More Profit, Better Outcomes

Question mark

Questions every physical therapy clinic should ask.

By Joseph M. Sapp, PT*

At some point, all physical therapy clinic owners find themselves wondering: “Are we as successful as we should be?”

That’s one complicated question. To answer this question, therapy clinics must start by breaking down their self-assessment into a series of questions that address the key pillars to success.

The fact is, many practices underperform critical benchmarks for revenue and service. That leaves them vulnerable to competitors or other market forces. By using the following questions as a starting point for self-reflection, clinic operators can begin developing concrete plans for better performance, better patient outcomes, and greater profitability.

“Are we hiring and retaining the right physical therapists?”

What is the biggest complaint we encounter when we talk to clinic owners? The never-ending problems involved in staffing:

  • Identifying—and persuading—the best candidates in a competitive labor environment
  • Staff churn that leads to the constant effort—and expense—of finding qualified therapists
  • Signing-on physical therapists who fail to meet performance benchmarks—or hiring superstars who leave in six months

Often, physical therapy clinics simply don’t have the in-house expertise or resources required to cast a broad net for applicants. Or they don’t have a process for identifying the physical therapists who will be a good fit for their practice and program. Another key hurdle: establishing an incentive program that keeps good physical therapists in place.

Here’s one thing most clinics don’t hear often enough: Those staffing problems are endemic to the industry, and they may not be your fault. A great hiring and retention effort often requires resources beyond what a clinic is able to muster internally.

“Have we established a culture that fosters excellence?”

You may have heard the famous quote from management legend Peter Drucker: “Culture eats strategy for breakfast.” He meant that an effort to impose a structure or process will be doomed without first creating a culture that fosters excellence—and having a team embrace that culture.

When it comes to physical therapy clinics, I’ve witnessed firsthand that sustainable, long-term success is only possible when you create a better experience for both therapists and patients. Is your clinic a high-energy, positive environment that encourages patients to return for subsequent visits and to refer your clinic to others? Just as important: Does your clinic create a nurturing environment that rewards therapists and encourages their professional growth?

Entire articles (and books) have been devoted to this topic, which also involves coaching your therapists on protocols that lay the groundwork for success. Clinics that focus on culture enjoy a host of benefits, both tangible and intangible: better patient outcomes, enhanced revenue because patients complete their full treatment plan, engaged therapists, simpler integration of new physical therapists, and better overall morale, among others.

“Are we using metrics to gauge performance?”

You can’t fix what you don’t measure. When it comes to running a physical therapy clinic, there are at least two dozen key metrics that successful operations track. Just a few of these include:

  • How many days does it take for your clinic to see a referred patient?
  • How many units do you bill per visit?
  • How much revenue does each therapist generate?

The clinics that fail to track metrics like these or to set goals driven by real numbers are prone to falling short of their true financial potential.

Once a clinic embraces the idea of gathering and analyzing metrics, it removes a lot of uncertainty. It’s much clearer where you should focus your efforts on change, because the numbers don’t lie.

“Do we have concrete action plans to improve performance?”

Those metrics just mentioned? They don’t mean anything unless a clinic tracks them weekly and then uses them to improve performance. A clinic should have a specific action plan for each metric that doesn’t reach a desired benchmark.

One quick example: If your clinic takes four days to see a referred patient and the actual benchmark is two days, you should have specific guidelines for closing that gap. In this case, the action items would involve patient and referral source communications.

Creating concrete action plans can be a painstaking task for some clinics. The upshot: Clinics that engage in this process can use the metrics in place to quantify short- and long-term effectiveness of those plans.

“Have we mastered the complexities of billing and compliance?”

It’s one of the most complex, and potentially frustrating, aspects of any clinic’s business: billing, coding, and documentation. Errors can lead to payment delays, which negatively influences cash flow. Even worse: Improper coding can lead to a huge expense after a visit from a recovery audit contractor.

If you are unsure whether your team or your provider can navigate this process affirmatively, you should strongly consider addressing this area immediately.


Joseph M. Sapp, PT, a licensed therapist and founder of his own successful physical therapy practice, launched Innovative Therapy Concepts in 2006. ITC’s practice management model, designed to reward therapists and improve financial performance, currently benefits 45 plus points of service.

*The author has a vested interest in this subject.