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 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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