Defining Private Practice Physical Therapy

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By Michelle Collie, PT, DPT, MS, OCS

Over the course of my career, I have had numerous discussions about how to define and message what private practice physical therapy is. Why is it that physicians, nurses, and dentists can easily define what they do, while physical therapists often offer a long-winded and simultaneously vague explanation? How can we expect the public to understand the value of our services—and our role in health care—if we continue to have difficulty defining it?

With this in mind, I am delighted to share the happenings of the Private Practice Section (PPS) Marketing and Public Relations Committee. The committee’s objective is to provide marketing and public relations educational programming and tools for individual members to implement within their communities and with their local media. The committee wants to encourage a grassroots effort where members have the tools and the confidence to comfortably promote their practices and ultimately improve the public’s understanding of what we offer.

This year, a number of this committee’s initiatives have come to fruition. After two years of work, “The Fit Factor” has been launched. This interactive, online survey will increase consumers’ awareness of the scope of private practice physical therapy, drive people to local private practices, and provide a fun opportunity for people to benchmark where their physical health is compared to the rest of the population. Webinars will educate members about how this tool can be used in their promotional campaigns. And this is only the beginning; the Fit Factor website and collateral materials, including educational videos and newsletters, will continue to evolve.

Simultaneously (and in answer to numerous member requests), marketing gurus Lynn Steffes and Scott Wick are producing a wonderful series of videos covering things you need to know when planning your marketing, such as budgeting. They will cover areas such as internal, referral source, consumer, community, and outreach marketing. This series will ensure all members have a basic understanding of marketing and public relations and will improve results when utilizing the tools our committee develops.

This year, we are also excited to offer our membership professionally written monthly press releases. Previously, these press releases were available only to our media corps, a group of 100 practice owners around the country involved with our committee’s public relations campaign.

Finally, we want to hear about your success stories. How did you gain new patients from the Fit Factor? Was your press release picked up? Which of our new marketing strategies resulted in success? Sharing your stories will help other members and strengthen our profession in these changing times.

I am grateful for the leadership of the outgoing chair Don Levine who has developed a committee of dedicated, knowledgeable, and experienced members. I would like to thank Scott Wick, Erica Meloe, and Jessica McKinney for continuing to serve on the committee, and I want to welcome our new members Darren Rodia and Jessica Burchett. We look forward to working together to effectively promote private practice physical therapy—and to help us all speak to our integral role in the health care landscape. 

Therapists Ownership Strategies

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By Paul Martin, PT, MPT, CBI, M&AMI

As we analyze the best therapy businesses in the country, we are seeing more and more staff therapists becoming “owners” within the companies in which they work. This is a great strategy to retain your most valuable asset—your clinical staff. The challenge is to make sure that you structure these relationships in order to align your interests with your therapist partners, and to protect the parent company from potential legal issues in the future.

The most common form of partnership, if your state laws allow it, is to create a separate Limited Liability Corporation (LLC) in which the parent company becomes the majority owner, and the staff therapist becomes a minority owner. Be sure that ownership is purchased and never given away, and that the resources that are being provided by the parent company are properly valued and paid for by the newly formed company. These partnerships become a great way to build value in your company and create a strong foundation for future growth. 

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Paul Martin, PT, MPT, CBI, M&AMI, president of Martin Healthcare Advisors, is a nationally recognized expert on health care business development and succession planning. As a consultant, mentor, and speaker, Paul assists business owners with building value in their companies. He has authored The Ultimate Success Guide, numerous industry articles, and weekly Friday Morning Moments. He can be reached at pmartin@martinhealthcareadvisors.com.

Tim Pedersen, PT

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Tim Pedersen, PT, is the owner of Synergy Physical Therapy in Fairhaven, Massachusetts. He can be reached at Tpedersen6@comcast.net.

Locations: Fairhaven, Massachusetts. 10 employees. Synergy Physical Therapy has been open for 5 years. Tim Pedersen has been practicing physical therapy for 25 years this year.

What or who is the most influential book/person/event that enhanced your professional career? There have been so many wonderful people throughout the years who have influenced, taught, encouraged, and guided me. I do not know if I have said this publicly before but Diane Cordeiro was one of my first supervisors and has been a friend and wonderful mentor for most of my professional career. She provides a benchmark that I aspire to emulate. Clifton Greenwood showed me what it means to truly care for the people that work for you.

What is the flow of your average day? I get in at 7 a.m. and open the office and take care of reviewing the clinic schedule, complete any paperwork, and usually begin treating at 8 a.m. I take some time each afternoon just before lunch to follow up on emails and other business matters. I enjoy treating patients so I do a lot of treatment hours each week. After five years I am starting to carve some time to work out more regularly in the evenings and prioritize my time a bit more.

How would you describe your essential business philosophy? My philosophy is to provide the best personal service to our clients. They should never feel like they could be doing their clinical program without us. A patient needs to feel that their time is well spent, that they are not just one body among many, and that we care about them. Even an unsuccessful course of therapy is a win for us if they feel that we listened to them, educated them, and did as much for them as we could.

What have been your best/worst/toughest decisions? The tough decisions are when to hire additional staff and when to fire staff. Show compassion in every daily interaction and things generally run smoothly, but you have to know when to cut the cord or be disciplinary and that is not always easy. I think the toughest thing to do is to manage the balance between my clinical time, administrative time, and personal time.

How do you motivate your employees? I motivate my employees by seeking their advice and opinions on what directions we should take, what equipment they want, and what training and education is important to them. I also motivate them by showing them that I value their time and their opinion in what we do. Our staff is very important to me and I want them to feel like a family team so that they are each vested in each other’s success as well as the clinic’s success.

How did you get your start in private practice? I had always wanted my own practice. I had been a manager for many years, then started and grew an outpatient practice for another organization. While I loved them, it was not mine and was never going to be. A clinic closed in my town and I saw it as an opportunity. After a lot of planning, projecting, and discussion with my wife, I decided to move ahead. She was teaching Zumba so we saw it as an opportunity to provide additional exposure for the new clinic. We wrote a lot of clinic names on scraps of paper and napkins but ultimately fell in love with Synergy, which is defined in the Merriam-Webster Dictionary as “the cooperative effort of two entities to achieve a more successful or productive result”—the patient and the therapist, the therapy and the fitness work together to achieve better health. It seemed to fit.

How do you stay ahead of the competition? We are constantly learning and striving to provide the most individual therapy programs. We do a lot of learning. We place the emphasis on our patients and we make sure that our communication to the physicians is short, clear, and concise to show that we value their time.

What have been your best learning experiences (mistakes) since the inception of your practice? Every day is a learning experience. I have been involved in running a clinic for many years but still learn new things about contracting, billing, and running the practice all of the time. I think that Rick Gawenda’s seminar on outpatient therapy Current Procedural Terminology (CPT) Coding, Billing, and Documentation was a great resource for keeping us set up for compliance.

What are the benefits of Private Practice Section (PPS) membership to your practice? I love getting each issue of Impact, which keeps me up to date on changes within the profession, insurance issues, and management. It gives me some focus on running my practice. PPS membership provides me with networking opportunities that help me run and grow my practice.

What is your life motto? Love, learn, enjoy your family, and never ever be afraid of hard work.

What worries you about the future of private practice physical therapy/what are you optimistic about? I am very optimistic about the future of Direct Access and the autonomy of the physical therapy practice.

What are some new opportunities you plan to pursue in the next year? We are evaluating electronic health records/electronic medical records (EHR/EMRs) and are hoping to increase our involvement in the community.

Automate!

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Using automation increases efficiency, referrals, and profits.

By Steve Young, PT, DPT

Fourteen years ago and out of school only 16 months, I said “yes” to taking ownership of a struggling physical therapy clinic. My sense of excitement was only slightly overshadowed by a sense of burden: The clinic was losing $7,000 a month. I had before me the challenge and the opportunity to turn things around and to build the practice of my dreams.

My experience as a practice owner is that the growth of a physical therapy practice occurs in phases. The first phase is limitless optimism and lots of learning, next comes nailing down the structure and management phase, and finally the systematizing and automating phase. The automation phase of practice growth can be one of the most important and beneficial to your practice.

So what are the benefits of automation?

When you automate, you put systems in place that will generate beneficial output with minimal manual input. In other words, automation can produce benefit to your practice by utilizing minimal staff time or effort. Automation systems can help grow your profits, allow for you and your staff to use time more efficiently and productively, and help build the value of your practice while increasing the quality of your service.

So what can you automate?

You can automate many of the activities in your practice that are repeated exactly the same way more than a few times a month. Examples would be inventory management, generating new patients online, charging copays, sending correspondence to patients, prompting patients to write online reviews, education, and prompts to decrease patient cancellation rates.

What do you need to automate certain systems in your practice?

Depending on what you want to automate, the resources can vary. In most cases you may want software that has autoresponder capabilities, credit card process capabilities, your electronic medical record (EMR) system, and a mind mapping software or a whiteboard to map out clinic processes.

Let us explore several useful ways to use automation that when implemented could have an impact on your practice profits and efficient use of staff time.

I have estimated that it takes a receptionist working in an average practice two minutes to take and process a patient copay. That includes taking the payment, possibly making change, writing the receipt, and getting a signature on a credit card slip. So, how can we save two minutes on every visit?

By using a Customer Relationship Management (CRM) system that includes a credit processing system. Several examples include, but are not limited to, Infusionsoft, Salesforce, Pipedrive, Insightly, Base, and ConnectWise PSA.

When your patient first registers for their initial evaluation, you can ask them for payment by using their credit card. With a simple script focusing on the benefits to them by using their credit card (saves time, less paperwork, easier to track), you can obtain card information. This information can then be entered into a credit processing system. From there, many CRM systems can be set up to autocharge with a simple “push of a button” for specific events like cancellations, visit arrivals, or equipment sales made during their treatment visits. Now, two minutes can be cut down to only a few seconds.

You can do so much more…

From day one, our patients are entered into our CRM system. They now can be sent a sequence of emails telling them more about our practice, our staff, our management, our practice specialties, and our practice culture and vision. This email sequence is designed to build a connection between our patients and our practice. It is used to educate them regarding cancellation policies, to encourage them to complete home exercise programs, and to encourage them to refer friends and family to our practice. We use a sequence of seven emails to help improve visit compliance (more profits and better treatment outcomes), to improve compliance in performing their home exercises (better outcomes), and to increase friend and family referrals.

Here is an example of a sequence of emails we have successfully used:

Day 1, email no. 1: Share your practice vision and office culture.

Day 2, email no. 2: Give a health tip and offer that you are never too busy to help their friends and family as well as them.

Day 5, email no. 3: Educate on the healing process while emphasizing the importance of consistent home exercise.

Day 9, email no. 4: Give health tip.

Day 14, email no. 5: Get feedback from them via a patient satisfaction survey (example: Net Promoter Score).

Day 20, email no. 6: Give a health tip and an additional reminder that you are never too busy to help friends and family.

Day 30, email no. 7: Ask the patient to write a review on your Google page.

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Now that you know how you can save time and connect regularly with present patients, how can you generate new patients using the same autoresponder concept?

Using your web page, you can insert an opt-in form for visitors to enter their email address. There are ways to prompt a prospective patient to do this. For example, in exchange for their email address, you can share with them a health care–related video, more information about your practice, or a printed report or article related to the benefits of physical rehabilitation. The articles or video could be specific to your practice specialties. Many potential patients will find that information obtained via a special video or article will solidify their decision to make an appointment with your practice. Others may still hesitate. For those that hesitate, you now have their email address and can send them additional information and even ask them to contact you by phone if they would like to discuss possible options for physical therapy treatment. This automated system can generate patients consistently without effort once it is built.

Begin automation one step at a time and work with what you are comfortable with. It may take some time and effort to research the CRM and autoresponder system you wish to use, but once implemented, it can save you time and money and will help build your practice. Automation and autoresponder systems can also help you to better establish and maintain relationships with present patients as well as attract new patients to your practice far better than many other marketing mediums such as television, radio, or print ads.

Automation is the present and the future. It will be important to every private physical therapy practice to continue to explore all of the ways automation can keep our practices alive and well—and also save us precious time.

Steve Young, PT, DPT, is chief happiness officer at Body Solutions in Voorhees, New Jersey. He can be reached at steve@bodysolutionsinc.com.

Overcoming Marketing Obstacles

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A cash-based practice perspective.

By Susan C. Clinton, PT, DSc, OCS, WCS, FAAOMPT

In 2014, with great enthusiasm, my partner and I opened the doors of our cash-based physical therapy practice—thus fulfilling a dream several years in the making! We soon discovered that our many years of treating patients did not prepare us for managing all aspects of a physical therapy business. In particular, we centered our practice in a region that is dominated by large payer consortiums that employ many of the region’s physicians. Though we had solid reputations with a number of physicians in our area, their health care consortiums severely limited their ability to consistently refer to outside physical therapy practices. Consequently, we quickly learned that a common practice—marketing to physicians—would not provide the expected revenue stream. Instead, a direct-to-consumer marketing strategy was needed and needed fast!

Marketing directly to customers demanded that we consider the following three parameters:

  1. clearly define the customer;
  2. answer the question, “Why should the consumer come to our clinic specifically and pay cash at our practice?”; and
  3. determine how to effectively reach that target market.

As a cash-based practice with a niche specialty in pelvic health, pregnancy, and chronic pain, our primary target customer was easily defined. The second parameter proved more challenging. To paraphrase Peter Drucker, “Consumers do not buy what you sell. They buy what has value to them.”1 Given our out-of-network status, we first had to educate the customer about our practice model to ensure that it provides value. For many of our prospective patients, it is absolutely critical that we overcome this issue first. If they do not understand the financial considerations, most will simply not consider utilizing our skilled and focused treatment programs.

As a result, we developed marketing materials that address this question head-on and advise potential clients on how to obtain insurance reimbursement and to consider the cost of copays to in-network providers versus our treatment plans. We can then focus on our approach to physical therapy and the value we believe in: a singular experience for the client by directing the sessions around his or her goals in a one-to-one environment.

As for the third parameter—effectively reaching our target market—we are still learning. The shift from a physician-focused to a customer-focused marketing strategy means we must directly reach the customer. Our multifaceted approach involves writing blogs and e-books, providing community movement classes, and offering wellness experiences. We also use Facebook to post educational information for the pregnant, postpartum, and chronic pain consumers as well as to post community education in pilates and yoga studios.

Other successful cash-based practices are using their own unique approaches. For example: Marianne Ryan, PT, of MRPTNY2 in New York City, has remarked that she had to change her practice model because many of her referral sources changed with physician- and hospital-owned practices emerging in her area. She changed her practice to focus on pelvic health and pregnancy and began a unique campaign by writing a successful book aimed directly at the consumer, The Baby Bod.3 The book is a great method to educate her clients/patients in an effective manner and bring national acclaim to her practice, which sets her apart from her competition.

Sandy Hilton, PT, and Sarah Haag, PT, of Entropy Physiotherapy & Wellness, LLC, in Chicago, are using community involvement and a strong social media campaign to help bring their message directly to their consumer group.4 Both of these physical therapists and their company have a strong presence on Twitter and Facebook and are successful in networking with the consumer on messages about chronic pain, pelvic health, and accessing physical therapy. In addition, they have found that working within their community Chamber of Commerce group and the Women’s Health Foundation has helped with their local position. Creativity also has set them apart from their competition: Sarah offers community yoga classes, and Sandy spreads the work about pelvic health in stand-up comedy and storytelling communities in Chicago.

Blair Green, PT, of One on One Physical Therapy5 in Atlanta, uses the success of the patients’ experience to emphasize how the practice is different. Having a physical therapist who listens, empathizes, and takes them through a full program is their standard of care. She reports, “Our patients are our best marketing tool. The most common comment is, ‘I wish I knew about you sooner.’”

In today’s changing health care environment, it is crucial that cash-based physical therapy practices clearly define their target market. Once defined, then it is imperative that the practice’s value proposition be clearly communicated directly to the consumer.

References

1. Drucker PF. 22 Quotes on Management. www.slideshare.net/bright9977/22-quotes-on-management-by-peter-f-drucker. Published July 16, 2011. Accessed December 28, 2015.

2. Marianne Ryan Physical Therapy. www.mrptny.com. Accessed December 28, 2015.

3. Ryan, M. Baby Bod: Turn Flab to Fab in 12 Weeks Flat! Baby Bod Press; 2015.

4. Entropy Physiotherapy and Wellness. www.entropy-physio.com. Published 2013. Accessed December 28, 2015.

5. One on One Physical Therapy. Gyrotonic Sales Corp. www.onetherapy.com. Published 2015. Accessed December 28, 2015.

Susan C. Clinton, PT, DSc, OCS, WCS, FAAOMPT, is a PPS member and co-owner of Embody Physiotherapy & Wellness, LLC in Sewickley, Pennsylvania. She can be reached at susan@embody-pt.com.

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