The Most Important Question To Ask In An Initial Physical Therapy Exam

The Single Most Important Question To Ask In An Initial Physical Therapy Exam

If I could show you a simple question to ask during the Initial Exam, that would improve your Physical Therapy Patient Graduation Rate by 10%, would you be interested? 

This is Part 4 of 4 in the blog series on Workshops

Specifically “How to Host Direct Access Physical Therapy Workshops” if you missed it.

So far we’ve talked about solving the first big problems.

Which is how to fill the room.


Then, after you have a room filled with skeptical onlookers and hopefully affluent back pain and sciatica sufferers, converting them to an appointment. Again if you can read the first post here, “How I got 21 Patients from a One Hour PT Workshop”  on the second post – “How to Convert the Most Skeptical Audience Member into Motivated Paying PT Patients” here.

So now that we’ve accomplished that.

How do we make sure we convert that IE, Initial Exam, 97001 to a full Plan of Care?

Where the person comes to all of their visits,

On time

And does their home exercises

And achieves their goals?

What We Ignore Is Killing Us

If you would’ve asked me 10 or 12 years ago, when I first started in Private Practice, ‘’How many of your patients graduate and complete their plan of care?’’

And I would have answered, “Almost 100%.”

And like most other Practice Owners I’ve talked with.

We’re both in SEVERE Denial!


The truth is most of us guesstimate this number.

And we tend to give ourselves more credit.

But, if you’re super brave and willing to get a dose of reality (that quickly will pay HUGE dividends),

Then here’s what you can do.

Calculate Your Graduation Rate

  1. Pick a month at least 3 months ago.
  2. Make a list of every single patient you or your PTs performed an IE, or 97001 on.
  3. Then right the number of visits each was seen.
  4. After that, go through the actual notes or EMR and notate why that person stopped coming to PT.
  5. If they met all of their goals, indicate “Graduated”.
  6. If they stopped for any other reason, including financial, illness, travel, forgot appointment book, etc., mark “Incomplete”.
  7. Now take the total number of “Graduated patients” and divide by the total number of IEs.

Less than 40%?

We call that a “Discharge Machine”.

More than 80%?


So after studying this for years,

AND having lived as a recovering “Discharge Machine”,

AND from the in-the-trenches experience of having “Discharge Machines” AND All-Stars work in my Private Practice,

I can give you a 7 Step Exam that will drastically improve the rate at which your patients graduate.

But here’s the problem…

I only share the entire 7 Step Killer Exam in my Killer Marketing class.

And we prescreen those Owners ahead of time.

And your simply reading my blog so you could be anybody.

So I can’t give you all 7 Steps here but I can give you the best, most important step.

Alright, enough of that.

So here’s what I’ve got for you.

The Single Best Question You Can Ask Your PT Patients During the IE Which Will Improve Your Graduation Rate at Least 10%

(There’s a good chance you’re not going to believe me when you first read this but it’s very true)

Here’s the Question…

“Have you ever had Physical Therapy before?”

Now, the patient can say two things:

“Yes”or “No.”

Now, they may perceive other conservative care experiences as “Physical Therapy” including:

  • Chiropractic
  • Personal Training
  • Athletic Trainers
  • Massage PTs
  • A manipulation from their family D.O.
  • Inversion tables
  • And even online exercises
  • Or my favorite, P90X

So, if the person says “Yes”, here’s the all important Second Step

You say, “Ok, tell me about it.”

Now the Killer to our profession isn’t the person who had PT on their knee in high school and did amazing.

It’s the person who had a BAD Experience.

And it will kill your Plan of Care before it starts if you don’t uncover it.

You’ll become one more “I tried that and it didn’t work.”

So after the patient tells you that she went down the street and the last guy “cracked her back” and she couldn’t walk for 3 days,

You don’t have to disparage or make less of that clinician.

You don’t have to make the patient wrong for doing that treatment.

(In fact, if you do this: just shake the patient’s hand and let them know it was nice to meet them and you doubt you’ll see them again because you probably won’t.)

What you do, is simply listen, acknowledge and restate.

“OK, so 3 years ago, you had back pain.  You went to the chiropractor down the street, they cracked your back.  You couldn’t walk for 3 days and you were very upset.”

That’s it…

No knock on the chiropractor (you don’t know their version).

Just acknowledge and restate.

Don’t tell them you’re different.

Just show them.

Show them what you can do and aim for a meaningful improvement on Day 1 – today.

So that’s it.

For Your PT Workshop, Your Action Plan Is To…

  1. Fill the seats
  2. Convert your attendees to an IE either a Free Screen or a paid Initial Exam
  3. Then convert the IEs to a full plan of care.

Pretty simple, isn’t it?

Leave me a comment below and let me know how you’re using Physical Therapy Workshops in Your Private Practice.

Hope this helps you,


PS- Looking for the full 7 Step Direct Access Exam?

Join This Free PT Online Training If You Want To Discover The 7 “Brain Dead” Simple Steps to Preventing No-shows, Drop-Offs and MIAs While Improving Outcomes and Profit

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