How to Stand Out from the Crowd

Stand Out From The Crowd

Why differentiation is key to survival of the fittest.

By Tony Pazzaglia, PT, DPT

As business owners, we all know it’s a challenge to set apart your physical therapy practice. The balancing act is part art, part science, and a degree of luck. However, what you can always control is what makes your practice stand out.

The goals of physical therapy sessions are generally the same across the board—to help patients achieve their self-defined and/ or physician-directed objectives; however, the path to the journey’s destination varies widely. That’s where it’s possible to find ways to develop your niche market.

Does it take an effort to put resources and energy behind niche market development? You bet. It’s a mental exercise in innovation, patience, and good old-fashioned plunge-taking. Yet every physical therapist knows that the only way to reach a dream is to move beyond our comfort zones.


Differentiate or die: That’s our philosophy.

From the very start of our private practice, we wanted to be unique, which isn’t a simple task in the physical therapy industry. Differentiating is deciding what you want to be and going after it full-force to limit the direct competition. It’s not just trying and seeing how it goes. We began by calling the business “Terrapin,” which is a species of turtle that lives on land and water, rather than choosing a more corporate-sounding moniker. Our brand reflects not only our stand-apart nature, but also one of our biggest niches: aquatic therapy.

Stand Out From The Crowd

Around a third of the solutions we offer are aquatics based, and roughly a third of our patients take advantage of this differentiator. However, that doesn’t mean they naturally gravitate toward it. Our passion (in the form of our education), combined with measurable results, is what turns patients and referrers into aquatic therapy proponents.

Being known as a cutting-edge provider involves more than aquatic-based equipment; it’s a mindset that carries over into every process and keeps us growing in the right direction. More importantly, it keeps us outside of the norm, which is exactly where we want to be.


Looking to employ a little differentiation for your own physical therapy practice? Start with these simple tips:


1Constantly review your techniques and procedures and look for better ways to do things. Your focus should be on the future, not the past or present. If you aren’t engaged in constant continuing education for every member of your team, you’re going to miss out on tons of chances to move up a notch. Find out what’s evolving in the physical therapy field that corresponds with your practice, and discuss with your team how you can use the tools, techniques, and discoveries to propel yourself forward.


2Practice exceptional customer service. It’s no secret that word of mouth is your best and worst marketing tool. If you don’t use it to your advantage, you’re losing out on future business, plain and simple. Human interactions are always more valuable than clinical skills or equipment. For us, that means giving more than just lip service to emotional intelligence. To make patients feel ultracomfortable and form a sense of trust, you have to treat them better than they expect. Do whatever you can—within reason—to make their experiences top-shelf. Your patients will become advocates for you and your staff members, and be much less likely to skip appointments. Never think they won’t notice all you do, or the additions you make to benefit them. After we added a new piece of high-tech aquatic therapy equipment, our cancellation and no-show rates decreased to less than 5 percent (a 50 percent reduction for us) compared to an average 14 percent by national physical therapy practices. It’s difficult to determine if this was directly because of our new equipment or because of our friendly atmosphere, but it definitely helped us see an immediate return on investment.


3Become an expert in specific areas. This doesn’t have to mean you’re the expert among all of your peers. Expert can be a term defined by your patients. Being passionate about your practice and staying up to date with all of the research on your niche subject area will let your patients realize they came to the right place. I had the advantage of working in aquatics before founding my company, so I already knew it was an excellent way to bond with patients and help them feel better about their progress. Knowing that they would gain back their range of motion for stiff joints or improve their balance, helped me stay the course and look for aquatic therapy items for my own practice. Over the years, I’ve learned more about the value of aquatics, to the point that I’m writing on the subject and speaking with peers. My passion brought me to where I am now.


4Consider implementing an Attendance Agreement. Cancellations and late show-ups make a quick mess of your daily schedule, not to mention your budget. Most clinicians are too lenient, or worse, afraid of losing clients to bring up this dilemma to the patient. But there are quick fixes available to illustrate to them how important your time is, like theirs. To illustrate how important we believe this is, we have all patients sign an Attendance Agreement: a simple “contract” that highlights their responsibility to attend all of their scheduled appointments or to promptly notify us of any changes in their schedule. It is up to you to determine how you would like to enforce it but it is there for you, signed and dated, if you ever need it. Ironically, we rarely have to enforce it because of our upfront communication on the matter. In the end, having this type of agreement helps everyone, because patients see the experience (and your time) as more valuable.

  Lead by Example

5Lead by example. While every practice owner should be doing this in some way, it’s important to understand there are plenty of ways to be a leader. For me, I constantly read books on physical therapy and share them with team members. I encourage them to do the same. As the head of Terrapin, I want everyone on the staff to be able to turn to me as a guide. Does this create a bit of stress for me or increase the time in my day? Sure. It’s always tough to be the one in charge. However, good business dictates smart leadership. If I’m making wise decisions and setting pragmatic examples, my colleagues are likely to follow suit. The way you portray yourself should embody the culture you want to represent in your clinic. We’ve all heard this time and again, but it bears repeating: Lead by example. Every. Single. Day.


6Offer a cash option. Not all private practices have opened the door to making it simple for cash-paying patients to set up appointments. Our aquatics pools and therapies have attracted a huge cash-only business, and we would be foolish not to explore options for those who would benefit from these therapies who are underinsured, have exhausted their benefits, or would incur high deductibles. Thus, we market openly to out-of-pocket/out-of-network patients and have programs and systems set up to easily accommodate client needs, whether they are brand-new or were prior patients paying through their insurance carriers.


7Build relationships and look for new opportunities. When patients end their relationship with a physical therapy provider, many are enthusiastic about having met all of their goals without pain limiting their daily life. These individuals are eager to keep feeling wonderful or are looking for ways to prevent further issues in the future. Capitalize on their desires by offering special programs to keep them coming back. Have you thought of wellness programs? Annual checkups? Or consultation visits? Think about ways to incorporate your patients who are begging to be able to work one on one or in groups at your facility after their plan of care. This extra revenue stream is a golden door opportunity: Walk through it and become unique in your marketplace . . . or risk losing these therapy advocates to a competitor.

Tony Pazzaglia, PT, DPT,is a Private Practice Section member and owner of Terrapin Physical Therapy, Inc. He can be reached at

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