The Compass for Strategic and Sustainable Growth

Person spying paper boat through a spyglass

Put people first, starting now.

By Dan Rootenberg, PT, DPT

As entrepreneurs, you’ll find many strategies on how to set the course for growth in a physical therapy private practice.

It’s common sense that your growth strategy should guide every business decision—from how to frame messages to your internal team, to how to chart your growth as you gain momentum and expand your geographical presence. But in a sea of strategic options with both experts and nonexperts telling you to take varying directions, how do you choose?

The advice I can offer fellow entrepreneurs is something that’s been transformative in our organization. It’s incredibly simple, almost cliché; a concept business leaders often hear for the hundredth time, nod their heads in agreement, and then seem to completely forget when it comes time to make the most important decisions: Always put people first.

I acknowledge that it’s easy to broadly say companies should put people first, but that doing so can be challenging and requires a new way of looking at decisions. To illustrate this, I’ve described what “putting people first” looks like for our team as well as some practical, actionable steps you can take to apply in your own practice.

Gather Feedback to Inform Change

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First and foremost, I advise you to use direct feedback from customers as your guide. Think of your practice as a customer service company that just happens to do physical therapy. Avenues like Yelp, Google My Business, and social media can provide great insight as you set your strategy. For example, customers have told us they value our clinical expertise and the friendly, welcoming environment we strive to create for each one of them. All of this points to investing even more in both areas, so we do. The feedback also reinforces the importance of recruiting the top candidates from the top physical therapy schools and continually offering ways for them to keep learning.

To build a warm environment, our team member orientations bring together new team members at every level, from our C-suite to our front desk, and together they learn about some of the intangible and critical aspects important to create welcoming environments. Together as one group we talk, for example, about the difference between empathy and sympathy and how even small acts of kindness can make a big difference in a customer’s life. We share personal stories, we listen, and that sets the stage for a strong culture and a positive impact on our customers.

I also recommend setting the precedent for your team to treat one another the same way you treat your patients. To illustrate this, we spend significant time critiquing not only external messages but also internal messages. We do this because we believe it’s critical that our team is constantly reminded of how much we prioritize them, and that they should prioritize each other, to maintain our strong culture. This is especially important during rapid growth. In terms of prospective team members, I encourage you to strive to be as transparent as possible on social media. We invest time in responding to customer review sites, but we also prioritize responding thoughtfully to employee review sites like Glassdoor. We do this because we know many of our future team members are visiting these sites, and we want them to know we care about how our team members feel.

Grow with New Locations

Strategic growth decisions should be guided by focusing on people, both your customers and team. When you’re faced with the customer demand to open new clinics, ask yourself if that is the right choice for your team. When the answer is “yes,” it is because we know that talented people seek to grow. Opening new clinics allows more leadership positions for our incredibly talented team, and this lets us know we are making the right decision.

To recruit and keep the best talent, we have invested in leadership opportunities, creating a cohort each year that goes through an MBA-style leadership curriculum. Graduates have told us how valuable it has been, and we’ve seen our people develop into powerful leaders in our company. This tells us to keep investing.

After we knew we should grow, we did our homework to decide where to grow and how to grow, all guided by putting people first. Our geographic expansion decisions are based on three things: data on people, feedback, and internal leadership strength. For example, conduct a robust patient zip code analysis and heat map, then overlay it with location data of referring physicians. Actively listen to patients and physicians for location feedback and suggestions. On top of this, be highly selective in choosing the leaders to open new locations. It’s obvious that choosing a bad location with a bad leader will lead to failure, but it’s also important to note that even choosing the perfect location cannot guarantee success. The strength of your leaders is a crucial factor in determining whether your expansion will be successful.

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Take Practice Steps for Growth

Everything I’ve just shared is how we’re putting people first, but there are countless other ways you can also apply this principle. To help make these decisions, I encourage you to consider the following steps to put people first in your own practice.

  1. Set your goals and make them specific. SMART goals (that is, goals that are specific, measurable, achievable, results oriented, time-bound) with action plans can spur tremendous growth, but even small ways to improve will enhance your chance of achieving a goal. In addition to writing the goal down, tell someone (or your entire team) your goal. You’ll feel the need to make good on your promise, and you’ll end up working harder.
  2. Listen to what your customers are saying outside of your clinic. As physical therapists we’re lucky to have 1:1 conversations with our customers, but there are likely a variety of online channels your customers use to talk about you as well. Establish active online presences in those places, engage your audience, and learn from them. Respond to each review or post on sites like Facebook, Instagram, etc., whether positive and negative. Internally we talk regularly about what we hear on our various channels and assess if we should make adjustments to how we do business. The answer is often “yes.”
  3. Communicate with your team. Don’t talk at your team, talk with your team. Listen to their concerns and suggestions and let them know how valuable their insight is. Recently our new CFO did a “Listening Tour” before making any suggestions on improving. We also hosted an All Hands Town Hall meeting where our entire team could ask questions to our top executives in person or submit them anonymously through an app in real time. This not only communicated empathy and transparency to our team but also resulted in better, smarter guidance for improving.

I’ve just shared our “secret to success,” our “magic recipe,” our “compass.” I encourage you not to be one of the many people who may read this, nod, and make no changes. Putting people first, both customers and team members, has allowed us to go on a tremendous journey of growth and given us the ability to treat increasing numbers of new patients. I wish you the best of luck in your journey!

Dan Rootenberg, PT, DPT, is the chief executive officer of SPEAR Physical Therapy in New York City. He can be reached at

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