Luck of the Draw? No, Not Really!

By Terry C. Brown, PT, DPT

One of the single greatest resources that can make our practices go from good to great is having a dedicated staff that believes in the practice and are with us for the long haul. Every practice owner knows that the people with whom they surround themselves play heavily into the practice’s success or failure.

Most of us are people persons and we can get someone in the door. We understand the need for a competitive salary structure and benefits. We are good at getting them on board, then spending time and money training and molding them into productive team members.

However, how many of us have a comprehensive retention program? Being good at getting folks in the door has nothing to do with keeping them as a longtime faithful employee. Why is this? I think many of us have a misconception about what factors matter for retention. Most of us built our businesses believing that salary, benefits, and incentives would keep our employees satisfied . . . when in reality the drivers go deeper into the human psyche to the actions and attitudes that make employees feel successful, secure, and appreciated.

As private practice owners, we must strive to engage all employees to feel as if they have ownership in the practice. We need to treat them as partners in our endeavor and ensure we meet their needs. I believe there are some core areas that we could all look at to make our employees feel like owners.

First and foremost, remember that communication is a two-way street. Listening and communicating your vision are equally important. Structure your communication to inform, emphasize, and reaffirm to employees that their workplace contributions have an impact. Properly done, communication with your staff will provide you with the insights you need not only to run your business better but also to know how your employees feel about working for your business. Employees need the chance to be heard and recognized.

Empower your employees to do their best. This requires having measurable objectives for each employee and providing steady feedback to them. Studies confirm that people have a deep desire to feel they are succeeding and that their talents and capabilities are being used in a way that makes a difference to the business. When people sense their actions are fulfilling this desire, they begin to develop a sense of belonging and a feeling that your company is their company.

Next is putting your company in a position of competitive advantage. Set yourself apart from the competition. People want to work for a winner. Be active in your community and engage your employees in those activities you support. Build loyalty by earning trust, respect, and commitment from your employees as they work along with you in volunteer efforts to better your community.

We as private practice owners should provide the place for young entrepreneurs to come and build a home that provides them with opportunity for success in the way that each of them defines it. I hope this issue of Impact helps you develop your staff as a competitive core of “business owners” that are providing top care in your community for years to come.


Because They Cannot Say No

By Tannus Quatre, PT, MBA

My dad always taught me not to take “no” for an answer. It has served me well both personally and in business.

While I am pretty sure the message Dad was trying to get across was to assert myself, there is a slight twist on this lesson that works well when selling your services: Do not let “no” be an answer.

When selling, many people are essentially asking the question, “Will you buy this from me?” A question that starts with the word “will” has two possible final destinations: “yes” or “no.”

That is not good enough. We do not want “no” as an answer. A good salesperson works hard to ensure the answers are all just different shades of “yes.”

Sounds great, but how does this all work? Here are a few tips that work to keep “no” out of the vocabulary for your customers.

Ditch the words “will” and “would.” When attempting to close a deal (schedule a patient, solicit a referral), never use the words “will” and “would.” Questions starting with these words can end in “no.” Starting your questions with words such as “when” and “how” provide options that do not facilitate “no” as an answer.

Do: “When is your next availability?”

Do Not: “Would you like to schedule your next appointment now?”

Use your watch, not theirs. Oftentimes, getting to “yes” takes several tries. As many will attest, a single lunch with a physician group does not by itself open the floodgates to new referrals. When a “yes” is not achieved, make sure that follow-up plans are directed by you, not them. If you did not get what you want, schedule a follow-up on your timeline and get agreement on your follow-up plan.

Do: “Thanks for your time today, I’ll plan to follow up with you in a couple weeks to check back in.”

Do Not: “Thanks, well just let me know if you want to follow up on this at a later time.”

Change the subject. If you do not see the answer you are looking for on the horizon, do not force the issue. Changing the subject will still give you the opportunity to leave a good impression and to work on getting to “yes” at a later time.

Do: “OK, enough about physical therapy for now . . . you said you had kids, where do they go to school?”

Do Not: “OK, it does not sound like you are ready for physical therapy right now. Let me know if you change your mind.”

Always leave an opening. Unless you have determined that you no longer want the business from your customer, never, ever, ever, let the conversation resolve with a final “no.” There is always the potential to earn the business at a later time, and leaving an opening to a future conversation can be key to landing good business down the road.

Do: “OK, it looks like you are all set for now but listen, I am going to stay in touch with you, and please make sure to reach out if your needs change before we talk again.

Do Not: “OK, well I am sorry I cannot serve you right now. I appreciate your time.”

“No” is a dirty word in sales, and it can unwittingly harm those who need our services. We have to be assertive. So, do not take “no” for an answer . . . better yet, do not let “no” be an answer.

tannus_quatre Tannus Quatre, PT, MBA, lives at the intersection of physical therapy and entrepreneurship, spending his time helping physical therapists build and operate successful practices through his company, Vantage Clinical Solutions. He specializes in marketing, finance, and business planning, and authors and speaks regularly for the APTA and PPS. He can be reached at

Build Bench Strength

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

In the current outpatient rehabilitation market, growth is not an option. There are multiple companies acquiring businesses across the nation and rapidly growing in their local markets. One of the best ways to grow your business is by establishing new clinics in contiguous markets. The challenge in most cases is finding therapists who can treat and manage these new locations.

We recommend building a program to mentor your existing staff to become those next clinic directors. Develop a career ladder in your business that points to a staff therapist growing to become a manager. Then create a training program that helps a therapist build those skills to become your next successful clinic director.

We work with some of the best rehabilitation businesses in the country, and one of the key attributes to these companies is a strong bench of therapists who can be called on to fill a need for a new clinic director.


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

Sean Flannagan, PT, DPT, Cert. SMT, Cert. DN

Sean Flannagan, PT, DPT, Cert. SMT, Cert. DN. is the founder, owner, and director of One Accord Physical Therapy, in Casa Grande, Arizona.

Practice specifics: 4 locations, 13 employees, 12 years in private practice.

What or who is the most influential book/person/event that enhanced your professional career? Outside the gracious support of my wife, the first person who comes to mind who continues to impact me daily is Brian Klemmer who died in 2011. Everything he did was about building up others. He wrote the book If How-To’s Were Enough, We Would All Be Skinny, Rich and Happy! He never feared competition, and I actually sat in a meeting with Brian where he helped a competitor become better and more profitable through his guidance. He truly practiced the philosophy of building people up, because when you do, they will build your business. He said most owners build a business and fill it with people, they remain unapproachable, they do not trust, they fear competition, they fear employees going beyond them, and they fear that there is not enough out there for them. I would rather have a great employee who wants to open a practice one day, than one who just wants to punch a clock. I feel honored to be part of their story and their success presently and in the future.

Describe the flow of your average day. Do you treat patients and how many hours a day/week? When do you perform management tasks, answer emails, market? I’m currently treating about six hours a day, with a lot of my management responsibilities done early in the a.m. Over the last three years I have been heavily involved with continuing education (, so I have to balance that passion along with my business pursuits. My family is the most important aspect of who I am and what I do, so I attempt to respect and balance my family time. I have had to learn to turn off the seduction of the entrepreneurial spirit within me. It is easy to get drawn into what I equate to an affair with your business. If I push, it grows and if I rest, it rests, and it does not directly point out my weaknesses unless I inquire. The business can become an addictive escape from actually growing and staying connected at home. Home requires you to be real, it requires you to be present, and it requires you to grow. I equate marriage to Lifelong Personal Development 101, kids are 201, and business is 301. You should never stop growing and learning.

How would you describe your essential business philosophy? We purpose to build a culture that builds people, inspires growth, encourages risk, and does not hold people back from their professional pursuits. We emphasize the patient experience before money, yet value profitability. Always make your employees think beyond you and attach to a bigger vision. I personally lead by example and put family and God first, and I encourage my employees to always keep family and personal growth a priority.

How do you motivate your employees? Employees are what I enjoy most about business. We have some creative hiring processes that allow us to get a true sense of the person we are interviewing and if they will fit within our culture. If I am going to spend more time with you than I do my wife, then let us agree to play big together. Personality assessments are a big part of that process, but I think how we use them is unique. I tell interviewees, “If you are here to just punch a clock, then we are not for you.” We have a rich learning environment that challenges us all to question our outcomes and clinical reasoning, as well as to balance professional and family life. As a group, we embrace students and enjoy working with those that will be the future of our profession.

How did you get your start in private practice? I worked both for a private practice and for corporate physical therapy prior to going into private practice. Being around people like Brian really sparked the entrepreneurial spirit in me and I wanted to invest in and develop people, as well as have the freedom to spend time with my wife and kids.

How do you stay ahead of the competition? In the beginning it was just to survive, then it grew to being able to become profitable; now we are working to develop staff and create freedom. A large part is our employees and their dedication to our patients. I am humbled by how hard they work. They describe our company as their second family, and truly it is their efforts and dedication to their professional growth that keeps us ahead of the competition. I wish we had a great marketing system, but we have not needed one. Our word-of-mouth marketing from our patients has kept us consistently growing, but that only happens because of the culture we have developed that puts employees first, so they truly serve our patients.

What are your best learning experience/s (mistakes) since inception of your practice? I am still learning daily; it never ends. We are always where we need to be to grow . . . it is hard sometimes to know that the struggle and challenges are our shortcuts to growth. I failed at asking for help early on, failed at searching out mentors, failed at being humble enough to admit my weaknesses. I think the best thing a business owner can do is find a coach and mentor. I did not early on and it is cost me, both professionally and personally. If you want to limit your struggles, then engage other private practice owners through the Private Practice Section or even other business owners who are willing to share their expertise and give you honest critical feedback about where you are weak and need to grow.

What is your life motto? You are always exactly where you need to be, to become who you are called to be. Your current trial is a shortcut to becoming mature, complete, and lacking nothing.

What worries you about the future of private practice/what are you optimistic about? I believe in every market there is opportunity and that we will survive, but we must adapt with others with a similar vision and culture.

What new opportunities do you plan to pursue in the next year? We are revamping how we measure success and approach profitability. Yes, I have a new mentor for this pursuit. With thinner profit margins and a commitment to improving our outcomes, we have to really redefine our practice model. In addition, we are focusing on our residency program and our continuing education company. It is going to be imperative to collaborate and grow with those who have a similar vision for the future of our profession.

Progress Toward Reimbursement for Telehealth

By Alpha Lillstrom
May 5, 2016

These days more providers, patients, and payers are evaluating the utility and benefits of using technology to support or provide health care services remotely. The use of telehealth is a significant and rapidly growing component of health care in the United States. Also known as telemedicine, the term encompasses everything from electronic visits, video technology, and remote monitoring to provide maintenance and preventive care for patients, to diagnosis and treatment when it is clinically appropriate. In some cases telehealth is used to provide access to care over distances that would otherwise present insurmountable obstacles to care. In other situations the technology improves convenience for both the provider and the patient. Over half of U.S. hospitals now use some form of telemedicine.1 In fiscal year 2013, more than 600,000 veterans accessed Veterans Affairs (VA) care using a telemedicine program—for a total of more than 1.7 million episodes of care.2 Even when effective mitigation of challenges is taken into account, reimbursement continues to present the most formidable obstacle.3 While your specific practice might not yet be delving into providing care using telemedicine, some are. Policy is evolving to make it more feasible and reimbursable.

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