Unlike other medical practitioners, you will be seeing your physical therapist several times each month or week. Aside from impeccable sessions, you will also be expecting quality - and welcoming - customer service every time. Steve Line, PT, author of The Feel Good Experience and co-founder of Columbus Physical Therapy in Columbus, NE, shares what it takes to improve patient compliance, engagement, and overall results - a 5-star patient experience that is intentionally created and trained. Steve and his team took the time to detail what an optimal patient experience is and what they needed to do to create it. He looks back on when they noticed an improvement in patient retention, cancellation rate, and referrals of family and friends. Steve shares some of the secrets detailed in the book on this episode.

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The Feel Good Experience: Growing Your PT Practice with 5-Star Customer Service with Steve Line, PT

I've got a returning guest, Steve Line, Cofounder of Columbus Physical Therapy in Nebraska. He is also a new author, The Feel-Good Experience, which we're going to talk about a little bit. Congratulations. Especially with Steve's background as a successful PT owner, the book is going to be great advice and input for PT owners. Steve, thanks for coming on.

I appreciate it very much, Nathan. It’s great to see you again.

We'll get into your professional background. You're a successful PT owner who has three clinics. I would highly recommend those who are reading that haven't read my episode with Steve in the past, we talked about the four buckets of marketing based on an article that he wrote in the IMPACT Magazine. That was in 2020, wasn't it?

Yes.

You've written two more articles in the September and October 2021 IMPACT Magazines. One was regarding financials.

Both of them were financial. Money Woes was the name of the one in September and then Go on the Offensive was the one in October talking about wealth management.

I highly recommend you guys go back and read not only the podcast episode but read some of his material, as well as the book that you've got up, The Feel-Good Experience. Number one, congratulations on writing a book. That's a huge, monumental task. It’s worthy of appreciation. Maybe tell us a little bit about where it came from. What was the germination for a book on this topic? We can talk a little bit about it.

PTO 168 Steve Line | Customer Service
Customer Service: Good customer service means knowing what the client needs in advance to ensure they don't make any complaints.

Customer service is what the book is about, The Feel-Good Experience, how to grow your practice using five-star customer service. It dates way back to my youth, working in different jobs through high school, experiences I had with those jobs and dealing with the public. I had some good mentors that trained me, honestly, how to deal with the public and customer complaints and make sure that you anticipate what they need and want in advance to make sure that they don't have any complaints. I've taken that model and I've also applied it forward in physical therapy. A lot of what the book is about is a lot of those principles and thoughts.

Was there a time during your PT ownership where you thought, “We need to focus more on the patient?” Was there a particular instance where you thought, “We need to make this shift and start focusing a little bit more on their experience,” and their relationship with you?

About 2006, to be honest with you, it was a specific year, a lot of it was due to the amount of competition that we had and our growth had stagnated. We hadn't been growing like we were. We’re also having some challenges within. I brought all of it back to culture. There's a culture problem we have. We're following a formula that is based on our training as therapists, following these things making sure documentation's good. We give patients what's appropriate and all of those issues. I would still have patients come 1 or 2 visits and then not return, like, “I'm doing what I was taught. Why isn't this working?”

The competitors were putting a lot of pressure on us. We're like, “We're going to have to do something different. We're going to have to stake our own claim and put our own brand out there.” This was an easy one, The Feel-Good Experience, something that we branded within our company. We've used it since about 2006. We have a jingle, all of it, but it isn't enough to have that. We wanted to make sure that it was felt from within. The patient comes in and they feel it with every staff member, their building environment, so on and so forth. That's what the whole design is about.

It seems like you essentially got hyper-focused on policy and procedures regarding how you have the patient to the point where you branded it, you gave it a name and you created a jingle. Essentially, this is an aggressive, well-thought-out policy and procedure manual for handling a patient.

We are making sure that we treat the patient with their physical needs. We want to target their emotional needs, spiritual need, and all those things. It comes down in a nutshell, TLC. Make sure you give them as much attention as possible, but communication is critical. The listening part is more critical than what you're telling them, making sure that we target them not only because it's a transaction.

That's written about in the book too. We want to make sure all of our interactions with the patient are not transactional but more experiential. We ask them, “What are your goals?” and all those things, but it's not just a check-off list. We're trying to flesh out what type of person this is, what's their personality type, what's going to fit for them.

Some people are more the structured, rigid, "Just the facts ma'am," kind of people. Others are more soft-hearted. They want to be led. They want those approaches and a little bit more tenderness and a little more nurturing. You have to be able to read that upfront. We've done a lot of training with the staff. Over the years, it's gotten better to where people within our organization pick it up faster. We look to hire people that are moldable within that, people who desire to give good customer service and make it a great experience overall. It's not just we want to give you results, but give them the whole package if they want to return.

How do you vet for that during the hiring/recruiting process that these people are moldable, that they're willing to come in and be trained on the way you guys do things in The Feel-Good Experience?

The first thing is you pretty much tell the minute they come in. If you think about it, you have a front desk receptionist. Their first test is when they come through the door if they are rude to our receptionist. It's simple things like that or if they're cold or not conversational. We understand everyone's going to be nervous. You're coming in for an interview. That's understood. Our front desk and our personnel are always trained to circle through. We don't refer to it as the waiting room. It's the reception area. Reception is a party. It's a social event.

We want the waiting area to be our social event. If those people never warm up, like you engage them with conversation and they have nothing to come back with, that isn't going to change. It's part of who they are innately. If they struggle with this, “I hope the weather gets better,” and they're like, “That'd be nice.” “That's it? There's nothing else going on?”

Aside from treating their physical needs, a PT must also take care of their patients' emotional and verbal aspects. Click To Tweet

Are they simply willing to smile? Even if they're a little bit introverted, I'm sure you have room for those people. When given a chance to converse, they add to the conversation. What's cool is also you put this way of doing things in place, such that it's generated a culture. Your front desk person can tell if an interviewee is going to fit or not. You don't have to wait.

They're probably better at it than we are. They will come back and say, “This is what we're picking up.” It's like, “We'll take it from here.” We ask for the input, but we also want to make sure that we don't get corrupted. You got back there and you have this branded mindset about this person. More than often, they're spot on. They get a sense about it right up. This is complex. There's no exact science. It’s like a patient. We assume that they all want to get better when they're coming in, but as you know, they don't always. There's a lot of different nuances that come with treating a patient.

Tell me a little bit about maybe how someone would use The Feel-Good Experience during any point of the patient life cycle, say at initial evaluation or when they first call into to a physical therapy clinic that would be different in your clinics than the run of the mill or outpatient orthopedic clinic. How do you guys do things? Can you give us an example of where you guys differ?

This is exactly where we were in 2006, as we knew the competition was good. They were strong therapists, technically sound, well-respected by the medical community. We were constantly getting an influx of patients who were over there at their location and kept coming to us saying they were dissatisfied, they were disinterested, they were too tight collared were some of the phrases we heard. They were very serious. You went into their waiting room and you sat there and they could hear crickets chirping. It wasn't inviting and warm.

We kept hearing this. Their instruction to them was not clear. When you ask more questions, it was more like, “Do it." It was rigid. I've found that to be consistent across our profession of physical therapy. The general tendency is that the individuals who go into physical therapy have a certain personality, let's be honest. If you're drawn to teaching, to PT, to be a fireman or a pastor, I don't care what the job is, you have a certain thing within you that's attracting you that direction or drawing you that direction, whether it's personality or your makeup or what have you. The general tendency of PTs is to be ultra-scientific and evidence-based.

We're focused on that side of it, but then we totally have zero training on communication skills, emotional intelligence, personality types, simple engagement, proper etiquette, body language, how you engage with a patient and how you position them. We talk about it in PT school, how to position, how to drape. I'm seeing therapists with twenty years’ experience totally violate all those rules. It's like, “What we were taught there was good.” Remaining dignity to the patient is critical. How you treat them with respect, not just as, “What is your problem? This is your shoulder problem,” and forget that there's a patient or a person attached to it. All of that is part of it.

Ultimately, when you call into our office, we gear our receptionists. We train them and then we go back and critique and we record phone calls and do all those things. It has to be the smile right away. A smile like you have a mirror, we don't have the mirror there, but we've done it in the past. If someone has a mirror at the front desk, what's your facial expression at that time when you answer the phone?

If you're smiling, it comes out. It comes through when you say hello. No matter what, it does follow that. Asking leading questions. A lot of the book is about leading. The Feel-Good Experience is all about leading, not commanding. Seeking to help whatever that person's looking for and ask the right questions to bring them along and hopefully get those questions answered.

What are a couple of leading questions? A leading question that a front desk person would ask, and what is a leading question that you expect your physical therapist to ask?

Front desk, when someone's calling in and saying, “Do you guys do something?” They read it somewhere in a medical journal or a newspaper article. “Do you guys do dry needling?” We do. Even though we do that, we want our receptions to go, “We do that. However, what is your ailment and what are you seeking to get from that? We want to help you. Can you tell more about it?” It comes down to the opposite of most doctor's offices. “What's your problem? The doctor's busy right now. He can see you next week.” We don't do that. It's like, “We can get you in as soon as possible today.” We make sure same-day appointments are held no matter what.

PTO 168 Steve Line | Customer Service
Customer Service: Make the reception area a place of social events. Warm up with the clients and engage in conversations with them.

 

That makes it a challenge with our staff and you need flexible staff to do that to make sure that they know that they will be serviced right away. We don't want them to sit and think about it. Most of the training involved as a consumer is we have to wait. When you order something, you have to wait. When you call the doctor's office or the dentist’s office, you have to wait. You're told, “You come right over. We'll take care of you. Is there a time today that works better for you?” “You can see us today?” “Yes. We're going to get you doing better.” It's that type of training.

As far as the therapists go, obviously it gets a little more in-depth. They're big around what do you want to get back to. This is what we're trained to do in PT school, to ask those questions. It’s very much documented so that we get it in the notes for payer source, approval of those things that we ask, what their personal goal is, but we don't flesh down, “You want to get back to hiking. Where do you like to hike?” “I like to hike around the lake here in Columbus. It’s pretty flat ground.” It’s like, “Where do you like the hike specifically? Do you like to go fast? Do you like to go with your dog? Do you like to go with your spouse?”

You start fleshing out and one thing leads into another in terms of family and work. We want to find out everything about that person possible. The therapist can get into that. Receptionists don't have nearly the time to get into all those things sometimes. Getting down to what you are into as a person, you'll listen to somebody so long and you can find out what they're about. They're going to keep bringing back similar talking points and concepts.

It's great that you've established a system around this. A typical PT clinic would say, “We do dry needling.” If the front office person isn't well-trained and that expectation isn't held, then they say, “Yes, we do that,” and that's the end of the conversation. You've had front desk people that are like that because they answered the question, they did the job. That's okay. If they took it a step further, they might ask, “What insurance do you take?”

We get to that. We do ask that later on. That better not be your first question.

That was a conversation I typically had with Sturdy McKee on previous episodes. Most doctor's offices are going to ask you your name, your date of birth, your insurance, all that information. What if it was simply more like, “We do dry needling, but tell me, what's your ailment and what are you trying to accomplish here? Do you want to get back to hiking? Tell us about that. Is this for you or are you calling on behalf of your husband, who won't call a doctor's office?”

We engage in those type of situations because we have a lot of families that do that. Men, in general, are terrible at setting up appointments.

We talked about what you're doing with The Feel-Good Experience at the front desk and how that might also change what you typically do during the care that's involved with the physical therapist. Does your Feel-Good Experience extend beyond that, like after a patient gets discharged, whether they have been discharged for months or even during the collections process?

Yes, we have a regular call sequence, checking up on people, how they're doing. Thirty days after they're discharged is making sure that our product is stuck and it's still working. If there are any questions at that time, there's obviously not bringing them back in. I got some questions about the home program or for whatever it is. They can get that advice then in there. We go 30, 60, 90, 120 days out. We send out letters, checking up on you. We also have a couple of events. With COVID, that eliminated a lot of those, but we have a patient appreciation event or two of them.

We always had one in the summertime, summer picnic-themed, if you will. We have one in the holidays, more holiday things. You then send out invites. Everybody comes back and tries to get as many patients returning for that. After they're gone, the financial statements are still out there. We're dealing with EOBs and insurances that are saying they will pay for it now. We try to stay ahead of that. We are a group. We don’t say, “This is your responsibility. You knew that when you signed that form when you came in.” We don't deal with them legally like that. It's more, “This is what your insurance is requesting. This is what we can do. We do need you to handle this part of it.”

“We can either bring it in, they'll be sending you one in the mail, bring that format, and we'll walk you through it. You fill it out.” We give them assistance. They’re discharged at this point. A lot of times, insurance wants to know, was it a work injury or was it an auto accident. They're trying to flesh out what their level of culpability is on the list. We will guide them through all that because it's extremely confusing even to us, how the whole insurance thing works.

Real good customer experience is all about leading and not commanding. Click To Tweet

It's cool that you have a process because most owners haven't thought that far ahead. Some systems like WebPT give some of that automation to it and allow them to now start thinking about it. Some of them haven't even turned on that system and WebPT Reach even though they have it where you could get that patient to be more engaged with you over their lifetime. You want to be known as their physical therapist going forward.

We want to be engaged all the way to the end. If they ever needed to go for therapy again or to send a friend or family member, whatever, we're the only name that pops up. We don't win all the time. If we can win the majority of them, that's where we've seen our growth.

You started implementing this back in 2006. Give me a timeframe. How long did it take for you to implement some of these feel-good experiences? What were some of the results? Did you see them rather quickly?

I wrote it out on a flight. It was a plane at my wife's cousin's wedding in Oregon. I had the brainstorm and I wrote out all the outline and bullet points of it. There are some theoretical. There are some of those related things like this is the background of it, but then you get into the nuts and bolts and it's a paradigm that's covered in the book. First level is to give a high level of perceived care, breaking down what perception is and making sure that we can target perception through the senses, hearing, smelling, tasting, seeing. There is a way to do all these things. When they come in and they hear us, think positive. The environment is cordial.

They hear therapists being polite and professional to one another. There's laughter. They hear all of those things. That is like walking into a sports bar and people are cheering and having a good time. You want that atmosphere to bring energy. You want to also have the patients see cleanliness and order. All of those things attribute. Whether we believe it or not, the psychology of all of us is we like order. You go into a place and tables aren't clean, a restaurant, the bathroom is filthy. It's chaotic and disordered. Their employees are all huddled in a corner, talking. It's not good sense. We don't want any open gaps in their mind to be started to where you have to start thinking, “Is this place professional? Will they be able to help me?”

Those five senses are targeted in that first-level paradigm of perceived care. The second level is what we call stations and zones. Within, there are five stations. The first one is a reception area. The second is hosting. It's like you go into a restaurant, how many, wait to be seated, the host or hostess takes you back. We have that individual that escorts them to one of several areas. The hand patients go to the hand area. Gym patients, they go there. If they need to go back to the private treatment room, they get escorted there. It's done by a PT tech, but we refer to it as a host so that you understand what that job is. There's a lot of body language there and not running too far ahead of the person.

I've seen that a lot where someone comes out, whether it's a nurse at the doctor's office and they yell your name and then they stand there. They don't come out to greet you in your place where you're sitting or call your name and when you say, “It's me,” they come over to greet you and bring you back. Instead, they stand over there at the door and then you have to get up in front of everybody and walk out. Everything is geared toward comfort, security, making that person feel secure. That's the second station of the five. Reception, host, and then we go to therapy, the actual treatment side of it. There's something else that has to happen in there.

It's all covered in the book. It's quite lengthy, but quality assurance. The Final is the reception area again. The reception area has got 2 of the 5. They have to catch them when they're coming in and they got to make sure that they give them the connection before they leave, that people don't just skate out. You go up the next level tier and it's seeking a win-win situation.

Everybody, when they're engaging with a patient, needs to be, “What's the win-win situation here?” The patient calls in and they have a problem with their bill. We talked about that before with the financials and stuff. Maybe there's a way we look at it and it's like, “I got their point of view on it. Everybody that calls him, we can't start dropping things out and cutting the bill.” Let's say they have a legitimate life.

“I don't believe I received that on that day.” “This person was always trustworthy. To be honest with you, ultrasounds have never been listed in their patient charts. I don't know how they ever got charged for it. We got to get that out of there.” That's a win-win. I've called into doctor's offices and hospitals before and it's like, “I don't know that this is right. The charges are correct.” There was no wiggle room. It was, “If you don't want to pay, I will come pick your chart up.” It was harsh. We try to seek that win-win on everything they do. "10:00 doesn't work for me, but 10:15 does. I know that doesn't sound like a lot, but at 10:15, therapists are too busy."

We try to make sure that we move some things around. In other words, the 10:15 patient is maybe one day away from being discharged. They go to a PTA. PTA has already been working with them as a group anyway. We start making moves on the schedule and bring that person in at that 10:00 time. That's a win-win for everybody, versus moving a patient that was going to be discharged in a day, another day. It's still a win-win for everybody.

Customer Service: PTs tend to be ultra-scientific and evidence-based. However, they have totally zero training on communication, emotional intelligence, personality types, proper etiquette, and body language.

 

They're asked to get their people that are on their toes. The final thing of the pyramid is to make sure that you're always delivering an experience, not patient care. Your goal ultimately is to do all of these things to get to delivering an experience. Don't deliver patient care. Patient care, “What are you here for?” “I'm here for PT.” You're just given physical therapy. XYZ PT down the street can do that. Anybody can do that, but can you give an experience? It’s something that sticks with the patient.

You have to consider that as a physical therapist. If these people are coming 2 to 3 times a week, for a period of weeks, that's much different than going to a doctor once or twice for an ailment. You might want to go to the best doctor there is for that ailment and maybe look past his bedside manner.

A neurosurgeon or a cardiac surgeon, I don't care if he's nice or not. I just need him to be good at what he's doing or she's doing.

If I found them doing physical therapy three times a week, and I'm going to see you twelve times, I might as well like you, or you might as well make that a good experience and keep them engaged. I remember the story. I hired who would eventually become my business partner, Will, to run a clinic for me. He was coming from the home health side of things. He was a little bit rusty on the outpatient side of things. We hired another physical therapist for that clinic who was McKenzie certified and did great work and was getting good results with these back patients. One of the back patients, we'll refer it over to him and they got great results.

This guy started coming back to Will’s schedule. Will said, “How'd you do with the other therapist?” The guy said, “I did great. Great results.” He's like, “Why are you coming back to see me? Why are you on my schedule?” He said, “I like working with you.” It was that simple. Sometimes the patients know they're going to get good care if you can pass the good care test, which I always do. What's going to set you apart? How are you going to keep them from falling off after three visits?

That's that patient engagement. Give them a reason to want to be there.

I can walk into some PT clinics now and tell which ones are doing well and aren't. The ones that aren't doing well seem a little darker and a little bit colder. It's quiet. You can hear a pin drop. There's not a lot of energy through the clinic. That's not easy for the patients to tolerate, but the therapists don't enjoy it either.

It feeds the whole system. That's talked about also in a book of how it's difficult to get up for every day at work, especially when your job is a therapist and all you deal with his complaints. It's a grind. We have a definite team atmosphere. If the atmosphere is down, pick up foot speed, do one thing, talk more, create more energy. You're doing something to create energy. That spark will take off. We've seen it time and time again. It takes just one person to do it.

We had a whiteboard. One of the things that we thought was super important in our clinics was crosstalk, talking to someone across the room, even though you were with a patient. We had a whiteboard that would put up either a question of the day or a piece of trivia. If things got quiet, everyone could look at the whiteboard and use that piece of information to generate crosstalk.

I wish that I was still writing my book. I would quote you because that was awesome. I talk about that, a lot of environments I was in as a student. I've heard other patients come in, say, “Over there, they put you on the mat. There are other patients in there, but it seems like everybody has their own cubicle, their own little area. We're crosstalking.” One hundred percent we believe in it. We've seen, like you have, the benefits of it.

What did you see after putting this in since 2006? Were you seeing a little bit more engagement? Were you seeing less follow-ups? What happened after that?

Customer service must be geared toward comfort security, making every person feel secure. Click To Tweet

The foundational part is putting in the service, but then we started measuring it out a little bit more specific with our stats in terms of people that fell off, percent of rivals, percent rescheduled. Those are all indicators of compliance engagement. People don't want to come back or they don't want to preschedule. In other words, they're being difficult. They were following our system and now they're bucking it, pushing against it. They don’t want it now. Those are major concerns.

Their personality and mode of operation were this way, now all of a sudden, they've taken a right turn and they're going in a different direction. We've trained our people to pick up on that as well. Once we started measuring it out, we could see the compliance was there. We started gathering more success stories and testimonials. We took all that and used it on the marketing side, but that was the measurable that we could see. We'd bump it to three percentage points from where we were.

I'm assuming back in 2006, was this the foundation that was laid to then start opening other clinics? Did you start seeing some growth that led to other things?

Yes. It's been an ongoing core of what we do. It needs to be corrected at times. It needs to be retrained. It needs to be put in judicially at times. You hear about a patient situation where a patient came to a few visits and then we pushed them off the schedule because they were good enough. It's like, “That isn't how we do things. The world is busy right now. We got workarounds. Let's think a little harder. I know it's harder work, but we got to put that work in.” How we answer the phone, are we doing it? I get it. I understand. It gets difficult when you have had a long day as a receptionist, but you can't lose that engagement part.

Considering you generated some more specific stats related to engagement, now you can tell if the patients are engaged based on the stats. If they start dipping, then you can start asking questions.

First off, are they getting worse? Start with a basic thing. “Are they feeling worse or better?” “They're doing better.” “Why are they dropping off then?” “It's because they're feeling better.” “Are they 100%?” “No.” “What did we promise them?” We have the sprays around there. It's probably not a great one, but we use it privately. We're going to drag them across the finish line because a lot of patients are like us. Sometimes you get to drag us across the finish line.

Some people are like, “I'm 75% of the way there. I'll take care of the rest.” No, you won't.

“You won’t because you're like I am.” You get somebody that if it becomes a real push and shoving match, they don't want to be like, “I get it.” You got to play that one correctly, but some people are compliant. “I work out all the time. I just had surgery. I'll go back to the wire, to my gym and I'll finish the last 10% or whatever.” We want to make sure that the win-win is in. If that's their win and they are certain of it and you sense it, then that's fine. We'll discharge.

It goes back to that initial evaluation once you've established, “What do you want to get back to?” “I want to hike around the lake.” “Are you hiking around the lake?” “I can't go that far.” “It sounds like we're still going.”

Always go back to that thing that motivates them. You'll find out from that even that maybe that wasn't their motivator. You dig further and so on and so forth. If you follow a normal progression of being a PT, it's all going be X plus Y equals Z. It won't be looking at some of these other nuances about the person.

Say for a PT owner that's reading this and they say, “I need to improve the culture or the customer experience that's happening in my clinic,” where would you direct them to first? This is something that has to be worked on. It's going to take some time. It may take a few months to get built. Where would you start them first to have the greatest impact to improve that customer experience?

PTO 168 Steve Line | Customer Service
Customer Service: Make sure you're always delivering an experience, not just patient care.

 

The first place I would direct them would be to my website so they can buy my book. TFGE.net, TheFeelGoodExperience.net, or go to Amazon.

What area? Should they focus on the PT that they're providing? Should they focus on the front desk?

First and foremost, front desk, start there. If your therapy is bad, if you're not getting any results, you're probably not sitting here thinking about, “I need to put her in a customer service program.” I need to clear house and get new therapists or get them trained or something. You need to flesh that out at first. Chances are, the numbers are already dipped so low in those clinics that it doesn't matter anyway.

We're assuming, let's say, all things being equal, but they're getting results. They're maybe losing patients or percent of arrivals have dipped around. They are maybe at 85%, 80%. They lose quite a few early drop-offs. People are discharging themselves, or new patients are never growing. To me, that doesn't follow a natural cycle because the more patients you bring in and discharge, they're now formers.

You should be able to have natural growth, even if it's a few percent every year just because of that. That tells me your front desk probably isn't doing a good job of engaging and pulling them onto the schedule book. Start with the front desk. How are they handling the phone? How are they handling walk-ins? Is it just a job or are they checking the boxes? I asked them if they had insurance, they said they did, but they didn't know what was led in the schedule. I'll try to do a little more. We’ve got all of them. We've got all types. Sometimes thinking beyond the most obvious is the thing that will get you there.

I've had this with some of my coaching clients in that they need to tell the front desk that their job is to fill the schedule.

That's your job.

All this other stuff is good, but understand this point that your statistic is this, it is to fill the schedule book. You do that by doing all the stuff that we're talking about. These are the things that fill the schedule book. Don't let patients cancel and fall off despite their excuses. Be engaging, recognize that physical therapy is in their best interest.

We can go down the list, but it starts with that front desk. If you have a good person there at the front desk, they are worth their weight in gold. If they are not engaging and personable, you're hemorrhaging money. I love that you said it that way because that's the truth. You are losing money. You shared the website. Is there anything else that you want to share with the audience before we sign off?

You mentioned the articles I've written, financials and stuff. Go to TFGE.net. Follow me on LinkedIn. Send me a message. I'd love to hear from you.

Are you going to be a PPS or CSM in the future?

I'm not going to be at those because I'm on a little bit of a sabbatical here.

Enjoy your sabbatical. Congratulations. You deserve it.

Thank you.

Thanks for your time. I appreciate it, Steve.

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About Steve Line

PTO 168 Steve Line | Customer Service

Steve Line, PT, OCS, ATC is President/CEO of Columbus Physical Therapy, P.C. He founded the company in 1999, leasing office space in a strip mall in Columbus, Nebraska. Since that time, he has expanded the company to 3 locations across Northeast Nebraska, going from 1 employee to 25 and boasting a nearly 14x growth in a underpopulated rural area.

Before starting CPT, he worked as a new grad PT for another PT practice that highlighted the importance of production volume, expansion and customer service. Prior to working as a PT, he attended UNMC PT program in Omaha, NE and UNL for undergraduate studies.

Throughout high school and college years, he worked at various customer service - oriented part time occupations to help pay for schooling. It was throughout those formative years of dealing directly with the consumer in grocery and bartending that developed his intuition for “anticipating consumer needs” and eventually developed a proprietary customer service model, “The Feel Good Experience” that is used primarily in all of the company clinics. Although, a physical therapist by training, Steve identifies more with the mindset of an entrepreneur, a leader and a teacher. He has published several articles with Impact magazine, a publication of the APTA PPS, and is currently finishing a book entitled, The Feel Good Experience: Grow Your Physical Therapy Practice With Five Star Customer Service.

Steve, married to Kristine for 21 years have 2 sons Evan and Derek, in highschool and twin daughters Alexis and Brianna in middle school. In Steve’s spare time, he enjoys being outdoors; hunting, fishing and working on his several farms he owns in Kansas and Nebraska. He enjoys reading, and talking about “anything business, real estate or property management related.” Steve is available for questions and consultations regarding business coaching and operations and can be reached at cptsl@columbusphysicaltherapy.com.

PTO 165 | NeuFit

 

If you want your business to generate seven figures, all you need is a business differentiator - small actions that can help your business stand out from the competition. Joining Nathan Shields today is Garrett Salpeter, the Founder of NeuFit  and the creator of the Neubie, a device that safely sends direct current signals precisely to where a patient is experiencing pain or muscle movement limitations, re-educating the muscles by tapping into the power of the nervous system. Garrett talks about some simple business principles that can help generate HUGE results in your practice. Learn how NeuFit differentiates itself from all the other recovery and training services out there. Plus, discover how to motivate and set goals for your clients so that they will keep coming back for more.

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Listen to the podcast here:

Small Actions That Generate HUGE Results With NeuFit Founder Garrett Salpeter

In this episode, I've got Garrett Salpeter. He is the Founder and CEO of NeuFit, which is a new company technology method for PTs who are using it to improve patient outcomes for a variety of issues. Garrett, thanks for joining me. I appreciate it.

It's a pleasure to be here. Thanks for having me on.

It's great to have you because I've heard about you through my network of people and they're excited about the technology that you've brought to their clinics but you're not specifically a physical therapist. Tell me a little bit about your background and how you got into this physical therapy space?

My academic and educational background is originally in Physics and Engineering. I did graduate work in both Engineering and Neuroscience. I had always been passionate about physiology and the human body. I'd been an athlete and was into working out and I did a lot of that in my spare time. This allowed me to combine all the things that I'm passionate about. I've found that place where that Venn diagram overlaps. From the engineering side, I was initially interested in the technology and then applying neuroscience and the principles of neurology into daily practice. How doing that could create these transformative experiences for people.

It's interesting because the initial catalyst for this is an experience I had back. When I was in college, I was an ice hockey player. In my senior year, I had some torn ligaments in my wrist. I was told I was going to need surgery to be out for three months and I figured that would be that based on my experience with traditional sports medicine. I, fortunately, met a chiropractic neurologist and he introduced me to these two powerful principles. These two powerful things were tremendous influences on me.

One was functional neurology. Instead of focusing on the tissues and structures of the body, we also could focus and there was a lot of value in focusing on the neurological response to injury and trauma, the guarding, inhibition and pain. By optimizing function, we could support, accelerate and optimize healing. The other major piece of that experience was seeing the healing benefits of direct current. It was a more primitive microcurrent type at the time, but I saw firsthand how that helped my ligaments heal on their own and I avoided surgery.

That planted the seeds and created within me this calling to share that type of work with as many people as I could. A lot of my graduate education and subsequent work was trying to follow the breadcrumb trail and piece together ways to explain and harness the power of those experiences that I had. Along the way, I started working with clinicians to bring in that clinical piece, take these concepts and bring them down to where the rubber meets the road in day-to-day practice.

When did you start the company, NeuFit?

We started working on the Neubie device in 2015 and doing various experiments and then we finally launched the device in 2017. It built out. As part of my experience along the way, I was using more primitive technology and working with a couple of clinicians here in the Austin, Texas area. I had been doing that for several years prior and that's where I kept seeing these opportunities. I want the technology to be able to do more. I want the methods to evolve. All of those experiences finally led up to the point where I had no idea I would lead a company that was creating a device or anything. I never had any idea that I would do that until it finally was like, we want it to happen. It seems the only way there is to do it ourselves and I decided to do it.

You eventually became a business owner. Now you own this device and this technology that's making significant changes in patient outcomes.

All your business needs in order to hit seven figures is a differentiator, a wow factor. Click To Tweet

I've had the tremendous honor of working with clinicians around the country now and in some other countries around the world. It's been incredible to see how they've been able to not only get as good outcomes as we were able to see here in Austin and our proof of concept home office but take it into new areas. Create these wonderful transformative outcomes in different patient populations, finding new applications and it'd be cool to see how it's grown in those last several years.

I'm hearing about it here over the past through a coaching client, people in my network, hands-on diagnostics and PT owners that are using it there but you were telling me that there are also professional sports organizations that are utilizing it for the benefit of their athletes.

We've been honored to work with the last two World Series Champion teams. The Dodgers and the Nationals have been using it. Working with them has been incredible. It's led to these cool behind-the-scenes experiences that I never dreamed I'd be able to have and going and training the staff of pro teams and this Division 1 universities, being in their facilities, meeting the players, coaches and staff. It's been fun and cool to see how it can impact those athletes. It can create some of these amazing outcomes with acute injury and then also with ongoing recovery, movement prep, activation and then across the continuum of care, return to play and ongoing performance.

Managing fatigue and training, managing all those variables in season in a grueling Major League Baseball or NHL. It'd be a season where managing training, rest and recovery is such an interesting challenge and opportunity because if you can do it better than the other teams, you can do better in the late season and playoffs. It's been cool to get to collaborate with people in that realm.

Congratulations that you've gotten that far with your business. I am bringing you on. We want to talk a lot about business concepts as it's related to what you've learned in your development of the Neubie through NeuFit. A lot of those business concepts are things that are immediately applicable to physical therapists. We're talking about differentiation, getting patient buy-in, retention, cash pay services, consistency of care for patient results that aren't owner-dependent. Talk to us a little bit about that and how some of the things that you've learned in introducing the Neubie have improved businesses in general that aren't specific to the Neubie?

I think we can spend a long time unpacking each of those bullet points that you mentioned there in terms of differentiation and helping to create a quality of care that's not owner-dependent. All of these things are wonderful topics. We started to see success in this area here in Austin. Our home office is our part laboratory and part showroom.

It's a facility where we have two physical therapists working with us. We've had other types of practitioners at different times, chiropractors, athletic trainers, several strength conditioning coaches, so we're working with people across this whole continuum of care. When we started to see our model grow, we hit a revenue milestone of doing over seven figures, over $1 million a year out of 1,200 square feet, all-cash with not a single dollar of insurance collected.

We started to see one of the biggest things that drove that for us was this concept of having a differentiator. This experience of being able to create that wow factor for people. A lot of it is as simple as in this day and age, “Our attention spans are short. We want results now.” That's a theme infused through our culture. If you provide a service to somebody where they come in with pain and they leave with noticeably less pain, more range of motion, some tangible improvement, then you have their attention because that's unusual, one and two, it meets a need for them. It gives them something that they want and they're willing to invest their time and their out-of-pocket dollars in order to continue to experience.

In that regard, we haven't done anything in our clinic that's interesting or compelling sales-wise. We use this product with virtually everybody and lead with our differentiator. In many ways, the experience sells itself and makes people want to want to come back. Also, complete their plan of care. That's something that we've now been able to interact with wonderful clinic owners around the country. We've heard and looked at some statistics and tried to wrap our heads around how we can help PT business owners. The same people you're working with.

One of the things that we found is that some of those statistics were staggering around how many patients drop off and don't even complete their plan of care. We'd have a lot of people come to our clinic all the time and be like, “I was seeing a PT, but they're having me do these wimpy exercises. I can’t do them on my own at home. I don't feel like I'm getting a lot of value.”

In the traditional model, there is a lot of that. Even if it's covered by insurance, they're still spending their time, effort and attention being with you. A couple of practice owners are shared with us that they dramatically increased the percentage of patients that complete their plan of care. That helps their volume, their number of visits per week and per month. It helps those averages go up.

PTO 165 | NeuFit
You can focus less on tissues and body structure and more on the neurological response to injury and trauma. By optimizing function, you can accelerate healing.

It's interesting because you've hit on a few of those things there and the first one that you talked about having a differentiator. Your differentiator could be certain body parts, demographics or sports. It could be anything in particular. What I've seen in terms of those people who are growing and have a unique culture and that has greater energy around it, so they are prepared for expansion are those that have, set themselves up as the experts in blank.

For example, the one couple that comes to mind is Angie and Joe McGilvrey down in Florida. I know they have a Neubie down there. I've done an interview with Angie. She talked about how several years ago, a hurricane came through and wiped out their clinic. They were down for a couple of months. Prior to the hurricane, they were your traditional outpatient orthopedic clinics. All patients and insurances. It seemed a humdrum run of the mill physical therapy clinic.

That was doing okay but took this opportunity with the hurricane, knowing that they were going to have to rebuild their business from scratch to say, “What do we want to do? What do we want to see? What patient population do we want to focus on?” When they decided to focus on the 30-year-old female CrossFit athlete, now they knew what their marketing message was. They knew what their focus was going to be.

A lot of people would say, “I don't want to see 30-year-old CrossFit athletes.” Those are the people that are going to tell their mothers, dads, friends and who are CrossFit athletes to come to you guys because you're specialists. They're also going to see that you’re focused on athletes and your social media messaging. Other athletes from other disciplines are going to come and see you. That differentiator could be any number of things. It can generate some energy, growth and at least being known for something.

One of the things that have helped us in our clinic is doing that exact thing, is creating that avatar, identifying that ideal customer and I'll share this in case it's helpful because I think it's a cool exercise. I know you talk about that in terms of being more specific in your marketing and messaging. At our clinic was the late 40s, executive type individual who was a college athlete or active previously, but has these chronic aches and pains that prevent this person from being able to maintain a regular fitness routine, shoot baskets or play tennis with their kids.

Being able to help them get out of pain not only gets this tremendous individual service and they want to do sessions for rehab but it also gives us an opportunity to convert them to a long-term fitness or wellness client, deepen that relationship and also increase the lifetime value of the customer. If their kids are high school or junior high school athletes, when they get injured, they send their kids in. They tell their friends and we've had a lot of success speaking directly to that type of avatar. It's cool to see those ramifications of who you choose and who they know.

From a myopic standpoint, you're like, “I'm going to focus on this group and that's all I'm going to see.” Focusing on that group focuses your care but they know those patients have family and friends that won't care and they're going to refer them to someone that they know, like and trust. That goes to the next step where you talked about getting patient buy-in.

If you're going to focus on a certain body part or demographic, you're going to want to have something that gives some wow factor. There is got to be something. Whether it's a dry needling experience or you pick it, whether it's your device or something else. There's got to be something that makes them come away thinking, “I like what I got from that first visit. I'm excited to come back for more,” so that they stay engaged.

I think that there's a good barometer for that. If we want to give people that level of service where they stay engaged, the way to measure that is to look and say, “How many referrals am I getting?” If I'm giving people such good service, some number of them are going to want to tell their friends, family and colleagues. That's a good measuring stick and that's something that we've heard from clinic owners that having these differentiators, it's increased the number of referrals, which has led to increases in volume and sometimes pretty dramatic growth. That's a good way. For anyone reading, that's something I would invite you to look at all of your lead sources and see how many of them are coming in organically from referrals. That's free advertising. We can mobilize our existing customer base.

That's the low hanging fruit because you always have this list of what maybe 50 to 100 physicians that you can always call out to but you as you grow and expand over time, you're going to have hundreds, if not thousands of people on your past patient list that you can market to. Your marketing efforts can be exponential and that's the low-hanging fruit. That marketing costs nothing.

The highest ROI is when you divide it by $0 cost of acquisition.

NeuFit is a very safe yet efficient and targeted way of training. Click To Tweet

The one thing that's cool is you've got your differentiator. You provide a buy-in and wow factor. Once you get that patient, traditionally in the physical therapy outpatient model, they complete their plan of care, they're done and you don't see them anymore. In your practice, do you have some maintenance programs or wellness programs that can be additional add-on cash services?

That's something that we've tried to find different ways to implement so that we can share that model, have everyone who has one of our devices, have them be able to use it as a template, learn from our experience, adapt it to theirs and perhaps even make it better. One of the things that we like to do is towards the end of each patient's plan of care is to give them a demonstration, either within a treatment session or as a separate session. Give them a demonstration of what training is like and what a fitness session would be like on a different area of the body.

With the machine, for instance, how they're able to put electrodes on, change the settings and get as much muscle recruitment and much of a strength or hypertrophy type of workout as they would if they were lifting heavyweights. They could be doing bodyweight, doing open-chain movements with their arms or something like that. We give them a sample of what that safe, efficient and targeted way of training, what that's like and that helps convert some of them.

Some of them will come in for transition into being training clients. You mentioned Joe and Angie McGilvrey in Fort Myers. They've been able to convert a lot of their patients into training clients. They've hired additional staff with more strength and conditioning type backgrounds so they can retain those patients and serve them along with the entire plan of care.

We also have these electric tune-up sessions that people will come in for maintenance from time to time. They could be 30-minute sessions. It doesn't have to be 1 hour or something like that. People will come in to lose and back up. If they were coming in for chronic low back pain, it just comes back from time to time, 1 or 2 sessions. They'd come in and pay cash. They do a quick one there.

It's important for physical therapists that even if they didn't have your device, they recognize that there are those opportunities to promote the ongoing wellness and maintenance of their patient's health. I hear from chiropractors that it's common in the chiropractic space, after a discharge from a plan of care that they'll set up a two-month post-discharge follow-up visit at that last visit. Inevitably, there are going to be some regression or they're going to mow the lawn sometime after discharge. Their back's going to get tweaked or their shoulder is going to flare up and they think, “I'm done with therapy. I guess I’ll handle this on my own.”

They schedule that two-month post-discharge to follow up and say, “How are you doing? Let's do a quick consult.” You could charge, maybe cash for it. It's probably not an insurance billable charge but you just follow up. I would guess probably 50% of those people turn into patients again, whether it's for that same body part or another body part that flares up down the road.

Some people also offer other health coaching services or other things too where they can use their physical therapy business to funnel and create for these ancillary businesses. That's a great idea. I may borrow that one from you if that's all right.

It's cool because you have a cash-based model at your current facility. Some of your traditional outpatient PT practices that are in-network with many insurances, what they don't recognize or don't expand their scope of practice. They're not looking for opportunities to provide some cash-based services, even though they're in-network with some of these things. I know some people might charge cash for a dry needling treatment or something like that. I think there are opportunities out there to look for and find some cash-based things they can do to “upcharge” what they're traditionally getting and thus combat the declining reimbursement rates that they're getting.

We've seen good examples of that. I'm speaking from experience of people using our device but anything that is a differentiator and adds value like you mentioned, dry needling, the same can certainly apply. We've seen several clinics that are in-network and do accept insurance. If they're going to use a tool like the Neubie or dry needling, they charge an additional amount on top of that. As long as they're able to do it within any insurance contracts or anything, as long as it's appropriate, ethical and legal to do so, we've seen that works successfully. People happily on top of their insurance, if they're like, “Do you want to use the Neubie? It's going to be an extra $50 to $75 for this session.”

We've seen at a lot of practices people will pay that amount or as you said, when their plan of care has been done, they convert to a cash-based fitness or wellness services type of arrangement. We've seen that health practices start to add some cash to supplement their insurance and give them a little bit of a buffer if there's an insurance audit or if they're trying to mess with the rate at which they're making payments. If the benefit is the reimbursements, go down even further. Having that buffer is nice. It helps us sleep better at night.

PTO 165 | NeuFit
Attention spans are shorter these days. People want results. If you provide a service to somebody who comes in with pain and leaves with noticeably less pain, you have their attention.

A few of my clients or friends in my network are also using is musculoskeletal ultrasound. Some insurances pay for that, some of them don't. It's a fight depending on which state that you're in to see if they recognize that as something within your scope of practice. Diagnostic ultrasound can also be a cash-based service that can provide greater value to the care that you're providing and also be a benefit to the patient.

I'm glad you mentioned that. We'd had some mutual overlap in colleagues through the HODS group and I love that you're involved with them and what they're doing because that's such a cool service. You go to a PT and get real-time information. That's perhaps even better and more specific than what you can get on MRIs or other scans. To be able to get something there with somebody who can do something about it and track progress along the way in real-time. With the EMG, nerve conduction tests and all that, I think that's amazing. I am excited to see more PTs do that and upgrade the whole way the PT profession is perceived by people who offer those services too.

When they can do some diagnostics, that's finally a step towards that gatekeeper of the musculoskeletal care that we can provide.

We're very excited to be working with the HODS group, partnering on a study where they're going to be using their EMG and nerve conduction testing capabilities to do before and after pre-post intervention tests on neuropathy patients using our device as the treatment intervention. Then measuring for changes in EMG activation for nerve conduction.

Based on some of the results, we've seen functionally and in different case studies so far, I'm optimistic that it'll be good. Being able to be to have that validation too, that's another thing that drives engagement. When we're talking about creating that wow factor, getting engagement for people, being able to show them a problem, offer a solution and be able to show them a change in that measurement.

We don't do the EMG work at our facility, although I'd be interested in finding a way to offer that. One thing that we do that is related is we'll do manual muscle tests. If someone comes in with a knee problem, you'll have to lie down on a table and they'll hold their leg up. We'll push down. We are testing quad and hip flexor muscles. There's nothing unique about that but one of the things that we do is we'll use a handheld dynamometer. I'll push down in someone's leg and say, “Your left leg is 50 pounds of force. Your right leg is only 30. There's a deficit here. We want to get this leg from 30 to 50.”

If we can do some of these neurological activation techniques that we do and see them get from 30 to 40 in one session. Know that 50 is their goal and that we're already moving towards it in one session, that type of objective feedback creates a lot of buy-ins too. That's one of the things I like about the ultrasound where you see the picture. EMG, where you see the number or this handheld dynamometer being able to show people tangible, objective, measurable changes. I think that is sticky and that creates a lot of buy-in, enthusiasm and engagement also in that same realm.

It's an extension of what we learned in our physical therapy schooling programs. One is the manual muscle test. The other is simply the usage of a goniometer. To take objective measures like that and translate that for the patients and say, “You're gaining, you're getting better. This is our goal.” There's a scoreboard now. We can look at the scoreboard and see how you're doing because I think many times where patients fall off is that the therapist hasn't told them what the game is.

They haven't set the goals and expectations. This is how we know we're winning when we can get to 90 degrees of abduction. Now we're getting to 120 degrees of abduction, f it's a shoulder or where we want to get your strength from 3-plus to 5. In your case, using the dynamometer is even a little bit more objective and saying, “We want to get from 20 pounds of force to 40 pounds of force.”

When we give them that and then they know where they are in relationship to the goals that they want to achieve, now they know that they're making headway and they can buy into a program like that. Whereas if you say, “We need you to get stronger. You need to be able to walk better and have less pain.” A lot of that sounds like subjectivity. It doesn't tell me the game and it's not that exciting.

I think we're getting into a conversation about human drives and motivation if there's that deep innate desire that we all have to improve, get better at something, work towards a goal and fulfillment. If the goal is ambiguous that we can't possibly know if we reach it, it's tough to be motivated by progress along the way and there are elements of that. Sometimes owners might have those goals with staff therapists like, “Your goal is 40 patient visits a week,” or whatever the number is. It's objective and motivates a therapist to work towards that but they may not use those same objective milestones with patients or vice versa. They may do it with patients but not with the staff. It's probably good to do it in both cases.

If the goal is so ambiguous that you're not sure you can reach it, it's tough to be motivated. Click To Tweet

The one thing I like about setting yourself up with a differentiator of some kind is that it leads to a cascade of events. One of those things is that if you're working with a particular demographic, in spite of having a number of different providers, inherently, you're going to come across similar issues that you find with patients. If you're doing it right, then there's going to be a consistency of care. There's going to be maybe a similar continuing education course that you take a certain diet or treatment process.

You're all going to be McKenzie and ASTYM-certified. Whatever it is, there should be a consistency of care and this is specific to those people who are reading as PT owners. Nathan has to see this patient or the patient has to see that provider. You want there to be a consistency of care. It's not owner-dependent. When a patient comes to your clinic, they know the results that they're going to get in spite of the provider that's providing it.

You and I talked about it that many clinic owners feel trapped or stuck. They may like providing care but they don't want to have their business dependent on them doing it 40 or 50 hours a week. If there’s much time in the business, you don't get that time to zoom out and work on the business. Do those more strategic things that can help it scale and help make it an even bigger impact. That was right in line with feedback we've heard from several owners. For us, it's the NeuFit method. You mentioned others too, by being able to get their staff certified.

I've heard this a couple of times from clinic owners who will say, “The first time that I heard a patient come in and request my junior therapist, I knew I was going in the right direction. I could see that light at the end of the tunnel where I was going to be able to get some time to travel, be with my family and do more strategic business things because now I can see that it's no longer going to be so dependent on me.” That's something that we've heard a lot and that's such an important topic. I’m glad that when you're teaching and mentorship that you speak so much about that too, because that's such an important element of overall life satisfaction.

You've done it in your facility and that you've trained people in the NeuFit method but I think it's important for most owners to recognize that there should be some consistency of care. I did an interview with Tom Dalonzo-Baker, where he shared with me one of the reasons why he could get out of patient care is he sat down with his team of providers every week. They'd go over certain body parts or diagnoses and they decide, “What are some common ground things that we all do that we can agree on? This is fundamental to the treatment of blank.”

After having that conversation over months and probably over a year, the patients could come in and if Tom dropped out, for whatever reason, everyone knew what the game plan was based on that body part and the diagnosis that they were going to do this kind of care. I think that conversation is extremely valuable because I'm gathering from your facility that it's not provider-dependent, whether or not they're going to get results for any diagnosis.

I love the collaborative nature where everyone's getting to talk about creating that treatment plan together and they're co-creating that. The staff is going to buy in even more because they've helped create it and the concept overall of having that continuity of care where it's going to be a similar experience. Whether they come in and they see John, Susie or someone else, the PTA, they're going to have that continuity and it's still going to be a good product. Even if you're gone for two weeks, your operation can still provide excellent quality of care. It will still make the impact that you want to have, even if you're not there.

Anything else that you want to share with us about how you're doing things at your facility and with the Neubie that you think other PT owners could glean from?

We talked about applications with pro sports teams, sports medicine and orthopedic care. Another interesting component that we've seen is a lot of growth and amazing impact in the realm of neurological injuries, diseases and impairments. We have a whole program now. We've done work and have other studies. We have made a lot of headway in helping patients with MS, spinal cord injury, stroke, restore function and make meaningful, transformative improvements and sometimes regain autonomy, activities of daily living, quality of life. There are some cool things there.

We've seen some practice owners who we're more in that traditional, typical outpatient orthopedic realm. Now they've expanded and they are working with some stroke or MS patients because we've done a lot of work with a brilliant doctor and wonderful human being named Terry Wahls. She's a medical doctor professor at the University of Iowa and she had MS. She was wheelchair-bound and she reversed her symptoms through a combination of intense physical therapy and The Wahls Protocol. She wrote a book, The Wahls Protocol. It's a lifestyle parameter that reduces inflammation that can quell and suppress the underlying auto-immune environment that creates damage that leads to MS and all that.

NeuFit: If you give people good service, they will tell their friends and family.

 

She has a fabulous research program. She has studies that show that her lifestyle interventions are getting as good or better outcomes with MS patients as immune-suppressing drugs without any of the side effects. These people have more energy. They feel better and sleep better as opposed to immune-suppressing drugs, where they're susceptible to other problems. We've worked with Dr. Wahls, who has this audience of hundreds of thousands of MS patients.

By working with her and introducing NeuFit to her audience, now we've had practice owners tell us that they're getting a few here and there. Many referrals of people who come to the website find their listing and they've created some of these new specialties, areas of interest or someone on their staff has started working more with neuro patients. They've seen some of these new avenues open up.

There is a benefit in being specific in messaging and choosing an avatar. For established practices, once you haven't dialed in on a certain target avatar patient, being able to branch out and serve other areas can help expand the practice and create more engagement with staff. It can lead to some cool things there. I wanted to mention that because it's something that we hear and that's something that's top of mind for us, for sure.

Some groundbreaking progress on some of those neurological issues is exciting to hear about because there isn't much outside of medication.

To be able to help these athletes is fun and exciting and has a certain appeal, but to be able to help a woman who's been paralyzed for many years because of a spinal cord injury. Being able to see her, over the course of years of treatment, to get out of a wheelchair, walk with a walker, regain some significant autonomy has been incredible to see some of these transformative things. That's rewarding in a whole different way than helping an athlete get back on the field or something. It's all wonderful.

If people wanted to reach out and find you, how would they do that?

My first book is called The NeuFit Method. If anyone's interested in reading and learning more about this, the book is on Amazon. It's a bright green color on brand with our color scheme and logo. Our website is www.NeuFit.com. We have a special landing page for readers. It's Neu.Fit/PTOwnersClub. If anyone's on social media, we’re most active on Instagram. It's @NeuFitRFP, for Rehab, Fitness and Performance.

Thanks so much for sharing and thanks for the landing page for those who are reading. I invite them to go and at least find out about it because this is a relatively newer company, technology and method. That's helping out improve patient outcomes. It's cool that I can catch you at this time because I'm sure you're not going to be as available down the road. Thanks for your time, Garrett. I appreciate it.

Thank you, Nathan. It's awesome to be able to work with somebody who's doing a lot of meaningful work in this business area. It's important for people who love the clinical world, but if you can't keep the lights on and have the financial results to show for it, it's not sustainable or as rewarding overall. You're doing wonderful work blending the clinical and the business. Thanks for having me on.

Thanks. Have a good day.

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About Garrett Salpeter

PTO 165 | NeuFitGarrett Salpeter used his training in Engineering and Neuroscience to create NeuFit and the patented Neubie device. He and his team have trained thousands of doctors, therapists, and other professionals in the NeuFit methodology, and these practitioners have used NeuFit to help their patients recover faster from injuries, reverse chronic pain, restore function lost due to neurological injuries or diseases, and achieve improvements in fitness and performance. His work is also used by dozens of professional sports teams and universities, and is the subject of multiple ongoing trials evaluating the effectiveness of its technology in areas like post-operative recovery, muscle hypertrophy, and functional recovery from stroke and MS. Garrett is the host of the NeuFit Undercurrent Podcast and bestselling author of the book, The NeuFit Method.

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