#1 Biggest Business Mistake in Private Practice Physical Therapy

The #1 Single Biggest Business Mistake in Private Practice PT

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

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