PTO 139 Neil Trickett | Marketing Strategies


The COVID-19 pandemic has pushed every one of us to adapt to this new normal and marketing strategies are no exception. In this episode, Nathan Shields interviews his long-time friend, Neil Trickett, who talks about how marketing strategies can be optimized in the post-COVID worldThe CEO of Practice Promotions, Neil is a marketing expert who has worked for over 900 PT clinics across the US and Canada. Neil and Nathan take some time to discuss online visibility, SEO, web content, and other elements that PT owners should pay attention to in order to keep their funnels busy. Stick around to the end as he shares his personal new normal strategies and what should owners be really focused on. 


Listen to the podcast here:

Optimal Digital Marketing Strategies Post-COVID With Neil TrickettPT Of Practice Promotions

Our guest is a long-time friend, Neil Trickett, CEO of Practice Promotions. Thanks for coming on again. I appreciate it. 

Thanks, Nathan. Its always a pleasure. 

Its been a couple of years since we last spoke and a lot has changed, but Im glad to bring you back. Im excited. If people are interested in learning more about Neils history. He is a prior PT owner that has transitioned into marketing with Practice Promotions. They do a wide range of things, especially digital marketing, newsletterswebsites, you name it. They cover the basics. Now, especially where Neil sits, a lot has changed with marketing compared to pre-COVID-19I decided to bring you on because you have a real pulse on the industry. You work with hundreds of clinics across the country. Youve seen how people have had to pivot and change, firsthand and what is working now compared to what was working back then. Im excited to get your insight. Letget into it a little bit right off the bat. What’s it like for PT practices out there now? 

Much has changed here and were working with over 900 PT clinics across the US and Canada. It’s interesting to have a pulse on whats happening in different states, in different parts of Canada with lockdowns, partial openings and all this stuff that has been a challenge for many practice owners out there. Itinteresting to see what is working now for practices and how people have evolved and changed their marketing and practice. Whatinteresting is a lot of the things that we were doing before that were helping clinic owners to focus on, which is going more direct to the consumer, that has become more of the way of life now. We see practices across the board. Theyre getting busier now. Avaccinations are becoming more used, things are starting to relax a little bit. 

When you open up your clinic, you're no longer a PT, you're an entrepreneur. Click To Tweet

People are starting to reach back for services. We see practices overall get busier, especially in March 2021. Some clients were at max capacity with space restrictions, less staff, things like that, or maybe they had done some layoffs in 2020. They have leaned down their staff. Now, they got this ramping back up and theyre busy, which is a great thing. By surveywe are seeing that more physicians are referring it to clinics, which is great. More past patients are coming back in for care. Thata great thing thats working out for practices. Things are starting to get busier and busier. 

I know youre pushing it, so its not the case, but do you see some owners who were reliant on physician referrals leaning back towards that and pulling back their marketing away from other aspects because you wouldnt recommend that? Is that a tendency, whether its because thats what they like to do or because theyre going into a slower season? 

I cant speak for practice owners that are not our clients or not working with us. The ones that are working with us are seeing going that route of going more direct to the consumer and working with their customer list and how valuable that has been. Whatfascinating is that quite a lot of our clients and practice owners that we work with from 2020 had their best year ever, which is shocking to say this was the worst business disaster that we probably have gone through in modern times. What we looked at, what we saw was that the practices were very heavy on physician referrals. Maybe more than 60% of new patients that were coming in were from doctor referrals. 

They were very busy, happy and complacent that referrals dried up when that crisis happened. If they didnt pivot fast enough to go out into their online community, working with their past patients and customer lists, theyve struggled. Therea lot of people in our community that need our help and they focused on that online marketing aspect and then also leveraging their customer lists. They had some of their best months ever. Weve seen them continue on that trend and wanting to do even more and more. They realized that theres a lot of potentials thereIve seen in conversations with prospective clients that they are saying, “Were busy now. We dont need to do anything because our physician referrals are taking back up. They were waiting, but they dont realize that it putall your eggs in one basket and thats not what you want to do from a business perspective.  

I had an interview where we talked about the four different buckets of marketingThere are your physician referrals, current patients who could refer family and friends, past patients who can return and/or refer family and friends. Then theres direct-to-consumer, the community around you. What COVID forced us to do is pull away from that main bucketwhich was physician referrals. Ninety percent of the owners out there were focused on those physician referrals. That was their bread butter to the point where they werent even looking at the other three buckets, unfortunately. It forced them to look at the other buckets. 

I even have a client who, through the pandemic, survived because of Facebook Ads. All his referrals came from Facebook Ads. He grew during the course of the pandemic because of Facebook Ads. Now that hes sprinkling back in physician referrals, ihis Facebook Ads wane for a week or two, hes getting some physician referrals that are coming back on. If owners can leverage those things, if they can put appropriate money, time, energy into each bucket, theyre going to see the maximum capacity of their clinics. 

Physician marketing is an important aspect of your practice, but where many people fall into a trap as they didnt work as hard on those other buckets. Sometimes its outside of your comfort zoneFor a lot of practice owners, its comfortable. You know how to work in physician relationships and that you need to get referrals from physicians. Even if in your direct access state, its pseudo direct access where you still need to get a physician’s referral for an insurance contract. Its still much better to have that person come in from finding you on Google, coming to the clinic, “We can do a free screen for you. This is going on. Let me coordinate with your doctor. Let me have my front desk reach out and recommend this. You may have to go in for a visit.” Youve already created that great experience for them. Theyre more likely to go ahead with their care at your clinic rather than purely waiting on the doctor. 

I did a Facebook Live event in our Facebook groupThe Physical Therapy Owners Club, with Vinod Somareddy. He shared the successful actions hehad with Google Ads and brought on his Google Ad agency to the Facebook Live event. What came to my mind was how a new PT owner approaches a billing meeting. We dont know the first thing about billing, and we dont know how to hold them accountable, and we dont know what the metrics are. 

PTO 139 Neil Trickett | Marketing Strategies
Marketing Strategies: If you want to have more connection with the younger crowd then you have to be on Instagram and Facebook.


You take an owner like thatthen similarly go into a Google Ad meeting, Facebook Ad, or whatever agency is doing those ads for you. Itthe same questions likeI dont know what Im looking at. What are the questions I should ask? How should I hold them accountable? What should I be looking for? Is this successful or not?” They could tell you all kinds of numbers and throw stuff at you. If it doesnt get to more new patients, then youre like, Im not sure if Im spending my money correctly. I like what you said there that they know they need to do it, but they dont quite know-how and to assess the ROI. 

One of the most important hats for a business owner, and lets face it, when you open up your clinic, youre no longer a PT. Youre an entrepreneur. Sometimes people dont realize how much of an entrepreneur they should be. They get comfortable treating patients going, I have a couple of therapists working with me.” The minute you open that door, youre a business owner. You have to think that way. For a business owner, especially a CEO, one of your main functions is promotion and marketing, but youre not doing it all. 

Youre making sure its coordinating, happening, and youre getting ROI. As you get bigger, you might have a marketing director or even a marketing team thats helping you out in the clinic, and you need to have a good pulse for them. Whatthe rhythm going on with your marketing. If you do not own that hat as a CEO, as an owner of your practice, thats when you get into trouble. Itan important aspect of being a business owner to focus on what is your marketing strategy and actions. 

What are some of those tips that you could share? What are some of the new normal marketing strategies? What does that look like? What should owners be focused on? 

Weve put the strategy together called The Ultimate PT Marketing Funnel. Weve been doing this for years. It’s based on research. This is what was working well before COVID. If you were starting to transition from that model of more reliant on physician roles to more direct-to-consumer and working with your customers, youre going to be much more successful. In this strategy, the first most important layer is building a large online presence. You have to be discoverable online in your local community. You need to be everywhere there, especially from a Google perspective, from local search, through Facebook and social media. One of the key things there is to make sure that youre focusing on search engine optimization. There are a lot of things that can be done there and you can work with different groups to help you with that. That makes sure that your clinic is going to get in front of more people when theyre doing searches for help. 

You want to have a nice clean website. You want to have one that might not focus so much on how amazing your clinic is but what you provide the patientsIts not so much about you and the letters behind your name, but more about the patients. Thatwhat we learned from past marketing interviews weve done here on the showI also remember an interview I did with Angie McGilvrey. Shebeen strong with her social media presence. 

Theyre posting 3 or 4 times a day. Theyve got a video person that comes in a couple of times a week which takes videos and posts all over Instagram. She quoted Gary Vaynerchuk. He said, “If youre not on Facebook, you simply dont exist as a business nowadays.” That works for certain demographics. She highlighted that. If youre talking to anyone above 35 years old, a lot of them are going to be on Facebook. lot of the decision-makers are on Facebook. If you want to have more connection with the younger crowd, then youre going to be on Instagram, possibly. 

Weve definitely seen that. We worked with all kinds of clinics, from pediatric to geriatric to super sports athletes and recovery clinics. You got to know your audience. Where does your audience mostly reside? For some of our clients, we’ve got some phenomenal clinics that are amazing at promoting themselves. They do a ton of video work. Theyre all over Instagram. Theyre able to build that up. One thing to realize is that theres no one media that is king over everything else. You have to realize that there are behaviors of patients when they are going to come to you. First off, youre mostly an unknown. People don’t know what youre going to do to help them. If you went to someone on the street and you said, “If youve got a back problem, who are you going to go see? 

Are they going to say PT? Most likely going to say chiropractic or maybe their doctor. First off, you got to be able to get in front of them. Theyre usually out there searching, not just for, “Physical therapy near me. Those are people who are looking for that service. You want to be in front of those people, but the majority of people searching for, “How can I help my back pain? I think I tore my knee.” Can you get found in those searches? That can get you in a much wider audience in front of people who are never even thinking of PT as the solution to that problem that theyre having. Now, you have that opportunity. That comes down to the SEO Trinity. SEO is Search Engine Optimization. That means you can get ranked higher better in Google. Also, Bing and Yahoo, still out there. Donforget those. A lot of seniors are on Bing because of Microsoft Edge and Explore. Thats the default browser. 

They dont know how to change it. 

You have to be discoverable online in your local community. You need to be everywhere, especially on Google. Click To Tweet

While Google is still the king of the hill, we canforget Bing in all those guys over there. With the SEO Trinity, what that comes down to is to rank better and get your clinic more found. You need to work within your website, and the content and the copy in there that works with the different keywords like physical therapy. Back painsciatica and all these things are keywords. The important part there is, “Whatgoing on with your website? How optimized is that? The other part of that Trinity is Google My BusinessYou are a local businessGoogle My Business is the key to getting your information out there. Thats where Google reviews reside, questions and answers reside, your hours and operation. You can do appointment requests through there. 

A lot of people miss the part of putting a lot of great photos in Google My Business. Think about when you look at a restaurant, and youre looking on Google My Business, you look at the menu and the food. Does the place look nice? Thata great thing to use for Google My Business. Do you have the same thing happening with your clinic? Have you put a lot of great visuals in Google My Business to get people to go, “That looks like a nice place. They look professional and hands-on with people?” Thatthe second aspect. 

The third aspect is called listings. Listings are how your business information address, phone number, what you specialize in all these data points. How is that on hundreds of different directories? When you go on Apple Maps, how does Apple Maps know your business information? When you go on Waze, how does it know your business information? How does your car navigation know your business information? All that comes from these online directories. The more your business information is out there on the internet, on these different directories, Google crawls those and finds your information and then ranks you higher. That makes the third aspect of that SEO Trinity. 

Do you find that a lot of clinics arent doing this? 

It takes constant work. 

For those owners who say they have an SEO company thats doing this for them when you look at that, are they covering all three bases? 

Usually, not. They might be focusing on one aspect. The thing to realize is that its never done. Its a constant battle for the top. You always have to be working on it. You always have to be tweaking, changing, and optimizing things and looking at whats working or whats not working. Were doing it constantly for our clients online work there. 

Case in point on that Facebook Live event with Vinod, his agency showed that in February 2021, they made 1,100 changes surrounding Vinod’s website and Google Ads to optimize them. Thatnot just one time. Thatongoing. They said they average 900 changes a month for most companies, which blew my mind. Itnot like a tweak here and there once a week. Its ongoing. 

There are thousands and thousands of directories online. Itabout getting all kinds of information from your clinic on those different directories that link back to your website. That helps build relevance for sure with the way Google looks at your business. 

Making sure that your online presence is thereGoogle Ads and Facebook Ads, what do you see with those? 

What I always recommend for people is that what we see statistically is that the person that will take the most action, meaning theyre going to call your clinic or are they going to fill out a request appointment form on your website comes from an organic search. Meaning that you rank naturally in whats called the 3-Pack, which is that part right under the maps then also the top ten. It comes down to the more spots that you can control on Google and page one, the more authority people think you have. 

If you see a business and it has or spots on Google, you think, “That must be the best one. Let me click on that. Let me call that one.” Itcritical that you get your SEO Search Engine Optimization cooking first and then start to spend money on Google Ads because then you can command even more of page one of Google with Google Ads. Whats interesting with Google Ads is that it drives those other behaviors. I know you probably realize this when you do it next time, but when you search for something, and you see their ad pop up, youre not so likely to click on the ad. Youre more likely to click on the organic underneath. 

Scroll past the ads, find the first organic one. 

If you see RISE PT on an ad, but you see RISE PT below it organic, the tendency is you will click on the organic. It is good to do Google Ads because it drives better SEO behavior of peoplcoming to your website. The bottom line is to make sure you get a good website going, get your SEO in place first, and then start to invest in Google Ads. 

Many people focused on that moving to direct-to-consumer during the course of the pandemic. I think a lot of people had a lot of success going back to their past patient lists, which they probably hadnt cultivated much in the past. Those who are successful are and thatwhy WebPT came out with reach and stuff. They focused on getting back to those patients that already know, like and trust them. 

Its your lowest hanging fruit. The most successful businesses in the world cultivate their customer lists. If you think of Starbucks, how many times do you go back to Starbucks in a week? Think about it with yourself. Itbeen fascinating journey of these last many years of building Practice Promotions and talking to thousands of practice ownersI always ask, “What are you doing to market to your past patients?” They giggle because they know they should be doing more like, “I know it should be doing more, but we do some emails. We do an email newsletter or maybe a birthday card.” Thattypically the extent of it but what they dont realize is that it costs you 4 to 10 times more to get a new patient in the door than just to get a returning patient. Your ROI is the cheapest thing you can do to get a returning patient. They know you and love you. What most patients dont want to do is come back to PT. You only go back to PT if you need to. 

You dont want to go to PT if you dont have to. 

When I was treating patients, it was, “Mrs. Jones, it’s good to see you again. Your knee pain has flared up. How long has that been going on? Six months. Why didnt you come back in sooner?” “I thought it would go away, or whatever the usual is with that. If you donfrequently communicate across many media channels to get in front of as many eyeballs as possible, then you cant capitalize on your list. When you do, you can build your practice up. Where I love to see clinics get to is 50% or more of their current caseload is returning or referred patients. That’s unconditional power. 

That was something that we frequently did especially as we went into our slow seasons and we were actively working against that mindset and being reasonable with a slow season altogether. One of our successful actions was to callback past patients. Getting providers on the phone, If a patient canceled, youve got a free hour. Lets look back at patients that came in six months ago or were discharged six months ago. Give them a call and see how theyre doing. Not only see how theyre doing, how are their family and friends doing as well? Because they could refer family and friends in as well. Surprisingly, a lot of patients would call back, and theyre like, “Idoing fine. I appreciate that you guys took the time to call me, and I hope you guys are doing well.” Theyll leave notes like that. It was good to build that relationship further more than just a cold email. It was very personal and that was a successful action of ours. 

We did that in our practice. What we did is we had our patient list of a few thousand plus people and every quarter we would call them. We broke that down intoWeve got to get to a third of that list this month.” We break that down. Were going to have the techs reach out and they got many calls they need to do a day. Itlike, “Just checking in. How are you doing? Are you doing your home exercise program? Do you need me to resend that to you? Hows your knee feeling?” It’s like, “Itbothering me again.” “Do you want to have your therapist con connect with you on that? 

I do a free consult on the phone or come in for fifteen minutes. 

There are many ways to reconnect. One of the things that you need to go into it is that, I need to cultivate my customer list as best as I can. How can I develop raving fans that send their friends and family who want to come back know that Im the expert to turn to when somethinghappening? Id rather have them call me like, I think I mightve tweaked my knee. Do you think I should come to and see you again? I’m like, “Absolutely. Let’s check it out really quick. Thatthe kind of conversation you want to have. To get in front of those people, you have to realize that people are across all kinds of media. Back in the old days, we used to be able to put a TV ad up because you get in front of about 30% of the people. Now, you might get in front of 2% of the people on that channel. 

You need to be leveraging newsletters and personalized emails going out. You need to be in social media engaging with that customer list, text messaging, phone calls, callbacks programs and direct mail works well nowadays. Even more so now than it was many years ago. Do you ever see that meme? Itfrom AOL. It was back when you, Ive got an email.” You get so excited and youve gone through your mailbox. Youre like, I got all this junk mail.” Nowadays, its like, “I got a letterIm so sick of my email inbox.” Direct mail works much better now than it ever did. The bottom line is with your customer list, youre trying to get in front of as many people as you can. If you rely on emails, you might get in front of 30%, 40%, maybe 50% of your list consistently. Youre missing over half of the people that youre trying to reach. How can you reach more people? Youve got to be on different media to do that. 

I talked about the four buckets and making sure you have time, money, and energy, and all four. It takes so much more energy now for owners. It was so much easier to drop something off of the physician and expect the referrals to come inTo stay afloat and survive in the way things are with economies, and competition around you, if youre not doing it, the large corporate brands are, and the physician-owned PT practices are. If youre going to stay above water, you need to focus on spreading yourself out across these different buckets and make sure you have the money and energy to do so. 

I always have a stat on this, but from up until 2012, there were about 25% of physicians who worked for a hospital network and thatin 2018skyrocketed to 45% of physicians who worked for networksI cant even imagine what that is now. Herethe deal moving forward. It is a different ball game. If youve been in PT for as many years as I have, its different than when you first started. You have to be in that mentality of a business owner. You cannot treat full-time if youre beyond yourself in the clinic. If you have additional therapists that are working for you, you have to have time in your day to be a business owner and function that way. 

Marketing is one of those critical components that you need to be on every single week looking at because acquisitions have skyrocketed. Therea lot of buying out of clinics. There are bigger groups coming into your area where they will be coming into your area. Hospital networks are gobbling up places around them too. There are lot more challenges coming up. There are also a lot more opportunities. If you know what you need to do and you know that you need to learn about that a little bit more, you can take those opportunities and grow your business with your goal is to be as profitable as you can with the clinic that you have, or if you have aspirations of additional locations, knowing how to market is going to help me get there. 

I’d like to say that your business’ love language is quality time. Your business needs quality time. Thatnot like in between patients, after hours or on weekends. It needs quality, consistent blocks of your energy and time to be successful and achieve the goals that you want to achieve. Otherwiseits going to lead to your burnout and lack of fulfillment. Im sure you probably still stumped a lot of owners when you say, “Whatyour budget for this? Is that like, Deer in the headlightsI dont know,” still? 

like the State of PT that WebPT does every year because they survey quite a few thousand practices. You get some good information out of thatIts always fascinating to me when they ask, “Whatyour marketing budget? What are you spending on marketing budget?” Across the board, up until probably a multimillion-dollar or a $5 million practice, the average was less than 1.5% of what you made that you spend out on marketing. The small business association average across all industries is 11%. In total healthcare, its about 8%. When you say, “Whatmy budget going to be for this? You have to look at, “Whatmy gross income? What are my goals? Where do I need to be in my clinic to maximize the space? If I hired more therapists, could I maximize and be as profitable as you can be? 

You work backward from that. “What is the number of patient visits I need to be doing? How many new patients do I need to generate on a weekly basis or monthly basis for making that all happen? Whatmy revenue going to be?” If youve been spending 1% or 2%, try to go to 5%, what happens? If youre spending it right, if you have a good strategy, youre going to get tenfold on your money. Itfascinating that in PT, we spent very little in terms of marketing compared to many other industries. 

Especially if you dont have the time and also if you dont have the know-how, youre going to spend that money and not know how to track itIm sure you would recommend if someones going to have a marketing strategy or alter a marketing strategy or want to assess their current marketing strategy, they need to, know what track, what statistics theyre tracking and then see what that impact is when they spend extra dollars in different buckets. 

PTO 139 Neil Trickett | Marketing Strategies
Marketing Strategies: You need to work on your website including the content and the copy in there. Add different searchable keywords to make it optimized.


Sometimes you go into it thinking, “This is going to be so complicated. You can go down that rabbit hole if you want to. The reality is you need to be tracking, Whats my general marketing expenditure here. Whats my number of new patients? Whats my number of returning patients coming in here? Let me look at when my marketing is arriving, doing things, and try to correlate that with your increase in new patients?” You can see whats working and whats not. It doesnt have to be super complicated. As you grow, you will need to get more complex in your marketing statistics, but to start off with, or if youve been not putting a pedal to the metal with that, you dont have to go crazy with trying to analyze a whole bunch of stats. 

What Ive seen is owners get a little bit gun shy with Google and Facebook Ads because the expense is greater than what theyre used to or extraordinary is what they think. Thats because theyve spent $100 to $200 for a doctors lunch here and there. Thatabout the extent of it. Now, theyre looking at spending $1,000, $2,000, $3,000 a month on digital ads. Talk us through that because a lot of owners aren’t seeing immediate results from that. The general idea is that its going to take 2 to months to gain some traction. 

It comes back to this whole strategy. Therea lot of shiny objects out there. “Well do your Facebook Ads and youll be getting guaranteed 30 new patients a month. Thatfor some. For most, what happens is if you dont have a very good website or a good organic SEO, it comes back to peoples behaviors. They might see you on Facebook. They might see the ad and be interested, but theyre going to go check out your online reviews first. Theyre going to look at your website, second. Theyre going to might call. They then might fill out a form. They might see that ad again on Facebook and then do something with it. First and foremost, before you go spending a boatload of money on Facebook Ads or Google Ads, you have to have other core things in place. 

Thatthe best place to start with your money isWhat are you doing to your customer list? What is your SEO presence? What is your online brand presence? Can you make improvements there? You will then start to see results from that and then, “Ive got to get a good solid foundation, let me tack on some of the more technical things like Google Ads or Facebook ads.” Those things will work even better than if you went at it without looking at those fundamental things in place. 

I love that recommendation as a step-by-step program because that is the trend or the shiny object is to jump in on Google Ads and Facebook AdsWhether youre struggling or whether youre feeling rather comfortable and want to make more progress than you are right now, lets maximize what youre doing with current patients, past patients and physician referrals. If youre getting 60%, 70% are returning patients and friends and family referrals, and then the last few are physician referrals, thatgreat. Maybe thats when you can start capitalizing on a Google Ad. 

Look at that customer list first, see what youre doing there and invest your time there first. For the current patients, you can ask for referrals and free screening offers workshops that might invite friends and family to their online reviews like, “Heres a statistic for you, 89% of people consider a review thatthree months or older irrelevant. If you havent a Google review in 3 or months, thathurting how people perceive you online. The most important thing to be doing with your online reviews is not necessarily leaving it to an automated system to do. Thatimportant to have as a backup, but you should be training your team internally, your therapist, and the front desk to be asking for online reviews because that is the best time. 

Its all about timing. You want that person whohaving an amazing transformation. Their pain is almost gone and they were happy. Thats the time to ask for review, and then you have the mechanisms for them to be able to leave that review. Ultimately, it comes back to ask that patient, “What can you do before and what can you do now?” Theyre going to leave this amazing transformational review that will convince others. Ita simple action but often overlooked and a great place to start. 

I like that you said that it has to be recent as well. People are going to disregard those. Especially a year old. I didnt know three months was too old, but if youre looking at past reviews that arent recent, youre like, “Maybe they were back in the day. Maybe theyre not so good now. Thatmy first thought. 

If you went to a restaurant and the last review was or 9 months ago, youd be like, “Are they still in business? Did something happen? Are they not good anymore? 

Is the chef still there? I dont know. Those are good questions to ask. Asking that routinely and I love that you share those things because those are all bang for your buck. You get so much return. To make a phone call costs time. Whereas the Google Ads and Facebook Ads spend is going to be money out of your pocket. Why dont you maximize whats cheapest first? Once you know that youve maximized that, then move on. 

Our most successful clients are the ones that have a good pulse on their marketing internally because they will be taking a lot of videos, pictures and asking for those reviews. They know that they need to market to their past patients and then were coming in with the technical aspects. We know how to craft the website, SEO, digital marketing, digital newsletters, email campaigns and all that to support that. We can then work closely with them and get the absolute best results because you have to customize it to your brand, What was your clinic all about? What are you portraying out there? 

Italmost like plugging a few holes in your bucket before you start adding more water into it. 

The worst thing that we get sometimes is a practice that comes on board and its like, Im paying you. You guys do everything.” That is the wrong mentality. Its like, “How can you leverage consultants and professionals around you to enhance what youre doing? Thata better mentality to have. 

Do you see that as youre taking off the items, going to your current and past patient list, doing Google reviewsbetter SEO on your websites and direct-to-consumers? Thats what people are doing now to be successful. Itgoing to get more and more so going forward, I assume. 

Itgoing to accelerate more and more as we go forward into the future. People expect it now. If youre not everywhere online, if youre not super active in social media, if youre not pumping out tons of video and pictures, then theyre going to look at the practice that is. 

Even if the doctor says, I want you to go to so-and-so physical therapy practice. Whats the first thing youre going to do when you sit in the car? Youre going to look them up. Youre going to see what their website looks like and what their presence is like. 

The practice now in physicians is, I want you to go to PT. Heres a list. You do your own research on who you want to choose. There are doctors that say, “You have to go to my clinic,” and we know that. For the ones that do refer out, they are giving them a list because they dont want to be like, I do recommend these places. They get amazing results, but I have to give you this list.” The patients going to do their due diligence. 

Anything else you want to share? You shared a ton already. I love what youve talked about so far and showing up whats happening within your practices and then moving on to the digital space. What more can you add? 

We covered so much here. My purpose is to help practices succeed in improving more peoples lives. Thats what were about at Practice PromotionsWe have great advocates there at the APTA level, the government level. It comes down as individual practices. If we work better to educate the public in how we can help them solve musculoskeletal neurological problems and empower each one of those clinics to be more successful at reaching the community, thats going to raise the ship. Thata huge focus for us. 

I would come back again. The thing that we try to portray to our clients and help practice owners understand is that you can definitely be in charge of your marketing. You can be empowered in your marketing, learn more about marketing. Its a critical hat as a practice owner. You have to look when youre working with different consultants out there, Are they going to help you build the right strategy? Do they have the right systems processes to help you get there? Do they have the specialists that are going to be able to advise you and help you get the results that you need? Thata critical focus for us. 

Itcool that you systematize things so well and youre not just some guy working on his own, “Lettry this, that, and the other thing, and see what works for you guys. You are coming from a physical therapy background yourself, knowing and talk to hundreds of thousands of owners over the years. You know what can work best for physical therapists. 

Itbeen a fun journey for me being a PT, working in lots of different types of facilities and outpatient. I haa real passion for manual therapy. I went for a while to the Canadian College of Osteopathy that was a passion of mine there. I did teach CEUs and did some teaching at a university for PTAs. I got into my practicing and learning how to then be a business owner. Lots of training around thatgetting better practice and then going through the process of selling your clinic. 

Focus on SEO but just make sure that your clinic is going to be in front of people when they're doing searches for help. Click To Tweet

That was quite an experience, then starting Practice Promotions many years ago, which is my wife, Amy and I. Now, weve been able to build that up to 75 employees and learning about being a business leader at that level. We always continue to grow and marketing at this level, marketing Practice Promotions to clients and learning a lot as we do that too. You can never stop learning. Thats an important part of your skillset as being a practice owner. 

Its cool to know your story and where you come from, but its equally cool to see how you, over the past many years, have changed your marketing company. You have gone into the digital. Youve had to learn so much yourself to be in charge of that but to hire people that are even smarter than you to do some of those things. Itnot just the newsletter here or there anymore. Ita lot more than that. You have it all. 

Many years ago, we started off with print and direct mail and newsletters. Now, we send out over five million newsletters for practices over the year. We have a big impact there in their communities. Many years agowe started to do websites. We wanted to do them a particular way. One thing thats always been a guiding light for us is focusing on the results. It’s not just putting something together that looks fancy. Italways looking at what’s converting better. Now we have lots of great data to look through and continue to focus and improve with that. The digital marketing that helps you rank better in Google, Google Ads, and all these things comes back to like a full all in one marketing solution for clinics. 

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

We’ve got tons of resources and free information for you, and video training. Go to PracticePromotions.netYou can learn a lot there, tips and strategies to help your practice. You can also get in touch with us there to scheduling a consult, a great way to get introduced to our strategy and our systems and talk about our specialists. We have different plans to help all kinds of clinics. We help everybody from small start-up clinics all the way through 80-plus location clinics. 

If they have some questions, then you schedule a consult? 

Yes. Get right on a consult call with one of our specialists. 

Thank you so much for taking the time. 

It was great to be on, Nathan. It’s a pleasure as always. 

Have a great day. 

You too. 

Important links: 

About Neil Trickett, PT - CEO, Practice Promotions

PTO 139 Neil Trickett | Marketing StrategiesNeil is a physical therapist, former private practice owner of 8 years, and CEO of Practice Promotions, the leader in marketing strategy, digital marketing, websites, and print marketing for the PT industry. With 20 years of real-world experience, Neil has helped over a thousand PT clinic locations across the US and Canada, implement the right marketing strategies and systems to exponentially grow their new patient numbers.

Neil and his wife, Amy co-owned their successful physical therapy practice in Boynton Beach, FL for 8 years, developing marketing strategies and systems along the way. He has dedicated his career to helping elevate the profession of physical therapy in the public, by empowering rehabilitation practices to successfully market themselves to their local communities.
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PTO 137 Jamey Schrier | Driving Referrals


"How are you showing up in the world?" is always a central question in marketing. For Jamey Schrier, PT, driving referrals is an essential first step in building up your business authority and reputation. Joining Nathan Shields once more, he talks about the best way to present yourself to referral sources, patients, and communities, which is an essential part of your marketing message. Nathan also discusses how to be clear with your goals, choosing the proper target market, and how to come across the public in the most engaging ways. He also explains why it is important to focus on delivering tangible solutions than mere therapeutic methods, making your PT practice more than just what is happening within your clinic. 


Listen to the podcast here:

Driving Referrals to Your Clinic With Jamey Schrier, PT 

I've got multiple-time guests coming back to be on the showJamey Schrierappreciate you coming back.  

I appreciate you having me, Nathan. 

Thanks for coming on. We've been talking about a bunch of different topics and trying to figure out what the connection was. We want to talk about how we make more connection with the audience. How do we provide them what they need? How do we prepare our messaging so that they want what we're giving? Maybe I'm not saying it the right way because we were thrown a lot of things out there. First of all, let me say, if you haven't heard my show with Jamey in the past, go back to those. I've had you on what or times now.  

I think so, at least 2, perhaps 3.  

Marketing is all about how you show up in the world.     Click To Tweet

Jamey hagot a great personal story. If you can find his first show from our first year of doing shows in 2019, go back and listen to it and what drove him to become a coach and consultant now for PT owners. Make sure you go back and read those because he's got some great wisdom to share and great value for you. We want to talk about how to connect. Where do you want to start this off, Jamey? I don't have a certain direction I'm going with this because we can provide some great value with simply the discussion, but where do you want to start here?  

Let's start by grabbing people's attention. What we're going to do is talk about driving referrals to your business. That's the essence of what we're going to discuss because a lot of this comes down to how do we connect. How do we bring in referrals to our business starting with understanding how to connect with the people that we want to come into our business? We're all caring and compassionate people that went out on our own to start a business. I've never met a business owner that wasn't busy, overwhelmed, and stressed in doing that but yet, we all have this challenge of getting consistent referrals in our business that of course convert into new patients or new clients. What we were talking about before is we’re discussing where's the real problem here.  

Not necessarily the tactical thing, which I can certainly provide some tactics, some tools and some tips, but where is the problem in doing it and what can typically be done? That's an area I've spent a lot of time and personally being a former private practice owner for years and now the Founder and CEO of Practice Freedom U, this is what we discussed. This is what we live for and this is what we do every single day. It’s providing this business knowledge to help people grow and flourish knowing that we haven't been taught this, we're out there, and there's a million clinical courses to help you treat your back better. This stuff is a little rarer. Where would you like me to begin? I can go in any direction you like.  

We can talk about driving referrals and start with where you were with your workshops. Most people are going to go once they get a referral for XYZ Physical Therapy and sit in their car with that prescription, they're going to Google XYZ Physical Therapy and see your website or they're going to say, “My back hurts. How am I going to get over my back? Let's start with the webpage because a lot of people nowadays are going to see your presence online. As your experience with what you shared with me, 99% of those physical therapy websites is hard to tell exactly what they can do for me, the patientThey're focused on saying, “We've got this certification, we do this service, we do that service. We do this kind of thing.” The messages seem to be off, they're highlighting themselves, and not highlighting the result or the product that they're producing.  

If we take a 30,000-foot view here before we dive into the ground level and get into the weeds a little bit, the 30,000-foot view is marketing is all about how you show up in the world. That's what marketing is. How do you and your company show up in the world? It could be your personal brand, but even your personal brand is still about you, your practice, and how are you showing up in the world. How do other people see you? When you look at it from that perspective, you want to consciously and intentionally show up in the world the way you want to show up in the world because if not, other people will pigeonhole you and stereotype you that, You're a physical therapist, you’re good at doing some stretches, but we're the ones that take care of people with back problems. We're the ones that take care of this.  

PTO 137 Jamey Schrier | Driving Referrals
Driving Referrals: With so many PTs in the world, make sure you are bringing something impactful and important.


That has happened to physical therapists for 50, 60, 70 years. The reason is because we are not communicating clearly and effectively how we want to show up in the world. It's confusing. We have a great saying at Practice Freedom U and it says, “Confused people, don't…” What it means is any time there is confusion, you are going to have someone that does not make a decision or if it's your staff is confused, they’re unproductive. If there's someone out there in the world that's thinking, I have a back problem. Who should I go see? If your message is confusing and it's not clear on whether or not you can help me, then I'll go somewhere else. I'll go to someone else that's speaking a louder message, a clear message, or maybe a message that's showing up either on the website.  

That's one of the big things from a higher-level perspective which as owners, we have to take that perspective first. We never want to dive in first. We have to look at it from that perspective first so we could make sure we're moving in the direction that we want. That's number one, marketing equals how we show up in the world because if you don't, someone else will have a plan for you and start to dictate how you show up in the world.  

How do you help someone get clarity on their message? That can be a difficult one. I know for Will and I with our practice, it took some work talking it out. We had to get back to what was our purpose and get clear on what were our valuesStart there before we can start talking about what we can offer to the world, how we present to the world, and that it derives from that. That's where we came from. What do you recommend?  

Nathan, that's not fun. I don't want to do that. Read books, you start with that, that’s not fun and yet here you are saying, “Do you know what we do in our program? We start with mission, vision values. Do you know where Donald Miller, Michael Hyatt, Tony Robbins people and others start? A mission, vision, values. Now, you might call it something unique. You might wrap it up in a different bow, but that's where you have to start. You have to start with, “What are you about?” Before you communicate that out in the world, you have to ask yourself. I'm going to be very honest with everybody. The world does not need another physical therapy practice. We will survive without you. However, the world needs you. We want to make sure that you are bringing something that’s impactful and important.  

You have the ability to do that but I don't want you to show up as someone else. Be unique and communicate at least to yourself, What is your practice about? Your vision or your mission? What are you about? Where are you going? What are you trying to do? What impact are you trying to make in the world? What impact are you making in your community? Why did you get into physical therapy? Why did you open up your practice? These are the questions that make you think. I get that most of us are impatient and we want this now but these questions are going to come up again and again as you start marketing, building your referral sources, building your presence online, and doing the other things that we do to drive referrals. We have to start there for sure.  

If you don't get clear in what you're about, then other people will just tell you what you're about.   Click To Tweet

I've had marketing people on in the past and they say, “If you can improve the customer experience and create a culture, that can improve your marketing efforts three times. That's where this starts from. When you're clear on your message, your purpose, mission, vision, values and all those things, then that drives the culture of the business and then you start developing something that people can get behind and people can buy into. Remember, when people buy, they never buy logically, they buy on emotion. If you can translate that into your message, that means the connection becomes greater. It's hard for me to work with PT owners because many of them don't have a clear purpose. I don't know if you've had the same experience, but that's where we'll start. As I'm working with clients, it’s okay, let's get clear on this and their purpose. You've probably seen this as I have. We're going to be the best physical therapy that provides hands-on treatment and a one-on-one approach.  

I was yawning when you said that. We're going to be the commitment to excellence and the best therapist place. That was mine. I got it from the Oakland Raiders back in the day.  

No surprise that we're a commoditized entity at this point because we all say the same thing. Physical Therapy is not your purpose and not your whyPhysical Therapy ends up being the vehicle through which you've lived out that purpose. You could be a roofer and live out that purpose as long as you're clear on that purpose, what it's doing for the community and those around you. It's important to get that clear in and that then drives the marketing and can improve referrals because people buy into that culture. They buy into what you're doing so much more than the services you provided.  

The way your prospect, your client and your patient are going to look at it as they have a problem and they want a result. What you're providing as a therapy provider is the solution to that. You're the bridge. There are lots of solutions. As you said, Physical Therapy has been considered a commodity which means Physical Therapies are Physical Therapy. We're grouped into it's all the same. It doesn't matter. It's interesting if you ask any physical therapist that they would not say that at all but if you ask other outsiders, they may say that. That goes back to my point that if you don't get clear in what you're about then other people will tell you what you're about.  

To your point, if you provide a better customer experience or customer journey as it’s often called, it comes from the Hero's Journey, that is critical in how you can generate referrals. What you have to understand before that, after the vision, after the mission, after you divide those values and this principles in which you live bywhat you understand, and what your business is about, the next most important step is understanding your audience. That means you have to first of all, figure out who is your audience. Let me tell you a quick story. We have something called the Velvet Rope Policy. Imagine this. If COVID is over, you go down to Miami, you're walking along, and you see this club. You hear the music on and you see this Velvet Rope. What's the first thing that you think when you see the Velvet Rope and there are people on the other side of that? What do you think, Nathan?  

There have got to be some special people in there.  

There are special people on the other side of that rope. They’re VIPs. You're thinking, They must be important people. You might also be thinking, “Am I one of those very important people? Am I VIP?” Here's what happens. Here's the psychology behind the Velvet Rope. The Velvet Rope is the target audience of that club. These are the celebrities, the big people, the big spenders, and the people that will attract other people to the clubThat's their audience, but here's the mistake that people make in our businesses. We're not clear on our target audience.  

One of the things that we discussed in our Practice Transformation Workshop that came up is, I'm afraid of becoming too niche. I can help many people and they go wide. They say, I can do this.” When you do that, nobody knows exactly, can you help them? By having that Velvet Rope and by being very clear, not only do you dial in your message to your ideal audience but other people go into that club too. Not just the VIPsMost of the club is not made up of the VIPs. Most of the club are the regular people outside. The false misnomer, the myth that is happening is that if you spend your time focusing on your niche audience, your target audience then you're not going to attract other people and the opposite is true. 

I have a couple of examples. One is Amazon. When Amazon first started, what did they sell? They sold books. They did not start with selling 42 billion items as they do now. They focused on books. They dialed in their messaging. They dialed in their operations. They dialed all of that in. Once that was dialed in, they started to expand what they offered. That's a perfect example of niche. Another example that came up in our conversation is Lululemon. It came up funny and someone brought it up. I bought a pair recently of ABC pants. Have you ever heard of ABC pants? 

PTO 137 Jamey Schrier | Driving Referrals
Driving Referrals: If you're clear on your target audience's fears, worries, needs, and frustration, that's gold on the messaging you will use.


I've got a couple of them.  

People were cracking up because what does ABC stand for?  

Anti-Ball Crusher 

A couple of friends of mine were wearing them. They played golf with them. They went out to dinner with them. They hung out with them. A lot of times, all on the same day, they never changed. I'm like, “That's cool to complete in their stretching. Do you think I'm Lululemon's target ideal customer? Heck, no. I'm the furthest from them but it doesn't matter. I understand who their customer is. My wife wears some of that stuff but I still paid them money to purchase something. When they do an ad specifically on the ABC pants, that ad is going to be reaching their particular audience, which is you and me, basically your 30, 35-year-old to 60-year-old male. That's who they're going to target. One of the things that we have to do right from the get-go and after where we established our vision, mission and values is to dial in our audience.  

When you dial in your target audience, you're clear on their fears, worries, wants, needs and frustrations. When you are clear on that, that becomes gold because that's the messaging that you will use. You can use it in workshops. You can use it when you speak to referral sources that I know seems to be a dying focus with people and our profession. We are specialists. People are referred to a specialist. That’s a fact. What we're talking about a lot of is that messaging online. "What is our website's message? What are we putting out there if you're using social media, Facebook or whatever? I don't think you need to be an expert at being a social media person. As you've mentioned, you've had a lot of other internet marketers or internet people on. There are talented people that can help you do it. Our job is to understand our audience and be able to speak clearly in our messaging to our audience no matter what medium it's in. You hire someone that can help you put all the tactical stuff together in order to do that. That's the next step, Nathan, that we need to begin before diving into all the other stuff.  

I had a bad experience with a website designer that I was sharing with you prior to our conversation and as I was discussing that experience with my coach, it led back to the fact that I wasn't clear on my message. They're lost in the woods as to what to design for me because my message wasn't clear and the same can be said for the physical therapy teams. If they're not clear with their message and who that specific avatar is, get it down to, “Is it a man or a woman? How old are they? What are their cares and concerns? What are their family and community look like? All those things. Get detailed so that you can speak to that. As you said, the fear comes up then what about everyone else.  

As you said, I don't know how many times I've seen it. My friend, Angie McGilvrey down in Florida had the hurricane come through. They had to start all over again. They decided, “We're going to do it this way. They are going to focus on social media, but their focus was going to be on 30-year-old female CrossFit athletes. That's their avatar. They’re busier than they've ever been before now because they treat those CrossFit athletes well. CrossFit athletes have families. They have friends who are CrossFit athletes. You and I both know if I have a rotator cuff issue, I want to get my rehab from the guy that works with the Major League Baseball operations. I want the specialists. I want the guy who's known for being good with the athlete rotator cuffs. I'm nowhere near an athlete and I'm not going to throw a ball more than 50 miles an hour but I want that dude. As your niche, you aren't limiting yourself. You're saying, “Here's where we focus. You can also be part of the groupWe're still going to take you that it allows you then to focus on your messaging.  

The more information you know about your audience, the more you'll be able to connect with them. Click To Tweet

This is an example that will hit home. Surgeons have done this. Everywhere across the country, if you look at multiple places that do, let's say orthopedic surgery, what you will see on their site, you will see very clearly the surgeon and the specialty, the back guy, the knee woman, the ankle specialists or the shoulder specialists. What they realized is that people are referred to a specialist. Nobody wants to see, I have a back problem. Can I see the generalists? I want to see the generalist, not the specialist in shoulders.” Here's what you don't see, “I have a good friend, Dr. Goldsmith. He’s great guy on the site. He's the back guy. What's interesting is he tells me that 60% or 70% of his patients are not back problems.  

I said, You're the back guy. He goes, Yes but they call me for everything.” As you said, they refer their friend, neighborkids, and their spouses. As a business owner, it hits me. I'm like, “That's brilliant.” In the workshop, I was telling you, we had one of the participants and they’re pediatric therapists. We went on the site and there was a picture of a child on the site. There was nothing verbally saying what their niche was. There was just a picture of a kid and they had all of the different diagnoses and all the different treatment techniques. It was way too much information but it never answered the question, “Can you help me with my problem? It became confusing and she's been doing this a long time.  

She was like, “I never realized that. I was like, “How much time have you spent getting clear on who your audience is and what your message is? What do you want them to know that is important to them, not you? What's important to us is our certifications. What's important to us is how much information we know. We want to throw up on people of how many years we've been doing and how many certifications. That's fine. Do that at your next conference with your other colleagues. You can show off all that stuff. Your audience doesn't care. The person that has back pain wants to know, “if you help them with their back pain so they can go back to playing basketball. If the answer is, yes, they come to you. If the answer is no, they don't. Either way is fine. When the answer is, I'm not sure, then you are potentially losing, who knows how many potential referrals. It's not a financial thing. You're losing the ability to help somebody, which is what we do, which is why we do all this.  

They may go somewhere else and maybe not get the help or they may go nowhere and try to look for the magic pill even though you could help them so well but they don't know that. They don't know what you know. If you do those first two steps, that mission, vision values, and start getting clear on your audience, start diving in like you said, “Tell me everything about them. Where do they live? How much they make? What do they like? Do they have a dog or do they have a cat? Are they married or are they not? What kind of car do they drive? The more information you know about them, the more you'll be able to connect with them. That's what this game is about. That's where the art of marketing comes in. It's the ability to connect with people. You have to start there. Iyou start there and find a good reputable person, let's say your website or other digital things, you are going to be much more successful at generating referrals consistently because you know how to connect with your audience. That's the part that's missed. We take a bunch of money that we don't have. We give it to somebody in the hopes that they're going to do all of this work.  

The expectation is, I give money, they give me a bunch of referrals. What they're saying is, “Yes, I can help you get referrals but I can't answer all these questions. Hopefully, they can do what they promised to do which is the links, connections, put the images up and all the stuff up. That messaging I've spent tens of thousands of dollars. I won't call it a waste. I will call it a lesson. It was an expensive lesson I hadI went to school. I paid $50,000. I got an F but I learned. I learned that there were some things that this person in this company did that I wish I knew but a lot of it was. I wasn't being clear in what exactly I wanted. That was the problem because wasn't clear. That's on me and that's on every single owner. We have to start focusing on that which of course begs the question we've talked about in the past, which is, I'm busy. I don't have time. I'm dealing with all the stuff. I'm like, “There's the real issue. What do you focus on and how do you carve out time?” That could certainly be for another time management topic. 

That’s completely another episode. As you're talking about that, I remember I had Aaron LeBauer on. If you don't know Aaron, he has his own cash-based or out-of-network private practice and is successful at coaching others in setting up their own cash-based private practices. Interestingly, in his practice, they don't bring up the words physical therapy. They talk about what they can do for their patients. They have an ala carte menu. Part of what we can provide you is physical therapy. That's one of the menu items. That's interesting because I brought him on to talk about how to market an out-of-network owner to ask someone to pay cash when they could go down the street and have their insurance pay for it all. That's a higher level of marketing acumen that you've got to attain to get people to pay cash for something that could be for free.  

PTO 137 Jamey Schrier | Driving Referrals
The 7 Habits of Highly Effective People

Yes and no, Nathan, so give me a chance to respond.  

I was going to say, it's interesting though that his focus wasn't physical therapy. That's not what we provide. It's a service that we offer but that's not what we do per se. What we do is we live out our purpose, providing you a pain-free lifestyle, getting you back to the functional activities you want to do, helping you enjoy your family, your friends, and your neighbors, and helping you play with your dog. That's what we do. Physical therapy happens to be a vehicle.  

Stephen Covey in his book, The 7 Habits of Highly Effective People said, “Begin with the end in mind.” It’s one of his famous sayings, and everyone grabs and uses it like me. What does that mean? In this case, the end is the outcome and what people want. They are coming to you with a problempain, a disability, balance issues, and their kid not able to play a sport. What they want is the outcome. Clear as day. That's what they want and that's what you want when you do the same thing. You want the outcome. What is not as important is the part where we spent our whole life, which is learning the solution from the problem that they have to the pain. That's not where the conversation begins. Is it important that they understand? Yes, perhaps. It all depends if they have those questions 

A lot of times, they don't ask every little thing that you're going to do. They connect with you, build rapport, trust you and say, “This is the place for me. Sometimes, they want to know so exactly what the process is. You can share that with them, but what has to be clear first is, can you help them solve their problem? That's the biggest problemI know Aaron, I've been on his show. He is smart and he understands the fact that the less you can talk about the widget of how you help somebody. A widget can be a product or a service. We're going to talk about the widget service, the dry needling widget service, the myofascial release widget service, the exercise widget service, and the pool therapy widget service. These are solutions to help people get what they want.  

People don't care about that initially. They may or may not care eventually. What they care about is, I’m in pain. Are you going to help me get here? If so, what do I do? How do I get with you? We have to be clear on that. As an owner, potential director, manager of your business, and as a clinician, it is very confusing in our heads that that's how our people are thinking. We need to make sure that when we're looking at marketing and our business that we step out to that 30,000-foot view and make sure we put this marketing hat on to start looking at our business from their perspective. From the perspective of our avatar of our ideal client. When you do, things will start to become so much clear and you will start to be able to get more people coming to you because they will understand the question. Can Nathan helped me get what I want? You said something about cash-basedCan we operate out of network? I’d love to dive into that. 

To add on there in my conversation with Aaron and also to what you're saying is one of his first questions in that initial evaluation goes back to imagine six weeks from now and completed your physical therapy, what would have happened? What does your life look like to say that this interaction with us and what we're doing to help you with your shoulder, back or knee has been a success? What does that look like? Starting with the end in mind, he takes that so far as to put it in part of his initial evaluation process and to get compliance, to get buy-in to say, I can help you do that. On subsequent follow-up visits is that's what they're going to allude to. 

Remember on our first visit, you said at the end of our treatment, we want to get here. How much closer are weThis is what we needed to get there. It's less, so much about mini me, my OCSECS, CSCS and CSS. No one cares about all the letters but it's what can you do to help me get to that goal. He takes it not from his marketing and getting that message clear then putting it into his first initial visit with that patient is, “Tell me, what are you here for? What do we need to get to in order for this to be successful?” Keeps compliance that way. 

You don't need many relationships to blow away your numbers. Click To Tweet

There are three ways to get referrals in your business to step out of the fray. You can get referrals online. We know about that through your website and different social channels. You get referrals through referral sources. It does not necessarily mean just doctors. There are lots of other people that have influence over your audience. When you're clear on your audience, you'll know who those people are. The third way to get referrals is one of the ways that we love to get referrals which is word of mouth. It happens when you're delivering an amazing experience to people, and we want the experience to be consistent and to happen regardless of who they are when they come in.  

That’s what you're talking about with what Aaron was saying. When you start focusing on the experience, it starts when they call your office, they come in, and go through the evaluation. You're always looking at the experience that you're delivering from their point of view. We can go into lots of detail about how to do that and all the different touchpoints of that experience, leading up to the discharge and then the experience after the discharge. That increases the ability for one patient to turn into multiple patients by referring others and shouting on the mountaintops how great you are. To the one point about beginning with the end in mind and the evaluation is a funny story. I had a mentor for many years, Dan Sullivan, strategic coach.  

It’s a great book he put out. Who Not How is crazy awesome.  

One of the most powerful things that he always talked about is delegating and the Who Not How. One of his biggest things that he developed was something called the R-Factor Question. It's called the Relationship Question. The Relationship Question says, “If we were sitting here blank time from now and we were going to look back on now, what would have to happen personally, professionally, depending on who you're talking to for you to feel good about your experience or do you feel happy?” Once you see that, you realize that there are lots of ways to take that question to that perspective and use it throughout your thing.  

Aaron is using that question, “If we're sitting here eight weeks from now, what would have to happen for you to feel good about your progress here? You're taking people into the future and into the possibility of what is going to have you feel good. That's some tactics and strategies of how to connect with people build rapport. When you do that, you reduce cancellations. The key is driving the referrals to begin with. That happens in of those 3 areas through a referral, an internal referral or word of mouth. Putting out there in that digital world and allow people to come to you and come to your website.  

It's more important than it has been in the past. We saw that with the pandemic where we couldn't visit doctor's offices, and there was no way to connect with our community unless we did use other avenues to get to them. It's important that we're clear on that message so we can connect with our community directly and have more of that connection without relying specifically on the physicians all the time.  

You and I talked about this. I want to caution people not to jump ship and say, “It's not where the doctor is at. It's all online. We’ve got to go online. We’ve got to get the people online. People are referred to a specialist. People ask their friends. I have this thing called Listserv in our community. We have a community of 400 houses. Every day, there is someone saying, “Does anyone have a recommendation for blank? Many times a week, it's always something health-related. What's amazing is multiple people then provide the solution or provide the answer like, “You’ve got to see my person. Sometimes they're so adamant about their person. They're like, “You’re going to go see them? I'll give you their information. I'll call them for you. I'll help you set up an appointment.” These are your raving fans. This is how people are referred to specialist.  

Now, they may then go online to do it or the reverse will happen. They're online in your Facebook Ad or social media post comes up and they go, “Whatever, then the person mentions that and you're like, “I've heard of them. They don't know where, but they saw you out in the universe and their world. Most of us are within a community, we're not trying to promote ourselves nationally. We're in a community where it's easier for you to do that because it's a confined area. I want to caution people not to stop building relationships with referral sources, with referral partners.  

Here's a tip on that. I want you to look at your referral relationships. People that have an influence over your audience, you have to identify your audience before we’ve spoken about that and I want you to look at them as they're your client and your patient. I want you to start looking at the referral partner as they're your target audience, not who they're referring, they are. What would you want to know about them? Would you show up? I have a blog that talks about one-night stands. You’re going to love it. It talks about we treat a lot of our referral sources like one-night stands. It's a one-way relationship and we want to get what we want where we want to call them up. “I'd like to meet with you because I want you to send me some referrals. Can you do that please? That's not a relationship.  

To your point, COVID said, “We can't visit doctors anymore. I'm glad that happened because we have to wake up. People have been asleep at the wheel and not woken up to the fact that it's about relationships, and it's always been. If you start to focus on these doctors, try to create a relationship, truly try to be interested in them, see how you might collaborate, and serve them better which ends up meaning helping them somehow with your expertise and your solution to their clients and patients. That mindset shift will help you develop key relationships.  

For most practice owners, let's say $500,000 or $1.5 million in revenue, you don't need many relationships to blow away your numbers. Get a handful of people. Get five good relationships sending you a couple of people a week. That's 50 new patients a month. Most likely you would blow away your numbers beyond belief. Your next problem would be hiring therapists to see everybody or getting a bigger space, which isn't a problem because there's plenty of space out there available. That mindset shifts of looking at them the same way you would look at your patient. You want to have two avatars. You want to have a referral source avatar and a patient avatar. Start there.  

I love that because you never try to think about who your perfect referral source is or what your message should be, what do they want to know and who is seeing your perfect avatar patient? That's a good mindset shift as you're considering your marketing strategies because those guys and girls that I know that did fairly well through the pandemic got through it okayThe people that they had the doctor's cell phone numbers because they had developed that relationship over time. They didn't have to rely on going into the office and dropping off candy. They had got the relationship with the physician to the point where they could say, “How are you guys doing? Do you need anything from us? We're still open. FYI.” They could market to them directly because they had taken the time to develop relationships with these people.  

Unlike a one-night stand, when you develop a real relationship, it can withstand things like this. It can withstand competitors. People are trying to move in a little bit. It can withstand a lot of things. Icomes back to why haven't we looked at it that way? Our perspective with doctors is they have served one purpose and that purpose is to feed me, people. If they don't, there's something wrong with them. This is a systemic problem that we need to shift the way we think about this. That could be the greatest collaborators with us. If we step up our game and start to look at it as how we can work together, how can I provide a service and help to you? That means increasing our own communication skills, ability to connect, and build rapport.  

These are things we haven't been specifically taught in that we have to learn. When you do, there's not a lack of people that need us. What was the latest AVTA number? Eight percent of the population comes to physical therapy but 150 million need or could benefit from physical therapy. Where's the other 92%? It's not because we're not good at what we do and you're not knowledgeable enough or smart enough. It's because we are not spending time educating and learning how to connect with them with their wants and their needs. When we start to do that, there is plenty for everyone.  

PTO 137 Jamey Schrier | Driving Referrals
Driving Referrals: Many people don't give that much attention to PT because not much time is spent educating and learning how to connect with them and with their wants and needs.


It's sad to know about physical therapists who worry about the competitor within a couple of mile radius. It's understandable to know what they're doing because it feels like with a mindset of scarcity, then we're all fighting over that 8%. Whereas if we improved our message and got that out to the community, we could be playing in a much bigger pool that is 92% of 150 million and not fighting over the 8% that are getting the therapy that they need. There's so much more to be had if we got clear on our message and focused on those people who need it.  

The shameful part of it is a lot of these people that you're referring to are very smart, talented people that are providing in a very small way and amazing servicesThey don't look at it as a business. More importantly, they don't look at themselves as an owner or as the CEO. As the CEO, your job is to 100% focus on not only where the company is going but servicing your customer. You have at least two customers. You have the patient that comes in and you have the people that refer patients that come in. If you spent a little bit of time and did some basic stuff, you can't get any less people connecting with people, building rapport, and showing them value.  

You can only go up. That's what we've seen with our program and with our clients. I'm sure you've seen the same thing. This is why we do this. My mission is to help every single practice owner and practice that wants to build and grow to do it because we have an endless number of people who need our services. It's not because our high is only ten people. That would be a problem. It's a blue ocean out there. It's endless. We do such great work. We need to have a little B-School for the practice owners. We need to get a little business education with the practice owners and that's what we try to provide and help them in.  

We’re going on for a while now and I appreciate you taking the time. We could go on for more. We had many tangents if we could have gone down thereIf people want to get in touch with you, Jamey, how do they do that?  

If you want to get in touch with me, go to PracticeFreedomU.comYou can check us out. Also on there, you can download my book, The Practice Freedom Method: The Practice Guide to Work Less, Earn More, and Live Your Passion. It’s not a bad three things to do. It's about my experiences as a practice owner and all the trials, tribulations, and disasters I've had but I was able to figure out a path and now trying to impart some knowledge to help some others.  

Thanks again for taking the time. I appreciate it as always.  

It’s my pleasure. I appreciate you and what you're doing, Nathan. 

Thanks, Jamey 

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About Jamey Schrier

PTO 137 Jamey Schrier | Driving ReferralsJamey Schrier, P.T. is the Founder and Chief Executive Officer of Practice Freedom U, a business coaching and training company. He’s an executive business coach and leadership trainer. Founder of Lighthouse Leader®, Jamey helps physical therapy owners create self-managing practices that allow them the freedom they want and the income they deserve. He is the best-selling author of The Practice Freedom Method: The Practice Owner’s Guide to Work Less, Earn More and Live Your Passion.
A graduate of The University of Maryland Physical Therapy School, Jamey specialized in orthopedics and manual therapy. He was the sole owner of a multi-clinic practice for more than 15 years. Jamey’s passions are basketball, tennis, golfing, and reading. He and his wife, Colleen, and their 2 kids live in Rockville, Maryland.

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PTO 125 | PT Marketing Basics

Steve Line, PT has spent plenty of time and $$ on all of the different marketing tactics over the years, and has made his share of mistakes along the way. Based on his experiences he shares his insight on the basics of marketing and the need to understand the different audiences and messages that are needed for a successful marketing strategy. What worked five years ago doesn't work now.  In fact, the marketing strategy that worked in 2019 definitely isn't as successful in 2020.  Thus, it's important to get back to basics and reassess our audiences and message. Join in as he discusses all of these on the show with Nathan Shields.


Listen to the podcast here:

The Basics Of Marketing - The Buckets, Budgets And More With Steve Line, PT

I have Steve Line, a physical therapist, owner and President of Columbus Physical Therapy out of Nebraska. I got Steve on because he wrote an article in Impact Magazine about marketing and covered some basics that are important to visit and revisit over and over again. I've done so with my clients after reading his article and discussing some of the basics that he mentioned. Steve, I appreciate you coming on. Thank you.  

I appreciate the opportunity, Nathan. This is a great show. I've enjoyed your previous episodes.

Tell the audience a little bit about you, where you come from, what brought you to where you are, a little bit of your professional experience and where you're at now.

I have been a therapist and an owner for many years. I wasn't a staff therapist very long and then I was thrown into the fire. I grew up in Kansas as a kid and went to Nebraska to PT school and everything. I've been in Columbus, Nebraska since 1998. What brought me to this point was I've always wanted to be an owner. I had the first love of Biology and the part of Physical Therapy that the patient care part that drew us all to it but there was always part of you that wanted to be an owner to lead the operation. I had a particular interest in customer service. A lot of that was grounded in some of the part-time jobs I had as a child. Through high school, I worked at a grocery store then I got to college and got more jobs that were customer service oriented. I was in a grocery store bartending, various things that had to do with dealing with the public. I could see the parallels and the weaving of this thread of, “We're all the same,” but it doesn't matter if it's a patient or if it's any consumer, we need to reach them at that level.

You've been a business owner for many years now so congratulations. Do you have one clinic or have you grown to multiple clinics by this time?

We've got three locations.

In your article, you talked about some of the basics. I was intrigued by the title itself, it's called Marketing Like an Engineer. I know where you're going with that after reading the article but let's start with some of the basics. You talked about marketing buckets to start off with. I think when PT owners look at marketing, they look at everything. Marketing is marketing but it's important to recognize that there are some distinct areas that you want to focus on and allocate monies and have completely different action items in those different buckets than you would with the other buckets. Lay it out to us. What did you define as the four buckets there?  

It's reverse engineering. At the end of the day, we want to have patients. What makes up the new patients that come into our practice? Time and time again, I measured it over a lot of years and kept coming up with these same four general areas. This isn't anything that I created on my own because now that I've talked with other clinic owners, they're coming up with the same stuff. It's common knowledge to some degree but we haven't talked about it. The four buckets starting out former patients or your patients in general. Those are the people that you're working with. Those should be your most loyal fans, the people that return to you, that is the most valuable of all of them.

I know I'm speaking to any therapist that is big into quality care and those issues certainly are patient bucket is number one. You want to put as much emphasis on energy. A lot of it is an investment of emotion and relationship into these people. You don't have to necessarily spend a lot of money to invest in that level of marketing. It's probably the cheapest of all the marketing buckets. You do a great job whether you build a relationship with them, give them great service and send them out the door with a great taste in their mouth or the experience that they had with you. It doesn't take a whole lot to get them back into your doors if they had a problem again. We got to stay in touch with them. That's one of the things we do there.

You're talking about not current patients but also past patients. That is huge. That's outside of the local community. That's your largest pool of potential there. As you said, it doesn't take as much money. There are other things that cost significantly more but it could get you more bang for the buck as you spend more time fully. With the current patients that are in your clinic, there are ways that you can improve engagement and their experience like you alluded to win them over. There's a huge pool of multiples that have been to you in the past that know, like and trust you that can put some added energy into them as well that can repeat returns.

Get on the reactivation but that's the first main bucket. I tend to count the next three as patient referrals being a branch off of patients. If you can have your loyal, raving fans then if you can get them to send friends and family, not only bring themselves back in but bring someone with them. Now, you've expanded the ROI of that particular bucket and then moving on to physician referrals or professional referrals. Not necessarily be physicians alone but any professional that can send you a referral like, “I know this group. They do a great job. I recommend you go there.” The final bucket is your general public. Now, you're casting the net out into capturing people with different messages across all of those buckets.

Look at money as energy and push it toward the things that are going to keep your venture going. Click To Tweet

Correct me if I'm wrong but from my experience, the amount of money you have to allocate to those different buckets increases with the way we've progressed thus far. Patients and past patients are relatively cheap. Getting patient referrals again shouldn't cost you a lot. Maybe a little bit of incentive might be in play for patients and past patients to bring family and friends over. Maybe spend a little bit more to get in front of the physicians. Maybe it's a newsletter, an occasional gift, lunch or something like that. You have to be mindful but it does take a little bit more and to reach out to the community, you got to spend a lot of money to net out.

A lot of that money comes into the various avenues and platforms you have to use to reach them. You have to do every door direct mail, however, you're putting on an event some of these things can get costly and in a hurry. Not to deter anybody from like, “I don't want to mess with that bucket.” I'm going to leave that bucket alone. The general public bucket can expand and explode your clinic but you have to do it correctly. I've learned a lot from Chad Madden, Shaun Kirk and a lot of different people that train in marketing systems. Having that specific message and knowing who you're targeting particularly is critical.

I want to get into that but before we do, since we're talking about budgets, I love the story that you shared about the marketing budget that got out of whack in your early years. If you want, you can go ahead and share that but let's talk a little bit about budgets and what people might need to allocate for marketing because as I'm talking to some of my coaching clients, they'll ask, “I want to do this thing or the other. What do you think?” I said, “How much money do you have to spend?” That's what everyone is going to ask you. A marketing expert is going to say, “How much are you spending?” That is a deer in the headlight question for every PT owner I've come across. They're like, “I don't know, how much should I spend?” They don't know. Talk to us a little bit about some marketing budgets.  

It isn't just marketing budgets. The same question could be posed if I wanted to get into a new location and I have a new lease, I want to build a building or whatever, it's like, “How much do you have to spend? How much is the clinic going to cost you? Is it going to be beyond what is feasible within your operation?” I've stood on the shoulders of many great mentors like all of us have and learned how to allocate it on a formulated basis so that no matter what, every dollar that comes in or X amount of cents, gets given out to labor, payroll cost, benefits, marketing, rent and utilities.

After a while, you start seeing some similarities on that to how much percent is appropriate. Give or take, in some regions, you're going to have to pay a little more to get a therapist so your labor cost goes up a little bit. Marketing in general, we always try to keep it generally around that 10%. We have gone in our start-up clinics when we're trying to get out there and push it off the ground and get it to launch 14% to 15% but it doesn't stay there. Once we start growing, you'd get those patients within, as long as you've got a good customer service and a reactivation system in place, you're staying in touch and keep a relationship there. You then can start lowering those costs overall and get it down to 10% and start reactivating the cheaper but the lower hanging fruit in marketing and that's your form of patients.

That's a surprise to some physical therapists because if they were to do the calculations, they'd find their marketing spend in the past has been somewhere in the 1% to 3% or less range but if they want to achieve the goals that they want to achieve, they got to recognize that they should allocate somewhere in the 5% to 10% range and more if they're starting up something new. That can be a hard pill to swallow for some physical therapists thinking, “I need to spend that much.” Maybe you don't. If you're happy where you're at and you're not necessarily focused on growth, maybe you need to be closer to the 2% to 5% range to maintain and continue going forward. If you have any illusions for growth, you're going to need to expect to pay more in marketing and that's where you start. How much do you have to spend? A lot of times, it depends on how you're going to spend it.

I try to look at all of it. It's an investment. I use the term ROI a lot around the clinic and everybody on the leadership team knows what I'm talking about but it's like, “I would like to do X, Y and Z program or campaign. I want to try this. What do you think?” I'm like, “I don't know. What's it going to get you? I don't know. I just want to try it.” I’m like, “We need to spend a little time and project out and think about, not, ‘We don't know,’ none of us have a crystal ball but we should have a pretty close estimation of where we're going to land, what we're targeting to understand how to get that.” When we're talking costs, 10% is an investment not only to grow your practice but keep your practice stable and keep it where it is because competition never stops and costs never stop growing and reimbursement never stops decreasing. You get caught between those three and you're squeezed. You need to always be pushing funds and energy, look at money and resources as energy, push it toward the things that are going to continue you and keep your venture going. That's probably another way of how to look at it if they're freaked out about the growth part.

That goes to like, “After I know what my budget is, how do I allocate that money?” That's where you were leading the discussion. Let's come back to that. It's like, “Who's your demographic?” If you don't know who your target audience is then you're not going to know where to allocate your marketing monies because you want to be where they're living.

You want to know your community and that takes time. Nobody pops into a town and knows everything about it but you want to learn what's your median range of ages? What is the household income level? What type of community is this? Is it white-collar or blue-collar? Is it farming, agriculture or manufacturing? Is it all tech? It could be all of it mixed into one. You need to know if you're targeting particular people of influence. Have they been well-educated? It's the same thing that political pollsters use. They are trying to identify who is that avatar within the community, that individual, that face, that nameless person because that generally reaches across to all of them.

We have a manufacturing, a heavy community in our first location. Our second is all agrarian, an agriculture is driven which is a smaller community. The third community that we have is a practice in is a combination of all. It is manufacturing, it got some retail, it got some white-collar related people there and it got a little bit of a mix. On the physicians, we have to target them differently too. We keep going. It's a piecemealing of all these buckets figuring out.

In each bucket, the message is going to be completely different but when you're looking at your avatar in the community bucket, what comes to mind for me is a podcast that I listened to is Paul Gough’s earlier podcasts. He's in England and people have the choice to go to the state-sponsored clinics but he's not part of that program. People have to pay cash to come to see him. His target market when it comes to marketing is the 55-year-old female kids or older. They have a little bit more income because they're upper-middle-class. Simply that alone can influence your marketing message. You're talking to females. How are you going to talk to females? How are you going to talk to older women who have a bit more money that can pay cash out of pocket versus going to the state-sponsored clinic?

PTO 125 | PT Marketing Basics
PT Marketing Basics: If you want to achieve your goals, they should allocate 5-10% on marketing and even more if you're starting up something new.

That alone is we'll generate a different message than the message that you're going to create for your past patients. There's a different message if you're going to focus on orthopedic physicians versus internal medicine. Honing that message to your target audience doesn't exclude the rest of the audience that you're reaching out to but it will capture their attention more so and bring you the type of patients that you want to see.  

It's as simple as this. When you are talking to a friend or a family member, you've known them your whole life, your level of understanding of that person is so much greater. You can talk pretty generically and more loosely and then hone in on specifically what they're interested in. Case in point, you have patients that are into baking, crocheting, hunting, fishing, football or welding or whatever it is and you learn those things. You can't keep records on everything but you do need to have some sort of semblance of, “This is what this guy or this girl was into,” then when you're sending out some personal related messages or the phone call systems that we do, “How are your grandkids doing? The last time we talked X, Y and Z.”

There is no better way to connect. You can't do that when you're talking to somebody you've never met before. Right in there are the basics of the message change. You're trying to target, what is important to them and what means something to them? In our particular case and a lot of cases, we're looking at middle-aged females, like you said and they're the family, consumer decision-makers. They decide when grocery day is and what they're going to buy for groceries. They decide where their kids are going to go to school. They're going to decide for certain where their health care is going to be done. That is who you're targeting.

That's good to know because although your interest might be in high school athletes, you got to recognize that they don't carry the purse strings. It's the parents that they got that. The majority of the time, it's the mother that you've got to influence.

Always target the decision-maker.

I interviewed Angie McGilvrey down in Florida. They've got a number of practices and we were talking about social media advertising. She's been very successful with that. She posts regularly on the different social media channels but her target audience is going to be the female athlete who’s probably in CrossFit and their 20s or 30s. She's got it mapped out. She knows who her avatar is down exactly. She tailors that social media message to those people and thus, has been successful with her social media campaigns. Know that message and know who you want to work with. Angie used to take all comers and the majority of it is in Florida and Medicare. Since they had a reset, which happened to be a hurricane a number of years ago, they decided to change their message to focus on the patients that they wanted to see. Now, the demographics of their patients are completely different because they tailor the message.  

We've never felt that we could wholesale, go and choose one group like the 30 to 40 female athlete or what have you. We still target all comers. We do it differently through different strategies to try to get them all. We're in a low populated area so we have to squeeze as much as we can out of what's available though.

Are you a little bit more rural?  

We are.

You got to be the country doctor, essentially. They're not bringing you their animals.

Haven't yet anyway.

Never assume that everybody knows what you do. Nobody thinks about physical therapy, ever. Click To Tweet

That can be some of the more difficult marketing that you do when you're reaching out to the public.

It is. In that article I wrote, I used some references from Dan Kennedy in marketing and they get the Marketing Results Triangle, taking, targeting and tying in together the message, the market and the media for the group that you're going after. Once upon a time, you could say social media, internet, email, all those things and don't work for Medicare people but that's not true anymore. As grandmas are all on Facebook now, you can now open up some of those avenues that once were viewed as well, you can only reach them with newspaper ads and mail. What worked many years ago now is moving and evolving and you have to keep moving with that.

We're at the end of 2020 and what worked at the end of 2019, now post-pandemic is different. You've got to recognize, if you don't have any energy, time and money put into the direct to community marketing bucket then you're going to be in a lot of trouble because that physician bucket is shrinking because maybe not in your community but I know in some of the larger metropolises they can't go in and see doctors anymore.

I don't want to say it's completely gone, but the only way we can ever reach those guys is we tried to do everything systematically so it isn't just licking and sticking. We try it once and see how it goes but making sure that our notes always read a certain way, particularly to the doctor because we know what they all generally want. They don't want three-page notes sent to them on progress. They want them as simple and short as possible. I still see at times therapists on the bigger ones. We are already missing them if you want to try to influence them. That's one piece but then always making sure that we do a quick phone call, “So-and-so is coming over to see you. We want to make sure that there's a note that's already been faxed. Have a great day.” It's trying to provide customer service to them as well. The last thing is we do an in-between progress call having our therapist make a call to the doc's office saying, “I want to touch base to let you know how so-and-so is doing. That is all. Thank you.” That's all the way you can make those touches when you can't see them face to face. They don’t want you in there and I don't want to be in there.

When you consider the direct to community type of marketing, that's new territory for many owners. Either they haven't used social media, don't know how to use social media or they haven't used mass market mailers, media posts, the radio, TV or anything like that. The post-pandemic forced their hands if they want to make some connections and growth. They might say, “I don't know what to do.” Start with, who are you marketing to? If you're thinking about the decision-maker is being the housewife, the majority of the time then where are they living? That might guide you to where you need to be in social media.  

That's an easy one from a mailing standpoint. You can do a target grid search on every door, direct mail, if you want to hit X amount people in certain age groups and so on and so forth, you can get that down to a fine point. Our mailers, once upon a time, wasn't an effective marketing campaign but it dropped off a lot as far as our effectiveness with it. Particularly if you're marketing the same old, “Come in for a free consult,” some sort of a new tripwire that connects them. That works well with us still but if you're sending something that says, “Do you have back pain? Call us today,” you're better off using some other strategy than that. It's going to be costly.

The one thing that therapists always make the mistake with is we assume everybody knows what we do. Everybody's thinking of physical therapy every day of their life. Nobody is thinking about physical therapy ever. Let me break everyone's bubble now with that. I learned that early on and that was probably a saving grace for me. I focused on, “These are consumers, these aren't patients.” That may ruffle some feathers with some PTs but if you start changing that mindset and knowing that that individual is being competed with by General Motors, by their utility bill, by their kid's college tuition, by all these other things that are drawing their time and money and energy, you're going to go in there and say, “If you've got back pain, call us today because we give great quality care,” you're not going to reach them. You have to do something more targeted to get them to reach out and call. One of the things that Chad Madden did is using a digital product, eBooks, things of that nature like, “If you have a low back pain, come and get your free low back pain workbook, learn how to treat yourself.” That speaks to some people. Things that bring them out and get them reaching to you. You're trying to attract people to you.

The important thing to recognize and you've alluded to it essentially, is that you do something and then you've got to assess the effectiveness of it. That's why you're changing the message on your direct mailers every so often. Recognizing that, “We sent out these three mailers. We've spent three months on social media,” which seems to be about the time it takes to gain some traction on some of these. Maybe you can share your experience.

It takes time.

People think that if I send out the social media posts, things should be ringing off the hook like, “I've increased my Google Ad spend for the past three weeks. Why aren’t we getting more new patients?” It takes time. At that point, that’s important to figure out exactly what was the ROI or the Return On Investment.  

Whatever you do, if you're doing social media for three months, make sure that we're measuring. Is it working? Make some adjustments as necessary. Marketing is conversational. You're talking with someone and you keep saying the same thing over and over to them. They're going to be like, “Something's wrong with this guy. I'm not reaching them. They're not connecting with me.” Your conversation has to adjust to whoever you're talking to in-person. Marketing is going to change in whoever you're talking to out there. The things that they want to hear is what you want to try to reach them with. As you know, there are only many things, what are the results and the benefits and then try to overcome those barriers of, “How much time is it going to take? How hard is it going to be? How much is it going to cost?” Those are the pieces of sales that you'll have to work on to overcome when people do finally reach for you.

PTO 125 | PT Marketing Basics
PT Marketing Basics: Start with identifying who you are marketing to. It will guide you to where you need to be in social media.

It's interesting, as more people have been doing social media posts and some of my clients have noted so much of the focus of the content can be like, “Here are some stretches for low back pain. Here's the anatomy of a shoulder that you need to consider,” and I'm not convinced that's what gets people engaged. Honestly, one of my patients said, “I get more engagement from posting a beautiful sunset than I do from any of that other how-to stuff in social media.” I'm like, “I probably wouldn't click on any of those things either and might give a thumbs up to a nice sunset too.” We got to consider that not everyone wants to know your how-tos and what- fors.

They don't want to know that. They want to know, “I have a problem. What are you going to do for it?” If they have shoulder pain or back pain that’s been bothering them for a long time, at some point, you send the right message out, “Are you sick and tired of this back pain?” That's different than we treat back pain as not emotional. It's factual. There's no feeling from it. Marketing has to derive a feeling. It has to create any emotion because that’s what motivates us to move, to go do something. You have to target that. Knowing where most individuals are at in their feelings about their problem, makes a big difference in how you tailor your message to them.

If you're in a running community and those are the people that you want to see are the roles, you're not talking to them about sitting at a desk and how that causes neck pain. You got to target the message appropriately and give it some time to take traction. I'm not convinced that it’s a home run out there to get new patients in the door but it's a repetitive single in the baseball analogy that usually gets some tractions.

It's always a small ball. It is the things of how much marketing have I done over the years and all the while, my marketing was great, my front desk personnel was terrible? You got people ringing in but unless you're taking the phone call, you're trusting that individual to hook them and say, “Come on in. Are you having pain? You need to go see your doctor first.” That is what we know. That works against your general public marketing. When you want the general public to reach to you and then when they do, you say, “Go somewhere else.” That’s wrong. It isn't just marketing. It's knowing how to handle all the other components that come with it.

It's customer service, at that point. That's what you were talking to at the beginning. I remember talking to one of the founders of Keet Health. If you can focus and improve the customer experience, that will triple your marketing efforts because those people will think about that, especially in the different buckets. It's going to improve the patient compliance and they're coming back if you can improve the customer experience. It's going to more likely help them refer family and friends to come to as well so it's going to help that bucket. If you focus on the customer experience, patients are going to go back to the physicians in that bucket and say, “I love this place and you ought to send all your patients there.” On the backend, if you're reaching out to the community and they have a poor experience on that initial call, you just wasted your marketing dollar at that point. It is so much that it comes back to customer service and the effectiveness of our marketing can be submarined if the customer service isn't there.  

It's got to be credible. If you say that you deliver the feel-good experience, which is what our brand name is. Our tagline on everything is the feel-good experience. Meaning, we do focus on not only making them feel good physically but emotionally, spiritually, making that connection with them, giving them a great experience all the way through. When they do call in and say, “You got to go somewhere else first,” and treat them like, “You've been here before,” we related to whatever then you've blown it. You got to make sure that that is incredible all the way through that you perform and behave as your marketing is.

Trusting somebody to do that naturally is a fault.  

You got to train it in.

They don't say whatever comes off the top of their head that they think sounds good, you have a script for them like, “This is what you say when a new patient comes in. This is what you say if they walk in the door versus if they say, ‘I heard about you on the radio or I got this flyer in the mail,’ and then you say, ‘Great,’ then you say this.” That's trained over and over and its role played. That training can be taken into many different sections of the customer experience. It's not just front desk training, that's training that can occur at any point in the customer service experience, providers, technicians and billers. You name it.

You're leading off into my last project here. I've been working on a book. I created a system many years ago and I'm getting around to putting together an actual book for it. It’s called the Feel-Good Experience: How to Grow Your Practice with Five-Star Customer Service. It covers all of the psychology of the human being, our needs, wants, the certainties and the things that we're looking for, all of us. It doesn't matter who you are, where you come from, what gender, nationality or any of it. There are certain commonalities that we all are seeking. Ultimately, it's respect and communication and that level of professionalism to lead them through the process. One of the worst things that I can see over the years and I've had it happen to me personally is when I go in seeking a service or an item and someone says, “It's over there,” and they point me toward it.

To me, the difference is when that person says, “Let me go take you there and show you where it is. Let me get it for you.” That's the difference. We always want our clinics to run within that model. We have five stations or so. Front desk, we use the aids, therapists, hosts and hostesses because their first action is to bring them back. There's a whole set of steps there on how you body language that action to show them respect, honor and appreciation for them being there and bringing them back with them, being cognizant of those things. Things that they tell you, things that they maybe don't tell you, the subtle tells. If you're sitting at the poker table, you got to be able to read people. Going through clear to the end again, the front desk individuals are the last ones to get them again. They got two important parts, in and out. That's all within the book soon to be released.

Marketing has to drive a feeling. It has to create an emotion. Click To Tweet

Do you have a title for it?  

The Feel-Good Experience: How to Grow Your Practice with Five-Star Customer Service.  

When is this coming out? If someone read this episode in the future, what do you think?  

It'll be out in February or March 2021.

Congratulations on that. It all goes back to the topic of how we can improve our marketing and much of that can be fortified and even multiplied by having a good customer experience.  

You'll find out quickly if you’re not, particularly if you're at an executive level of management in your company where you're managing a lot of different sites and you're not right there watching everything. When your former patient bucket starts tanking out and you're still doing all the ingredients that you've always done that work to bring people back in and you're dropping off quickly, there's a reason they're not coming back. You definitely want to target some of those things.

You're saying that a lot of people will measure the return patient percentage of their new patients. What percentage of your patients are returning patients that have been there before? You're finding a correlation between that statistic, that number dropping and maybe a worsening of the patients.  

It's usually two different things. The first thing I'm targeting is I'm going to my marketing going, “What's fallen out? What are we not reaching out to them with?”

We're not sending emails and calls to the patients.

We're doing it all and it's all because everything is well documented in our system. I'm like, “They're not coming back then on the phone calls. What are they saying?” “They didn't want to come back or they went somewhere else.” You then start taking note of all that. They started going to other places and that's when bad things are happening. You want us to fortify former patients and get them served.

I love that you brought that up because that can be key for some people who are seeing numbers dip and give them something to look into because they might be saying, “This circumstance led to not coming back,” but you are not looking internally and saying, “Maybe they're having some poor customer experiences that they didn't have in the past or something's fallen out.”  

PTO 125 | PT Marketing Basics
PT Marketing Basics: If you focus on improving your customer experience, it will triple your marketing efforts.

Particularly if it's a lifelong person that keeps coming back and they've been back for ten years and we've had this happen, it's the most painful thing ever as an owner, when you treated that patient. When I was a therapist and you had this such tight connection that they would text you, they will call you at home and you took care of them. All of a sudden, the next time you see them, they're standoffish and then they say things like, “I went somewhere else.” It's like, “What happened? Something's not right.”

That's such valuable feedback that maybe you get that from physicians occasionally if they're honest and you have that relationship with them, or the one person in the community that came through and then decides to go back on Google and give you a one-star rating or something like that. You can simply trust and get much more out of those past patients if you stay in communication with them regarding how things are going in your clinic. That's something that you have to do as you personally step away from treating everybody, which is the most PT owners. There's so much value there, for sure.  

They're a wealth of survey knowledge, instead of hiring a survey group to do surveys, survey your past patients. That is the simplest and most cost-effective way to find out how you're doing. You've got to make sure that they're being honest. You allow them to be honest, you give them a safe place to be honest. If they say something bad, you can't lose your cool with them. You have to say, “I appreciate that,” then you can mark it and make your changes off of that.

You covered a ton of great stuff and shared a ton of wisdom. Steve, is there anything else you want to share before we start wrapping things up?  

Thanks for having me. I appreciate it. This is an absolute, tremendous opportunity. If anybody would like to contact me, they can contact my clinic number at work (402) 564-5456 or reach me by email, which is

We'll look forward to your book here. Thanks for your time and sharing. Hopefully, everyone gets a ton out of it but I appreciate your time.

I appreciate it, Nathan. Thank you.

Thank you, Steve.

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About Steve Line

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

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PTO 89 | Marketing Strategies


Getting patients to enter the door may seem simple but is actually one of the hardest steps PT clinics tackle. Today, Nathan Shields talks to Peter Decoteau, the marketing director at Physical Therapy & Sports Medicine Centers (PTSMC), the largest privately-owned PT group in Connecticut. Focusing on breaking down any barriers that keep new patients from coming in the door, Peter recognizes that the first barrier for a majority of people is simply knowledge - not enough people know what physical therapy is, thus your message has to recognize that. He shares aspects that make these technical such as location, insurance, and those can be further addressed after you've captured their attention. Peter believes that regardless of the steps taken, it is necessary to know what your brand is, who your ideal client is, where they get their information, and the content they need to hear all of which leads you to begin to generate marketing campaigns.


Listen to the podcast here:

Marketing Strategies To Ease The Path For New Patients With Peter Decoteau

My guest is Peter Decoteau. He is a Director of Marketing for a large physical therapy company in Connecticut. I brought him on because I want to talk a little bit about a couple of things. First, the things that we need to consider as we are advertising directly to our local community or direct to consumer marketing. Secondly, what are some of the things we need to do on the back end, which is number one, how did we get that patient who is interested to convert? Number two, how do we track the KPIs related to our marketing strategies.

Important stuff as we're considering that a lot of our marketing strategies need to spend more time and effort either direct to consumers, via mail, email, or social media and rely less on physician referrals. That's the trend that we're seeing. I'm trying to highlight physical therapy clinics that have been successful at doing it. If you do have a marketing strategy, I’d love to see how yours compares to what Peter represents. Also, if you don't have a marketing strategy, consider some of the basics during this episode that you need to do to be intentional about your marketing efforts to grow.


I've got Peter Decoteau. He is the director of marketing, Physical Therapy & Sports Medicine Centers, Connecticut's largest private practice group. I wanted to bring him on because I saw a past impact magazine article in which he talked about marketing. I'm always open to that and we need to consider marketing outside of the traditional physician relationships. Based on his article and further talking with Peter, I wanted to talk a little bit more about marketing and some of the things that we need to do and look outside of the traditional relationships or things that we're doing. Peter can give us some light and insight into how to make it easier for new patients to get in our door in general. First of all, Peter, thanks for coming on. I appreciate it. 

Nathan, thanks for having me. I'm happy to be here.

Give us a little bit of breakdown about you. You're not a physical therapist by trade, you're in marketing, but tell us how you got into this all and your experience with physical therapy.

I came into physical therapy cold. I didn't have any experience with physical therapy personally. I had not gone through physical therapy. It's an interesting experience to come in not knowing too much about the industry. I have a strictly marketing background. I started in a nonprofit in Hartford, Connecticut and then moved onto a private school up in Simsbury, Connecticut. I was an ad agency for a little bit as well. The benefit for me of having those experiences and coming into this environment is that I have a pretty broad breadth of knowledge in terms of different approaches to marketing. The different pieces of marketing like PR, digital or advertising, all those different things that you'd want someone to be doing.

A different perspective.

Working with different audiences. If anybody out there has worked with a nonprofit, they would know that you were pretty much every hat possible there. It was a good starting point for me. I was doing some multimedia marketing for them, but I was also doing some membership relations and some sponsorship relations and things like that. It gave me a good foundation for where I wanted to go next. The opportunity to come into Physical Therapy & Sports Medicine Centers came from working with someone in our leadership group. I was working with her husband at the private school and they needed someone to come in and do a little bit of consulting for some of the digital marketing and social media stuff that they were looking to expand upon and reach a broader audience with. I jumped on as a consultant in that way. I did a pretty extensive audit of their digital presence and gave them recommendations and I was doing some ongoing work with them.

Do whatever you can to break down the barriers for new patients to get into your clinic. Click To Tweet

When the opportunity came out for a marketing director to jump on board here, they reached out to me and things were tumultuous at the ad agency. That's a different story. Suffice to say that they don't exist anymore. It was good timing, jumped on board here. I had already been working with the team here. I knew that it was a good fit and I was interested in coming into the physical therapy world knowing that it'd be doing something that at the end of the day is helping people. Not necessarily for me doing the hands-on treatment, but getting people into the physical therapy clinics, especially clinics that we have that I believe do top-notch work. It felt like it was a good industry to jump into.

That's cool that we have you on because you bring a different perspective than the typical physical therapist that might be talking about marketing. I want to ask you, are there some false ideas that physical therapists have about marketing and how it should be done that you have to come in, break down or challenge and change their perspective about it? If so, what might some of those things be?

The number one thing that I've seen, in coming into the industry and being a part of the private practice section committee, is that physical therapists greatly overestimate how much the general public knows about physical therapy. We tend to exist in an echo chamber of our making. In an impact article that I've put together, we're the fish living in this water all day. We tend to think that everybody else sees it the way that we see it. We talk to the general public. You realize that their knowledge about the scope of services provided through physical therapy, the way that you might come to physical therapy, even where their nearest clinic would be or the difference between outpatient and inpatient.

There's not a lot of knowledge in the general republic and that is a matter of messaging for the industry. For the most part, the industry itself was mainly surviving on doctor referrals to physical clinics. Most of the messaging had to happen from the therapists or if they had marketing people, which a lot of them didn't to the doctors and to trust there and build relationships there, which is still important. Given that direct access is something nationwide that came out in Connecticut. The focus should be on pushing forward on self-referrals, direct access, teaching people even what that means and what that is, especially the scope of service that we provide.

Tell us a little bit about that because that leads to our topic as far as how to get those new patients in the door, direct consumer marketing. It’s getting the knowledge out to the broader audience because the stack gets thrown around and I don't know where it was found. I wouldn't be surprised if it's true that only 10% of those patients with musculoskeletal injuries get the physical therapy that they would need or could need to overcome their injury. That means that all of us are fighting for a pretty small pie. If we're focused on the physician referral route, there's 90% of the population out there that could use our help that isn't getting it because they don't know about us. We take for granted that everybody knows about physical therapy or at least some version of it. Maybe they don't understand how physical therapy could help for minor traumas, for simple injuries and stuff like that. Talk to us a little bit about how you work to help those new patients get in the door from the population and utilize direct access.

I love that you use that number. That's a number that our Vice President of Business Development, Mike Durand. He’s been a part of this company and he was an athletic trainer before. He throws that out all the time and says the same type of thing. It's like, "If that's true, which the study shows that's the case, that we're all fighting for that little piece of the pie instead of working together to try to make the pie bigger for everyone." If we're talking about ways that we can increase self-referrals or increase our patient volume with people who are not coming directly from the doctors, is that we first focus industry-wide on our messaging and create a little bit of consistency.

At least acknowledgment to get the messaging out there in a broader sense before we start doing more clinics specific or company-specific messaging, if we do that successfully in terms of having clear, consistent messaging, talking about the benefits of physical therapy as a whole because that percentage of the pie gets broader. Even if there are fewer people specifically knowing about our clinic at some point, all the whole thing grows. We'll be reaching maybe more of a niche audience, but that niche audience is also bigger. Our patient volume still grows.

It sounds like your marketing starts with developing the knowledge-based of the community as to what physical therapy itself is and how you can benefit those people who are having less traumatic issues. Maybe simply low back pain, you're marketing your message is a little bit more knowledge-based and then you add your tag or logo at the bottom? How do you guys go about doing that?

PTO 89 | Marketing Strategies
Marketing Strategies: Physical therapists greatly overestimate how much the general public knows about it.


We talked a little bit about this, something that David Straight had mentioned on a previous episode of yours, which I encourage everyone to go back and read it if they haven't. He talks about starting with establishing your brand identity and figuring out who your target audience is. Also, figuring out where that audience is in terms of platforms you can reach them most effectively. We always start there. Once we've gotten to that point, we know who we're talking to, we know who we are and how we're positioning ourselves and we know which platforms we're using. We get to this piece about the intellectual property that we can bring to that, the content that we can put together.

The value to the users or the audience while also educating them on this broad range of topics that we're talking about. That doesn't necessarily have to be broad with each piece of content, but that we're covering a lot of bases in the messaging that we're putting together. The more that the audience sees these messages, the more comprehensive of the picture they get and the more personality they get about our companies specifically. The pieces that I'd say differentiate us from the other clinics that are in Connecticut.

I love that you bring up David Straight's episode one of the few first episodes and you talked about marketing. The evolution of your marketing doesn't necessarily change. You've got to figure out who you are and who your ideal client is? Some people might say, "What is that avatar?" Once you have that figured out and what you do best and what patients you want to work with, then you can focus on, where did those people get their information from? Is it social media? Is it mail? Is it email? Is it postcards? Is it community events? You can focus on the content. Based on knowing who your demographic is, you can structure your content accordingly. To invite those specific people in the door, that's how you would structure your marketing program as you're going direct to the consumer.

In terms of what we're talking about with getting people into the clinic, educating the public both on an industry level and then on company or clinic specific level. What we're talking about is breaking down the barriers of entry to the general public. This piece of it that we're talking about is the barrier of knowledge. It's a general knowledge barrier that people have for physical therapy. What are the things that we can do that breakdown that knowledge barrier in a general sense of the benefits of physical therapy? That specific level of physical therapy can help with your recurrent back pain that you might not need surgery for but keeps you up at night. Here are the ways that our clinics specifically can help with that because we offer dry needling. We do hands-on therapy. We focus on the manual. We are closer to you than the other clinic. There are these other things that make us a better option for you. We can start from that broad sense and get more specific as we continue to try to reach that audience in the way, read the messages that resonate with them.

If you look at their websites and some of their content, they might focus more on the treatment they provide instead of the benefits they can provide to the patient. As we're talking to ourselves, we know the benefits of say, dry needling or some manual therapy technique but that's not what you want to highlight and advertise. You want to get down to their knowledge level and also, what's important to them, which are their functional capabilities and how you can improve those and focus there. What you provide is off to the side. This is how we do it. If you can simply get them to buy into what you're doing to improve their lives, you can talk about how we do it later on.

Our motto is improving the quality of people's lives. That's the thing that we always go back to because we do say that PT in general if you're going to a good physical therapist, that's what they're doing. They're improving the quality of your life because you can sleep throughout the night. You can pick up your grandkids. You can play rec league soccer on the weekend, which I do. I've needed to go back to physical therapy for that specifically to get me back out on the field. Those are things that provide quality to my life or somebody else's life that we're trying to get you back to. Starting at that point and then getting more specific.

I like to think about it and you talk about a marketing funnel, getting people down in the funnel and then wondering where do they go once they convert? I made up in a previous position. I tried to visualize what it looks like to me after they've converted and put a little bit of a tornado in the middle of the following, say, "If you've created the awareness and then you're getting to the point where the people exist in the middle point." Especially with physical therapy, which you want them to be aware of the fact that you exist and you have these benefits. Maybe that person doesn't need physical therapy but you want to be there for them when they do need it.

You want them to exist in this little middle part of the funnel that's like a little tornado of information that they can keep on receiving. How can we keep them engaged? How can we keep them interested? How can we get new little tidbits of information to them? That's the way that I like to think about it. The content marketing that we're doing that we are getting people to that point and then staying in front of them with all this relevant information that speaks to both the services that we provide, but also the personality and the differentiator points that we offer. When you talk about something like dry needling, you're right, we're not going out there necessarily promoting dry needling to the general public as a selling point for us.

Reach the audience by reading the messages that resonate with them. Click To Tweet

Once you're engaged with us, we'll do videos about dry needling and talk about the benefits of that and show you what it looks like. I had the barrier to entry for that would be thinking that it hurts. Can we show you in a video that we're dry needling, someone and they're not reacting to it at all? We did a video with one of our clinicians. She specializes in temporomandibular dysfunction. She dry needled two parts of one of her aide's phases. We'll first show the type of treatment that you would be offering, but also, ancillary it showed that it did not hurt her at all. The more we can bring that type of content into the fold, the better.

As you consider breaking down the knowledge barriers and providing them what they need to know about physical therapy and how it can help them? Do you have a secret sauce when it comes to getting that conversion? If they call and they want to utilize direct access and come to you without going to a physician, what can you share about how you get those people to convert and become new patients?

I wish we had all those answers because that would be fantastic. That's something that we're working on daily. I talked to our operations people and our employees as much as I can about the things that we should be doing that are consistent. I see that as two separate things. One is the functionality of getting them to convert. The other is the interface with our employees when they're interacting with them on the phone or when they come into the clinic. The functionality piece is, we try to optimize everything we have. Everything that a potential patient might be interacting in a way that again, breaks down the barriers to getting them into the clinic.

For example, if you're someone who doesn't have any relationship with PTSMC in the past, and you probably maybe even not had a relationship with physical therapy in the past or you've had a bad relationship with them, which is something that we hear sometimes. What's the information that you're looking for? How are you looking for it? How can we get it to you faster and easier and more effectively? How can we make it easy for you to book an appointment? Ideally, what's happening in the person's thinking, "I need physical therapy." The doctor said, "You need physical therapy." I'm going to tell you to find your therapist, which happens more often. They go to Google, they search for it. You come up, they go to your website, they're looking for maybe, do they take my insurance and do they offer the treatment that we're looking for?

We know that those are two things that people are looking for most often than not. Are you getting them to the right page initially? Is it easy for them to find that information? Once you've given them that information, how easy is it for them to book an appointment? The way that we have it set up for us, our organization is that we built a new website specifically with that user process in mind. It's optimized for the user flow. Also, for the SEO flow to the individual pages, search engine optimization flow. On purpose-built out landing pages for every treatment option. We've got that landing pages for every individual clinic so that if you're Googling, "Best physical therapy in Avon, Connecticut." If you do it in Connecticut, the first three things that probably show up are one, a Google Ad campaign that's running for that says best physical therapy in Avon, Connecticut, that when you click on it, it goes directly to Avon's location page.

The second thing that shows up is probably the organic result for that. The third thing that shows up is probably either the maps result or staff result for the same thing. We're trying to dominate the search results there as relevant as possible. When they get to the site, make it easy for them to find that additional information. We have, I believe, two or three conversion points for submitting a request for an appointment through the website on every single page. There are a floating button, a sidebar and a top bar that says, "Request an appointment." Everywhere on the site, it's there, it's ready to go.

Whenever you want to request an appointment, we're ready for you. 

Ideally, what would happen is that they would click on that and they'd be able to integrate with your scheduling and requested an exact date and time. We're not there yet. It's somewhere that I would hope for us to be pretty soon. Also, there's some friction in terms of what's available in someone's schedule. Maybe it's available for a reason that you know all about because I'm not in the clinic. It was a little bit of like, "How much can you do there?" You're breaking down those different barriers to book an appointment or they put them to call and they're going right to the clinic that they're trying to.

PTO 89 | Marketing Strategies
Marketing Strategies: Figure out where clients are and be really specific about what you're doing in terms of the platforms used.


It's great that not every individual practice owner is going to have a director of marketing like you to handle a lot of the Google Ads, the SEO and stuff like that. What it shows is, we put out some marketing promotional material or an ad, you name it, but in what you've done intentionally is, how can we make this as easy as possible for patients to get in the door and make an appointment and convert? That's a necessary exercise for any owner. That is to say, we put out this ad when someone calls or when we're calling out for a referral, how easy are we making it? Are we forcing them to give us all their insurance information before we answer their question? Are we making them jump through hoops and getting the date of births and that stuff?

Are we more focused on them and maybe what their name is? What their ailment is and how it's limiting their life, maybe establishing that relationship right off the bat. I'm saying there are other ways that you can go about it and it's worth the exercise for owners to sit down and say, "At this touchpoint with a potential patient, how can we break down the barriers?" Maybe they've got an understanding, a knowledge-based. What can we do to make it as easy as possible for them to make an appointment? Everything we can or in that call and I'm sure you're doing it with your calls. You're also doing it with your website. How can we make it as easy as possible for that internet traffic to translate into a visit as well? You can look at those touchpoints and say, "How can we make this as easy as possible?” 

You bring that up and that speaks to that other point that I was talking about the interface part of it. One of the things that we try to do, everything I was talking about the functionality wise is called technical side of it. At the end of the day, we always have to remember that we're dealing with people who are probably in some pain or representing someone who's in pain. Not only that, but they have to deal with the pain of going through the healthcare process, which is usually not simple. From that point, can we come to them from a perspective of empathy? Can we make that part of it easier? When they come into the clinic to treat the real pain that they're dealing with, they haven't had to jump through all these hoops beforehand?

Typically, what we do on that end is a lot of different folds to it. I would say that our operations group does a good job of onboarding people to the particular culture that we have at PTSMC. We focus a lot on the differentiator for us being one of the tenants of our mission statement is lifelong relationships. That's a key tenant of that. We want to be known as the physical therapy company that focuses on, we say that the person, not the problem. When we onboard people, we focus on that as a key element of everything that you do when you're working. You're getting people in a database and your scheduling. You're first and foremost, a representative of that philosophy that we have here.

Likewise, we do that with our clinicians too and we have to do that with the front desk people were feeling most of the phone calls. Another thing that we do that speaks more to the marketing side of it is we do a separate onboarding event process with all new clinicians’ call, "Living The Dream," which is they met our president loves to say. We've got to wrap it into that. It's focused more on that what we call the soft skills that you don't necessarily learn in PT school that are related more to that interpersonal piece. What's beneficial for me as a marketing person to be involved in that is again, not knowing that I'm not a physical therapist and I'm not having these face-to-face interactions with them. Giving them some more consistent tools to bring to those interactions that might help the growth of both their client base and the clinic more broadly has been useful for them. Sometimes it's something as simple as always have business cards on you.

When you're discharging a patient, if you think that they had a positive experience, which we think that most people do and our survey scores reflect that, give them a few. You can say, "I'm your person. I'm your PT. Hand this off to any friends or family that you think is dealing with pain and tell them about direct access because people don't know about that. Let them know that you've got a guy and I can get you in as soon as possible." That little intimate touch of saying like, "You've got a guy, here some cards, and bring other people into the fold." It both allows you to get that word of mouth out there for the referrals, but also, it puts the value into their hands that they've got a connection that they get to reveal to people who are in their circle enough to take advantage of. We do small things like that.

As you're Looking at some of these efforts that you're putting out, are there certain KPIs that you follow to see if these are being effective or not? You brought up Google Ads or SEO costs, how do you measure KPIs or ROI on some of these things?

I tell partners at all the different clinics and this is my number one byline to all of them. My job is to get people into your doors. That's the ultimate thing that I do. If all else fails, if we're getting more people into your doors from a marketing perspective, then I'm doing my job. Their job is to provide world-class physical therapy care, so that people want to spread the word and come back as return patients. Let their friends and family and colleagues know and all that stuff. We do a lot more than that in terms of supporting brand awareness within the clinic and supporting the clinicians to get out in the community. The number one KPI for me to answer that question is that if we're getting more patients into the door, either self-referred, returning patients or referred patients, then that's the number one KPI. In terms of tracking the performance of individual campaigns that we're running, it's a lot easier to create KPIs and track them when it's coming from a digital campaign. For Google ads, you can track the clicks through to the website and the conversion rate from those clicks.

PT clinics must remember that they are dealing with people who are in pain or sending someone in pain. Click To Tweet

There's direct percentage of saying, we have a little bit of an equation that we use that's like, "If we're spending $300 a month with this clinic on Google Ads and we're seeing six conversions through that ad campaign because their phone calls and requests through the website, we're going to estimate that only three of them are coming in. What are three patients worth in the life cycle of a patient coming for ten treatments?" The average is nine or ten. That return on investment might be $3,000. We can say those numbers of conversions and the percentage of click-throughs and say, "For that ad campaign, we're getting a ten-time return on investment of those numbers." You start to look at that and say, "How can we get those percentages higher? How can we tweak the campaigns?" Those are the types of KPIs that we start to focus on in terms of like, "We want to get more conversions through that, how can we do that without blowing out our whole budget?"

What's a percentage of return that you're expecting typically? What is the sweet spot for you at least this number and above?

We tend to see it. It works out well because we have the 25 clinics, soon to be 26, where I built out from the start a few ad campaigns on Google and optimize them as much as I could, knowing what our budget was going to be. I pretty much copied them and duplicated them down, changing the location information in the contact information. We're working off of these few optimized ones. We're the good month for one of them, we might see a 10% conversion rate, which is pretty good. Typically, we're probably seeing 4%, 5%, or 6%, which is still pretty high I as an industry average, which is good.

You work with a large company and you had soon to be 26 locations, what would your recommendation be for a guy that's only got one or two locations? He can't bring on a full-time person for marketing, maybe has room for part-time to find somebody or maybe as needed for a campaign. How would you recommend they go about looking for marketing help or doing it themselves?

I always say to start with the low hanging fruit. In this case, if you had to pick out two people who are your ideal client personas whether those are based on payer mix. Maybe you have enough volume, but you want to get volume from a higher payer or payout. Maybe it's volume focused specifically. What's the low hanging fruit in terms of the people that you know or in your area that need PT who aren't getting it or don't know about you? Start with the groups that you would most like to reach as the low hanging fruit, easiest people to get to. Figure out where they are and be specific about what you're doing in terms of the platforms that you're using. One of the things that I tend to see, and I saw this at the ad agency too, that we would bring on clients who wanted to do everything.

They were only working with the small budget or maybe it was a small organization we were working with. We dealt with a lot of that and nonprofit because nonprofits don't have a lot of money for marketing. You want to do a little bit of everything. You want to chase every new trend and you want to be on the TV and get the print ads and also do the social media thing and do the Google thing. It's important to focus on those audiences and focus on where are those audiences are or those audiences are and be that targeted and specific. It's better to maximize the effectiveness of something efficient in terms of your budget and your resources and time that you can put into. Rather than spread yourself thin and maybe see success at a few of those different things which are using up way too many resources. Be specific.

You've brought up a couple of things. Number one, be specific. Focus your marketing efforts on something and focus on that only instead of trying to hit every button out there. You also brought up something else that it's important to bring up in that is most small clinic owners don't necessarily have a budget. Number one might be figuring out what your budget is for marketing or this campaign, and then set that money aside and limit yourself to that budget and see what it does for you. Make sure you're measuring it appropriately. I brought it up with David Straight and I also brought up with Neil Trickett. What your budget is for marketing can vary wildly simply because if you're a startup and you're new. You're opening up a new location, while you want to put more money aside for your marketing purposes and may be up to 10% of your gross revenues if necessary.

Whereas if you're going along and you're nice and steady, you've got a reputation, you've been around a long time, maybe that number pairs down to 3% to 6% of your gross revenues for marketing. Number one, come up with a budget first. I like what you said, "Focus on what you want to do." How do you focus while you focus on where your demographics are? Who do you want to hit establishing your brand identity? Who's your typical patient, the ideal patient? Focus on those platforms with that predetermined budget. That budget can allow for maybe bringing someone on as needed to fulfill that campaign for you or doing it yourself if you have the capability of doing so. 

PTO 89 | Marketing Strategies
Marketing Strategies: Broad messaging is a good marketing technique for building good relationships.


I'm in a unique position at PTSMC because the way that the partnerships operate is at each clinic technically has its individual budget. We all have things wrapping up into a broad marketing bucket budget for us to work with for the most part. I have to have these conversations with each partner at the beginning of the year and then in the middle of the year when things are rolling out. The piece about, how much are you willing to spend to maybe test a couple of things out to see what works? How much are you willing to spend on things that we already know works? What's that breakdown look like? An important piece of it, what are you doing to drive organic results as well? Things that don't require too much of a budget and that's when we get back to this knowing the language to talk about self-referrals.

Having the knowledge and the language to use in talking to patients to tell them to talk about you're going on in the community or leave reviews on Google, leave reviews on Facebook, things that you know have a pretty high yield do anything asking for those things. I was talking about this piece of patient interaction that's called the point of delight. It's a marketing term that speaks to this point where people, I've received great service and they're looking for a way to reciprocate. Especially when it comes to physical therapy. They may not be paying too much for it. Hopefully, their insurance company's paying for it.

Maybe there was small copay, but they don't feel like in terms of the monetary interaction that's happened, that they've necessarily reciprocated for the service that they've received, especially if you're building a relationship. That is trustworthy, caring, they feel like they need to do something to make it up to you. Catching them at that point and saying, "Would you mind leaving a Google review or going on Facebook and sharing some of our staff or I would think most value telling people about us." That's free advertising for you. Having the language to do that, it doesn't require any budget, once you get that point if you're doing those things and you want to continue to grow and expand your patient volume, yes. How much are you willing to spend? Are you willing to test out a few different things?

Not spreading yourself thin, but you did the research, you looked at your analytics, you know that they needed the demographics, they're trying to reach out to you. This is where they are. Let's try a couple of different AB tests and see if we can track results there. Also, having the tracking measures in place to know if it's working or not because I've seen a lot of that too. Where it's like, "We're doing the social media stuff or the Google stuff." It's like, "How are you tracking performance on that? What does success mean to you there?" "We want to see more patients." Like, "Are you separating them and tracking them individually to see that this one's working, this one's not?" It's having all of those points in place before you start rolling things out.

It's important to ask the question, "Do you want to try new things or do you want to continue with what you're working on that will determine your budget?" You're going to spend a little bit more, but you don't want to forsake the stuff that's you've got going already. You want to continue doing what you're doing and then if you're going to do something new, make that an add on so you can see the benefit of it. You have to be intentional about that and plan those things out.

Don't be afraid to cut off the things that aren't working. We saw a lot of that when I came on board originally. We have relationships that had been going at certain clinics, whether or not they're community relationships where we pay $1,000 to be a part of this event. Also, print relationships where we have a monthly percentage of the budget going to these print ads for these smaller local publications. I'll see value in those things, but typically it's not that top-level value. I see a lot of value coming from people reading the paper and seeing the admin like, "I should go to physical therapy." For me, is there a way to leverage that relationship? Can we talk to the sales rep or the smaller publication?

Usually, it's a small staff to leverage the consistency of advertising into actual news coverage? Those things have a value that you might be able to parlay your investment into it, unlike a regular basis. For the most part, you come in and you see that we're throwing a few thousand dollars a year at this print ad stuff and we haven't done any of those relationship pieces. They're expecting it to keep on coming in and you pull the plug and talk to the clinician and say, "Do you know if you're getting any new patients out of this?" I would say, "Someone mentioned it to me one time. I don't know." We'll try to create some metric for measuring success there, but if we don't see that in the next two

Reviews are reciprocations of the services clients receive. Click To Tweet

Move that money somewhere else that's more effective. Anything else you want to share with us before we take off, Peter? 

I'll say one thing and this is a call out to all physical therapists out there, whether or not they have a marketing team or if they're small staff doing the marketing for themselves. I'll push this again because we talk about it a lot at the PPS and APTA and all this stuff. For us, a rising tide certainly lifts all boats. We as an industry, do have a great opportunity to take advantage of the huge percentage of people out there who need physical therapy but aren't receiving it. Also, for some reason aren’t getting the information about the benefits of physical therapy, the scope of services that we have. The ways that they might be able to bypass whatever healthcare system they were working within using referral direct access to come straight to your therapist in ways that that might save you time and money.

If we can be more consistent in not being necessarily self-serving on a marketing side to talk about, we're the best all the time. Let's talk about physical therapies the best because it's a part of a healthy lifestyle. If you commit to it and if you build a relationship with the physical therapist in a way that you might have a relationship with primary care doctor, attendant or anything like that then. Down the line, first off, that's a longstanding relationship that you have. Also, that person's going to have a healthier lifestyle and be able to maintain activity and stay active in the older age. For me it's more about broad messaging, getting those talking points out there, direct access, the scope of service, and then being specific about what the differentiators are for you. That speaks to your brand identity as you've outlined it.

I love the insight and that you're willing to share some of what you guys are doing. I appreciate that. If people wanted to reach out to you and ask you questions or where you might be doing, are you willing to share some of your contact information?

Sure. I'll share my email, Always feel free to reach out to us on Facebook. You can message us on Facebook. We have one account for the whole company. We try to keep it all tight together.

If people want to check out your websites, you were talking about the Google Ads that you use and how you set things up to allow people to request a referral or request an appointment, what is the company's website?

It's easy The individual locations are available there. Hopefully, you'll see in the coming month we're rolling out. This speaks to the idea of breaking down barriers, but we're rolling out an AI chatbot on the site. The goal of that is to get people to the information they're looking for as quickly as possible. We know that people are looking for insurance location or treatment. It pops up and says, "What can we help you with?" If they don't need any things, it goes like, "Here it is." Try to get people to the stuff that they're looking for.

We'll have to check it out. Hopefully, it's already in place. 

Hopefully, it's in place and it's all working correctly. If it's not, you can email me and tell me that it's not.

Thanks for your time, Peter. I appreciate it.

Thanks for having me on, Nathan.

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About Peter Decoteau

PTO 89 | Marketing StrategiesBen has been a member of Teton Therapy since May of 2010. He graduated with a Doctorate of Physical Therapy from the University of Mary in Bismarck, ND and conducted his field work primarily in out-patient settings while in school. During his time at Teton Therapy, Ben has taken many continuing education courses on topics such as Dry Needling, Kinesiotaping, neuromuscular re-education, running analysis, and injury prevention—a topic which he immediately found a passion for and has since conducted classes to the community. Ben quickly applied this vast amount of knowledge to the practice and sharpened his therapy craft. His general interests include water sports, running, outdoor activities such as camping, competing in triathlons, and most importantly spending quality time with his wife and children.

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