United Front


Establish shared goals of success for both patients and clients.

By Brian J. Gallagher, PT

In any field, improving performance and accountability depends on having a shared goal that unites the interests and activities of all. For many, a lack of clarity about what their goals are leads to complicated approaches that many times slow progress in production.

Achieving a high value for our patients must become the most important objective in our practice delivery system, with value defined as the health outcomes achieved for every dollar spent. This goal is what matters most, not only for our patients, but also the other players involved such as the providers and third-party payers.

Value is neither an abstract ideal nor a code word for cost reduction. Yet value in health care remains largely unmeasured and misunderstood. Value should always be defined based on our patients. In a well-run clinic, the creation of value for patients should be based within the systems of operations in such a way that the patients, the staff, and the practice are all winning at an extremely high level. Since value within your practice depends largely on results, not input, it is measured by the actual outcomes achieved, not the volume of services delivered. Therefore, we must have a shift in focus from volume to value, and therein lies a challenge for many practice owners. This five-point system can be used objectively to improve outcomes and track value:

1. Access to Care
In order to maintain the maximum level of efficiency within our clinic when it comes to personnel utilization and patient accessibility to care, what we have found works best is to have every patient scheduled between two clinicians throughout their entire plan of care. This is virtually successful 100 percent of the time, so long as the evaluating therapist and the front desk personnel are coached appropriately on how and why we are scheduling in such a manner.

The Value: This will allow the patient more days and time slots to choose from and create a greater team approach with peer-to-peer self-learning occurring between the two treating therapists.

2. Scheduling Out the Entire Plan of Care
Your front desk should be scheduling every new patient for their entire plan of care at the end of their first visit. This should be done in accordance with the physical therapy (PT) frequency order slip given to the patient during their evaluation by the evaluating therapist. With this scheduling practice, you will see much greater overall patient compliance.

The Value: Because the patient perceives this as a physical order being given to them by their doctor of physical therapy, their compliance rate is much higher throughout the duration of care. You will also achieve the added benefit of having the patient making physical therapy a priority in their schedule over the upcoming weeks because they already have it booked in their schedule.


3. Management by Statistics
Managing statistics through a software system will allow for the measurement of pertinent statistical data to show the vital trends that can be graphed, so a weekly action plan can be applied accordingly.

The Value: Having the key operating metrics identified so that the outcomes can be tracked and graphed, one can be assured that everything from clinical efficiency to production, collections, patient reactivations, patient visits, new patients, and gross income divided by staff, can be acted on weekly.

4. Patient Surveys and Success Stories
Patient feedback in the form of surveys collected directly from the patients themselves at the time of their evaluation, two weeks into their care, and at discharge, can be scored to provide a qualitative evaluation of patient satisfaction. Another mechanism can be used to quantitatively measure the number of patients per therapist who are having an overall good patient care experience.

The Value: No other mechanism can be used to more accurately depict the patient care experience better than surveys and testimonials/success stories, so long as they are numerically weighted.

5. The Delivery of an Abundance of Care
The need is higher now than ever before to deliver more care per visit. This is largely due to the fact that more costs associated with the patient’s PT care are being passed on to them from their insurance carrier, in the form of higher deductibles and copayments.

The Value: High-quality clinics are striving to ensure the maximum number of units of care can be delivered to patient per visit according to their condition. This is often easily tracked within the practice’s electronic medical records (EMR) system.

The failure to prioritize the sequence of actions that bring about the greatest value is one of the most common mistakes that physical therapy owners make. Lacking a weekly action plan that addresses the statistical results of your production simply keeps you busy devoting time to “putting out the fire” closest to you. We can no longer afford to perform our services without measurable outcomes, which ensure high-quality care while at the same time meeting the production and efficiency needs of our practices.


Brian J. Gallagher, PT, is the chief executive officer of MEG Business Management, LLC, in Severna Park, Maryland. With more than 24 years’ experience in the field of rehabilitation and 19 years in business, he specializes in physical therapy practice management and executive coaching nationwide. He can be reached at brian@megbusiness.com.

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

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