How to Market 3 Different Cash-Based Services in Your Practice

Piles of money

Simple marketing tactics too easy not to try.

By Stephen V. Rapposelli, PT

Cash-based services account for over 10 percent of my practice’s gross revenues.

That is not a trivial amount. If your practice is not offering cash-based services, you are making your business vulnerable. Marketing the following services does not have to be expensive. In fact, using the following tactics can help you market to your best customers—your existing patients.

1. Fitness

I don’t like to use the word “gym” because you will likely struggle if you add a “gym,” as well as have additional laws that are applicable to you. The March 2019 Issue of Impact discusses some things to be aware of in, “Is Your Physical Therapy Practice Also a Health Club?” The key to success in the fitness field for physical therapists (PTs) is to get super specific with choosing your customer. I want to exclude most people from my fitness center. Why? I cannot serve everyone well. In fact, I strive to narrow my focus to who is my ideal customer. However, the people I do serve really well would never go to a big box gym. (Hint: Your ideal customer is your current patient population.) I have found my ideal customer group, and they all have musculoskeletal dysfunction. When my fitness member, who is 95 percent likely to be a former patient, or a family member of a former patient, has a question about the safety of a certain exercise, they get advice from their own physical therapist (PT), who directed their care, and knows all about their specific musculoskeletal dysfunction. Do you think that kind of customized advice is valuable? Do you think they will get that kind of advice that you can give over at the 24-hour gym down the street? Our advice is so valuable to that person, that it effectively puts a steel cage around them that no “$20/month” gym can touch. By the way, you already have the equipment. You already have the space (we use 1,200 square feet, but you adjust to what you have—for now). You already have the customers who love and trust you. You can name one of your top aides to the post of fitness center manager and give them the opportunity to grow it. Now you are offering career growth inside your business on top of everything else. Use your existing patient email database to start sharing your unique content to give exercise tips. You can even segment your emails in your email management software to send tips about the back to former back patients. The more focused, the better. Offer the first month free after discharge, or even free use while they are a patient. Let family members come in for $5 a day. Throw “fitness member only” parties after hours.

2. Personal Training

This is low-hanging fruit for your business. Once you have even a tiny space dedicated (or shared!) for fitness, you should offer personal training. We have found that not all personal trainers are alike, and not everyone will resonate with your desired customer. Our experience has been that you interview for people who desire working with special populations, and offer a collaborative work environment, where the trainer will be meeting with the PT to best manage the client. The key to our success here has been finding the right trainers who share your values and culture. They best work as independent contractors, but many would gladly moonlight as an aide also to get more “rehab” experience. Let them! We do a simple fee-split arrangement. The fitness trainers are expected to donate some time to interact with our patients as they exercise to create relationships. Everyone wins in this situation. How many times have you treated a patient who said, “I joined the local gym, and some college kid there showed me some exercises that he does, and I got hurt.” I find local gyms are great for our business, don’t you? It is easy to differentiate your offering in this space. Your trainers then will refer back to therapy if there is a problem that needs the skills of a PT.

3. Massage

Do you have an 11- x 11-foot room? If so, you should be offering massage services. We view massage services from a few different angles. First, it is great as a stand-alone service, just like getting massages anywhere. The convenience it affords your current patient population will make it successful. You simply need to tell people you offer it! Second, we offer it to patients in conjunction with PT. For example, we find that it really helps our knee replacement patients with postop pain, swelling, and stiffness (who knew?!). Patients love it. I love it when patients love our services. Third, we use it as a great marketing tool. How? Well, unless you are tactiley defensive, you probably love a massage! Most people do. We donate them, discount them, gift them, run specials with them, and even reward employees with them. This may be the best marketing tactic ever. How about sending over an hour of chair massages to your best referrer’s office staff?

All three services that I have briefly touched on give you cash, allow you and your staff to think creatively, provide opportunity for staff development and growth, and elevate your exposure to the public. The marketing tactics are very simple and easy. You can start as small as you want, and are limited only by your time and ability to find the right people. Can you afford not to do it?

Stephen V. Rapposelli

Stephen V. Rapposelli, PT, is a PPS member and owner of Performance Physical Therapy and fitness in Delaware. He can be reached at

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