The “Four C’s” of Growth


Building blocks for business success.

By Heidi Jannenga, PT, DPT, cofounder and president of WebPT*

*The author has a vested interest in the subject.

Ten years ago, if you had told me I would be the cofounder of a rapid-growth technology company, I probably would have laughed—and then gotten back to evaluating my patients. I was a physical therapist, after all, and I definitely did not have my sights set on becoming a tech executive. But here I am, coming up on my company’s 10-year anniversary. In the decade since our launch, the electronic medical record (EMR) platform that my cofounder and I originally built specifically for my clinic has become the industry-leading software solution in the rehab therapy market, achieving 30 percent market share1 (and growing to a team of more than 300).

That growth did not come overnight, though. It took a lot of hard work, and we learned a lot of lessons along the way. And while we are still learning every single day, I feel like I am in a place where I can share some of the best practices we have honed over the years to get our business to where it is today.

The following four C’s of growth encapsulate everything we have done at our company to achieve consistent success and sustainability. Although there are many other keys to whom we are as a company, I believe these tenets represent the main reason we have been able to grow rapidly, repeatedly win the hearts of new customers, forge important partnerships, and retain existing members and employees. And these principles do not apply only to technology companies. In fact, they are well suited to practices of all shapes and sizes.

Commit to being conscious
Throughout my career, I have met—and been inspired by—countless people in the rehab therapy industry. We all seem to share the same heart—one that prizes healing and has a deep passion for serving others. It is because of this mindset that the philosophy of Conscious Capitalism resonates so much with our profession.

In a nutshell, Conscious Capitalism is a global movement that champions a purpose-driven and people-first approach to business growth. If you are not familiar with the specifics of this ideology, it revolves around identifying your company’s higher purpose—one that aligns and integrates with the interests of all its stakeholders (including patients, employees, and partners) and cultivates a culture that gets everyone on board to help fulfill that purpose.

It is about embracing a mentality of “we” versus “me.” In my mind, physical therapy private practices are perfectly positioned to implement this type of business approach—and reach new echelons of success as a result. And it all starts with creating a solid culture.

Cultivate a winning culture
When we were a small startup, we naturally took on a tight-knit, fun culture. As we began adding employees at a rapid rate, however, we knew we had to be more thoughtful about preserving the culture we had organically built; otherwise, it could quickly erode. So we enlisted our entire team to help define the characteristics that matter most to us and form the basis of who we are. These core values—or culture commitments, as we call them—guide our overall strategy as well as every individual decision we make, from who we hire, to which partnerships we pursue, to what new features we roll out.

Ultimately, though, your organization’s culture should be rooted in the passion you and your team have for what you do. It is about being a part of something bigger—something meaningful. It is about creating an environment in which every individual—employee, patient, or referring partner—feels valued and personally invested in your company’s overall vision. This, in my opinion, has been our greatest success to date—not to mention the core driver of our growth. And the good news is, it truly can apply to every business.

Create raving fans
At our company, we fondly refer to our customers as “members.” And we have made it our mission to create a community we all contribute to. With this in mind, we have prioritized customer feedback and iterated our product to meet customer needs quickly (and even proactively, when possible).

One of the best tools we have used to achieve this is Net Promoter Score (NPS). At first, we measured our NPS twice a year. But eventually we found that collecting this valuable feedback data every six months just was not enough. So we revamped our entire NPS process, segmenting our members into different groups and sending out an NPS survey to one group per week. That way, we were able to obtain a steady stream of real-time customer feedback, which helped shed light on how system changes or issues impacted our scores.

We also started including an optional comment box below the NPS question (which, for those not familiar with NPS, simply asks how likely the customer would be to recommend our company to a friend or colleague). This allows members to elaborate on why they selected a particular rating, or even to make suggestions. The comments are then appropriately routed to various teams: the sales team if they need to get in contact with the customer to learn more about a particular issue, the technical team if an issue needs to be remedied, or the product team if there is a need to discuss the potential introduction of new features or integrations. This plan has helped us dramatically increase our NPS score, and it further demonstrates how our team works together to serve our deeper purpose.

We also create and distribute educational content via our website and other marketing channels to reach customers with useful information when they need it most. From a marketing perspective, while it is important to include calls to action in the content you create, you have to start from a baseline of providing extremely high-value information. Every piece of content we develop—whether it is a blog post, e-book, downloadable guide, or webinar—explores a topic that is timely, relevant, and useful to rehab therapists. For example, we might cover tips for improving your clinic’s bottom line, explain how to handle high-deductible insurances, or discuss ways to leverage outcomes data to improve patient care.

As a rehab therapist, you have endless options for providing valuable educational content. Simply find the intersection between your expertise and what your patients—and prospective patients—want to know about most. Then build your content program around the topics that fall into that realm. The goal is to become a trusted resource. And remember, you can start small, perhaps with a weekly blog post that addresses a question you are often asked or covers a helpful exercise you want to share. As you gain momentum, your content program can become more sophisticated. What is important is that you get it started—and focus on how you can use it to deliver value.

Foster collaboration rooted in strategy and empathy
Like most other successful businesses, we would be off-our-rockers if we claimed to have gotten to this level on our own. We appreciate and invite strategic partnerships, especially when they help us get closer to achieving our deeper purpose. For example, as part of our commitment to interoperability, we recently completed software integrations with several key hospital-based electronic health record (EHR) systems. And in contributing to the development of a better, more interconnected health IT framework, we are helping foster a better, more efficient, and more patient-centric health care landscape. So, instead of looking at other organizations as competitors, consider viewing them through a different lens. Could this person or business help you better serve your patients’—or the entire health care community’s—needs? If so, you may benefit from forming a mutually beneficial partnership.

And while the examples given are more formal in nature, we have informally paired up with many organizations and leaders throughout the years to give—and get—value. Synergy in your local business community is crucial to sustained growth, and I encourage every business owner reading this to reach out to a like-minded company or leader to explore the potential for a value-based partnership.

I started this piece by talking about some of the major growth markers that WebPT has achieved. But whether you have aspirations of building a multimillion-dollar company, or you simply hope to generate a few more new patients in the coming months, you can apply the four C’s to your business. Your practice is unique, and your approach to growing and improving it should align with your own values. But if you weave in some of the tactics I’ve shared here—like committing to Conscious Capitalism, intentionally building your culture, using tools like NPS and content creation to better serve your stakeholders, and collaborating wherever possible, you will be in a great position to reach your goals even sooner.


1. Accessed January 2018.


Heidi Jannenga, PT, DPT, is the co-founder and president of WebPT. She can be reached at

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

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