PTO 09 | Raving Superfans


What's the secret to creating loyal, returning patients? It's not all about the therapy. It's about the patient experience before, during, and after they've received your care. Neil Trickett, PT and founder/CEO of Practice Promotions shares the secrets to creating raving superfans. Neil says when you create raving superfans, the domino effect begins - patients complete their plans of care and are happy to pay for your services, they return to you when they're injured or, better yet, they refer family and friends and promote you to their doctors.

Then those patients pay for your services, you grow your foundational patient base, gain a good rep in the community, you build a steady, increasing base of revenue, increase your mailing/emailing list, and the cycle continues. It gets exciting and PTs across the country are thriving this way. Listen to the podcast and you'll gain insight on what you can do to create the raving superfan.


Listen to the podcast here:

Do You Want Steady, Recurring Revenue? Create Raving Superfans!

Our guest is Neil Trickett, Physical Therapist, CEO, and Founder of Practice Promotions. Neil is a Physical Therapist, private practice owner, a bestselling author with twenty years of real world experience in the physical therapy profession. He has helped hundreds of physical therapy practices implement the right marketing strategies to sustainably grow their clinics. Neil and his wife, Amy, co-own their physical therapy practice in Boynton Beach, Florida for eight years, learning and implementing their marketing techniques and tools. They eventually decided to help practice owners grow their own businesses by forming Practice Promotions, which provides print, newsletter, website and online marketing tools for physical therapy practice owners.

In talking with Neil, we discussed what might be of interest and importance to the audience. The one thing that came up that he suggested was to talk about how to create raving super fans. I know a lot of us with our initial physical therapy experience coming out of school thought, “If I create great programs, become a great therapist, certified in a number of techniques then that will create a following,” but that is not all that it takes. Neil and I discussed everything from the patient experience, what we can do to market our services better and most importantly, what we do after discharge with those patients. I'm excited to talk about this aspect of Neil's four-step marketing plan and hope you get a lot out of it.


We have Neil Trickett with Practice Promotions who's joining me for the podcast. Neil is a Physical Therapist of twenty years and has owned a physical therapy clinic for eight years. For the past eight years, he's been a physical therapy marketing expert and founded Practice Promotions. I'm excited to talk to Neil because he has some great ideas about how to create the patient super fan. It's a part of our marketing plans that is essential, sometimes overlooked and something that I'm excited to talk to Neil, so he can share his wisdom. Thanks for joining me, Neil.

Thanks, Nathan. I appreciate it.

Before we get into how to create the patient super fan, tell me about what got you into physical therapy, PT ownership, and into what you're doing now?

I graduated in ‘98 from Florida International University as a physical therapist and jumped around different things from inpatient, got into a lot of outpatient, and got into osteopathy a little bit. I went to the Canadian College of Osteopathy for a little while. I loved the manual therapy side of things. My wife's also a physical therapist, Amy, and we decided to start up a practice together. That time we were living up in Upstate New York. We decided to move back to Florida and we started up our own practice. We were great clinicians but lousy business owners. We don't get taught that in school. It was school of hard knocks and then also go into different business consultants and learning a lot along the way, self-training and doing different business and marketing courses.

We did start to get better and better at what we did. We went from the two of us treating to then starting to have staff and then eventually we were up to a staff of about nineteen. We put in a lot of organizations so that Amy was able to take three years on and off maternity leave and I was treating twenty hours of patient care week just because I wanted to. That was a nice position to be in and then we built the value up in that. We were able to sell it to another great practice owner in our area.

At that time, we decided to move halfway up to Richmond, Virginia. That's where we've been. During that time, going through all those challenges that we do as practice owners, one thing I got into and I enjoyed a lot was marketing. If you get good at marketing and knew what the good core concepts behind it, then it gives you a lot of freedom and stability to hone your practice. It's the key controlling mechanism to business. Getting good at that, I saw the opportunity to help a lot of people.

How does marketing then create freedom and stability in your practice? Some of the practice owners out there might be having an issue with getting patients in the door. Some practice owners might not have an issue getting patients in the door but retaining patients and keeping them on. How did you find that marketing created the freedom and stability that you're talking about?

People are in different situations with what they need in their business and your business will only grow by depending on the demand that's placed on it. Depending where you want, and part of that demand is created by you, where do you want it to go? Where do you want it to be? If you know how to market it so that you can create a desire or want from the public and if you know how to leverage your customers and their customer base to your advantage, then you're in more control.

Rather than having times when, “We've got some great physician referrals in here. We're busy, we're slammed, and things are going well,” and then all of a sudden, the bottom falls out and you're struggling to make payroll. You don't want to have that rollercoaster effect. You would have the predictability, the stability of growth. You can have some slight ups and downs from time to time, we all do. If you can know what to do to turn on the faucet, then you can make that happen and keep on your growth path.

The days of relying on doctor referrals are long gone. Stability and freedom comes from not relying on the doctor referrals. A lot of us that have been in practice for a while have experienced the situation where one of our main referral sources then decides to retire, leave town, has some medical emergency or snafu on our part, we messed up on one of the patients that were not getting the referrals anymore.

Then all of a sudden, the bottom drops out of our referral sources. Creating a marketing plan that provides stability from those ups and downs is essential. Is that something that you recognized in your practice that you were able to get to a staff of nineteen by having some more stability and real programs in place for your marketing?

In any business, you look at if it’s a physical therapy business or it's Starbucks. There's a plan in place, you have to have systems. Struggling practice owners, they often are shooting from the hip on things and are like, “I'm down. I got to go out and bang on doors with doctors and go feed some people,” but they don't have a good system in place that control things from customer experience at the front desk to how they're reaching out to people online to how they're engaging with their past patients. They do build those systems in place, then they bring that marketing plan together, build that stability.

What did you do then to step away from treating 50 hours a week and then start to establish some of those processes, procedures, and establish a marketing plan? For those guys who are seeing patients nonstop, what advice or experience can you give them?

The best thing you can do is observe. Look at what's working for others. Don't try and reinvent the wheel when there's proven methods out there. I would look at other owners, I would look at other companies, I would look at other industries, what is working for them? At that time, especially with much heavier dependent on physician referrals. For a while, PT had it good. We had to rely on a few doctors sending us patients and then the whole healthcare thing turned upside down.

We were behind the times when you compare a PT practice to a massage place or a chiropractic place. They didn't have that luxury that we had of physician referrals. They had to go out and market to the public. Especially if you've been in PT for a while and you're not new to it, you’re still a little bit old school. You’ve got to change your thinking method to it's about going to the public now, it's about ask your doctor if a PT is right for you.

You've been focused on PT marketing specifically for the past eight years and I believe that makes you an expert. I'm sure you've seen a lot from your perspective. What is one of the main problems that you see in PT practice marketing or that PT clinic owners typically do and aren't focused on?

We've worked with over 300 practices nationwide and also in Canada, and a wide range from a startup practice to big, multi-location, eighteen clinics and everyone in between. Everybody has a different place that they're in, but there are some important core things that at any level you need to focus on. After talking with hundreds of different practice owners around the country, the most common theme that I see a pop up is that as PTs we do not focus enough on creating raving, loyal customers, especially at the discharge. If a patient gets better and we're like, “You never need us again,” that's absolutely wrong. My philosophy is you never discharge a patient, you only discharge their condition. I want that that resonates in people’s head.

My philosophy is you never discharge a patient, you only discharge their condition. Click To Tweet

It’s so critical, if you look at any business that's grown well and they have great customer loyalty, like Chick-fil-A, Massage Envy, Starbucks, and Disney, what do they do? They keep people heavily connected with them. They do a lot of things with that customer experience and it builds, so you get the repeat people coming back in. They’re telling friends and family about you and it's the best way to grow your business. If practice owners put more attention on building systems around that, it's the number one thing that we push with our clients. They get huge results as they start putting more emphasis on that.

That's been the bane of the physical therapy profession’s existence is that we don't create people who are loyal to us. I’ve mentioned it in previous podcasts and I'm sure we've heard it in different venues before. Physical therapy has tended to become commoditized to the point where if a patient has a bad experience with physical therapy, they don't look at it as the practice having had an issue in their rehabilitation, but rather physical therapy didn't work for me.

They don't say that about other healthcare professionals like they do with physical therapy. Instead of the patients walking away saying, “So and so physical therapy clinic didn't work for me, so I'm going to go to another physical therapy clinic,” it tends to be, “Physical therapy as a profession doesn't work for me, so I'm going to avoid physical therapy altogether.”

The practice owners issue is we don't focus on what sets us apart from other physical therapy clinics and what sets us apart from massage therapists and chiropractors. That's where creating the super fan providing education, constant contact with them, reaching out, seeing how they're doing on a regular basis. They get to know that and so physical therapy, that Neil Trickett Physical Therapy or Nathan Shields Physical Therapy is a physical therapy that works for me and that I want to go back to again and again. What does a physical therapist need to do then, Neil, to start creating that super fan? What develops that loyalty?

It's not that hard. Where a lot of practice owners might get stuck is they can't get into the viewpoint necessarily of the patient as much as they need to. As someone comes into your office, what is the experience for them? Instead of thinking about yourself, the goal is to make your customer the hero of the story. It's their story. Everybody's looking out for number one at the end of the day, so it's about them. What are they going through in terms of their experience with your clinic? I want the audience to think about what are you doing to grow your customer loyalty? Do you have a patient, or do you have a super fan?

If you have a patient, by definition that's a person that receives a medical service. If you're in a hospital bed, you're a patient. You don't want to be a patient in a PT clinic, you want to be a customer and you want to be a super fan. That's the mindset of a practice owner that you need to flip is, "What am I doing to create super fans?" People that are loving their experience here, they're going to continue to stay with me and they're going to continue to talk about me. That's what a super fan is. The main areas to focus on to create this are what is the customer experience at the front desk and all the things that go around that? Especially from that initial impression but also the ongoing impression, and the handling at the front desk even through discharge.

The second key area is what is the customer experience during treatment? That's back to the therapist, the experiences, someone's heavy handed, they can have a bad experience and then they shut off the rest of the treatment. There are all these things that need to go in your protocols and how you're training your therapists to make it a great customer experience during the treatment side of it. The customer experience after discharge and this is again an area that a lot of practice owners fail to put a lot of emphasis on.

How are you staying connected? How are you maintaining that relationship, even years after someone is discharged and they're fine, but they threw their back out again? Will they choose you again? Their spouse hurt themselves, will they think of you first? That's what you have to create, it doesn't just come. Sometimes I talk to practice owners and they assume that people are going to come back to them because they were happy when they're discharged. Maybe that person’s back pain came back six months later and they're like, “PT didn't work for me.” Little did they not know that it's because they have bad posture, they stopped doing their exercises and whatever it may be. That customer experience after discharge is absolutely critical to building your business and it's a good place to put emphasis on it.

Once we have “healed” them and they walked away from our clinics, then you don't see a lot of programs in place that physical therapists have to maintain contact with them. It could be any variety of different ways. What's your social media plan? Do you have an email marketing plan? Do you have a mailing plan, whatever it might be? Do you have follow-up calls later on?

There could be any number of things that you do, but anything that you do would be better than letting them fall off the face of the earth. You want them to keep you front of mind if and when they have a problem, especially if and when their friends and family have a problem. You talked about those three steps, the experience at front desk, the experience during the course of treatment, and the experience after discharge. What are some of the things that physical therapy practice owners should be looking at in terms of the front desk experience?

This is a key area and a broad overview. In Practice Promotions, we have a 4-Step New Patient Power Marketing Plan. Building patient super fans is the third main component of that plan. Within that we're looking at building those patient super fans through this front desk experience. Some things to consider here and looking from that patient viewpoint as they come into your practice on a three times a week basis, how are you creating that wow experience for them? Let's look at first when that person calls. They have become a patient, yet they haven’t come to evaluation yet, but how is your front desk or whoever typically answers the phone handling that call?

Have you trained your front desk to sell your services? A lot of people call probing to know information, if they say, “Do you take my insurance?” They're like, “Yes, we take Blue Cross Blue Shield,” “I'll give you a call back later,” that was a poorly handled front desk conversation, versus the person calls in about the insurance. “Yes, we definitely take a lot of different insurances. Tell me a little bit more about your problem,” engage that customer. They have a job to do and quite a few front desks will let leads completely fall through the cracks. Not by anything malicious, just that they haven't been trained on how to handle the phone conversation, probably the sales process. It is what it is. It's sales and it's not a bad thing, it's a good thing.

PTO 09 | Raving Superfans
Raving Superfans: The goal is to make your customer the hero of the story. It's their story.

They need to be salesmen. They need to probe when someone calls in and says, “I'm thinking about getting some physical therapy or my doctor told me they need to be under the impression that this person's probing, they're looking and they're window shopping essentially. You need to make sure that that person that's answering the phone recognizes that and also knows how to explain what they're going to experience when they come in the front door.

What it's going to be like and especially how that transaction’s going to go with the front desk when it comes to collecting copays and things like that. The patient isn't shocked, surprised or worst of all, disappointed when they walk in the door.

That's all part of that front desk experience is the handling of the patient. The front desk is one of the most vital posts and positions in a PT practice, much more than a physical therapist because they control how your business flows. If they've got a rock star on that front desk, they can get people in the door, you're booming. It goes back to how your front desk also handles people on the check in, the checkout. Let's face it, people are having to pay a lot of money upfront these days for deductibles and high copays. That can create a big ridge in people when it comes to money.

You need someone who's good and easy going with asking for money, being able to make things, and processes. There are some good systems out there. We work with the Go CardConnect. That's great because they have a token-based system on the front desk so that the patient swipes their card one time at the beginning, it retains the credit card information securely without the front desk knowing all the card details. Each time that person comes in, they can click and check them in and it pays. They don't have the pain of pulling out the credit card every three times a week.

Simple things like that can make that customer experience a wow experience for the person at the front desk. Those kinds of things are out there and it's looking for those kinds of things. Is your front desk warm, are they welcoming? Are they being enthusiastic? Are they caring? Are they guiding the patient and the appointment time? Here's another tip for practice owners on the front desk. Instead of the front desk saying, “What day of the week would you like? What time would you like?”

The person in their head is thinking about, “I’ve got five days a week and I’ve got eight hours a day to pick from,” it's too much. Versus saying, “I have a slot for you at 2:00 PM on Tuesday and I have a slot for you between 2:00 PM and 5:00 PM on Friday. Which one would you like?” then they have two choices. It's a better customer experience on the front desk. All those kinds of things go into play there.

Two more things here, one is basically your facilities. When they come through that front desk on your building, do you have good parking? How's the appearance? How's the smell? Do you have a gazillion of brochures, flyers and messy waiting room? Definitely don't do that. I would do a trick in my practice where I'd walk out of the building, put my patient hat on and I would walk through the door as a patient and be like, “What's my experience when I come through here? Is it clean? Is it nice smelling? Does it look a great place to come into? Is it inviting? Do I feel comfortable here?” and I walk around the gym and if the gym was a little messy with pillows everywhere and whatever, I would get on the therapist like, “This is a bit messy here. Let's clean it up so that it’s a nice aesthetic and nice experience.”

All those little things do you play a role in creating that edge. At the end of the day, if the person has a great front desk experience and they're handled well during treatment, your patient retention rates go way up. If you're having patients drop off at six or eight visits and they're not completing care, that hurts you a lot. If you can do certain things like this that are simple, and you have ten or twelve visits for the plan of care. A huge revenue of difference there.

It's such an important part of the clinic experience simply because that's the first person they see and it’s the last person they see out the door. You can be a great physical therapist and it can be completely undone by a poor experience at the front desk.

Another key thing here to look at the overall patient retention rates and experience at the front desk, something that we worked on in our practice that we do for other practices. Think about what marketing materials are you giving to that patient when they walk in the door at that first eval? Ideally, let's say they call up for the eval but they don't book for a week out. They've got a week to stew and maybe their pain starts to get better and they're like, “I don't know if I need PT.” What have you sent them to wow them about your clinic and educate them what they're going to get coming in?

After the initial evaluation?

Before they even come in for an eval, if you get them for an eval the next day, that's great. If for some reason you're not getting them in for a week, then you need to be able to send something prior to that visit so they know what they're getting into. They're excited about coming in for that service. We always had a new patient packet. This was a nice, branded folder with inserts on the actual bios of the therapists. What to expect from therapy? What are you going to get out of it? Then all of other services. If you give them that nice, professional packet beforehand or right on the eval, they're wowed.

They come through a great experience through PT and they book for their ideally twelve visits ahead and then they go back to their spouse. Their spouse goes, “You’re going to pay $1,000 for therapy? Can we go less? Do you really need all of that?” and they got nothing to show for it and they're trying to explain what happened and it's not the same. They're trying to explain in five minutes what you did in an hour. If they can give something to their spouse and show them like, “This is where I'm going,” and they start to connect, they start to see, “This place looks professional. Maybe they can help my husband and my wife, whatever it may be.” It helps with that cancellation rate and that patient retention rate.

The front desk is one of the most vital posts and positions in a PT practice, much more than a physical therapist. Click To Tweet

I know that you guys create those marketing packets and I’ve seen them. They're nice and professional. Let's talk a little bit about the customer experience during the course of treatment. What can you highlight about the customer experience during treatment?

This falls more on your procedures. We're looking at timeliness of appointments. Make sure that people, even if they come a little early, can you get them back a little bit early rather than have them wait for twenty minutes in the waiting room. The education and the guidance to the plan of care. Instead of saying, “We’re going to do this,” explain why you’re going to do this. “It’s going to have the outcome of this.” You helped educate and guide them on that plan of care because they're buying into it, a good sales process. Some therapists are great at selling naturally and some need some coaching.

One thing here that's important from a customer experience point of view is develop protocols in your office that create similar patterns if they have to switch to another PT or PTA. What stinks for a patient is when they come in, they see a therapist, they get a good visit, they get a good manipulation because this person knows how to do this one thing with the knee. The next visit, they come see the PTA or another PT and then they do something different and they’re like, “I like Joe better because he did this thing on my knee.”

That's bad customer experience. You want to have a standard outcome almost every time. We did a lot of training in our office on protocols. Everybody has different skillsets, that's fine, but we like to go this overall methodology with back problems. What can you develop protocols with that? Good handling of scheduled appointments, reminders and follow ups as part of the front desk, but also a little bit with the treatment. “I forgot I had a PT appointment here at 2:00 PM. I’m glad I was reminded. That's nice.”

Going back to the beginning of the patient experience during the course of treatment is that the provider has to take on a salesman's hat. They've got to think about what is in the best interest of the patient. If the best interest of the patient is to be seen three times a week for the next four weeks, then that needs to come across as to why and the importance of it and don't shy away from that. The therapist needs to be able to act as the professional and say, “I need to see you three times a week. This is why, and this is what we're going to do with you when you come in.”

They need to step forward and say that. To know that someone needs three times a week and you're scaling back to two times a week as you're talking to them because you know their situation, it can be seen as unethical. You need to be providing what is best for that patient, no matter what their situation is. If they decide to do something different, that's up to them.

The therapist needs to create a plan of care that's solid, that's in the best interest of the patient and go about developing protocols so that you can even talk about the protocols going forward. In the first week, we're going to focus on this, on the second week we're going to focus on mobility. Third and fourth weeks we're going to start implementing a home exercise programs. It really needs to be an important part of the therapist's discussion during the initial evaluation and going forward on a regular basis so the patient doesn't forget why they're coming in, when they're coming in and what they should be focused on.

You’ve got to carve out that time to make sure that you have enough time at the end of the evaluation to have that discussion, where things are going, and then also at the beginning and the end of each treatment session. I had a thought when you were saying that before about the three visits versus two. If you had cancer or something like that and you went to the doctor and they're like, “You need these three medications to help you get better,” and you're like, “I don't know if I can afford it.” “We could probably get away with two,” then you're thinking, “Why did you try to sell me?”

It's the same thing. You recommend three, it is for a reason and you want them to get that, so stick to it. It's a training thing. You can't be wishy-washy. We’ll have financial considerations, but this comes back to also the front desk. What have you created in your office as financial systems and plans to help people with spreading out cost? That's another thing to look at.

On the treatment side of things too, I would suggest a big thing here to look at, one that's going to help you with marketing and one that's going to help you with the patient experience is asking for success stories. Asking for online reviews. It's important and people are scared to do it. You got to get your therapist like, “No." Look at it as a subjective part of your self-note. You're getting the patient's point of view. What happens is people come in, they're in enormous pain, and then four weeks later, you got them better. They’re happy, but they forgot where they were.

They forgot that they couldn't walk at 15, and when you remind them, they’re like, “I can do that.” Writing a success story, writing an online review is a self-reflection point for the patient to say, “Look where I’ve come from. These guys have helped me in my journey.” You get the added benefit of the online review being able to obviously use that as a marketing tool online and build trust that way. That's an important part in getting your therapists, all your staff to partake in that is big.

PTO 09 | Raving Superfans
Raving Superfans: You need to be providing tips, advice, things of that nature. People welcome that information.

I talked about that a lot with Sean Miller where he started sending successful stories that the patients would write out to the physicians that referred to them. The physician, whether or not they got the reevaluation report in a timely manner, at least they got this success story sitting in front of them that the patient wrote by hand that, “I’ve gotten better. You sending me to physical therapy were a huge success and I appreciate it. I recommend you send patients to them again,” or whatever they want to say, but at least it's in their own words and sent over to the doctor.

They care more about that than they do what you write.

You question whether or not they're going to look at our reports in the first place, but when that patient comes in the door, you know that they're going to ask him right off the bat, “How’s your physical therapy going?” You want that to be a success story right off the bat.

Another good training point here for therapists during the treatment process, especially towards the end is coach your therapist to find opportunities or people get into conversations about friends, family, spouses, coworkers. They're like, “Do you know anyone else that has a back problem?” You can start that conversation and you’re probing for referrals. Easy conversation to start off with and then that can be handled with a therapist or that can be handed off to office manager or front desk, whoever’s going to help with the marketing end of it.

I can't recall how many times I’ve worked on somebody's shoulder and then they saw a patient across the way getting their back work done in the last. “Do you guys work on backs? Do you work on low back pain? Do you deal with sciatica?” I'm like, “Yes. We’re masters at low back pain and sciatica,” that's the fault of his physical therapists not promoting that more. Taking that opportunity then to say, “Do you know somebody that has back pain or do you know that we also work on ankle sprains, that we deal with athletes from this sport or the other.” Taking the opportunity to probe and see if they have friends or family that are in need because we can definitely help.

As that conversation develops, it happens all the time. I'm sure our audience can think in their heads how many times that's happened to them? What you have to help that customer then tell others about you and that's where good marketing materials in the office can help. One of the things that's hard to say is, “Would you send that person to me? Would you recommend them to us?” You just turned that customer into a sales person and that's hard.

You want to make them into a marketer, where they're going to say, “This PT place, they helped me so much. You told me your back is bothering you, you should go see them. Here's some information about them.” They’ve been given a nice rack card, a brochure, a flyer or something like that that's professional. That’s all the transaction that needs to occur from that customer to that friend. That’s easy because then that friend starts to explore your website and they’ll see that marketing material. Making sure you have enough good, branded, customer market materials within the waiting room and places that can easily be taken out.

We've done great. We've gotten them better. They're doing well and you told them, “Tell friends and family about us.” What do you do after discharge? What's the secret sauce to keep them raving fans going forward?

We never want to discharge the patient. We only want to discharge their condition. You need to stay connected. One thing to look at in this world is we live in a multichannel world. 30 years ago, if you had TV ads, you were in front of 20% of the population in the area. Today, you're in front of 2%. People are on social, they're on email, they're on TV, they're on radio.

They’re all over the place. You have to be able to connect with your customer base through lots of different ways. What I see sometimes if I’m in a conversation, I say, “What do you do to market to your past patients?” “We sent out an email newsletter.” “Fantastic. What else do you do?” “That's it.” “That's great. You’re sending out an email newsletter it's cheap, but statistically email, you might get in front of 20% of the people opening it. 80% of the people never saw your stuff.”

That's something to keep in mind is this is a place that you do want to invest money into, resources, and action because you need to be on Facebook, Twitter, social presence. You need to be sending emails. You need to be doing texts, phone calls, birthday cards, direct mail, patient newsletters. You're not going to upset anyone if it's good stuff. What I mean by that is you need to be providing tips, advice, things of that nature. People welcome that information. If you have a great patient newsletter and it has good tips and advice, if you're doing a good blog and that goes out to them on their email, their social and they’re reading that. That's interesting to them; they're going to share that with friends and family. They like receiving that stuff there. Their value of you goes up in their head.

Multichannel, don't stick with one thing, like an email and newsletter. You've got to be everywhere. Another big thing, because we do patient newsletters for clinics, so we do them through blogs, we do them through email and we do them through social. At the end of the day, the one that works the best is still snail mail, direct mail. It's tangible, it's in their hands. Direct mail gets into 95% of someone's mailbox or more, whereas an email might get into 20%. You have a much larger volume of people that you're connecting with. Even though you are going to spend a little bit more because you're printing and you're using postage and things like that, the return on investment is way higher.

Thinking about this and considering some in our audience who are feeling overwhelmed already, and now you're recommending that they use all kinds of different channels for staying connected. What do you recommend? They don't need to do it on their own. How do you recommend they get involved in these different mediums?

There are different services out there and as a practice owner myself, I went through that too where you try to do it all yourself and it's overwhelm. You're already overwhelmed treating patients, running a practice and running a business. Good business owners outsource key things to them. They pick on expert do things like that. Even at Practice Promotions, we outsource different things because I'm not the expert in everything. I need experts advising me on things to do. There are different services. We're one of those services for PT practices where we do websites, newsletters and we handle direct mail, all kinds of things like that. That's where we help take that off of the plate. It's a done-with-you solution for them. They're still very much part and we want customization.

We want to tell the stories of the clinic, pictures and success stories from patients. It's very much customized and it's part of that experience for them. At the same time, you're not putting it all together, you don’t have to do all of that part of it. You're able to then push the marketing of your practice beyond where you could have ever done it yourself but still be a part of it. I do advise people to seek out help from others because there are other good companies out there that can help you build your marketing rep presence.

If you're a startup practice, you are going to invest more because people don't know you. Click To Tweet

When you talk about ROI, how much should a practice owner plan to spend on their marketing? Whether it's a marketing budget? How much money? How many cents on the dollar? How many dollars per patient would you recommend a therapist needs to use as a guideline for their marketing budget?

In our Cracking The Code To More New Patients e-Book download, there are a couple things you want to look at when it comes to ROI. One is total budget spend. I see many practice owners, they're struggling because they don't budget enough. They can't get themselves over the hump. They might only be spending 1% or 2% of what they make trying to drive in 98% of the business. They wonder why they can't grow. Typically, if your marketing budget is anywhere between5% to 8% of your gross income, that allows you to grow. People are like, “That's a lot of money.”

It's a lot of money if it doesn't produce more income. If you're doing it right, that amount of money is going to continue to build new patients flowing in the door. If you wanted to go from doing fifteen new patients a month to 100, how are you going to get there? You can't do it on the same budget that you're doing now. You've got to invest more to double your practice. Think about that too. Total marketing budget, 5% to 8% is good. If you're a startup practice, you are going to invest more because people don't know you. You've got to invest in websites, building an online presence and all that stuff.

The first year of practice is usually the most expensive. As you start to build your customer base, you can start to leverage those, and it starts to get less and less. The other main critical thing to look at is customer acquisition costs. What does it cost you to get a new customer in the door? With that, you're looking at all your marketing expenses and if you have a marketing staff, what's their salary? You take that whole amount of marketing and you divide it by the number of new patients and that gives you what it costs you per patient to get them in the door. You're always trying to lower that.

You're trying to get a person in the door for less money per person, but that doesn't mean you spend less money on marketing. Often if you have to invest more in your marketing to get that customer acquisition cost lower. Let's say for example, if you started doing direct mail, newsletters, you might spend another $1,000 a month to make that happen. You were able to generate twenty more new patients out of it. Overall, you spend $1,000 more per month, but the cost of each person, a lot less like $20 per patient. Marketing budget and customer acquisition costs are key.

Those are huge, and I appreciate you laying that out for the audience and for me. You talked about staying connected with the patients after they are discharged for their diagnosis. What are some other things that you can recommend people do to maintain connection with those patients after discharge?

One of the big things that you need to be doing in staying connected with your past patients is to make it human. Your goal is to tell the stories of your clinic. You have so many stories every single day of what people are going through. You have so many incredible wins that are happening and you need to be able to tell the world. You need to tell it through your customers for that.

This is where patient newsletters area perfect medium for this because you can tell a lot of success stories. You need permission and around HIPAA and all that kind of stuff. Once you get permission for folks, you take that picture of the therapist with their arm around the patient, they're smiling. They tell the story of how they couldn't walk before and now they're walking again. People read that like crazy. That's what you need to be pushing out there.

The same thing with social, when you’re on Facebook, the most read posts is video testimonials. In the clinic, what are you doing with written permission to capture those? People are willing to tell their story. Will you take a video and tell me how it was for you and why were you where before? Don't make it about the therapist, don't make it about the clinic, make it about the patient. Tell their story and use that. People will gravitate to you like crazy. The other thing is you're pushing those stories out there. You're telling all the good works that you're doing, but you still need to provide offers. You need to get someone an offer, a way to come back and connect with you.

One thing you want to push consistently is the offer to reconnect with the clinic by doing a free consult. “If anything happened with you again, come back in, we’ll do a free check on you. Fifteen, twenty minutes of a PT time, no big deal.” Nine times out of ten it's going to turn into another eval. Free consults are huge, offering that there.

Another tip I would suggest is offer free consults to friends and family members. “If you have a friend or a family member that's had a bad back or sciatica or they hurt their knee, and you want someone to take a look at it, we offer free consult because you've been our patient,” that's going to spread word of mouth. They'll take a quick look at you. You've got them in the clinic, you can work your magic and then fifteen-minute conversations. They get five with the doctor. Fifteen minutes with a therapist is like, “These guys really love me and listen to me.”

Once you get them in the door, it's a much easier sell. Once they get comfortable simply walking in the door, seeing what the place looks like and some of the people that they're going to engage with, especially you as the provider, they're going to engage with and what physical therapy looks like. That's an easy sell after that point.

If you're not running a free consult, we've tried free screenings, free consults on all kinds of different practices around the country. Free consult seems to resonate pretty well with the public, rather than a free screening, that can be a little confusing to someone like “What's a screen?” Consult they used from a medical doctor language. Free consult as a way to test the waters with that. If you haven't done it, look to others who have done it, you can get some ideas there.

It doesn’t have to be complicated. You can put together some simple systems there within the clinic. What I used to do, I stopped doing it after a while. I just had another therapist doing it because she was good at it too. Carve out a couple of hours a week where they can slot those free screens and you could bump out two or three free screens in an hour and you turn those into new patients. Sometimes I get the concern from a practice he is like, “I have to give away all my visits.” I'm like, “You weren't busy anyway. Get some people and get looking at them.”

PTO 09 | Raving Superfans
Raving Superfans: Free consult seems to resonate pretty well with the public, rather than a free screening, that can be a little confusing.

One thing I'd like to ask some of my interviewees is I'm wondering any particular books that you might recommend that have been influential for you in the past?

Many good books, but I would say one that always stands out for me from a business growth perspective is the book Scaling Up by Verne Harnish. That's a great book, especially for practice owners that are a little bit established and they’re hitting a bump, they don't know how to go to that next level. It's a great book for that because the reason that you're not bumping up to the next level is you don't have the systems in place that you need to scale. This teaches you those important systems, not just from a marketing perspective but also from an administration, financial, operations perspective. That was the book that stands out in my mind.

What I want the audience to remember is that what we talked about in creating the raving super fan is part of Neil's Four-Step Marketing Plan. If you want to learn more about not just this in detail, but the other three steps, definitely reach out to Neil. How can people reach out to you, Neil? What are some of the things that you are offering?

We have tons of free resources on our website at Definitely go there. I would highly recommend you download our Cracking The Code To More New Patients e-book. That's free on our website under the free training tab. Once you get that, you'll be directed to the next page where you can get our PT Marketing Kit. We’ll actually mail that out to you. It’s a physical copy of that book and tons of other stuff as well as samples of our newsletters. We provide lots of different free webinars on marketing training and things like that. We've got some email checklists that are free downloads and also our Website Checklist on how to improve your website, also on there too.

If they want to reach me directly, it's or they can go right through our website and get some of our free downloads. I would highly recommend they look at our schedule product webinar to learn more about our systems and processes that we do for practices from PT performance websites to online marketing to patient newsletters.

All of your webinars are posted on your website as well?

Yes, tons of free training there.

Thanks for offering so much to the PT universe, but also thank you for your time on the podcast.

Thanks so much for having me. It was a pleasure.

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About Neil Trickett

PTO 09 | Raving SuperfansNeil Trickett, PT has been a practice owner and now consults hundreds of PT practices nationwide, he lping them implement powerful online and print marketing tools. Neil founded Practice Promotions and PT Performance Websites. His passion for helping PT practice owners, has led him to build multi-million dollar PT marketing agencies that now service practice owners all across the U.S. and Canada.


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