The Secret to Success

Hand holding key

Focus on your company’s culture.

By Brian J Gallagher, PT

Whether you are the administrator, director, or owner, most likely you are looking for ways to differentiate your practice from your competitors. This may mean the development of services that are uniquely different from those which your competitors are currently providing. However, this may not be the answer. Actually, creating the best niche practice and having a thriving business has more to do with your company culture—how you treat your staff, patients, and community—than the actual clinical services you deliver. The balance between passionately developing a practice full of services you believe in and sustaining a company culture that is uniquely yours is the challenge we all face in private practice. We don’t want to be so specialized that our practice becomes only about what we are interested in as physical therapists. Even though it may sound like a good idea, it can wind up causing more stress with greater financial pressures. The key is to deliver what the majority of people in your community are actually looking for.

Steve Jobs once said (something to the effect of): We don’t need to ask people what they want; we have to show them what they need. While that may have turned out great for Apple during the tech boom, when new and exciting inventions were hitting every other month, I don’t believe that strategy will work as well for our industry.

I would suggest that you always survey your public in addition to surveying your staff. I believe when it comes to health care people really do know what they want, and will tell you what is important to them. My experience has shown me it’s a balancing act between the patient experience, the needs of your staff, and the expectations of your referral sources. Today more than ever, referral sources are no longer just the medical doctors within your community. You have patients referring patients, social media, and numerous other health care professionals all contributing to your patient base. Your brand and reputation are critical to your overall success, and it must represent what you stand for as a business leader.

The most important quote

Every great leader knows that they must be doing one of these three things at all times: leading, educating, and motivating. Creating a niche practice is much less about having a narrowed scope clinical specialty such as women’s health, vestibular, or some type of holistic practice, and much more about your public’s experience. Remember that it’s your public reputation that is the largest contributing factor to the value of your practice. So, take the following actions to create a truly valuable practice, one in which your niche is creating a company culture about patient care advocacy, regardless of the services you deliver.

1. Recognize that it is your front desk staff that are the most impactful staff members you have. When it comes to your patients forming their initial impression, no one is more important! So, take every step possible not to chance it with someone mediocre at your front desk. Know the 5 phases of hiring (see sidebar), how to ask the right questions, and what to look for in their responses. This will give you confidence that you have the best candidate. Even after they are hired you will need a step-by-step company and position orientation checklist, to ensure that everything is taught to them clearly, with full duplication. The perfect person should be fully independent by their fourth week, and if they are not, then you most likely have the wrong person for the job.

2. Achieve high personnel morale by having one-on-one, 10-minute meetings with every new hire. Do this one time per week for their first 90 days, and then once a month thereafter, for the lifetime of their employment. This time is exclusively set aside for them to come in and talk to their supervisor about whatever they choose. This is their time to feel validated and heard, so don’t fill it with in-services and training, unless that is what they want. This action ranks very high in the eyes of today’s Millennials.

3. Maintain an internal and external incentive program with an objective and subjective performance review format that will give the feedback and confidence that there is room to grow, both professionally and personally, within your company. All too often this step gets overlooked and the administrators fail to recognize that their juniors are really interested in knowing how they can improve and advance with greater skills and ability. An internal incentive program might include participating in a Work Out at Work program, which gives your employees time to exercise while still on the clock, or earning written commendations that can add up and result in increased compensation. External incentives might be a financial bonus system that is paid out at least monthly, or a tuition reimbursement program to help them pay back their student loans (which, in this current atmosphere, is very popular).

4. Use a Patient Care Representative (PCR). Educate employees to use highly effective tools such as patient games, success stories, patient surveys, Give Me Five drill (everyone has to know five personal things about every patient), or a Wall of Fame (placing patient photos with their success stories next to them on a hallway wall for everyone to acknowledge). This level of staff/patient engagement is different than what is typically expected, and allows for an atmosphere where everyone feels a bit more valued. A PCR in my opinion is a must-have position and makes all the difference in the world.

My experience quote

The most important thing to remember when creating a successful business model you are passionate about is to find out what your community actually wants, and then give that to them in a way that exceeds their expectations. For example, many restaurants serve good food, but very few actually provide great service. My experience has shown me that patients and families are looking for good customer service, and employees are looking for a positive, upbeat place to work where they feel acknowledged and are given opportunities for growth. I encourage each of you to do your own surveys and find out the specifics of what is needed and wanted in your area from your patients, staff, and referral sources. I equally encourage you to not fall into the trap of trying to overspecialize but to do everything possible to be a niche provider delivering a superior customer experience. Yes, it is true that the consumer is driving their own health care choices, more now than ever before, but it is still very expensive for most people to have access to their health care provider. Therefore, it is vital to add greater value through exceptional service at our clinic and make that their niche practice experience.

Brian Gallagher

Brian J. Gallagher, PT, is the chief executive officer of MEG Business Management, LLC. With more than 24 years of experience in the field of rehabilitation and 19 years in business, he specializes in physical therapy practice billing and coaching nationwide. Brian supports the APTA through lecturing, writing articles, and performing webinars. He can be reached through his website at or via email at

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