What’s the Secret?

Running a physical therapy practice is similar to running any kind of a business: You need to find (or make) a niche. What that niche consists of is up to you and your team, but it has to stand out among the other options patients and physicians have.
Years ago, our Vermont practice needed to increase not only the number of patients we wanted to see, but also our options for treating those patients. Though we use land-based methods, we realized that being able to offer a complementary type of therapy treatment would be advantageous for both our patients, as well as our business. After careful planning, we determined that adding aquatic programming to our physical therapy techniques was the innovation we needed to round out our abilities and offerings.
We are all looking for innovative ways to get our name out to the public. If you have been in practice for many years like me, you may have tried signs, newspaper ads, high school banners, pens, backpacks, stress balls, billboards, lunches, and many other things. Does this marketing work? Is the public more aware of who you are and what your practice represents through these single dimension advertising venues? Who knows? It is difficult to objectively measure the impact of advertising this way. My experience tells me that they work minimally, if at all.
Provider networks are anything but a new phenomenon in the insurance industry. Payers have been engaging preferred providers for decades dating back to the managed care era. Consumers have had to factor in provider availability and coverage when selecting a health plan if they were involved in such a selection process. This process of consumer choice has been magnified by the adoption of the individual mandate included in the Affordable Care Act (ACA). Likewise, once the initial choice is made, patients must make decisions at the time a health care need emerges—do I stay in network and pay less or choose to incur higher out-of-pocket expenses by accessing an out-of-network provider? Often, this is when they discover their provider of choice is not in the insurer’s network.
In October 2007, my practice had been open for four years, and I wanted to differentiate it from competitors and create new revenue sources. I attended the conference “Newest Concepts in Work Injury Management and Prevention” in Chicago, hosted by Susan and Dennis Isernhagen. At the conference, Manny Keisser, then manager of Cast Health and Wellness at Disneyland Resorts in California, spoke about occupational health and safety at Disneyland. Manny’s dynamic presentation captured my attention. Two of his principles have remained ingrained in my thought process for business development and differentiation. His first statement was “I’m so busy pulling people out of the river that I don’t have time to go upstream to find out (and stop) who is pushing them in.” I underlined it and tabbed the page; it described the day-to-day operation of treating patients in a busy clinic. The people I saw were already injured—about a third of them had been injured at work. There was no time or opportunity to prevent the injuries. And often, I did not understand my patient’s job title, much less what they were actually required to do at work. I worked on restoring range of motion, increasing strength, and improving tolerance of activity. Relationships with the employers were limited, including participating in employer health fairs and teaching some back and lifting safety classes. I was onsite at the company, but did not really know anyone. I viewed this time that pulled me away from the clinic and patient care as a nuisance.