July 23, 2019

WebPT's Heidi Jannenga Discusses The Results Of The State Of Rehab Therapy Survey 2019

PTO 57 | State Of Rehab Therapy


There are opportunities out there that we can and should take advantage of to improve our practice. Looking for these opportunities from a unique perspective, Heidi Jannenga, PT, DPT, ATC is back to discuss the results of WebPT’s “The State of Rehab Therapy – 2019” and takes on the challenge to address the obstacles and detriments to the profession. As Heidi breaks these down, arm yourself with the data to work from and grow your clinic’s value. In this episode, look into solutions you can possibly do with student loan debt, stagnant salary and insurance issues, and regulations and documentations.


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WebPT's Heidi Jannenga Discusses The Results Of The State Of Rehab Therapy Survey 2019

On this episode, I'm lucky enough to bring back Heidi Jannenga of WebPT. She joined us before and we discussed the State of Rehab Therapy that WebPT does every year. We're bringing her back again because the new State of Rehab Therapy Survey and Report is out again and you can get that at WebPT. Heidi and I sat down to discuss some of the takeaways that she took away from this year's survey. It's a little bit dark on the front or maybe not dark, but somewhat discouraging. We talk a little bit about the burnout issue that is in physical therapy and what might be leading to that. There's still a large amount of student debt out there that the new grads are coming out with and salaries haven't changed all that much and yet reimbursement rates are declining. We talked a little bit about that and we also talked about some of the greater opportunities that are out there for physical therapy as well.

We see a lot of consolidation that could lend it to greater reimbursement rates, as some of those companies are starting to negotiate with insurance companies and gathering their data and outcomes. Also, from what I can see as a possibility that those larger corporations are willing to invest in greater benefits for physical therapists and invest into the cultures that they're creating. There's a further opportunity out there and the needle hasn't changed much in that 90% of the people that need musculoskeletal care are not getting it from physical therapists. In spite of the fact that all 50 states have direct access, still eight out of ten providers are reporting that insurance limitations or their perceived insurance limitations are a barrier for patients to get physical therapy. Simply, it's important that we educate ourselves and start acting like the forerunners and the gatekeepers of musculoskeletal injury.

There's an opportunity to communicate with the public and be on the front lines and not waiting for the referrals. There's an opportunity in regards to the burnout and whatnot. It's an opportunity for you as the owner to sit back and say, “What am I creating here that would make my culture such that people want to stay, that would keep them engaged? How can I align purposes or find people that are aligned with me and our purpose as a company?” To work together as a team, develop a culture max out of the customer experience and make it enjoyable for them and thus, that makes it enjoyable for the patient. There are a lot of opportunities there even though we see some negative signs that came up from the report, but there are also some positive signs and we go into that a little bit.

Heidi is a busy person. I'd love to spend a little bit more time on what WebPT specifically is doing to overcome some of the challenges that physical therapists have in regard to the amount of time it takes to do documentation. Also, to address the regulations that are upon the physical therapy providers themselves on a day-to-day basis. Nevertheless, I'm sure that will come up in WebPT’s business conference called Ascend 2019 in Minneapolis on September 19th to 21st. Check out their website. I’m sure if you Google Ascend WebPT 2019, you’ll get all the information that you need and if you mention that you are a reader of the blog, you will be able to get a discount. Check that out and put it on your calendar. It's one of my mantras, “Step out, reach out, network.” This is an opportunity to network, get some business training, see what's happening out there in the industry and network with other successful physical therapy clinic owners. It will be a great opportunity for you to learn and network and feel like you're not alone in this. Let's cut to the chase and we'll get right to the interview with Heidi.


I've got Heidi Jannenga of WebPT. She's always very busy so I'm excited to bring her on. Heidi, thanks for taking the time to spend a little bit of time with us and talk about The State of Rehab Therapy.

It's honestly my pleasure. We have lots of interesting things that have happened over the year and I'm anxious to share a little bit about some of our new findings that we had from our 2019 State of the Rehab Therapy Industry Survey. I'm excited to be here. Thanks for the opportunity.

It's great that you guys have done this survey and I think this is the third year running, if I'm not mistaken. Looking over it, the amount of data information from it is interesting because I don't see a lot of this data coming forward from other parties and sharing such a broad perspective of The State of Rehab in general. First of all, thank you for doing it because I think it provides a lot of great insight into the profession for all of the professionals. What was your impetus for doing it in the first place?

What we don't want to do in PT is lose the best and brightest minds coming into this amazing profession. Click To Tweet

That exactly was the impetus that when we went out looking for data, we couldn't find it. At WebPT, our mission has always been to help therapists achieve greatness in practice. To be able to truly do that effectively, we need to understand the lay of the land, like what is happening and getting direct feedback from therapists themselves. In order to understand the state of our profession, we wanted to be able to see sweeping industry trends. We wanted to understand more about how people are treated and what barriers they're encountering nationwide. We decided to embark on our own survey and we started it. Every year, we've gotten more and more people to be able to give us feedback and take the survey.

Each year, we've dived into a little bit more information based on what we received the previous years. To be able to compare, we ask a lot of the same questions as well. We divided everything up into four categories first of all, which I think is important as you look through the survey. We dove into things like payer mix and therapist productivity, referral sources, utilization of direct access, market consolidation, provider burnout, technology use, growth strategies and salary. A lot of the top of mind things that people are asking about. We get lots of questions around these things that we wanted to have interesting information directly from the sources which we frankly couldn't find elsewhere. We said, “No one else is doing it, we're going to do it.”

You found a hole in the market that was needing to be filled. How has it changed in the last few years? Is there some data that you found that's most valuable now that you didn't expect back before? What are some of the things you're noticing in the information that you want to collect?

We had about 6,500 unique responses to the survey. Just for clarification, 53.2% of those were not WebPT members. This is a clear, very diverse population of respondents and definitely not biased by whether or not they're using WebPT. At the end of the day, 90% of our questions had nothing to do with technology or EMR usage, although we did ask a little bit about that because it's important to us. About 63% of the respondents were therapists. We also had rehab therapy assistants, so 8.5%. The rest were classified as non-clinical, whether that's an executive, a clerical worker or a student. About just shy of 50% of the survey takers were also in outpatient private practice, which we also liked. It gave us a diverse cross-section into the entire industry, not just outpatient where some of us live and breathe most of the time.

Some of the things in the past that have been thought-provoking around salaries and student debt were asked. Despite our information being spread and wide and the American Physical Therapy Association does a great job of making this an important issue, the needle has not moved that much yet in terms of the amount of student debt that students are carrying these days. We might have talked about before that the average is about $70,000 in debt when a therapist graduates from PT school and close to 35% will have over $100,000 or more in debt. You compare that to the average salary is about $65,000 coming out of school. The question mark becomes, “Is the juice worth the squeeze? Am I getting into something that I'm going to be in debt for a long time to be able to pay off those $100,000-plus in debt?” There are also the sentiments of burnouts that we captured quite a bit in the survey.

Is that something that came up? I don't remember it last time the burnout that you're recognizing.

We added that. We now ask very specific questions about burnouts and thoughts about leaving the profession based on the feedback and also the data that we received in 2018. The survey continues to evolve based on information that we're getting and wanting to learn more about the industry as a whole. That was unfortunate but also an important data point. About half the survey respondents are considering a profession change in the next five years and one in five of those respondents would like to move into a non-clinical role.

PTO 57 | State Of Rehab Therapy
State Of Rehab Therapy: It's harder and harder to be a physical therapist who wants to affect change and treat patients these days.


Some of the reasons that people were giving for that are the immense compliance and regulatory burdens that t they feel like they have to endure and not at the end of the day, why you and I got into this profession. I didn't want to have to fill things out in triplicate and have to substantiate everything that I specifically need to do three times over before I get approved for it. We're getting squeezed on a number of visits. We continue to get reimbursement changes that happen. It's harder and harder to be a physical therapist who wants to affect change and treat patients.

I've noticed the burnout thing a little bit more recently. Someone said you look around our profession, you don't see a lot of 60, 70-year-old physical therapists that are practicing at full-time and loving it, just like you might see a family practice doctor or a general dentist or someone like that who it goes to work every day and loves their job. You don't see that a lot in the physical therapy profession. I don't have any data behind it and maybe you guys do, but there seems to be the burnout, the constant focus on production now that reimbursement rates are declining and the regulatory issues that are on top of us to stay in line. All that squeeze makes you question whether or not it's worth it and that makes it difficult.

The burnout is becoming earlier. In general, we age out because we have such a physical job as a physical therapist. It's in our name. Whether it's transferred or whether it's manual therapy, it's a very physical job. You're getting down and showing people exercises every day. It's not conducive to be doing that into necessarily your 70s. I don't know that's really changed so much. It’s in terms of the earlier burnout and also seeking other professional tracks as a physical therapist, not just being held to, “I'm going to be in clinical care for the rest of my career,” which I thought was interesting. For me, having taken a completely different path outside of clinical care, what I don't want to do and what we also have seen is that there is a decline in students applying to PT schools. Now, the outcome of after PT school and that burden, things like that are starting to become issues to even getting recruits into PT school. What we don't want to do is lose the best and brightest minds coming into this amazing profession.

At the same time, once they're in and once they are starting into clinical care and they find out, “Maybe this isn't necessarily what I thought it was going to be.” We need people to stay in clinical care, that's why we become a physical therapist. I also love the fact that some of the smart and brightest people are doing things representing the physical therapy profession in other ways, whether it's technology, whether it's entrepreneurship, whether it's going into public health or whether it's going into hospital administration. To demonstrate that our profession has a lot of very diverse but brilliant people that are not just ancillary providers. I see it on both sides that it's not great that we have the potential to lose clinicians that can help people and continue to improve the overall brand of who we are. I think that brand can also be accelerated by having more therapists exploiting the value of rehab therapy and PT in different arenas that we're not represented in now.

I interviewed somebody like that, David Self of Keet Health. He was the guy that went through PT school and never treated patients but rather developed his PRM program. It's people like that that you can hopefully say, “There is a track for physical therapy to treat patients and whatever, but there are also other tracks outside of it that can lead you to promising careers as well.” It's tough when you see on some of the social media posts and maybe you've seen them. I've seen them as well. People are saying, “I'm doing this and that and I'm interested in getting to physical therapy. Is it worth it?” I see, just looking forward, some of the respondents are very positive, “It's a great profession.” Some are very negative, “No, it's not worth it. It's tough.” Nowadays with the social media and the capability of people to reach out ahead of time and talk to larger audiences, it's tough if people aren't happy in their positions inviting those bright people into the profession.

There's whole track now of non-clinical PT rise even on social media. Meredith Castin leads a whole podcast and blog post and a group of non-clinical PTs, which I don't necessarily see as a bad thing. They are promoting the profession of physical therapy in such a fantastic way that sometimes I think clinicians who are treating patients all day don't have the opportunity to do. There are a lot of opportunities there but to your point, those that are in clinical care and those that we need to continue to have a pipeline of more amazing clinicians that want to do clinical care. Even those that are getting to the horizon of their career have said that, “I am not as readily willing to tell people, ‘You should become a physical therapist anymore.’” That's the sad part because usually your evangelist of people who love what they do are willing to tell more people and get people excited about the profession.

Did you find that through the survey, some of your hallmark findings were led into the burnout that we're talking about, whether it's some of the challenges that came up consistently that led to the possibility of some of this burnout?

The PT profession has a lot of very diverse but brilliant people that are not just ancillary providers. Click To Tweet

The regulatory change, the number of hours that people are working. Of those respondents who I mentioned who are considering a professional change, about one in four of them are doing to decrease the hours that they have to work. I thought that was very interesting. Whether that's based on working more than 40-plus hours in order to make ends meet, you're working your regular full-time job, but you're also doing PRN work on the weekends and things like that. I did that when I was coming out of PT school as well. I don't think that's anything new. In this next generation, work-life balances are even more strongly emphasized and wanting that a component of their life. I think that's reflective of this next generation’s expectations of their professional life. The other thing I would say and part of the reason that we publish this information is for people to use it and take the data and say, “What could I do differently?”

As new grads coming out, they're looking for a great culture in clinics. They're looking for a career passing and mentorship. They're looking to learn. There are a lot of therapists, whether you're new or not, that are wanting those things. As we get busier and busier, sometimes it's hard to find that balance or those great cultures. For leaders to be spending time and money, the bottom lines are not what they used to be. The additional ability to spend more money on benefits and things like that is not as easy, but it's also important. That is a good segue into what we see as far as consolidation in the market. It's been the pendulum that has swung back a little bit through my career.

When I first came out of PT school many years ago, it was very dominated by “corporate PT organizations.” We had the dissolving of a lot of those organizations due to corruption, the Medicare fraud. We saw the rise of entrepreneurship. With that, we see the opportunity now. Private equity money floats into our industry several years ago and now we're seeing the cause and effect of that with many medium-sized organizations being on the quest to grow. I don't always think that's a bad thing. There is a lot to say about economies of scale. I think that people have learned a lot from the past and how they want to do things. There's technology now that helps to make more of the communication and centers run more efficiently. We did see in our survey that larger organizations do have a higher patient volume requirement.

About 40% of our full-time therapists in single providers see six or fewer patients a day, which if you're seeing cash-based patients, I could see that. Still, that's a very small number overall. In organizations with 21 or more full-time providers, they're seeing about nine to twelve patients a day. If you have twenty-plus providers, your patient load can increase from twelve to fifteen patients per day. I think corporate organizations or these large entities get a lot of bad rep for having to churn and burn and see tens of patients a day. Twelve to fifteen patients didn't seem at outrageous to me or outrageous at all to me. I think that there has been a tide change in terms of being more efficient operationally and yet still being able to give great quality care with also that emphasis on outcomes.

You talked about the swing towards more, if you could say corporate care or consolidation. The benefits definitely could be these entities having greater funds, the economies of scale in which they can reinvest into a culture where they can reinvest into providing greater benefits that the entrepreneurs might not be able to provide. Also, coming back to having a seat at the table with the insurance payers to renegotiate those contracts and bring reimbursement rates up. Even though some people might hate to see that coming down the horizon and more mergers and acquisitions occurring, you can see some benefits on one end when they might be willing to reinvest if they're willing and able to do so with maybe a little bit but still maintain high productivity. I think there might be a little give and take on that.

I think one of the downfalls in the past, which we've learned from was that these large organizations try to undercut each other to increase the volume of patients by decreasing the amount that they were willing to take per visit. You don't see that as much. Insurance companies have already done that for themselves because now they also have a lot of data of what they're willing to pay. What we are starting to see and it's low, only 17%, 18% of organizations that collect outcomes data are using it to negotiate with payer contracts. The majority of those are the larger organizations, but they're using those outcomes to increase their payment adjustments, not trying to undercut.

Insurance companies have already that for us because of what we were willing to take in the past. Now, we're negotiating to increase. If I'm going to get better outcomes in improved utilization and less visits, overall that the insurance company pays less, even though the price per visit is higher.” That's the negotiation that's starting to happen now with data. To be honest, that's what it’s all about now. Being able to prove with hard facts and clinical outcome data as well as utilization data, patient-reported outcomes but also patient satisfaction scores as well as the trifecta. What we've talked about in the past of what everybody's focusing on, making sure the patient’s happy, make sure the providers doing what they're saying they're going to be doing and also being cost-effective at doing that.

PTO 57 | State Of Rehab Therapy
State Of Rehab Therapy: The burden of the high co-pays and co-insurance to show value and have patient buy-in becomes greater because there's so much more out-of-pocket costs.


You talked about some of the things that can link to upset for a provider, whether that's regulations and student debt and satisfaction in the profession. Are there some things that you recognize are challenges within the care of treatments that therapists are regularly reporting? Whether that's pressure from supervisors for production or the documentation time that it takes to get a patient through or time away from patients that don't make them? Are there some of those things that came up?

Those are all part of the challenges and opportunities. The things that we found were most concerning to therapists that were within this policy and regulation area where high co-pays and co-insurances, referrals and certification requirements, then the therapy thresholds or targeted medical review thresholds given by insurance companies. The autonomy of practice is not what it used to be. The burden of the high co-pays and co-insurance is now the pressure to show value and have patient buy-in becomes so much greater because there's so much more out of pocket costs.

That's tough when a physical therapist has to have that financial conversation. It's something that's come on over time, especially in the last several years or so. I didn't have to have those conversations as much earlier on, but it's almost regular now that you see that the patients are having to have some conversation regarding the financial responsibilities of the patient have and displaying the value that we provide as physical therapists. That can be tough for people who aren't used to that situation.

This goes to a bit of a crack in the foundation of ourselves as professionals in terms of the brand of physical therapists in the first place. Of people understanding the doctorate level professionals that they're seeing. That your average consumer understands the education and the value that a physical therapist can deliver but not only that, just the fact that we should be the first provider that people are thinking about for musculoskeletal injury. That's another good segue into one of the biggest items that I'm going to be talking a lot about and have talked about, but emphasizing it now is the direct access issue.

We have now direct access in all 50 states. We have that now. It's not new. Some states like Arizona, where I'm from, we have completely unrestricted access and we've had it for more than twenty years. Yet people are still very intimidated by the ability to take someone off the street, walk into your clinic and have them get treated without a physician referral. The confidence in ourselves as therapists has to be promoted. I don't know how we get past the change in behavior. We have the knowledge and we have the skillset. It puts us in this incredible driver's seat of more level-playing fields with referring physicians because now we become a referring provider as well. Especially in states where you have some limited access where you can only see them for an initial eval and/or maybe a couple of visits or even just the initial eval, let's take the Medicare. To be able to then send that back to a physician and say, “Patient came in. This is what I found. Here are some issues that you might want to look at. Here's how I can help this patient as a physical therapist. You go do your workup and then I'd love to see them back to help them with the issue that they came in with.” Now you become a much higher prominence, if you will in the overall healthcare continuum where people see you as more of an equal.

Where do you think our hesitancy or fear to take the reins in those situations comes from? Is it just from a longstanding history of being, for lack of a better word off the top of my head, subservient to the other medical professionals? Are we not getting proper training beforehand in our schooling? Where do you think that comes from?

Let's face it, we're still a fledgling profession in terms of the grand scheme of things. Where we started was being subservient to physicians and having to rely on referrals from the get-go. It's the longstanding behavior that you have known for most of your career and I don't think that referrals should go away 100%, but I think that it should be a 50/50 split in your clinic. It's going to take a lot from not only ourselves of being willing to take these patients in, which I think is the first stage. Secondly, doing a lot more promotion and education to the consumer as to the value that we deliver and who were good at helping. I will say that I truly believe that the time is now to be 100% emphasizing this. This is why this is my biggest soapbox because of the opioid crisis.

In this next generation, work-life balance is even more strongly emphasized as a component of life. Click To Tweet

We know that insurance companies, hospitals and everybody are focused and this is at the highest level of administration of all of these different entities of finding, even at the state level. I was listening to NPR and even in our state level, the top of the conversation in every healthcare arena right now. A significant percentage of the patients that have been given opioids suffer from chronic pain and musculoskeletal pain. Who else is better to be treating these patients for musculoskeletal issues? It's us as therapists. There was a big study that was published by the American Physical Therapy Association and OptumLabs and UnitedHealthcare in which UnitedHealthcare finally came out and said, “We've had this data for a while but now because of this crisis, we understand that physical therapists need to be a primary provider. We need to get them in earlier as an intervention provider for these patients that come in with musculoskeletal issues, specifically low back pain.”

They published in their study that if a physical therapist or I should say conservative care provider, so that includes chiropractic or massage therapy, is the provider that the patient is seen for in the early stages or more acute stages of their injury, they have a 75% to 90% chance that they will never encounter opioids through their episode of care. The data is there to show our value. We just need to scream from the rooftops. I keep threatening that and maybe I should do it. Get a crowdfunding thing to do a Super Bowl commercial or something to make this a known thing, who we are as physical therapists and what we do and how much value we can add to patient's lives.

My next question is part of it is communicating to the public and some of the other healthcare individuals, but how do we change within to have the confidence to stand up and say that we are the masters of musculoskeletal injury care? We are the first line of defense. We are the gatekeepers or whatever you want to call it. It doesn't seem like we've taken that upon our shoulders to be that. From your perspective, what needs to happen? What do we need to do?

First, it comes back to education. Although we've had direct access in all 50 states for quite a long time, in our survey we found that only 13.5% of respondents said patients could directly access PT in their state.

They didn't know.

It baffles me that they don't know, but they don't know. 80% of the organizations said that they still require a physician referral for treatment. Roughly eight in ten respondents claim that payers are the top reasons why. We know that that's not true. It’s a lack of education and lack of understanding of the changes that have happened. Most insurance companies now will allow at least the initial evaluation. If your state practice act says you can see them unrestricted for more visits, it may not be the case based on insurance, but the majority of insurance companies now will pay for an initial evaluation, even Medicare, which is always the one red flag that people throw. The biggest barriers to direct access in which it is perceived are insurance requirements and then the lack of awareness in the patient market. There are not that many patients walking in the door.

This is where this movement for patient retention management, more marketing to the consumer, more of a change in mindset that we are a consumer-facing provider and not just a B2B or a physician to therapist provider where all of your targets in the past and marketing efforts have been much more in terms of getting to know your physicians. Now there's this change, which I'm hoping becomes more of a tidal wave of understanding that we need to go directly to the consumer and get these people to understand that, “You can come in and see me. Here's who I am, I'm an amazing therapist. I can help you in so many different ways.” We just got to get them into the clinic.

PTO 57 | State Of Rehab Therapy
State Of Rehab Therapy: The confidence in who we are as therapists has to come from the education first.


Being an owner in the past and I'm assuming that probably a majority of your respondents not only coming from outpatient settings but if they are owners, they've probably been owners for a longer period of time. I'm making a couple of assumptions there.

Only 50% of our respondents were outpatient. It is the broad spectrum of respondents.

From my personal experiences is that you hear that, but you're not sure if you trust it enough to change policy inside the clinic and risk losing so many visits on some patients by not getting that referral or getting the prescription ahead of time. I think it's constant education that needs to be consistently reinforced and then taking action and dipping your foot in the water a little bit more and saying, “It's okay. Come on into the pool. It's all right.” It's a lot of education and showing proof of concept to these people that you don't have to have some of these things. You can be the gatekeeper, you can stand up and you can be the person at the forefront and not need what was needed in the past. That can be difficult when you said we need to shout it from the rooftops in order to get the message across.

Change is always difficult. If you don't have a cash pay schedule now, you need to make one and what do I charge? There's the fear of, “I don't want to charge too much.” All of those unfortunately things that our clinician brain takes over versus the business brain. When we know that people are willing to pay $100 an hour for a personal trainer, why wouldn't they and why shouldn't they pay that for a doctor-level professional who is going to do so much more for them than supervise and provide an exercise program? It's also the mindset and when you said, “How do we make changes?” It does go back to student education in our academic setting of priming the pump early. The confidence in who we are as therapists have to come from the education first and truly believing that this is the norm. This is what you should expect when you go out and if you don't see this, how do you help to make that change as well?

It's a tactic that we've used even from a technology perspective. Introducing electronic health record and electronic medical record in the academic setting and having students use it. When they go out to their clinicals or even when they go out for their first jobs, to then see something that is much less efficient, not as user-friendly or pen and paper, that they are willing to raise their hand and say, “Have you ever tried this? Why are we doing it this way?” It’s the old adage of asking why.

A lot of it is education. Do you see anything else that we need in our tool belt to become more of the front-line defense? Not just to let therapists know that they can be, but from my perspective and because I'm a little bit biased, I'm doing more diagnostics. I do EMGs and I have also been trained in musculoskeletal ultrasound. Do you see diagnostics being a big part of being recognized as that first line of defense for musculoskeletal injuries?

Of course, we have a shortage of primary care physicians. Pushing that line of the scope of practice with these additional certifications and aligning with physicians who are willing to have that information and refer you patients to get that information or that data I think is important. Also, going straight to a patient. The patients’ potential population out there to have them understand, “These are our certifications and value-add activities that we do as physical therapists. It’s part of our scope of practice. It's part of who we are and what we do.” This goes back to the part of our big purpose and mission here at WebPT in the data that we've found and validated with a lot of insurance data as well is that 90% of patients who have diagnoses that a physical therapist could help are not getting into physical therapy. We're fighting over this 10% of people and that number hasn't grown. It comes back to what a lot of people have been talking about for the last several years of the brand of physical therapists.

Physical therapists need to be a primary provider and an intervention provider for patients with musculoskeletal issues. Click To Tweet

Tell me what is WebPT working on to help alleviate some of the concerns we talked about or some of the exciting things that are coming forward that WebPT is working on that you'd like to share?

We're continuing to work on efficiency. It's been one of our big mantras here. We’re starting to release our WebPT Documentation 2.0, which has a full new look and feel, but more importantly, much more efficient in terms of getting through your documentation. We're using the data from this survey to make sure that we're hitting all the marks on the biggest barriers. We are working on what we're calling WebPT’s network effect of now working with credit card processing as well as with our outcomes tools. Getting that data and information out there through an analytics platform that can help and empower our clinicians and our owners to use the data. Go and negotiate more with insurance companies to increase those reimbursements or payments that they should be getting.

From the marketing front, we're continuing to improve our PRM or Patient Retention Management platform in which we have so many cool new ways of increasing your HEP, your Home Exercise Program compliance, as well as retaining patients so that you have this constant communication them. Our big thing with that is to hit that 90%, to get more of the marketing component out there. Not only to retain the patients who have come to see you, but how do you increase that by social media likes and email and everything else that you can do to get your clinic more notoriety.

You talked a little bit about analytics and that was always something that I always wanted more for my EMRs, the management statistics so I can have more access to that. Even if it's not for going out and renegotiating contracts, that's a great end goal. Just to manage the day-to-day and make sure that you didn't have holes in your bucket and you could manage it appropriately and manage it by statistics. That's exciting stuff.

We have a whole dashboard of the top nine clinic metrics. You can watch it. All about efficiency where you don't have to do a bunch of spreadsheets and have all this backend work. The data's already in our EMR so how do we then aggregate that and allow you to use that on a day-to-day basis to run your business at the highest efficiency?

That's where the independent practitioner is going to be benefited the most by an EMR like WebPT. Being able to have that as a dashboard and not go looking for it and spend the time on it and thus manage their clinics. Though we're not trained as businessmen, we own businesses. Even though we're not trained as such, it's important that we have those KPIs available to us on a regular basis and managing them and tracking them, even though that's maybe not our forte. It’s exciting that WebPT has that available to us to help us manage appropriately and thus capture what we're supposed to be getting paid for. Like we talked about, maybe reinvesting in culture, reinvesting in benefits and making it a wonderful place for physical therapists to join and be a part of.

This is an area, especially for your small businesses and single provider owners who are wanting to grow or are wanting to make their business more efficient. We have heard you because this is an area that we don't come out of school knowing a lot about, is the business side of physical therapy. What are the KPIs I should be looking at? How do I take those KPIs and make sense to them? What do I do when it goes down? What are the dials that I need to look at to be able to improve those numbers? That's also why we started our annual rehab therapy business summit which is called Ascend. We've been doing this now for years. This 2019, it’s going to be on September 19th through the 21st in Minneapolis, Minnesota. We would love to have you guys come out. If you come to the website and decide to sign up, please let us know that you came from the Physical Therapy Owner's Club show and we'll make sure that we get you a discount code.

PTO 57 | State Of Rehab TherapyThank you for doing that. I, number one, love the idea that you've got the Ascend conference going and that it's focused on the business aspects, especially like what you talked about. We come out of school, we don't know some of these things and then you hear about, “You need to keep your KPIs.” “I can start keeping my KPIs.” As you said, when they go down, now what? I'm reading the WebPT dashboard that I have and my stats aren't where I want them to be. What do I do? That's where a conference is so invaluable. The networking can be incredible. My mantra is step out, reach out and network. This is how you network. This is how you get information from the other successful business owners. This is how you learn successful actions and take advantage of those who have gone before so you're not reinventing the wheel. It's conferences like this where you'll gain a ton of information and get some of your business acumens.

You learn from people from similar-sized practices to larger practices. We've got speakers from all over the country, the best and brightest minds that we can pull in for an event like this. We’ve got some amazing keynotes from outside of the industry, which we also are big promoters of, to learn from people outside the industry. It's going to be an amazing two full days of super content and lots and lots of learning. Most importantly, lots of networking. We have a lot of time for that very specifically because we know how valuable that can be. Hopefully, we'll see you there. Let us know if you've found us on here and we'll make sure we give a good discount.

Thanks for your time, Heidi. I appreciate your willingness to talk to us, especially about the insight that WebPT has gained from the state of the industry.

You're very welcome, Nathan. Thank you for all that you're doing for the therapy owners out there. The more education that we can get on this business side and more people working together towards the greater cause of helping our profession only makes us stronger. Thank you for everything that you're doing for the industry as well.

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About Dr. Heidi Jannenga

PTO 57 | State Of Rehab TherapyDr. Heidi Jannenga, PT, DPT, ATC, is the President and Co-Founder of WebPT, a six-time Inc. 5000 honoree and the market-leading software solution for outpatient physical, occupational, and speech therapists. Heidi leads WebPT’s product vision and company culture initiatives while advocating for the rehab therapy profession on a national scale. She's an APTA member, belonging to both the private practice and sports medicine sections, and she's on the board of directors for the Institute for Private Practice Physical Therapy.

In 2015, she won the Arizona Physical Therapy Association’s Physical Therapist of the Year Award, and in 2018, she received the APTA’s Marilyn Moffat Leadership Award. Prior to co-founding WebPT, Heidi practiced as a physical therapist for more than 15 years. Today, she regularly speaks as a subject-matter expert at regional, national and international technology, entrepreneurship, and leadership events, as well as at national and international PT industry conferences.

Heidi serves on the boards of numerous organizations, including the Arizona Science Center, Support My Club, the Physical Therapy Political Action Committee (PT-PAC), the Institute for Private Practice Physical Therapy, Conscious Capitalism AZ Chapter, and the Arizona Community Foundation. She also dedicates time to mentorship within WebPT (through her women’s empowerment group PropelHer) and in the broader community (through her work with physical therapy students, entrepreneurs, and women in business).


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