Overcoming Marketing Obstacles


A cash-based practice perspective.

By Susan C. Clinton, PT, DSc, OCS, WCS, FAAOMPT

In 2014, with great enthusiasm, my partner and I opened the doors of our cash-based physical therapy practice—thus fulfilling a dream several years in the making! We soon discovered that our many years of treating patients did not prepare us for managing all aspects of a physical therapy business. In particular, we centered our practice in a region that is dominated by large payer consortiums that employ many of the region’s physicians. Though we had solid reputations with a number of physicians in our area, their health care consortiums severely limited their ability to consistently refer to outside physical therapy practices. Consequently, we quickly learned that a common practice—marketing to physicians—would not provide the expected revenue stream. Instead, a direct-to-consumer marketing strategy was needed and needed fast!

Marketing directly to customers demanded that we consider the following three parameters:

  1. clearly define the customer;
  2. answer the question, “Why should the consumer come to our clinic specifically and pay cash at our practice?”; and
  3. determine how to effectively reach that target market.

As a cash-based practice with a niche specialty in pelvic health, pregnancy, and chronic pain, our primary target customer was easily defined. The second parameter proved more challenging. To paraphrase Peter Drucker, “Consumers do not buy what you sell. They buy what has value to them.”1 Given our out-of-network status, we first had to educate the customer about our practice model to ensure that it provides value. For many of our prospective patients, it is absolutely critical that we overcome this issue first. If they do not understand the financial considerations, most will simply not consider utilizing our skilled and focused treatment programs.

As a result, we developed marketing materials that address this question head-on and advise potential clients on how to obtain insurance reimbursement and to consider the cost of copays to in-network providers versus our treatment plans. We can then focus on our approach to physical therapy and the value we believe in: a singular experience for the client by directing the sessions around his or her goals in a one-to-one environment.

As for the third parameter—effectively reaching our target market—we are still learning. The shift from a physician-focused to a customer-focused marketing strategy means we must directly reach the customer. Our multifaceted approach involves writing blogs and e-books, providing community movement classes, and offering wellness experiences. We also use Facebook to post educational information for the pregnant, postpartum, and chronic pain consumers as well as to post community education in pilates and yoga studios.

Other successful cash-based practices are using their own unique approaches. For example: Marianne Ryan, PT, of MRPTNY2 in New York City, has remarked that she had to change her practice model because many of her referral sources changed with physician- and hospital-owned practices emerging in her area. She changed her practice to focus on pelvic health and pregnancy and began a unique campaign by writing a successful book aimed directly at the consumer, The Baby Bod.3 The book is a great method to educate her clients/patients in an effective manner and bring national acclaim to her practice, which sets her apart from her competition.

Sandy Hilton, PT, and Sarah Haag, PT, of Entropy Physiotherapy & Wellness, LLC, in Chicago, are using community involvement and a strong social media campaign to help bring their message directly to their consumer group.4 Both of these physical therapists and their company have a strong presence on Twitter and Facebook and are successful in networking with the consumer on messages about chronic pain, pelvic health, and accessing physical therapy. In addition, they have found that working within their community Chamber of Commerce group and the Women’s Health Foundation has helped with their local position. Creativity also has set them apart from their competition: Sarah offers community yoga classes, and Sandy spreads the work about pelvic health in stand-up comedy and storytelling communities in Chicago.

Blair Green, PT, of One on One Physical Therapy5 in Atlanta, uses the success of the patients’ experience to emphasize how the practice is different. Having a physical therapist who listens, empathizes, and takes them through a full program is their standard of care. She reports, “Our patients are our best marketing tool. The most common comment is, ‘I wish I knew about you sooner.’”

In today’s changing health care environment, it is crucial that cash-based physical therapy practices clearly define their target market. Once defined, then it is imperative that the practice’s value proposition be clearly communicated directly to the consumer.


1. Drucker PF. 22 Quotes on Management. www.slideshare.net/bright9977/22-quotes-on-management-by-peter-f-drucker. Published July 16, 2011. Accessed December 28, 2015.

2. Marianne Ryan Physical Therapy. www.mrptny.com. Accessed December 28, 2015.

3. Ryan, M. Baby Bod: Turn Flab to Fab in 12 Weeks Flat! Baby Bod Press; 2015.

4. Entropy Physiotherapy and Wellness. www.entropy-physio.com. Published 2013. Accessed December 28, 2015.

5. One on One Physical Therapy. Gyrotonic Sales Corp. www.onetherapy.com. Published 2015. Accessed December 28, 2015.

Susan C. Clinton, PT, DSc, OCS, WCS, FAAOMPT, is a PPS member and co-owner of Embody Physiotherapy & Wellness, LLC in Sewickley, Pennsylvania. She can be reached at susan@embody-pt.com.

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