Customer Service


No mystery for your practice!

By Lynn Steffes, PT, DPT

When was the last time you called into a retail store or doctor’s office and received such a warm greeting and such compelling information that you really were convinced that you wanted to do business with them? If you are like many of us, it is a rare occurrence. Would you like every patient who calls your practice to become an immediate and loyal customer? Creating and maintaining a high level of customer service is increasingly important in the face of relentless competition and a difficult economic environment in health care. Improving the patient experience is also a key component to the triple aim of health care.

Monitoring and Improving the Patient Experience: The challenge for physical therapy private practice owners is that you spend the majority of your workday separated from the front desk operations. You are busy treating patients or handling myriad administrative functions. These tasks prevent you from hearing everything else that is happening in your practice. You may never know how often people call into your practice and never become a patient.

Patient Satisfaction Surveys: One accepted method for evaluating the total patient experience is to utilize patient satisfaction surveys. Some practices use them only at the final visit. Others survey after the first and middle visits to ensure that their patient care can be adjusted during an episode as needed. While surveys are key indicators of a practice experience, they do not target the specific goals and vision of the practice culture.

Mystery Shopping: Another very beneficial method of gathering patient experience information is to incorporate a mystery shopping program into your standard operating procedures. Hotels, restaurants, and retail businesses use mystery shoppers because of the high level of competition. Mystery shopping has not seemed as important in medicine until recently.

According to Measure Customer Perspectives: “When it comes to gaining a competitive edge, more and more health care professionals are using mystery shoppers to better understand their patients’ experience.”1

Even the American Medical Association (AMA) has come out in support of this practice: “Physicians have an ethical responsibility to engage in activities that contribute to continual improvements in patient care. One method for promoting such quality improvement is through the use of secret shopper ‘patients’ who have been appropriately trained to provide feedback about physician performance in the clinical setting.2

Private Practices Need to Invest in the Initial Customer Contact Experience

Having spent more than 25 years focusing on growing private practices through marketing and customer service, I am amazed at how little attention is given to that first phone contact. In the past 20 years, I have mystery shopped nearly 100 practices across the U.S. and been generally underwhelmed at what my initial call has been like.

Most practices do not understand that that first phone call initiates the customer interaction. In fact, I would like to suggest that all the marketing you do can be undone in a poor 5-minute inquiry call.

To ensure that your initial customer experience is outstanding, look at creating or accessing a mystery shop program for your practice. Start with phone shopping and then progress to some in-person shoppers as well.


1. Accessed December 2014.

2. American Medical Association (AMA) CEJA Report 3-I-08 Supports use of Secret Shopper Patients. Accessed December 2015.


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

Educate and Motivate


The other side of customer service.

By Jeff Moore, PT, DPT, OCS, MTC, Cert. SMT, FAAOMPT

Top-quality customer service is an important aspect of any business striving to be successful—this is not breaking news. When my brother and I sit and reflect on what single aspect of the clinic that we run is most responsible for our year in and year out growth, we easily agree that it is our commitment to customer service. This is coming from a guy who is board certified and fellowship trained and who would really like to think his exceptional manual therapy skills and clinical reasoning set us apart. But they do not, not much anyhow. It is how we take care of people that makes us different. At our shop we are borderline fanatical about customer service, but let us go a bit deeper on exactly what I mean by “customer service.” We are not talking about the front office being ready with a big smile and warm greeting when Mrs. Jones enters the clinic, offering her a cup of coffee, and knowing that she takes two creams and one Sweet’N Low without having to ask. We are not even talking about the therapist being a hyper-attentive listener, paying attention and responding to her verbal and nonverbal cues to create the best therapeutic experience possible. Customer service goes way beyond the red carpet treatment our patients get inside the clinic walls; in fact that part is only half of it, and it is not the half that creates a gap between our operation and the competition. Nowadays this level of service, while not yet the norm across health care, is certainly expected from the top 25 percent of clinics and is not enough to distance one practice from the rest of the pack.

The “other half” of customer service involves taking care of your current and prospective customers when they are outside of your clinic. A physical therapy clinic stepping all the way up to the plate seeks to improve the movement quality of life for everyone in their community, not just the subgroup of folks paying for 1:1 individualized attention. As with anything else it starts with education. Our clinic runs an original post every Saturday in the Daily News here in Iron Mountain, complete with literature references. Want to know about physical therapy treatment found to be as effective as surgery for atraumatic rotator cuff tears in folks over 55? Our community knows about it. Every week the latest research about how physical therapy can help people is spelled out in our local newspaper, multiple social media outlets, and occasionally the radio. A common complaint on social media these days is that the public does not know what we do as physical therapists. Whose fault is this? Certainly I cannot blame the American Physical Therapy Association for not educating the citizens of my little town in Michigan. Nope, it is on me, if they do not know what physical therapy can offer them it is solely because I did not tell them. While education is the base of the pyramid, it is action that really turns heads, showing the community that your team cares and that you have boots on the ground to prove it. For us it means screening patients free of charge at the Y (formerly the Young Men’s Christian Association or YMCA) for two hours after work once a month, donating athletic training services to our youngsters trying to stay active, clinic owners coaching multiple sports without compensation, organizing the county triathlon and half marathon, and the list goes on. We are not targeting our patients with this service, we are targeting our community. We are using all of our available resources to educate and motivate people of all ages to maximize their quality of life.

For clinic owners and directors there is an elephant in the room here; namely, how do you get employees to make this level of extra effort? Lou Holtz, the legendary football coach at Notre Dame and several other universities, once said: “Motivation is simple, you eliminate those who are not motivated.” Sound advice for sure, but is it not even better to do everything in your power not to hire unmotivated personnel in the first place? I look at this latest crop of doctor of physical therapy (DPT) students and have a hard time conceiving why any clinic director would ever hire anyone who is not over the top motivated. My last student, Jake Hegge out of the University of Wisconsin La Crosse, voluntarily—and without any prompting on my part—developed and delivered a 12-week couch to 5K program for my community during his internship with us. No financial gain involved for himself, just a way of expressing his vision and taking the chance to share something he is passionate about with my community. This is a beautiful example of the “other side of customer service.” Now I am not saying that students who are self-motivated to this level are a dime a dozen, they are still in the minority, but there are plenty of them out there and more importantly, it is easier than ever to find them. In this era of social media and information exchange it takes all of a week following Twitter to recognize ten of the most highly motivated DPT students in our country, and reaching out to them is only a click away.

To summarize, the other half of customer service involves educating your community and following through with action to raise every willing citizen’s movement quality of life. This is not being done well by most clinics in our country; if it were, we would not hear the constant outcries of how “people do not know what we do.” It takes a special kind of team member to capitalize on this aspect of customer service. Fortunately, they stand out like sore thumbs on social media and are eager to connect with like-minded clinicians and business owners. So the time has come to gather up the motivated and change the national brand of physical therapy, one well-serviced community at a time. Good Luck!

Jeff Moore, PT, DPT, OCS, MTC, Cert. SMT, FAAOMPT, works in outpatient orthopedics and is the owner of The Institute of Clinical Excellence in Kingsford, Michigan. He launched the Institute of Clinical Excellence in 2012 and became a faculty member with Evidence In Motion in 2015. Between these two companies Dr. Moore regularly teaches manual therapy courses around the country. He can be reached at

Patients First


Creating a client-centric care practice.

By Susan Nowell, PT, DPT
“Nobody cares how much you know until they know how much you care.”
—Theodore Roosevelt

Any smart business person knows that solid customer service lies at the heart of a company’s ongoing success. I recently went to a business conference attended by a diverse group of small business owners seeking feedback and marketing development strategies. The expertise among the group ranged from the tech-savvy software engineer specialized in building social media platforms to the real estate agent focused on how to stand out in the competitive San Francisco market. The resounding message for the various business problems being discussed: Your client needs to know that you care.

This was amazing to hear, especially coming from a highly intellectual group of business people when so much of the customer service that we receive in our own lives has become so watered down. Think about it. How often do you end up waiting for unapologetic customer service? I can think of a few instances from just this past week.

On the heels of this business conference, I was thumbing through the sports section of the New York Times and found myself pulled into some fine print on baseball. That never happens. Baseball is not my sport. What drew me in was the humanistic aspect of this article. The Mets’ pitching coach, Dan Warthen, a 62-year-old former professional pitcher, faces the greatest professional task of his second career: developing one of the best young pitching staffs in baseball.

A torn ulnar collateral ligament thwarted Warthen’s pitching career years ago. Tommy John surgery was then too new a science and too expensive a procedure for Warthen to partake. He now protects his players by teaching “innings limits” and his “Dan Warthen slider,” a pitch that puts less gapping stress on the elbow. He exemplifies the famous quote he uses to describe his coaching style: “Nobody cares how much you know until they know how much you care.”

Across the board, whether in the competitive business of creating apps, selling houses, or training professional athletes, the message for improving the customer experience remains: Your client needs to know that you care. The true challenge lies in effective application.

Health care is a challenging business with respect to customer service. For one, our patients do not always “choose” to become paying customers. A person who is unexpectedly thrust into a trauma or injury situation does not necessarily choose to become a paying customer. Furthermore, in our reimbursement-focused system, patients are not the only entities paying for our services. Every therapist, at one point or another, has probably experienced an abrupt end to treatment sessions due to reimbursement issues. Aborted care does not qualify as positive customer service.

Reimbursement issues, while major, are not the only source of customer service dilution in our field. As therapists in reimbursement-based care, we often act as the middle person in health care delivery. What I mean is that we are relying on efficient and effective communication and service delivery with referring providers, other practitioners, and equipment vendors. Just this last week, I found myself struggling to maintain quality service while feeling caught between poor interdisciplinary communication and ineffective equipment delivery. I had been treating a patient status–post open reduction internal fixation (ORIF) for a distal radius fracture. She had a follow-up appointment with her surgeon and came to therapy verbalizing that the doctor had progressed her weight-bearing status. Meanwhile, the equipment we ordered for this patient had been misplaced in her home facility. As I placed multiple, unanswered calls to her surgeon (for weight-bearing status confirmation) and the durable medical equipment (DME) vendor and facility (to locate equipment), her therapy progress felt stalled. The obvious challenge of documenting progress to third-party payers and maintaining a positive customer service situation remained.

Luckily, the above example was an extraneous case, and I can just as easily think of positive, efficient interactions that I have had with surgeons and vendors. The most effective, quality care-inducing interactions I have had with vendors and other health care providers has always involved the three classic “C’s” of communication. This means that professional communication is clear, concise, and current. If we can expand this communication to a level of doing what is clear, concise, current, and client-centric, we are much closer to quality customer service.

Over the years, I have surveyed different patients and family members on their therapeutic experiences. Here are some of the most common complaints about therapy care I have heard:

  • “Beautiful space with great gear, but impersonal feel.”
  • “Not enough feedback/supervision on exercises.”
  • “Not enough 1:1 time with my physical therapist.”
  • “Not enough explanation about injury and choice of exercises.”
  • “Spent more time with the aide than my therapist.”
  • “Not enough visits/got cut off from therapy.”
  • “Had to wait too long to see my therapist.”
  • “Billing enigmas.”

I am a big believer in listening to complaints as feedback and a way to improve the patient experience. Most of these complaints include an aspect of careless customer service. More often than not, an unhappy patient is not questioning the knowledge of the therapist, but the application of the knowledge. “People don’t care how much you know until they know how much you care.” Turning these complaints and carelessness inside out, we get a list of therapeutic service strategies with clear, concise, current, and client-centric delivery of care:

  • Gain an awareness of the whole persona so you can individualize treatment based on patient’s motivations/passions and progress treatment properly.
  • Engage your patient in the care, encourage patient ownership of care.
  • Encourage communal cheerleading between client and support staff.
  • Create and communicate realistic expectations.
  • Manage resources to minimize waiting periods for start of care.
  • Promote proper use of therapy time; avoid idle “wait” times by utilizing support staff or maximizing therapist/client interactions.
  • Promote clear and efficient division of labor among support staff so client receives appropriate supervision and communication time with therapist directing care.
  • Invest in your client as an individual.
  • Listen as much as you talk.
  • Promote fun; motor-learning is most effective when individuals enjoy the experience.

In summary, the main ingredients of good customer service in therapeutic care involve positive management of the client:therapist interaction through establishing communication, management of expectations through realistic appraisal of outcomes, proper time management, proper resource management, and therapist self-management in maintaining both transparency and accessibility.

Patients who receive focused, individualized care are more likely to refer themselves back to you and/or opt for recurring private pay care. It is not about abandoning your intellect to shower your patient with unicorns and rainbows. It is about using your clinical intellect to find the most appropriate treatment approach and using your emotional intellect to communicate and show that you do indeed care.

Susan Nowell, PT, DPT, is a PPS member and owner of Endurellect. She practices physical therapy in San Francisco. She can be reached at

Meet the Press


They are your untapped referral source

By Ben Montgomery

When you think of your referral sources, who comes to mind? Physicians, specialists, clinical providers—they all serve as trusted professional partners who view you as a credible source for rehabilitation and pain management services, and likely much more.

Yet these sources live on a distinct island. They are some of your greatest advocates, but beyond their own line of patients, their reach is limited. Traditional referral sources can guide clients in your direction, but you cannot rely on them alone to tell your story, the story of your clinic, or the story of the physical therapy profession.

To tell such stories, you need a much wider megaphone—a credible messenger with an eager audience made up of a bold cross section of your local market. Regardless of where you are or the size of your market, such a megaphone does exist: It is your local press.

Loosely defined, “the press” is any person, company, or organization that produces content reaching a wide audience of readers, viewers, listeners, subscribers, and/or members. The channels they use to connect with their audiences vary from print publications and online blogs to television and radio, yet they all have one thing in common: the need for compelling content.


That is your cue.

As a private practice physical therapist, you have value to add to the public conversation. The press wants your news, stories, expertise, and perspective—they need it, in fact, because such things are valuable to their audience, and hence offer value to their products.

Few writers, journalists, and assignment editors are experts on issues of exercise, functional movement, or overall lifestyle enhancement, so they are always on the lookout for credible health care sources. The goal of a media strategy is to create relationships and establish your credibility with such gatekeepers of content so you can fill this valuable niche.

As a natural educator, you as a physical therapist should thrive in this role.

Media relations is your opportunity to educate your community about yourself, your clinic, and the role physical therapy plays (or can play) in improving people’s lives. It is also a way to enhance your credibility in the eyes of your community at large, propelling you and your brand above others simply due to your willingness to speak up and share a little of yourself.

Needless to say, a consistent media relations strategy should be a part of every private practice’s marketing effort. It is your time to grab that media megaphone.

Here are a few tips to get you started

Be a media consumer: Read newspapers, watch the news, pick up a magazine, scan your chamber of commerce newsletter, and subscribe to the local blog for active moms. As you get better acquainted with your local media landscape, pay particular attention to who covers health and lifestyle news, what topics they are covering, and how you as a physical therapist might enhance the conversation.

Develop a media list: Do not make a list of places, but of people who cover health, lifestyle, sports, and business within your local market. If you cannot find their contact information online or in local publications, call the media office(s) for names and email addresses. Most are happy to oblige.

Create and share content: Share an inspiring story about a patient. Provide a physical therapist’s perspective on a trending news topic. Offer seasonal and consumer-ready tips or advice about exercise, movement, or injury prevention. Whatever you choose, consistent content (generally shared via monthly press releases) is your “in” with the local media.

Be available: Always make it a priority to keep communication channels with the media open and free of delay. Writers, journalists, and editors often work under the pressure of tight deadlines, and returning messages promptly will show them you are an eager and reliable source, perhaps opening the door to future contact. Also, they will likely return the favor next time you reach out to them.

Be consistent and realistic: Media relations is a long play. Not every press release you distribute will find its way online or in the paper, but it all contributes to building relationships, establishing trust, and keeping you top-of-mind with people in the press. It is a process that takes time and consistency—but one that can pay big dividends for you, your clinic, and the profession as a whole.

Ben Montgomery, a former journalist, applies years of copywriting and message development experience toward serving physical therapist through BuildPT, the recently developed marketing services arm of Vantage Clinical Solutions helping private practice clinicians develop media relations, email marketing, and online engagement strategies. He can be reached at

An Apple a Day


Take the pain out of your rehabilitation marketing.

By Brandon Moser

If you have a chance, look at some health industry advertisements. Do you see a difference in their visual marketing? It should come as no surprise that they are similar—a lot of toothy grins from 30-somethings; slightly graying yet attractive women gardening; guys on bikes; and dream teams of confident health care professionals standing together (including a guy with his arms folded, wearing scrubs, and a lady wearing glasses and in a lab coat while carrying a clipboard). Oh, and do not forget the apples. Apples always mean a healthy lifestyle.

Before I entered the marketing and advertising world 20 years ago, I was a physical therapy practitioner. I had some great patients that took their home exercises seriously. I also had patients who constantly complained their rehabilitation was not happening quickly enough. When the patient was pushed for details, it was evident they were not doing the necessary effort outside of the clinic to recover as fast as they hoped. There are similarities in marketing.

Health care providers often take shortcuts in their marketing and promotion. Then they are unsatisfied with the results. There are no shortcuts in rehabilitation—and there are no shortcuts in creating effective, revenue-producing marketing.

Cheap can be very expensive
I wish I had a nickel for every time we had a new customer come to us with a story about how they were disappointed by someone who had designed a terrible marketing piece for them. After further questioning, I usually found it was a result of the customer giving the business to the lowest-possible bidder.

The growth of your business, and your livelihood, depends on successful, effective marketing. And yet cost is always one of the biggest drivers in marketing decisions. Do not be cheap here. Be smart, because “You get what you pay for.” It is true. You also get what you do not pay for—such as stress, inferior quality, and dealing with more daily pain than a torn triceps surae muscle. Because if they are charging next to nothing, it means that they have next to nothing to offer. It does not mean spend indiscriminately. You do not need Don Draper to write your jingle. Just spend intelligently. And sometimes a little more than you may be comfortable with.

The truth is that solid, evidence-based marketing from industry experts will usually pay for itself and then some. If you choose the right marketing partner, with the right skill set, cost should never be an issue. You will be concentrating on bottom-line revenue potential rather than short-term costs. Being cheap with marketing dollars is an ailment for which there is no cure.

If you do not stand out, you do not stand a chance
The health industry has traditionally been very conservative in their marketing efforts. Whether it is due to past regulatory intimidation or just becoming creatively lazy due to the conservative nature of the health care industry, it provides an enormous opportunity for those who want to stand out from the crowd.

If you ever wonder why the response rates are low for your advertising, take a good hard look at your creative. Take a look at the images you are using. Are they different from the competition? Or are you walking along the same beaches, frolicking in the same parks, and gardening with the same slightly graying, attractive ladies? Are you overemphasizing the importance of representing all ethnicities to your audience at the expense of decreasing the emotional pull it may have with your audience?

Instead of using emotionally stirring imagery that truly tells the story of the organization’s brand, the pictures are spiritless and overused stock images that have no association with the copy, but do represent 80 percent of the ethnicities on earth because someone told them to represent all ethnicities in their marketing materials. This belief that organizations have to visually represent all cultures in their target market is just not true. I have yet to see valid evidence and peer-reviewed research that shows using models representative of the target demographic substantially increases conversion. However, if you go and really examine the health care space and all of the marketing, you will see an abundance of these, “We are the world” stock photos. Do not market yourself like everyone else. Break the mold and make your brand get noticed.

It is about results
Do not go through the motions with your marketing efforts. Remember the end goal—results and a healthy marketing return on investment for your organization. A patient cannot just walk into a rehab clinic and demand electrical knee stimulation. Before any therapies are recommended, there is a solid medical strategy put in place by a trained professional. Organizations cannot assume that a print ad or a web banner will cure their marketing pains—they also need a strategy in place before any modalities are recommended. Just like with physical rehabilitation, the more attention and effort it receives, the healthier you will ultimately be.

Brandon Moser is the president and chief executive officer of HowlandMoser Advertising. He can be reached at

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