Calming the Chaos with Systems

building blocks

Implement solid systems to move your practice toward operational excellence

By Liz Plowman, PT, DPT

The opposite of chaos is order. However, order does not create itself.

That would be a violation of the laws of nature (specifically, the second law of thermodynamics). Without intervention, organization moves naturally to chaos. This holds true in business, too. To achieve order, one must impose it. In business, the best way to impose order is through systems.

Before starting my practice, I was an active-duty military physical therapist. I can tell you firsthand that one thing the military does better than most is systems. For every function and activity, from the most vital to the most mundane, the military has a policy, procedure, and instruction. In military physical therapy clinics, there is an instruction for everything from scheduling to wiping down tables. Do you need to know how to book a patient? Check the instruction. Do you need to know how many minutes to let the tables dry after disinfecting them? There is an instruction for that, too. Do you want to know exactly how to hang up the hot pack covers after use? You guessed it! There is an instruction for it.

Whatever stage your practice is at, good systems will improve daily operations and help keep your focus on the bigger picture of where your practice is heading. Creating solid systems takes tremendous work up front, but the operational excellence they create is well worth it—and so is the possibility of an actual uninterrupted vacation. 

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Liz Plowman, PT, DPT

Liz Plowman, PT, DPT, is based in Tomball, Texas, and the owner of Pain Boss Physical Therapy. She can be reached at

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

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