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  • 2016-09-September

Actively Seeking Social Proof

By Lynn Steffes, PT, DPT

Nielsen Ratings indicate that 63 percent of consumers value consumer opinions posted online! What does your practice currently do to ensure that you have an online consumer opinion presence?

According to LocalVOX, “How to Grow Your Business with YELP,” “Yelp makes customers more comfortable choosing small businesses over major brands.”1

4 Steps to Ensuring Your Social Proof

1. Check on the consumer opinion websites including Yelp, Google ratings, and Healthgrades for opinions posted on your practice and your top three competitors.

  • Do you have opinions posted?
    • Are they positive? Negative? Neutral?
  • Do your competitors have opinions posted?
    • Are they positive? Negative? Neutral?

2. Check your own website as well: Are you harvesting your customer testimonials and applying them to your website and social media platforms (e.g., Facebook, Twitter, LinkedIn)? Testimonials utilized on your website, especially genuine videos, or written statements with photos, can boost consumer confidence in your ratings. Having these integrated on your landing page and the page highlighting your staff can be especially powerful.

3. Build a presence on the ratings platforms:

  • Develop a simple in-clinic poster asking patients to “Like us on Yelp, Google Ratings, or Healthgrades.” Hand out simple postcards at the midpoint or end of care asking people to rate you or better yet send an email with a link to these websites to make posting easier! If your customers have never posted before, perhaps suggest that they rate a few of their favorite businesses. Single Yelp postings may be sorted out and blocked.
  • Ask family and friends who have used your services to post. Spread out those requests over time.
  • Include a Yelp link with your email signature asking for feedback. Add a link on your website to “Like us on Yelp!”
  • Avoid scripting posts and using clinical jargon; sincere consumer-friendly language is the most convincing.

4. Monitor your practice on these sites: Harris Polls reports that a combination of positive postings and an occasional negative review actually makes your ratings more believable than all-stellar ratings! Best practices in Yelp suggests the following strategies:

  • If a positive review is posted: Promptly thank your customer!
  • If a negative review is posted: Try to respond quickly and kindly without being defensive. Address the problem with a proactive response. Lead with an apology and try to respond empathetically. Be brief. If you find a back-and-forth response, suggest that you communicate offline directly to resolve the issue.
  • If an extremely negative post goes up, you may want to review and try to remove it.


    1. http://localvox.com/blog/how-to-use-yelp-marketing-to-promote-your-business-slideshare/. Accessed August 2016.

    Steffes-Lynn-2016 Lynn Steffes, PT, DPT, is president and consultant of Steffes & Associates, a national rehabilitation consulting group focused on marketing and program development for private practices nationwide. She is an instructor in five physical therapy programs and has actively presented, consulted, and taught in 40 states. She can be reached at steffbiz@gmail.com.

Success Is Never Perfect

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

When I was a high school and college football player, I created elaborate plans for improved strength, speed, power, and ultimately improved sport performance. I worked hard implementing those plans by training almost every day. The actual workouts were never perfect, and the results were not always exactly as planned and graphed—but that was reality. The end result was a senior year in college where our team (the 1985 Gettysburg Bullets) and I displayed performance beyond our wildest dreams!

Plans and Reality

This reality also relates to business. In our experience, change in an organization does not always go as specifically outlined in a sterile plan as there are external factors out of our control that will impact execution. Success comes from the ability to know that you will get “off course” but can quickly redesign to get back “on course.”

Seek Success

Advice and strategy are lofty while action and execution are gritty. Seek success, not perfection. Accept that virtually nothing will be exactly as intended, but it will be better than before. Make midcourse corrections. Don’t be afraid to get your uniform dirty. No one ever won a football game with the crispest, cleanest, or brightest uniform.

Even in Adversity

We have worked with companies that have shown the discipline to work toward goals and work through adversity, and while they may be muddied, they showed million dollar–plus changes in their value. You’re next. Create a plan and follow your dreams.

paul_martin 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.

Connie Ziccarelli, COO and principal

Connie Ziccarelli owns Rehab Management Solutions located in Mt. Pleasant, Wisconsin, and has been in business since 1995. The business provides practice management solutions and has outpatient physical therapy clinic locations in several states with over 100 employees.

What movie has inspired you professionally/where is your most memorable vacation spot?

I have a real passion for movies, especially those with historical content and how those events shaped where our country is today. But I have a real soft spot for Legally Blonde. My daughter was in her formative years when that movie became popular, and it really spoke to me about the internal fortitude to achieve what you want to achieve, even if there are naysayers all around you. To me it is a true championship-spirit movie.

I have been fortunate to be able to travel quite extensively both professionally and personally. I enjoy learning about all cultures and customs (even just the differences in the regions of the United States). I want to return to the South of France—Monaco and Nice. Not only is it a beautiful area, but also the people were incredibly hospitable and proud to share their communities and gifts.

What do you like most/least about your job/what is the most important lesson you have learned?

I have been fortunate to work with physical therapists who are absolutely ardent about their profession and the patients they serve. The first time I walked into the physical therapy clinic I met two dynamic physical therapists who are experts in their field and passionate about entrepreneurial outpatient clinics. I knew that my business background would bring to life the philosophy that excellent business practices should parallel excellent medicine. The financial foundation I build with patients often lasts longer than the plan of care for therapy. Taking away the financial worry can help therapy treatments work more successfully for the patient, creating a customer for life. This marriage of practice management and clinical management led me on a journey that has exceeded anything I could have imagined. Serving on various committees with the American Physical Therapy Association (APTA) and Private Practice Section (PPS) and becoming the chair of the Administrators Council speaks volumes about the recognition and value of what I live each and every day.

One of the most important lessons I have learned through the years is to stay in front of any problem. Identify it, acknowledge it, discuss it, and find solutions to remedy it. If a problem grows legs, it can be a silent killer of morale and ultimately affect the bottom line of the business. Patients come to our clinics to return to a higher level of function and performance. My practice management team strives to take away the stress during their plan of care as it relates to financial worries; if we remember that each and every day we are all here to serve our patients, we will grow as individuals and as a company.

How would you describe your management style/how do you measure success?

My management style tends to be nurturing yet empowering. Keeping up with the latest trends and technology is key in our ever-evolving discipline of physical therapy. I take advantage of continuing education where my entire team can sit alongside me, ask questions, and learn. I feel this is the best way to demonstrate leading by example. In this way, I am fostering a sense of “worthwhileness” and a natural progression of pride in their work. I see success every day as I witness the extra mile my team members are willing to go for patients and the ownership they take of their positions. Transparency and information sharing has also led to a stronger sense of team. When my team is happy . . . I see success!

What have been your best learning experiences throughout your professional journey?

Two examples readily come to mind. One was the creation, early on, of a dedicated, aggressive approach to managed care and credentialing. I placed a lot of emphasis on building relationships with payer representatives including traveling for face-to-face meetings. Growing and maintaining healthy and strong relations has paid off in big dividends as we explain physical therapy to the payer community. Another learning experience that helped me reach way beyond my comfort zone was in 1995, when I became an active member of the APTA/PPS. Membership led me to various positions including member of the Payer Relations Committee, secretary, vice chair, and two terms on the PPS Annual Conference Program Committee. I am honored to currently be serving another three-year term as chairperson of the Administrators Council.

What are you optimistic about for the future of private practice?

PPS is an amazing ready-resource and network of support for like-minded PTs to benefit from the “been there, done that” experiences. I am optimistic in regard to the strengthening of the involvement, especially through PPS, in the legislative arena. No one knows our issues better than we do. It is incumbent on us to make our elected officials aware and educated on our issues and the impact that their decisions inflict on their constituents/our patients. Vigilance is a key word as our marketplace gets tighter and mergers could make us as outdated as the floppy disc. I am also optimistic about our future as we become a nation desiring a fit lifestyle and more sophistication with aging and maintaining performance and movement. More emphasis is being placed on wellness, and we have always been the champions of living well! We continue to be a nation that will always have room for the entrepreneurial spirit.

What are your goals for the next year?

We are looking at ways to meet needs in our communities in the areas of after-school sports/athletic performance, providing services as industrial rehab specialists, developing and implementing postdischarge wellness programs and truly listening to our patients to learn what other voids are out there for us to fill. Combining these cash-based programs with maintaining strong third-party payer relations should set us up for continued success. And of course we will maintain our goal in three areas: to look for low-cost, revenue-producing opportunities, to service our communities better than ever, and to have a little fun along the way!

What is your life motto?

I always tell my team to listen with an intelligence of heart and mind. Also . . . Shoot for the moon! At the very least, you’ll land on a star!

The Value of Feedback


Centers for Medicare & Medicaid Services seeks to implement merit-based incentive payment system.

By Alpha Lillstrom Cheng, JD, MA
September 9, 2016

The Private Practice Section’s (PPS) federal policy efforts focus on advocating for and supporting the passage of bills that impact private practice physical therapy. However, the passage of legislation is not the end of the road for policy development. After a bill is signed into law by the President, the intent and direction of the law needs to be determined and implemented by an agency in the executive branch. The Department of Health and Human Services (HHS) and its Centers for Medicare & Medicaid Services (CMS) are tasked with drafting, proposing, and finalizing regulations that put meat on the bones of health care laws. Through a process known as “notice of proposed rulemaking” (NPRM), CMS releases draft regulations to the public and requests feedback and comments from stakeholders. Based on the summary, analysis, and draft comments developed by your lobbying team, PPS routinely weighs in on these proposals on behalf of the membership.

Scheduling the Next Visit


Ensure your patients follow through with treatment with one simple task.

By Brian J. Gallagher, PT

Just about two years ago, I realized that the basic metrics being used when benchmarking a performance in a physical therapy outpatient setting were drastically changing. Prior to that an outpatient orthopedic physical therapy practice would be able to sustain its weekly visits so long as 10 percent of those weekly visits were new patient visits. However, because of the changes in our health care system we must now have 12 percent to 15 percent of our weekly visits as new patient visits. In addition to that, there is an increased financial responsibility being placed on our patients through higher copays and deductibles, thus resulting in fewer visits per week causing the potential for greater noncompliance with their prescribed plan of care. Compounding that with flat or decreasing reimbursement per visit, today’s practice owners must be innovative in their approach to their administrative operations. Because, let’s face it, there is only so much one can do on the clinical side of the practice to reduce operating expenses and increase efficiency without negatively affecting your patient care experience.


So, when owners are looking to increase patient visits, they must look at their clinical delivery system. Simply put, if your physical therapists are not 85 percent efficient according to their schedule, maximizing their productivity per visit, and getting raving feedback in writing from both their patient and your referral sources, then you have found a good place to start. Assuming that you have successfully implemented a management-by-statistics system of measuring your staff’s productivity so that you know each week which of your clinicians are hitting these targets, then you can turn your attention toward the administrative operating systems.

A solution that works in virtually every office where it has been implemented is one that ties together the administrative staff and the clinical staff so that a cooperative effort is being launched to maximize clinical efficiency and patient care compliance with almost no additional cost to the practice. How many times have we seen a patient be prescribed three times a week or two times a week by their therapist only to result in the patient at the front desk negotiating a one time a week schedule instead? They will cite either time or money or scheduling as their justification for not wanting to follow through with what the therapist had just instructed them to do for their physical therapy scheduling. The solution is for the therapist to write out a “physical therapy frequency order slip” and hand it to the patient at the end of their evaluation for them to take up to the front desk for scheduling. This action is no different than when a doctor writes an order for the patient to follow. scheduling-the-next-visit-03When the physical therapist writes an order and gives it to the patient, it increases the significance of that recommendation purely because it’s in writing and results in greater patient follow-through and compliance. This allows the patient, the front desk staff, and the therapist to be on the same page and adhere to what is the best recommended plan of care for the patient. And, if the front desk schedules out the entire plan of care at that time, patient compliance also increases.

What does your front desk actually say when scheduling the patient out following their evaluation? This is another area that can improve carryover of the plan of care. They should never ask the patient when would they like to come in but rather say, “So what days and times don’t work for you?” With this method you will save time when scheduling and get greater patient compliance with their schedule. Try it. You’ll be surprised how such a small simple change can have such a large effect.


Brian J. Gallagher, PT, is the chief executive officer of MEG Business Management, LLC, in Severna Park, Maryland. With more than 24 years’ experience in the field of rehabilitation and 19 years in business, he specializes in physical therapy practice management and executive coaching nationwide. He can be reached at brian@megbusiness.com.

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