) who already know, like and trust us…

And WAY outside of the box of typical “marketing” you’d get from your PT.

At this point, it’s in your court…

Are you going to continue to rely on physician referrals 100% to grow your practice?

Even though you KNOW they’re being bought up by the local hospital system…or may be opening their own POPTS clinic in the future?

Or are you going to start working your past patient list?

Warming it up?

And eventually seeing them after their TKR, for your PT, even when the orthopedic surgeon says he wants them to go to the PT in his basement because they “communicate better” (even though we really know it’s because the ortho owns that clinic)?

So what’s it going to be?

If you’ve been following the full Patient Funnel…then you know we’ve covered 5 Steps so far:

  1. Lead Magnet
  2. TripWire
  3. Core Service
  4. Upsells and Cash Pay Services
  5. And now, the Return Path

Next time, I’ll be covering “Referrals”, and how we just hit a Highest Ever for New Patients referred by other patients in one week: 14.  (That’s for one clinic.)

That will be my last blog covering the Patient Funnel…

Do you have something you’d like to read about regarding Private Practice PT Marketing?  Hit the “Like” button and leave a suggestion below…

Also, as I mentioned earlier, my Killer Marketing Training Enrollment is closed as of this writing, and won’t open again for likely another 6 months.

BUT in the mean time, I do have a few tools I can share with you IF you’re a Private Practice PT or Private Practice Owner.

I put together a “Fix Your Funnel” package which includes:

  • “My Greatest Promotion Ever”…which is the step by step guide to a single day promotion we used at Madden PT which resulted in 65 New Patients in one day (October 29, 2013) and 50 New Patients PLUS a Waiting List (on November 4, 2014).
  • The Killer Testimonial Machine…which is how we’ve collected over 4,000 Patient Stories and Testimonials from our patients…this includes the “What to say”; the template we use…and what we do with the testimonial once it’s written by the patient.

Go here to check out the offer:

I’ll leave it up at least through the next month.

Hope this helps you,


So far, in case you’ve missed it… in looking at Patient Funnels & Private Practice Physical therapy business models, I’ve covered:

  1. Lead Magnets
  2. Trip Wire Offers
  3. And Core Service

So that brings us to #4: Up-sells and Cash Pay Services.

You’re probably sitting there wondering the following questions:

  • Are physical therapy business models profitable?
  • How much do physical therapy clinics make?
  • What’s the Average Physical Clinic’s revenue per year?
  • How much do PT Clinic owner’s make?

You’re asking the wrong questions

There’s an inherent irony in Private Practice Physical Therapy…

Successful service usually results in less service… and less income.

You know the deal… Mary came in for her back pain.

By the 4th visit, her pain is 80% relieved.

By the 8th visit, she has full ROM and strength.

And after 10 total visits, she’s back to gardening and walking the 2 mile loop around her neighborhood without pain.

You’ve done your job… so now all you have to do is go out into the marketplace and find another Mary or two.



Especially if you want to relegate yourself to the 99% of Private Physical Therapy Practices (myself included) who’ve suffered with tunnel vision, and have scraped and clawed for year to try to make a profit out of our Core Service… PT.

What if I shared with you a better way?

One where you could almost “break even”… that’s not even need a huge profit margin, and still have an amazing physical therapy business model with killer profits?

Until recently, I never thought about business this way…

But after studying Dan Kennedy, Frank Kern, Ryan Deiss, Jeff Walker (modern master marketers), and looking at the founding fathers of Direct Response Marketing (Hopkins, Collier, Ogilvy, Halbert), I’ve learned an amazing revelation…

And one I’ve seen almost no PTs use.

And that’s the Back End Cash Pay or Upsell Service…

Attracting a Customer to Make a Sale OR Making a Sale to Gain a Customer?

So think about Mary above.

She’s completed her plan of care in PT…

She probably knows, likes and trusts you and your staff…

You’ve likely given her a new lease on life: she can live her life again, sit on the floor and play with her grandkids, take walks with her husband, and in Mary’s mind, YOU are the reason she’s back to normal.

Put yourself in Mary’s shoes…

How else would you want to be served?

What We Did at the First Physical Therapy Place I Worked At… (Mistake)

The classic PT clinic answers this with a “Wellness Program”.

Call it what you may… I’ve never seen it work.

$40/month, $180/month… for a membership to come in and use your equipment.

Again, I’ve never seen this work, and by that I mean where the now discharged (I use the term, “graduated”) Mary comes back in 3 days/week, and continues to exercise on the PT clinic equipment, most likely unsupervised with a clipboard in hand.

If you take an honest business assessment of the cost of the equipment, the lease and utility overhead, and add in the one or two times Mary talks with the PTs and PTAs about how she’s doing…there’s NO WAY $40/month, which is only $3/visit, OR even the $180 would cover that.

I’ve heard the viewpoint that it helps the discharged patient stay connected, and more likely return in the future.

It’s a viewpoint… but one I’ve seen not work.

If you want the patient to stay connected, just offer them a FREE Check 2 to 6 months down the road.

Mary comes in for a 10 minute appointment where her PT takes basic objective measurements and compares them to her last visit…

They can discuss any difficulties Mary is having with her back OR maybe even a new problem, and she can be reactivated into PT.

But it only takes 10 minutes of the PTs time.

Small investment… big reward for the PT patient and the clinic.

How Would a Master Marketer… a Savvy Business Person… Look at the Situation?

If you brought Dan Kennedy into your Private PT Practice… here’s how he would look at it.

He would likely say “OK, Mary just bought a $990 Plan of Care (National Average of 11 visits at $90/visit).”

“So you’ve got a customer… now sell her something else.”


“But wait Dan!  I did my job… Mary’s better… she’s got her life back!”

And Dan might argue, “Well, then you may not be in business very long.”

(His book series is most appropriately titled, “No B.S.”)

See from the Master Marketer perspective (or “All-Star Practice Owner” if you’ve seen my 4 Levels of Private Practice PT Video)… they think a little bit differently than how we normally think as Private Practice PTs.

We normally think, “I need New Patients, so I can provide more service.”

Translated… the Master Marketer would say: “I need more customers to sell my services to.”

And the Master Marketer learned long ago this thought process is doomed to failure…

The Master Marketer knows the most successful physical therapy business models ever think:

“I want to make a sale to gain a customer…”

OR translated into PT speak:

“I want to provide PT to gain a lifelong client.”

“Hey, but wait, we’re not chir_________”…

Whoa, whoa… let’s keep this politically correct and professional, partner.

So What Can We Possibly Sell Mary?

We’ve surveyed our PT patients, and by far the overwhelming most requested service statement is, “Do you offer massage therapy?”

For years, we’ve almost proudly said, “NO.”

Foolish… shame on me.

So here’s what I did…

Last year I was in Dan Kennedy and Dave Dee’s Platinum Mastermind Group with the #1 Largest Most Recognized Spa Consultant in the world…

No joke.

Dori Soukup has been in the spa business a long time and has advised thousands of clients all over the world.

And just last week we were talking…

And she asked if I’d added spa services yet.

I sheepishly said, “No.”

And in 10 minutes, Dori dropped more spa business knowledge bombs on me then I could write.

And then she sprung a killer idea on me…

She said, “Why don’t I help you build an amazing spa to complement your Physical Therapy business model?  We’ll record the whole process (she already finished the outline for a 6 Module course)… and then you can offer that to other Private Practice PT Owners who are looking to add cash based services to help their PT business make money on the back end of PT.”

So that’s where we left it… and I want to hear from you.

If I build a spa that adds $200,000 in cash income to my Physical Therapy business… would you be interested in learning about that?

If so, then I’d like to hear from you…

Leave a comment below with 2 things:

  1. The one thing you would most want to learn about in setting up a back end massage or spa service.
  2. The most burning question you have about setting up a massage or spa service.

So Thats It?  Spa or Bust?

Absolutely not. There’s a ton of cash pay services and upsell services you can offer to accelerate your physical therapy business model growth…

From weight loss…

To fitness…

To cardio health…

To nutrition…(especially with the new PQRS requirements for BMI)…

Once you have your customer, or patient, and you’ve laid the groundwork for a lifelong relationship by building trust with them…

Continue to serve them and their needs.

Dan would.

Have a Killer Idea for Cash Pay or Upsell Services?

Leave a comment below about a successful service you are using in your PT practice…

Or if you want to mention one, in the hopes that I’ll offer my Private PT Practice as a guinea pig, go out and learn about it, and implement it and mention it below.

Chad Madden

breakthrough pt business courses

If you want to attract more PT patients to your practice, you can use this 6 Step Patient Experience Funnel:

  1. Lead Magnet
  2. TripWire
  3. Core Service
  4. Upsell and Cash Pay
  5. Repeat Patients
  6. Referrals

And so far, we’ve covered Lead Magnets and TripWire offers… (If you have not read those, you can click them to catch up).

Now we’re on to the Core Service.

If there’s one part of the above 6 steps that we Private Practice PT Owners know inside and out, it’s this: the Core Service.

This is where we’re providing our PT service, our IE’s or 97001, plus the manual therapy, exercises and other modalities to help our patients achieve their goals and complete their plan of care.

And frankly when most of us think about our Private PT Practice business, we envision it, or at least 99% of it consisting of the Core Service.

This is where we try to make all of our Profit…

It’s the way I thought for years…

And the only way I ever heard another PT talk about their business.

“It’s all about New Patients, New Patients, New Patients… If we have more referrals, then our business is bigger and better.”

Contrary to popular belief, this thought process is a colossal mistake.

There’s a lot more to Private Practice than getting referrals, POCs, and Discharges.

That limited tunnel vision can financially cripple a practice…or any business.

But before I rail on about my mistakes and limited vision, and how it nearly cost me my private practice… twice…

Let’s talk about the Core Service and how to make it better.

3 Keys to Creating a World-class, 5 Star, Disney-like Physical Therapy Patient Experience


Did you ever have an amazing experience in another health care professionals office (doctor, dentist, etc)?

Did you ever have a lousy experience?  (all of my lousy experiences seem to involve an Emergency Room)

Have you ever taken your children to an appointment?

Or a parent or other family member?

What was most important to you?  What stood out?  What made you say “Wow”…they’re good, I’m coming back here” OR “I’d never go back to that place again.”

What have you chosen to create in your Private Practice?

I’ve surveyed our patients repeatedly over the years, and we’ve focused in on what  “Mothers and Grandmothers” want and need in a PT practice, and have worked hard to deliver that.

And the following are 3 tools you can implement to make your PT service different from the “run of the mill” place down the street…

1. All Physical Therapists (including you if you’re still treating) can use a systematic approach to your initial evaluation (we call it an IE or 97001).


Why is a standard approach important?

Well, have you ever had a patient go through their IE, and first treatment, seemingly in agreement with all of the treatment and PT knowledge you just shared with them, and go out front to schedule, and they report they forgot their appointment book… never to be seen again?

Raise you hand if you’re guilty of having this happen to you…

Me too.

(If you didn’t raise your hand… there’s a name for your condition, it’s called, “DENIAL.”)

From studying Physical Therapists who have high drop-off (patients NOT completing their Plans of Care) and comparing them with PTs who have amazing patient compliance, super high attendance rates, higher than average frequency of return patients (patients who’ve been discharged and return for a plan of care for the same or different body part) and word-of-mouth referrals from other patients…

What would you guess is the biggest difference between the All-Star and the Discharge Machine?



Years of Experience?

None of those.

At least from what I’ve seen and studied, a PT with a standard script, who is disciplined at touching all bases, easily outperforms the PT who does not have a standard script.

I know… I know…

“But I treat the individual…”

“And provide a super high quality of care…”


If there are key points that you miss in your exam though, it can absolutely kill your practice (kill in a bad way).

So, in our Private Practice, at Madden PT, all of our PTs use something we call “The 7 Step Killer Exam”.  (Killer here is used in a good way).

(As an aside, we train all of our PTs to do this… in their sleep… so they don’t miss steps.  We then record them, to help them see what areas are smooth and what areas need work.  I recommend you do the same.)

And what’s the 7 Step Killer Exam?

I don’t have time for the entire 7 Steps here, but I can give you the MOST Important Step…

And it’s the step that is missed the most often.

By adding this in, you are guaranteed to dramatically improve your Graduation Rate (Patients completing their plan of care divided by total number of New Patients)…

And here it is:

  1. Ask this question, “Have you ever had Physical Therapy before?

If “No…”

Then ask, “What about Chiropractic, Massage therapy, personal training, seen an athletic trainer or DO?”  (This is super important as many people in the general public confuse Physical Therapy with other interventions…including P90X!)

If “Yes…”

Then ask, “OK, Tell me about that…What happened?”

Then just listen.

Many times, the people who drop off have had a past bad experience.

And if you leave it uncovered, they’re done the second they walk out to schedule.

If you uncover it, then just listen.

Acknowledge they had a bad experience through restatement…

“OK, so you went to XYZ Physical Therapy down the street for your back…3 years ago.  They gave you an exercise sheet and told you to come see the PT when you’re done with your exercises.  You did that for 4 weeks…only saw the main PT on the first day…and it didn’t help you at all.”

Acknowledge through restatement.

You don’t have to tell them you’re different…

You don’t have to talk bad about another clinician…

You just restate it.

That’s it… seriously.

(If you’re interested in learning and implementing the full 7 Step Killer Exam… send me an email to [email protected] with Subject line: 7 Step Killer Exam)

2. Give them a unique experience…

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“What’s your receipt?”

I highly recommend you buy and read Jeffrey Gitomer’s Little Platinum Book of Cha-ching.

In it, he shares the story of John Patterson, one of the premier sales trainers for National Cash Register (today know as NCR), in the late 1800’s.

There’s no way I could do the story justice in the limited space here, but basically, John Patterson first failed at selling his cash register directly to store owners…

Until he created the demand for a receipt amongst the general public.

Then the store owners came running to him to buy his NCR cash register.

He went from trying and failing to chase sales (being the hunter) to having his ideal customers demand to do business with him (being the hunted).

All by changing the game.

You can do the same.

A few years ago, I challenged our team to do the same.

We wanted to do something unique around the home exercise instructions we were handing out…

We used to hand out this ugly green sheet system with up to 9 exercises per sheet.

And that had to go.

What we ended up creating was an Exercise Card System.

Every patient who comes through gets an Exercise Card carabiner, complete with full color exercise cards and simple instructions.

The sheets were lost constantly, so the Exercise Card System is a keeper.

Women hang it on their purse… and tell others about it.

It’s our John Patterson “receipt”.

3. A System for Your Patient’s Graduation Day


Your patient kept their appointments…

They did their home exercises faithfully every day…

They’re pain is 100% relieved…

Their motion, strength and function goals are met…

And they made you a tray of brownies.

Awesome, right?

What would even make it more “awesome”?

If you could capture the appreciation they have for you and the high quality of care and service you provided.

And make a super good impression on the patient’s referral source (or family doc).

And attract more patients who were compliant, friendly, and respected you for the care you provided.

AND provide killer proof to the insurance company that your care was worthwhile.

How do you do that?

Well, create a system for your Discharge Day (we call it “Graduation Day”… and you’re welcome to do the same).

Here’s what our Graduation Day consists of:

  1. Normal full treatment
  2. Reassessment with full objective measures and discussion of comparison of Initial Evaluation numbers.
  3. Testimonial capture (we call this The Direct Access Marketing Testimonial Machine).
  4. A Graduation Day interview with Tammy, our Internal Marketing Representative.
  5. A goodie bag (we just had a Graduating Patient post this on FB… it’s free press!)
  6. A picture of the patient in their Madden PT T-shirt with the PT team who treated them.
  7. A hand-written note from the PT to the patient…

And it’s the same for everyone who comes through our doors.

Wrapping It Up

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So far, if you’ve been following my blog… we’ve discussed:

  1. Lead Magnets
  2. Trip Wires
  3. And now, the Core Service

Don’t be lulled to sleep thinking that there is no advantage to be gained here within your marketplace…

Put the work in.

Study what others are doing to create an amazing, 5-Star experience for their patients.

And model what they do in your clinic by implementing.

Your patients and banker will both be thankful you did.

Next up on our list is Step #4: Upsells and Cash Pay Services.

What is one thing you want to implement in your practice from this post? Let me know in the comments below.

PS. And if you have any questions on creating a world-class, 5 star, Disney-like patient experience in your private practice, leave a comment below as well. Happy to help.

And please be sure to check out some of our Direct Access Marketing Testimonials!