1. Creating your success Preserving your success

2. Key to Success #1 Minimize Costs!
Key to profit is NOT high income
Key is low EXPENSES (esp. today!)
You must take control !

3. Maximize income Maximize patient access*
Early AM.. Late PM.. Sat?.. Eve?
ASAP intake… same day-24hr
Hurting bad = priority intake
MD relations tactics
Patient relations tactics

4. Maximize income Examine your EOB’s Reveals billing errors
Reveals insur pay rip-offs
Skip a day or a procedure*
Tells you what they pay for what Rx
Aetna-Medicare multiple procedures discount

5. Paying attention to business: Metrics-I
Stats…. daily-weekly-monthly-annual
Gross billing, collections, A/R aged
Expenses, per category
Know cost-per-visit, cost per-case
Know what you need to break-even!!
Monitor.. Assess.. Respond

6. Monitor.. Slowdown?.. RESPOND…
e.g., marketing investments to increase patients
(slower, bigger response)
or, collection efforts: call payers, bill-dun patients
(quicker response)
or, immediate cuts in expenses
(quickest response)
Determine if problem temporary vs long-term!

7. Financial Crisis -I Is it a temporary shortfall ?
If so, tap into savings… as you fix the problem.
OR..
Is it a long-term trend ?
If so, cut costs… and adapt to the change.

8. CRITICAL!! Diversify income streams 1/4
Insurance payers
Employers
Services
MDs
Dxs
Diverse ‘product line’
Multiple income streams

9. Diversify income streams
Multiple income streams
Because whatever is working best for you,
can & will go away one day

10. Diversify income streams WHY? …2/4
Your best MD dies or retires
…or opens a POPTS
Hospital plays hardball push on MDs,
… or hires a good go-getter PT
Private health insurances go bad (very bad)
(Lethal contracts-rules)

11. Diversify income streams WHY? …3/4
Big employer switches to cheaper, bad insurance
Big employer contracts another PT or Hosp
Big employer closes down
New PT – POPTS - DC opens shop
Medicare imposes huge restrictions
State socializes Worker Comp
ACO-hospital monopoly

12. Diversify income streams HOW …4/4
Outlying underserved areas for branch office (overhead!)
Special Dx (TMJ, vertigo, HA, runners, golf, women’s health, fitness)
Special Rx (McKenzie, Manual Rx, laser, kinesiotape, orthotics, gym)
Employers (Worker Comp, ergonomics, microstretching, RD, on-site)
Schools (Spl Ed, ATC, preseason screen, coach-parent-athlete inservice)
Build Private Pay base – value-added PT

13. Scams Yellow Pages Toner Equipment leasing Credit card processing
Blind invoices
Business loans

14. Chapter Three MARKETING
Marketing Physical Therapy
Marketing Your Practice

15. 17

16. MARKETING A Dirty Word ? An Evil Concept ?
Or connecting those with needs to their solutions

17. MARKETING Why? You may be a great PT..
You may offer best, essential services..
But…
You are useless if you cannot
empower clients to access you

18. MARKETING An essential part of your skills set
An essential part of your practice
An essential part of your success & survival

19. MARKETING !! You have a responsibility to get
your services to those who need them,
to educate them re what you can do for them.

20. Marketing ~is ~ Education Educating your client re your services

21. MARKETING !! Essential Not ‘dirty’ a dirty word
You must be good at this !
Without this skill, you will fail.
PT Profession needs more of this.

22. MARKETING !! You are already doing this
as you educate & motivate your patients
to accept responsibility to do their HEP-ADL

23. 10

24. “Brand” crisis in PT (repeat visit)
Kleenex
Subaru
Apple
Plumber, carpenter, cosmetologist, massage therapist
But… PT ??
What is that ?????
(many bad examples)

25. Public’s perception of PT
Vague
Varied
Distorted
Inaccurate
Incomplete
Limits demand, utilization, value
This is a major part of our challenge

26. “Branding” PT What is PT? (in the eyes of others)
HP-US-ES… Massage… Walk Granny… Transfers
Vision 2020… Movement Disorders
You will need to Brand PT
Then need to Brand YOU..
Branding YOUR practice.. YOUR uniqueness
Patient tells MD they want to go to YOU for their PT
Marketing PT

27. Build Your MARKETING PLAN around your Business Plan

28. Independent Practice marketing role
You define your practice and
create your customer base via marketing

29. Big deductible – copay make most
patients ‘de facto’ private pay
THIS marketing challenge
…………
Many defer care altogether to avoid costs

30. Write your goals!.... your strategic plan your business plan!
*Long-term goals*
Short term objectives-steps
with a timetable
This leads to your Business Plan
This requires a Marketing Plan

31. Clinical Niche’s These succeed on marketing awareness.. demand.. dominate
How will you market each of these niche ?
patient-public … referral sources ?
MSD Post-op Spine Care.. Orthotics-prosthetics
Work Injury Prevent-Ergonomics Sports.. Fitness.. Podiatric..
Runners.. Golf.. Performing Arts PT.. Animal PT-canine-equine..
Women’s health.. Lyphedema.. Bladder & Pelvic Floor.. Dry needle
Balance-falls Vertigo Wound care TMJ HA LLLT

32. Marketing…
How it is done 35

33. MARKETING What is it ? Educate client base..
You help them to self-define their needs
Educate them re. your roles re. meeting needs
Guide them to decide they need & want you
‘You have needs… I can meet those needs’

34. MARKETING You already do this with each patient via patient education
We market the patient to accept responsibility to do their exercises & ADL
That is PT
That is marketing

35. Service Advantages that give you a market edge
Access… 24hr intake… early AM.. late PM.. WE ‘s
Better outcomes … Fewer visits.. Lower cost
Advanced specialty skills… EBP
Take time… Educate… How to take care of yourself
You excite & motivate patients!!
MD communications (fax notes asap)

36. Branding:
PT… You 38

37. Public’s perception of PT
Review from day one…
Vague
Varied
Distorted
Inaccurate
Incomplete
Limits demand, utilization, value
This is our marketing challenge

38. Public: what is PT? What is PT? (in the eyes of others)
HP-US-ES… Massage… Walking… Transfers
These impressions likely accurate, for some PTs
Vision 2020… Movement Disorders

39. By 2020, physical therapy will by provided by
physical therapists who are Doctors of Physical Therapy, *recognized by consumers and other health
care professionals as the *practitioners of choice
to whom consumers have direct access
for the diagnosis of, intervention for, and prevention
of impairments, functional limitations, and disabilities
related to movement, function, and health.
*Marketing objectives

40. “Branding”
A brand is core essence of a person, company, organization, profession
It is that single, ownable thought or "mindshare" that allows for creation of a meaningful bond with one's customer
A solid brand allows its owner to deliver on a promise to customers
or, in the case of the physical therapist, to patients.
A strong brand builds trust and recognition …and grows business.
e.g. Kleenex (or: in Dixfield = SmartCare)

41. “Branding” PT www.apta.org/brandbeat www.moveforwardpt.com
In 2007, amid growing competition in the health care industry and shrinking budgets, the APTA Board of Directors determined a need to re-brand the physical therapist and the profession to better position us as the experts in restoring and improving motion in people's lives.

42. Your Branding Challenge
Brand PT
Brand YOU
Brand YOUR practice

43. WHAT ARE YOU
BRANDING ?
MARKETING ?
SELLING ? 32

44. ** What you are selling? -I
Do not sell WHAT you offer: (PT, ther ex, etc)
Sell the VALUE of what you offer: (outcome of PT)
Not “PT”… it is “what PT does for you”
Eliminate pain (patient)
Restore function (therapist)
“You will move better before you feel better” (pain versus function)
Cont. 

45. ** What you are selling? -II
Better yet…(KEY ELEMENT!!)
We TEACH... YOU… how to take CONTROL of your problem
Personal control of your life.
Control of your health care costs.
Challenge : personal responsibility

46. What you are selling? -III
OUTCOMES…
Customer’s criteria for selecting you
Track Record
“SmartCare averages 5 visits per case, with 92% successful outcome”
“IMPACC average 72% reduction in MSD, at 600 workplaces, since 1982”

47. What you are selling? -IV
Confidence in you
You are the best
You are unique
You are the ‘provider of choice’

48. What you are selling? –V KEY !
We TEACH you how to treat yourself…
So you can take CONTROL of your problem…
With less treatment sessions and COSTS…
** You get better, faster, at less cost **
Prevent and control recurrences…
You LEARN to TAKE CARE OF YOURSELF .

49. What you are selling? -VI
Differentiation from the others
Your Uniqueness
You are different from the rest
Special services & value
Value-added (you are more than the others)

50. What you are selling? -VII
Relentless name recognition
Become very well-known in community
BRANDING YOUR PRACTICE
Ads, sponsorships, web presence, PR, articles, etc..
Presentations, running clinic, Back School, UE School,
office ergo, falls risk screen, fitness, scoliosis screen, etc..

51. What you are selling? -VIII
Identify & build niche market(s)
Dominate your marketplace
Be foremost... be best
Be first

52. What you are selling? -IX
First impressions
Appearance & demeanor
Very professional
Very motivated
Very excited

53. Marketing the Doc’s? no… market the Public
Traditional focus: marketing the MDs?
No… instead.. market the patient-public
The patient tells MD where they plan to go for PT !
This fights POPTS & HOPTS
with their captive markets

55. Marketing the Workplace also….
Traditional focus: marketing the MDs?
No… instead.. market the workplace.
The workplace tells MD where their workers go for PT !
…regarding Worker Comp care
(lots of POPTS-corp competitors)

56. Counter Your Competitors
Hospital Health Care Systems
MD’s as hospital employees
Physician-owned PT
Corporate PT
Occ Health
Other PTs

57. Counter Your Competitors
Differentiate yourself-your clinic
Unique niche(s)
Unique service
Access-intake
Cost-quality
Become THE local PT brand

58. Relentless Name Recognition I
Ads that catch the eye… unique size-shape-text
Press releases, articles
Full-page educ-ad
Diner place mat ad
Sponsorships
Card mailer
On-line local news ads
Public BS-UE-HA-Ergo-wellness ‘classes-schools’

59. NOTE: title addresses their needs, not what you do

60. NOTE: title addresses their needs, not what you do

61. Relentless Name Recognition II
P2P…’word-of-mouth’
Tell your friends & your MD about your experience with us
Call after evaluation visit
Thank-you card after D/C
Here are my cards
(very) nice brochures
Patient satisfaction survey
Testimonials

62. Relentless Name Recognition III
Fax eval & notes to MDs
Heads-up call-fax to MD
Professional-looking notes (WebPT)
MD office mgr.. Nurse.. Referrals person
Ergo consult MD offices

63. Marketing Objective -I
PT is the Provider of Choice for mvt disorders
YOU are that PT provider of choice
They view you as the VERY BEST choice
Relentless PT brand & your name recognition

64. ** Marketing Objective -II two messages…
“We teach you how to take care of yourself”
Independence.. Control.. Cost
“YOU can choose your PT provider”

65. Mary Smith, DPT, joins SmartCare
LH, DPT, of SmartCare in Dixfield, announced yesterday that Mary Smith, DPT, of Carthage, Me, has joined the SmartCare as an orthopedic physical therapist. Mary received her graduate education at UVM, graduating with a DPT in She underwent internships at xxxx, xxxx, and xxxx. Her specialty skills include care of people with back and neck pain, TMJ, vertigo and women’s health issues such as post-mastectomy lymphedema. Mary grew up in Rumford and resides in Carthage with her husband and two children.
Physical Therapy is treatment of people with pain and movement disorders of the musculo-skeletal system through the use of carefully designed simple exercises, gentle joint mobilization-manipulation, and pain control modalities such as cold laser and electric stimulation. The primary treatment emphasis is on teaching patients how to take care of their problem themselves, so they can control their pain, restore function, and avoid the costs of ongoing health care. Using this approach, SmartCare averages only 6 treatment sessions compared to the national average sessions.
Physical therapists now undergo 6-7 years of university education and clinical internships leading to a Doctor of Physical Therapy degree. The physical therapy profession had undergone a transformation to a Doctorate level education based on extensive research to develop Evidence-Based Practice, whereby PT treatment is based on clinical research evidence that assess treatment effectiveness and defines the most effective treatment methods. For details on this see
SmartCare is an independent PT-owned outpatient Physical Therapy clinic specializing in musculoskeletal pain problems, work and sports injury, headache and TMJ, and post-orthopedic surgery rehabilitation. SmartCare is located at 94 Weld Street in Dixfield and on Route 4 in Turner. For details go to

66. Marketing Objective -III
Do the doctors send their spouse-kids-mom to you?!

68. Ads… examples1 Odd size… 3-column Bold border.. Shading design
Multiple ads… w/ varied messages

69. Ads… examples2 Address their needs-benefits Unique.. Uniqueness sells
(rather than your features)
Unique.. Uniqueness sells
Direct to web site and FB friend for details
Interesting-informative-educational

72. Pictures personalize
What is PT?
Patient needs
Puff us up a bit;
Qualified experts

77. Counter the Chiro’s ! 80

80. Answers a challenge
Patients pressured to
go to hospital PT?

81. *

82. Version 1/2

83. Version 2/2

85. USPS Every Door Every Box mailing
17.5 cents each
5 cents each print
Dixfield 2000 boxes.. $450

86. Vistaprint.com !!
CONT….

87. What is PT
LBP
TMJ
Headache
Vertigo
Sports
Work Injury

88. Press Releases -I Headline Who-What-When-Where
Contact person-phone
Who-What-When-Where
Background on who-what-etc
What is PT, and this topic defined
SmartCare located at Weld St, Dixfield, Me
300 dpi photo.. good pose!

89. Press Releases -II New PT joins practice (What is a PT)
New equip-device (cold laser)
New Service (bladder control)
Seminar: new technique (manual; tape)
Award (OCS, CHT)
Student (PT internship)
Presentation (APTA, chapter, seminar)
Teaching at Univ… (like this class)

90. Print Articles ! Buddy up to the ad exec… Weekly column What is PT?
Sitting hazards
PT for Headaches
Managing Vertigo
Six Types of Back Pain
Stop Computer Work Pain
Female athlete knee injuries… Runner’s feet
Bladder control…Balance-Falls…Lymphedema… etc. (niche list)

91. Print Articles ! Maine Sportsman… THE HUNTER WITH A BAD BACK by
LH, DPT, RMG
(Then do press release re this article)
Monthly column ?

92. Your web site -1/3 HAVE ONE !! EXPLORE examples !! Hire a teen ?
Mac iWeb template
Blog– WordPress.com
FB page

93. Note… testimonials.. free clinics.. our services

98. Have a Facebook Page ! Similar content re web page One for YOU, then..
Link to another for your CLINIC
Check Lauren Hebert… SmartCare.. IMPACC

102. Branding your practice.. Specifics..
Branding you & your clinic………………...
Memorable descriptive name brand
SmartCare…WorkSmart…IMPACC…No-Lost-Time
Results PT.. Dragonfly.. Proactive.. Innovative
Again do web search for examples
Get creative

103. Why should they come to you?
You are good.. very good.
Good means results in fewer sessions (cost)
Outcomes data support that.
You are different.. special.
You are confident.. You make that contagious.
Why are you the best choice? 

104. Why will they ask for you?
You have ‘secret weapons’ for great outcomes……….…
Non-TMJ C-txn
McKenzie enhanced by Dontigny SIJ
LLLT; non-needle acupoint stim
TOC input to UE-NVC
hip inputs to knee
LB inputs to plantar fasc
Three-exercise rule
Simplified TMJ
PT for HA
MWM; kinesiotape; SCS
Vertigo & BPPV protocols; balance-falls
Piriformis inputs re LB-SI-Hip-Troch bursa

105. Outcomes -I Quality-improvement-excellence-marketing
Track your strengths & weaknesses
Address improved quality & capabilities
TE-PFasc: MWM, laser, kinesiotape… LB: MET-SI
…..
Market to MDs, insur, employers, public
Bragging rights re outcomes (eg, SR)
FOTO.. or.. Homegrown

106. Outcomes -II Homegrown, roll-your-own approach
At discharge = score 8/A:
8 visits… ‘A’ outcome
Number of PT sessions
A-B----C-D outcome
Diagnosis group
Per group (WComp; Sunday River)
107

108. Outcomes -III Quality-improvement-excellence-marketing
Per Dx group… Published functional outcome measures
PSFS.. SPADI.. NDI.. LEFS.. DASH.. Oswestry
OPTIMAL… APTA

110. Outcomes -IV SmartCare averages 6.2 visits per patient,
(compared to national average of visits)
With average outcomes success (A-B) rate of 87%
FOTO named SmartCare to the top 5% nationally for outcomes costs / success

111. Outcomes -V real-life perspective
We are cheaper than a root canal.. and more fun
Cost per case..
root canal.. contacts.. eyeglasses.. set of tires.. dog

112. 113

113. Physician Relations Timely intake Same day slots They reciprocate?
Mutual referrals
Staggered hours-days
MD Office mgr, staff, nurses!
Fax eval… Fax notes… Excellent notes (eg, Joe C.)
Heads-up alert notes
Thank-you notes & calls
‘He said, she said’ risks
Does MD send you their family members?!

114. Patient Relations -I Timely access Staggered hours
Initial eval follow-up call
Convenience, warm setting, welcome
Focus on their goals, mutual goals
Educate, Motivate
Thank you at D/C
Thank you… Tell your friends… Ask P2P referrals
Cards-brochures

115. Patient Relations -II Time! Listen! Exude confidence Be excited
“I love treating this problem”
Motivate them
“You will move better before you feel better”
Objective measurements to assure them

116. confidence.. valid expert

117. My patient Lorraine She said, “tell your students about me…
When I called, you said, “Good, I love treating that problem. It is a specialty of ours.” That gave me confidence, rather than fear. When you examined me, you were excited about what you found and that you thought you could help me. That made me excited. That made me know that you cared about me and my outcome. You explained what you found and showed me visuals (skeleton & pics). You taught me how to take care of myself. At D/C, you told me I may have setbacks and that it was OK You assured me you would be available for calls for questions anytime.”

118. What they want, need, appreciate the most..
Patient Education !
Understand pathomechanics-biomechanics Less fear.. Re-assurance
Confident.. Committed.. Motivated
Avoids nocibo
Part of Pain Neuroscience Education

119. SHOW them exactly what their problem is and how we will fix it.

120. PDF s

121. Patient Relations -III
Post & explain billing & fees
Help contact (LH or Debbie)
Warn of insurance difficulties
Unaccepted insurances explained
(Copies of examples for those dis-believing)
Waive co-pays/deductibles? ..NO.. illegal kickback
Intake form: rules-issues-DC criteria-compliance
No-show… Late-show

122. Employer Relations - I We can save you money.
We can help your people & your company.
Treatment.. Preferred provider
10-day HCP… Prevention !
Your clinic’s occupational health services (W.Comp)
Taking care of employees & families (Health Plan)
Ergonomics-Prevention Programs

123. SmartCare IMPACC Primary Care Direct Access Occupational Health
PT practice
IMPACC
Injury-claims prevention
W. Comp cost reduction
No-Lost-Time
Irving
Sunday River
Ethan Allen
CMP.. Cianbro
Willis

124. Community Relations Back School for public NAS for public
Office ergonomics inservice
FMS.. HA.. Bladder Control.. Osteoporosis
Runners School.. Golf health
Office ergo screens… MD, insur, many workplaces, schools!
BS-NAS for EMS, schools, fire, police, charity, food pantry
High school sports: pre-season, ATC, weekly rounds

125. 126

126. Marketing Tactics -I Display ads Press releases
Annual full page.. educate
Local diner place-mats
Articles series
Open house
Art exhibit

127. Marketing Tactics-II WORKSHOPS !
Public BACK SCHOOL
Public TENDINITIS SCHOOL
Public STOP COMPUTER PAIN SCHOOL
Public HEADACHE SCHOOL
Dentist-ENT… TMJ SEMINAR
Local employer BACK SCHOOL
Local employer OVERUSE MSD SCHOOL
(esp. school-fire-EMS-police-town employees-DOT)

128. Computer work pain
Falls Risks Screen
Avoid Fitness
Training Injuries
Back School
Tendinitis School
Headaches
TMJ seminar

129. Seminar for
EMPLOYERS
Treatment
Prevention

130. Marketing plan philosophy
132
You have to actively pursue this!
My good work will attract patients?
WRONG!
Make a Plan.. Follow it.. Keep it going

131. Becoming an Employer -I
Now… your world changes!
$$ risks… Legal risks
Taxes (lots), benefits, insurances, salary, laws-rules-regs
Selection process… ADA, EEOC, broken ‘promises’

132. Becoming an Employer -II
Now… your world changes!
New responsibility for:
Leadership, set examples, enforce discipline, say no
Are you a push-over; avoid conflict, need to be liked?
You’re fired… versus putting up with marginal-problems
A business is not a social democracy… it must be a dictatorship
Lawsuits

133. Becoming an Employer -III
Family employees?
Sister, mom, deadbeat in-law, spouse
Can you-will you fire them??

134. Becoming an Employer -IV
PT, PTA, ATC, aide, secretary, billing person
What if only mediocre, barely adequate?
Would you rather keep that expense as profits or retirement fund?

135. Policy & Procedures Manual
Legal document that defends your business and practice
Defensible business practices
Medicare & HIPAA compliance manual
Employee manual
Employees sign they have read it

136. Policy & Procedures Manual
Patient processes
CPT-ICD codes
Referral mgt
Correct coding-CCI
Patient scheduling
Billing claims processes
New pt register-intake
Bill agency procedures
Insur-payment verify
Payment processes
Info-Records Mgt
Billing authorize-consent
Records retention mgt
Discounts-writeoffs-adjustments
HIPAA compliance
Refunds to pts-payers
PHI mgt-protection
Coinsur-copayment mgt
Fess schedules-hardship determine
Patient confidentiality
Credit card processing
Identity Theft red flag compliance
Check processing-deposits
Physical records protection
EOB
Electronic records protection
Pro Bono care
BA mgt-controls
Private pay
Security incident mgt
Coding-Billing

137. Policy & Procedures Manual
Patient safety
Outcomes measures
Incident reports
MD protocols
Infection control
PT protocols
Blood-borne pathogens
Confidentiality
Patient supervision-protection
Clinic Privacy
Patient care
Intake
Specific modalities procedures
History
Health screen
EMPLOYEE MANUAL
Expected performance
Pain diagram
Functional measures
Accountability-discipline
Initial evaluation
Initial eval follow-up call
Number system
Progress reports
Staff education-compliance-signoff
Discharge summary
Updates
MD-etc. fax report
Sign plan-of-care
Fax log