Telehealth Today


An overview of telemedicine services in health care today as well as some specifics related to physical therapy practice.

Kelly Sanders, PT, DPT, OCS, ATC

Advances in both medical as well as communication technology have paved the way for the rise of telehealth. According to the American Telemedicine Association, more than 15 million Americans received some type of medical care remotely last year, and that number is expected to grow by 30 percent this year. Communication technology is allowing physicians and other health care providers to be accessible to patients for urgent care as well as specialty care when it may not otherwise be immediately locally available. This health care delivery medium has also increased the convenience of not having to physically visit a health care provider’s office or a specialty health facility. In addition, it is allowing for health care providers to access colleagues within the medical community, specifically in rural or underserved areas where a specialist may not be available locally for consultation. Telehealth becoming mainstream will make a significant impact on health care and should afford the health care community the ability to improve care delivery, access, and cost.

Taking Steps


5 steps to recharge your marketing strategy.

Ben Fung, PT, DPT, MBA*

Marketing is a world filled with words like timing, precision, intent, purpose, metrics, outcomes, sales, profits, growth, sustainability, hacks, strategies, tactics, methods, segments, striation, analysis, data, social, end user, consumer-facing, and many times, luck. As is true in physical therapy, marketing is both an art and a science, yet evidence-based business practices must guide decisions. Fortunately, as business becomes more digital, things become infinitely more measurable. The key is to track the right things, at the right time, for the right purposes, in order to execute the right strategies.

When any given business applies their executive seal of approval to their marketing strategy, it is because they are convinced that the channels, methods, segments, venues, tactics, and campaigns set forth will lead to positive growth and improve sales. Growth can mean a great many things (consumer awareness, brand positioning, market share, etc.). Sales can also mean a great many things (expanding product/service lines, increased accounts landed, user acquisitions, new customers versus returning customers, etc.). Both eventually converge into the multidimensional space of customer relationship management (CRM) and corporate social responsibility (CSR), along with the strategic planning principles that have been thoroughly interwoven within the framework of the grand marketing strategy.

Still, even the best marketing strategies require renewal and revival. Some even require a little rehab. Ultimately, it is best for a business owner to regularly reevaluate their marketing strategy and give it a full recharge. As the customer lifecycle and digital business cycles continue to accelerate, recharging your marketing strategy will become a regular and welcome exercise that will lead to sustainable growth and true marketplace significance. This article centers on the unified focal point between traditional business principles, digital marketing, and startup entrepreneurialism with five steps to recharge your marketing strategy.


1. Draft Your Dream Team
If you have ever played fantasy sports, you know that this is the longest step in the process before things start getting fun. Popularized by the “Bullseye Framework,” this method is a functional staple of product launches and startup companies. Rather than obsessing over inbound or outbound strategies, this first step is all about gathering the full spectrum of opportunities for your business. Some of these opportunities may be ideal. Others may be truly foolish. The purpose of this step is not to make some definitive choice. Rather, the purpose of this step is to consider the big picture of how each marketing channel jives with your overall business direction and synergizes with each other.

While the Bullseye Framework lists 19 channels, I have condensed two of their channels and added two that have become increasingly relevant to the millennial economy. The 20 ubiquitous marketing channels are:

  1. Traditional (offline) Ads
  2. Traditional (offline) Events
  3. Search Engine Optimization (SEO)
  4. Search Engine Marketing (SEM)
  5. Social and App Ads
  6. Special Engagements
  7. Trade Shows and Conferences
  8. Sales
  9. Guerrilla Marketing
  10. Community Building
  11. Content Marketing
  12. Blogging
  13. Business Development
  14. Public Relations (PR)
  15. Existing Platforms, Channels, and Venues 16. Email Marketing
  16. Function and Features-Based Marketing 18. Affiliate Marketing
  17. The Crowd
  18. Corporate Social Responsibility (CSR)

Now, it is time to draft your dream team among these 20 channels. Rather than just pick four or five channels to test out, choose a dozen. To do this strategically and systematically, be sure that your draft includes channels that have a natural congruence with your company’s direction. However, be sure to also include an oddball and wild card in the mix. You never know what might happen. Just as in baseball, players who may not otherwise have been thought of as having All­Star potential have been known to rise to the occasion and surprise us. Pick a few obvious players, one or two wild cards, and then move on to Step 2.


2. Put Them Through Spring Training
You have finally picked out your team; now it’s time to see how they do. The resource to testing hypotheses is your marketing budget. In the world of marketing, you have got to spend money to make money. At this first step, there is no need to optimize, adjust, or tweak the players on your dream team. Here the goal is to see how the team plays naturally, both as individuals and as a team of marketing channels. Make a careful note of who is naturally excelling. Also note the underperformers. Take special note of two players who seem to work very well together. Be sure to give an equal chance for each player to shine. Don’t be surprised if your first pick doesn’t do so hot. Also, don’t be surprised if your wild card ends up being the All­Star. During this step, the key is to see how they do on their own without coaching and without changing how they naturally play. That is the task in Step 3.


3. Focus on Your Starting Players
Spring training is done. You know who the winners are. You know who is lagging behind. Now that you have thrown a little chunk of your marketing budget at them to see how they play, it’s time to make them play well. It’s time to coach them, train them, strengthen them, and understand their behaviors.

Step 3 is all about taking the top performers and seeing how they do under pressure. This is a phasing step before true optimization can begin. At this point, you probably have a metric-based or instinct-based idea of who your All­Stars will be. Some of them are completely intuitive; one of them is probably not. During this step, take on small, incremental improvements on each marketing channel that you have selected as your starting players. For a set period of time (a month, a quarter, or whatever your business cycle determines), start small improvements on your marketing channel based on the bit of data that you have and what your instinct tells you to do. This is the last step before you choose the final two or three marketing channels to call your All­Stars.


4. Optimize Your All­Stars!
It is finally time. Optimization. It’s a favored word among marketers for an important reason. A single, optimized marketing channel can easily do what four or five suboptimal channels will try to achieve. Once you have identified two or three All­Star marketing channels in your mid­phase testing period, it is time to truly make them your stars.

If you have identified the winners to be a combination of social media marketing, email marketing, and content marketing, then you need to sit down and figure out the strengths and weaknesses of each, how each player affects the other, and ultimately the grand effect on your consumer base. If one or two of your channels have obvious synergistic effects, be sure to pour extra resources into refining their teamwork; however, if you find that one of your All­Star channels does not play nicely with others, it may be a good idea to separate out your audience into channel segments. Alternatively, you could reach back into your starting players for another All­Star who may not have made the first cut.

Optimizing your marketing channels means you need to collect, analyze, test, and re­test all of your metrics. From your open rates, engagement ratios, click-throughs, total attendance, satisfaction surveys, focus groups, readership, sales conversion, and other metrics, the key to optimization is to base your actions on data and truly measure the consequences of each iterative change for each marketing channel. That is how you get evidence-based business improvements. On to step 5.


5. Go. Fight. Win!
Execute. Reassess. Redeploy. By now, you are two or three business cycles in. You have more or less optimized your All­Star marketing channels. You are getting good returns on your investment, your marketing budget has grown, your sales have improved, and life seems good.

It is not time to get cozy. It is time to reassess your strategic position and redeploy the troops. This is an excellent time to look back at your starting lineup to see if there were any gems that may not have had their time to shine due to poor timing, bad luck, or otherwise. Consider your backup players who did not make the cut as starting players. Many times, missed opportunities, false negatives, or false positives have left diamonds in the rough—unattended, uncut, and unpolished. Since you now have the momentum and capital for exploring growth channels, you also have the opportunity to creatively strengthen and optimize channels that were less attractive during Steps 1 through 3. If you avoid this step of looking back and reevaluating your options, you risk developing tunnel vision and may be quickly overtaken by competitors who remain agile and ready to move. By following these five steps, and most importantly, making these five steps a habitual business practice, you set yourself up for success to enjoy sustainable growth and a competitive edge across the marketplace.

Ben Fung, PT, DPT, MBA, is the chief content officer and partner at UpDoc Media. He can be reached at

Suggested Reading­Startup­Achieve­Explosive­Customer/dp/1591848369

The New Selling Paradigm


To Sell Is Human: The Surprising Truth About Moving Others

By Daniel H. Pink | Reviewed by Gene Shirokobrod, PT, DPT

We are living through a paradigm shift. Have you felt it? In our new, hyperconnected, global culture the old methods of “selling” are not effective. Today’s environment demands new thinking and new action.

The essence of relationships is communication.

Communication is crucial for developing genuine, sustainable, deep-rooted connections with others. Humans are social creatures. We build communities, find partners, share our journeys, and tell stories. And we sell every single day. Whether we are selling for a business or selling to make our kids eat their vegetables, to sell is human. New York Times best-selling author Daniel Pink agrees.

In his keynote speech at the 2015 American Physical Therapy Association (APTA) Private Practice Section (PPS) Annual Conference, Dan presented an overview of his concepts around selling. Dan’s book, To Sell Is Human, outlines the current state of selling.

In short, as the title suggests, selling is part of the human fiber.

How is selling different now than 30, 10, or even 5 years ago?

The paradigm shift of communication and information has resulted in an asymmetry. Years ago the asymmetry was in favor of the seller. Now, the asymmetry is very much in favor of the consumer. The consumer has information from social media and the internet within minutes, and social media and the internet are made up of other people. While social media is technology, without people it is nothing (see Myspace). Technology is the vehicle we drive every single day. Sometimes we wave politely, occasionally we use a finger, but mostly we focus on our destination. Technology allows for scalability of communication and connection as we travel toward the destination.

Physical therapists are the worst best salespeople . . . in the world.

Let’s delve a little deeper into selling. As mentioned, we are always selling. Dan breaks this down into categories: sales and nonsales selling. Sales is the typical process of convincing someone to make a purchase. Nonsales selling is what we do every single day in attempting to convince or influence others for an exchange to occur. For example, a physical therapist is clinically trained to convince hesitant people in pain to do exercises. A physical therapist has to sell the person, fairly quickly, on the belief that they will eventually feel better. If that’s not skillful selling, I don’t know what is. Yet physical therapists are very hesitant to participate in “sales.” The fear of being perceived as a salesperson is so strong, most therapists never move beyond it. As a result, many physical therapists do not adjust to the market. If we are not careful, we might not feel the paradigm shift until it’s too late.

How can you become an effective salesperson?

According to Dan, becoming an effective salesperson is as simple as ABC:


Attunement is the process by which we think like someone else—it is the cousin of empathy. I believe that attunement is a critical step in effective, genuine communication. As humans, most of us have a difficult enough time figuring out our own emotions, let alone “feeling” as someone else does. Thinking like someone else is only slightly less difficult. Skillful attunement to another human being’s thoughts and perceptions, when supplemented with empathy, can help us become relatable.

Buoyancy is the ability to keep going in the face of constant rejection. I relate business to baseball. If you are successful 30 percent of the time you will be in the Hall of Fame. You need to be able to strike out four times one day and look forward to getting another chance at bat the next day. Your ability to keep going through failures and rejections is critical. The journey to success always passes through the lessons of failures.

Clarity is the ability to wade through nonstop rhetoric, information, and problems. The information asymmetry means that most people have too much access to information. Your ability to guide them to the relevant information to solve their problem is crucial. If you and your customers are working to solve the wrong problems, then you are wasting precious time.

The ability to connect the ABCs will result in genuine connections and relationships.

Those relationships are what great customer experiences are based on. We are all consumers of something. We are all in sales. Don’t let yourself be the limiting factor because of preconceived notions of selling. Allow your customers to decide.

Can you feel the shift? Your customers can.

If you were unable to attend PPS Annual Conference, you can hear Dan on my podcast Therapy Insiders, where I interviewed him (available free on iTunes).


Gene Shirokobrod, PT, DPT, is an entrepreneur who began his career as a physical therapy clinician. He started Therapy Insiders Podcast, which grew into a top 100 show. Gene is also the cofounder of UpDoc Media, a digital marketing and content creation company as well as chief operating officer of TerraFlix, a GPS and video tech company. He can be reached at

The Basics


Performing a HIPAA risk assessment for a suspected breach.

By Paul J. Welk, JD, PT
October 2016

Most private practice physical therapists, even those who devote only limited time and attention to current events surrounding the Health Insurance Portability and Accountability Act of 1996 (HIPAA), are aware of the risks associated with a breach of Protected Health Information (PHI) and the potential negative ramifications of the same. That being said, many of these individuals nonetheless believe they are “careful enough” that neither they nor their practice will ever need to assess a potential HIPAA breach. The purpose of this column is to illustrate that breaches do occur in private practice physical therapy offices with more frequency than practitioners might imagine and to review certain steps in the risk assessment process that are undertaken should an impermissible use or disclosure of PHI occur.

Mastering the Org Chart

By Tannus Quatre, PT, MBA

Does your physical therapy practice have an org chart (organizational chart)?

For those of you who do, your answer is probably something like, “Um, duh . . . how would I survive without one?!”

For those of you who don’t, your answer might be something like, “Hmm, I should probably read on.”

All teasing aside, if you don’t have an org chart, I don’t want to cause you panic, but I do want to be clear that you need one. No matter how large or small your practice is.

Org charts are critical to efficient business operation, and form the foundation for growth through clear delineation of responsibilities and reporting assignments. Furthermore, you will learn a ton about your business as you go through the exercise of building an org chart for your practice.

To highlight the importance of an org chart, imagine for a moment that you didn’t know to whom you were ultimately accountable within your business. You may have one direct supervisor, but maybe two or three. You’re not totally clear.

Perhaps when all appears to be working well, this may not seem to be much of an issue, but now take a scenario where performance falters. A productivity measure is unmet, a customer is unsatisfied, or financial stressors have made their way front and center. When performance breaks, somebody is going to be looking to hold staff accountable for resolving the issue. If you are the owner, that somebody is probably you.

But who is accountable?

An org chart is your road map. It’s a top-down and bottom-up chart that provides each member of your organization a direct reporting relationship to someone else within your company. The flow creates specific accountability in a simple, easy-to-understand format.

For managers, it provides clarity for whom they are responsible. For nonmanagers, it provides a clear hierarchy that allows them to understand to whom they are directly accountable.

I find good org charts to be in equal parts insightful, beautiful, and fun. Putting them together can be a challenge, but the end result is nothing short of an artistic (albeit quasi-corporate) overview of how your company works.

Follow these tips to create a simple and effective org chart for your physical therapy practice:

  • Start at the top. Somebody—possibly you—is ultimately responsible for the entire company. Place this person at the top. If it’s a board that governs your organization, place the board at the top. However or whoever your topmost responsibility is structured, determine next who reports directly to them. They will be your second-tier management structure in the org chart. Continue down the organization until all leadership roles are identified.
  • Respect the “one boss rule.” All (or at least most) within your organization should report only to one person. If you find that your org chart has a web of connections whereby one person reports to more than one supervisor, clean it up. This is usually a symptom of lack of clarity for those responsible for running the organization (this might be you!). With few exceptions, each member of your team should report only to one supervisor, and this will show through on your org chart.
  • Titles carry meaning. Your titles are meaningful; they should be succinct and accurate on your org chart. Making sure your team understands their titles, and the duties required of them, is critical to the creation of an org chart that works.
  • Be neat. I am a big believer in the mantra that “doing is better than perfect”; however, when it comes to an org chart, we are focusing on clarity. Clarity is facilitated by a clean, organized look that is professionally presented. Make sure that your final draft of your org chart is done in a software program that presents the chart clearly and can be easily updated and maintained.
  • Publish, publish, publish. You’ve got a beautiful org chart, but it is only as good as those who rely on it. Publish your org chart on your company’s intranet, bulletin board, or wherever else your employees consume company information. An org chart is a working, living document, and it should be easy to find for those who need to rely on it.

If you don’t have an org chart, commit to making one before the year is over. You will be amazed at the clarity it brings. If you do have one, get it updated and review the tips featured here to make sure it is ready for prime time as 2017 approaches.

vantage_TannusQuatre 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

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