Shapeshifting Yourself and Your Business with D2E – Myth into Magic!

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How to expand your offerings to include on-site services

By Glenda Key, PT, and Christine McCallum, PT, DPT

In mythology, shapeshifting requires transforming oneself or others through unnatural means. Marketing and delivery of services “Direct to Employers” (D2E) may seem to be an unnatural practice model for you. To keep up with the rate of change in the world, metamorphosis into new business models needs to be a natural transition for those providing physical therapy and wellness services. Initially, the provision of D2E services may seem completely different from the work you are doing in your clinic. However, when it comes down to it, you and your staff are using all the same knowledge and skills you use every day — screening, assessing, educating, consulting, negotiating, motivating, and ensuring safety — just in a different setting for a different customer. Expanding your mindset to include a focus on Total Worker Health®1 and marketing to Employers opens up multiple revenue streams for your practice.

Some of the most common D2E services include2:

  • Post-offer employment (POET) and return to work testing
  • Work conditioning
  • Job function analysis
  • Ergonomic assessment and implementation
  • Preventive care such as education and OSHA first aide
  • Injury care.

POET and injury prevention services make an early and quick impression. Encourage employers to begin with these offerings in order to realize a quick ROI through decreasing costs due to injuries. POETs are a great opportunity to introduce the company’s safety culture to future employees while also ensuring their job readiness.


Identify types of businesses in your area and then procure number of employees, injury rates, health insurance model, and more. Here are eight ways to get started:

  1. Get in your car and do drive-arounds within 60 miles. It’s amazing the places you drive by every day and never realize the business opportunities right under your nose!
    • Up to 15 miles: Employees can access your clinic for out-patient care; you can deliver injury prevention at employer’s site.
    • 15-60 miles: Employer Partners can be serviced for both direct treatment and prevention coaching/education on-site at their facilities.

    The more time you are delivering services in the employer’s space, the more quickly your business expands into additional services.

  2. Access the Bureau of Labor Statistics (BLS) and Occupational Safety and Health Administration (OSHA) online sources of employment and injury data. Look for companies that have total injury rates that are higher than the industry standard. This data is free to the public.
  3. Attend and network at Association meetings: Manufacturing, Transportation, Hospitality, Workers’ Comp, Safety, and Human Resources.
  4. Query each new patient regarding their work place — you never know who is a connection for an introduction of your on-site services. Are you seeing a disproportionate number of patients with work related injuries from a particular company? They need your help on-site!
  5. Capitalize on your community connections and peers. Golf, play pickle ball, go to book club, and sooner or later, business will come up! Ask them if they are happy with their health care and Worker’s Compensation costs, and you will most likely always hear “no” — there is your open!
  6. Focus on self-insured companies because they can be creative when administering their employee health plan, and fostering healthy employees to keep costs down.
    • ZoomInfo is an excellent resource to find self-insured companies. The platform provides users with access to contact information and company profiles, which can be used to research potential customers and create targeted lists. ZoomInfo can also help with lead generation and marketing research.3
  7. Participate in Employers health fairs. Demonstrate services you can provide on-site and bring new patients to your clinic at the same time.
  8. Research online. Annual reports and job recruitment sites where past employees post about their experiences give very useful insight to company’s pain points.


Now that potential clients have been identified, what is the best way to market the benefits of D2E services to them? Have a capabilities statement, elevator speech, and business card ready to go when reaching out to employers. These tools make potential clients aware that you understand their problem and can solve it with your product.4

Appeal to Employers’ needs which are usually centered around OSHA recordables/workers compensation expenses, lost productivity, and overall employee healthcare spend. Track these outcomes and utilize them in your marketing materials. Include custom cost savings information and ROI/VOI utilizing the OSHA cost calculator to provide accurate monetary value to on-site services.5


Your “quarterback,” your marketing person engaging Employers, must be chosen carefully. Provide them with education in business language and sales techniques. Your quarterback needs to understand their own personality style so they can easily shift their approach as needed to maximize communication and comfort. It is important that they can find and connect with the employer’s ball-carrier, the person who can either make decisions or get your proposal in front of those who can. Again, Zoominfo is a great resource for finding your ball-carrier.


One approach is to score them as A, B, or C. The three factors are interest, need, and $$$.

  • A: Employer has all 3. Utilize strong sales skills such as active listening and interest-based negotiation to create an alliance and get the business
  • B: Employer has 2 of 3. As above and coach them through the insights of the missing factor
  • C: Employer has 1 of 3. Same as B, but now coach through the insights of the missing 2 factors

No better time than now to shapeshift into D2E services. Consider this:

  • OSHA First Aid is a large bucket that pays dividends beyond the on-site provider’s direct interaction. Not only are OSHA recordables and workers’ compensation claims avoided for minor injuries, but those employees are more likely to have positive health improvements after seeing an on-site physical therapist.7 And they know that their employers care about them.
  • The growing movement for physical therapists to be a primary care access point can be actualized at employer sites. Presenteeism costs US employers >$150 billion a year in lost productivity.8 Treatable conditions such as low back pain, headaches and arthritis are responsible for >5% productivity loss, on average, which equals millions of dollars annually for employers. With direct access, physical therapists can improve the health of all employees and strengthen companies’ financial health simultaneously.

D2E care is an effective and rewarding practice model. So, take these tips and jump in with both feet to shapeshift your revenue stream and patient care.


1Total Worker Health Program. Centers for Disease Control, The National Institute for Occupational Safety and Health. Total Worker Health | NIOSH | CDC

2Key G, Oeffner J. Open Employers’ Doors and Step Into Direct Pay Revenue. Impact 2021, June; 27-31

3LaRiccia R. Ultimate Guide to the Data-Driven Sales Funnel. Sales Funnel Strategy: Why Data Makes the Difference. Zoominfo

4McCallum C. The On-Site Physical Therapist: Direct-to-Employer Care. Gatekeeper Press, Tampa, FL, 2023, 122.

5OSHA’s $afety Pays Program, Estimated Costs of Occupational Injuries and Illnesses and Estimated Impact on a Company’s Profitability Worksheet, U.S. Department of Labor. OSHA’s Safety Pays Program | Occupational Safety and Health Administration

6Coleman B. How to Use BANT to Qualify Prospects in 2022.

7Fritz JM, Brennan GP, Hunter SJ. Physical therapy or advanced imaging as first management strategy following a new consultation for low back pain in primary care: Associations with future health care utilization and charges. Health Serv Res. 2015;50(6):1927-1940.

8Hemp P. At Work – But out of it. Harvard Business Review. Published Oct 2004.

Glenda Key, PT

Glenda Key, PT, is the CEO of KEY Functional Capacity Assessment Network. She can be reached at

Christine McCallum, PT, DPT

Christine McCallum, PT, DPT, is the owner of McCallum Physical Therapy, P.C. which provides on-site PT services to employees. She also consults for PTs and employers regarding the D2E model and has recently authored “The On-Site Physical Therapist: Direct-to-Employer Care.” Chris can be contacted at

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