PTO 117 | Grow Using Social Media


Angie McGilvrey, PT of Apex PT had the opportunity, after a hurricane shut down her clinic in Florida for a prolonged period (sound familiar?), to revamp her clinic and create her ideal scene. One of the things she committed to when she opened back up was greater usage of social media to market her clinic and attract her ideal clientele - female athletes between 30-40 years of age. By focusing targeted messaging to her avatar on a couple of social media platforms and posting content consistently, she has been able to not only grow her clinic but see more of the clients she wants to see. Plus, she's created a reputation as being THE place for athletes to recover in her community. She's been able to niche down and grow because of it.


Listen to the podcast here:

Using Social Media To Niche And Grow With Angie McGilvrey

I've got a fellow friend and HODs or Hands-On Diagnostics owner with me, Angie McGilvrey, out of Florida. She and her husband, Joe, own Apex Physical Therapy in two locations. I want to bring her on because she's done a lot of great work in growing her practice and has used social media to do a lot of that work. I want to get into her story to share what she's done on social media and how it's been successful for them. First of all, Angie, thanks for coming on. I appreciate it.

Nathan, thank you for having me.

Before we get into the social media stuff, you've been an owner for many years, so congratulations. You’ve got multiple practices and you guys have been successful. I'm sure the story hasn't been sweet-smelling roses all the time. To give everybody a little bit about your journey, do you mind sharing your professional story quickly?

My husband, Joe and I, opened Apex Physical Therapy in 2005. We packed everything we owned up in U-Haul. We were from Chicago and said, “We're going to Florida. Forget this cold weather. We're going to give this whole PT private practice a try.” We are blessed to be here growing and being productive many years later.

Have you been in the profession for a while? Had you been practicing for a while before you decided to open your clinics?

We did. We were practicing underneath other owners for about five years before we decided to take the leap.

Did you practice in that area in Florida first and then open up your clinic? Or did you go to Florida and decide we're going to open from scratch?

We opened from scratch, cold turkey.

That takes some courage. You had some confidence and I'm sure you hit the bushes. You worked and marketed hard, all that good stuff. I'm sure you've pushed hard and it's part of your success. Are there any particular times along the way that were somewhat hard on you that turned out to be a learning experience and a success in the end?

Yes. I would say two large things come up. The first one being in Florida, we have a high Medicare population. I can't recall the year right off hand, but we went through a Medicare audit one where they put us on 100% prepayment review, which meant that in order for us to get paid by Medicare, they had to review all of our documentation first on 100% of our patient volume. I did learn how to document for medical necessity.

Florida got hit with that, didn't they? It's a Florida thing.

Unfortunately, there are some fraudulent things that happen. Secondary to that, everybody was looked at with high scrutiny. I am proud to say that we came out of that on the other side, but it is a huge learning experience and something that made me a lot stronger in understanding medical necessity, billing, coding, documentation and all those things that as PTs, we don't sometimes want to care about, but I figured out fast why we have to care about it.

Social media, strategically utilized, instantly puts you in front of your ideal patient without dealing with a physician's referral Click To Tweet

How long were you under review?

It lasted about six weeks until we finally were able to get off of 100% and down a different percentage. We had to work with an attorney and all the things. It was rough.

How far into your ownership was that?

I believe it was about 8 or 9 years in.

You are going strong, but that’s a huge roadblock in the middle.

Medicare was our payer, like 75% of our population, especially the season is Medicare. This was a big undertaking.

That was number one. Did you have a second one?

My second one was in 2017. We were hit with Hurricane Irma and that was a big deciding point and a big pivotal point, which leads us into the conversation that we're having around social media in the sense that we chose after Irma to rebuild our practice. One of those building blocks that we used was growing and niching through social media.

Did you have to close down your clinic for a period of time?

We did. We had some damage. We had no power for about ten days in the entire Florida, which was 90% of our patient population left and evacuated. Even if we would have power and been ready to operate the day after, none of our patients were here. Everybody was gone. The whole state had been evacuated, especially in our area. That was a scary time to figure out how do we get through this. I do have to say with the COVID pandemic that we've all been dealing with, Hurricane Irma was the best thing that I could relate it to and figure out, “What did we do then to navigate?” Our practice went down to almost nothing. How do we use that experience to navigate through COVID? I'm grateful for them looking back because I know that they contributed to our successes.

It's not uncommon. As I'm working with clients or talk and interview people over the years, it's tough to go through those hard experiences and you wouldn't wish them on people or yourself, but after having done so you come through having learned so much and having grown stronger. In your case, you were able to create a different practice than what you went into Hurricane Irma with. That's relative nowadays, even with the pandemic. That was a lot of push over the pandemic as I talked to people on the show and my clients. It was like, “Here's an opportunity. It sucks, but how can we make the most of it? What can you do so that you can make the changes in your clinic to reflect what you want in your clinic? Who are the clients that you want to see? Who are the fellow team members you want to work with? Are you seeing the paramix that you want to see? Do you have policies and procedures in place that make things easier? Do you have time set aside for admission or tests?” I could go on and on, but taking advantage of these opportunities is what makes us stronger. It gives us opportunities in the face of challenges. As you did that, how did you then work social media to your advantage to create what you wanted? I would love to know what you did, why and what were some of the instigating factors? What was your clinic like before to what did it become?

The clinic was very much a general outpatient orthopedic, physical therapy practice. It has no different than any other outpatient orthopedic. If you looked out the window, it would look like all of the others.

PTO 117 | Grow Using Social Media
Grow Using Social Media: Social media allows you to bring patients into the clinic without having to rely on a third party referral source.


We take all comers, whoever has got a script, we bring them all in.

We take them all, we do it all, we market to everybody, we take all the insurances. We do everything. We market 75% of the time to referral sources, mostly physicians and those others in the medical community. That's what we looked like going into Hurricane Irma coming out on the other side. One of the biggest things that the storm taught us was that, as you said, we have the ability to create change. We have the ability to reset this practice to what it is that we ultimately wanted to be. We wanted it to take more control and be more at the cause of the specific patient we were working and identifying our avatar. Also, be at cause at bringing those patients into the clinic without having to rely on a third party referral source. That's where social media started coming into play for us big time.

Social media is something that I wish I had more time to do that. Did you think about that in the past or was this something that forced your hand into, “How are we going to take advantage in social media came to mind?”

It was more the latter. I've never had my own Facebook, Instagram, Twitter, nor Pinterest. I was the person who fought social media for a long time until I started listening to a mentor who I've used in, Gary Vaynerchuk. I have to give him credit for what I've done and what I've learned through social media. I started to learn that if I wanted somebody's attention and especially my avatar's attention, I had to go where they were and they were on their phones. More specifically, they were on social media. I was like, “Angie, you better get your butt on social media.”

What's your avatar?

Our avatar is the 30 to 40-year-old female athlete, specifically the CrossFit athlete.

You're CrossFit as well. Are you performing CrossFit athlete yourself and Joe?


You can speak their language, you know what they're dealing with, you know the moves and the lifts, and some of the common injuries that go along with being a CrossFit athlete. That's exactly where you live in that space and it's easy for you then to talk to those people I assume.


It's a little counterintuitive to what I heard and that was to create where you live and that is, if you're on Facebook all the time, create a lot on Facebook. If you're on Instagram all the time, create a lot on Instagram. Maybe there's something to that, but you had to learn how to navigate and use some of these social media accounts. Was that a tough learning curve? Was that hard for you to adopt? Has it become easier for you?

It's like anything else in life, you have to start doing it. That was it. I had to start doing it. Joe was always involved with it on a small level, but it was when I decided that we had to put a ton into this and I wanted to be that driving force. I had to learn by doing. The first 500 posts that I made, it's like a therapist, the first 500 backs that I treated didn't do that great of a job, but the more we do, the more we learn. It's the way that it goes in. I still am learning all the time and I'm trying different things, seeing what captures attention, what is giving more value and what do people respond better to. It's a work in progress.

People want to do business with people. Click To Tweet

To get into the weeds a little bit, are you using your own personal account or is it an Apex PT account that you're using on these platforms?

It is a business account. My practice is a small business and our philosophy is much that mom-and-pop small business family feel. We have in two locations. We know our patients and we develop meaningful and lifelong relationships with them. We infuse a lot of Angie and Joe's story, Angie and Joe's history and some personal things with Angie and Joe in there because people want to do business with people. That's what we've done.

How much time are you setting aside to do all these posts and get your stuff out on social media?

As a team, there are three of us that do this, myself, Joe, and one other gentleman in my practice. Between us, we can talk about what I mean by working, but this is working. The entire part of working social media, we do 5 to 6 hours a day collectively between the three of us.

You're each doing a small portion, at least an hour or two. When you're talking about that, you're talking either you're creating video or content, you're editing, posting a video in some form or another.

That side of it, but then also there's the other side of it and the engagement side.

Tell me about that.

We work from two different angles. It's the content creation and the posting, and then also the customer engagement. We will go through and literally either search through the #CrossFit or #Fitness or something like that. We'll see the accounts that pop up and you go on and somebody posts something and you comment on their posts. We’re engaging in two-way conversations with that avatar patient of ours. Sometimes this person could be across the country. You never know what that brings because maybe that person from across the country says, “Let me give you a follow.” They follow you. They see something cool you're doing. They post it and maybe they've got 100,000 followers and all of a sudden, you’ve got the attention to somebody down the street. With what technology has done in the way, it opens up our market so big to who we can create conversations and engage with and get our product out in front of them. It's not limited to our 10-mile radius like we used to think.

A Gary Vaynerchuk thing to do is to get engaged on all those hashtag groups and throwing your two cents and then people follow you and it cross-references each other. It sounds familiar. Do you use any gadgets to help you along the way with a few accounts and platforms running? Are you using something to help you out?

I tried to dabble in Hootsuite for a little while, which is a platform that lets you do all of the pre-programming and setting. It wasn't fitting for me. I know there are other people that use that, I don’t. We post to the date, to the moment like, “What is happening?” I'm like, “Look inside the clinics.” That lends itself to doing it on the fly sometimes.

If I see something on your posts, more than likely it's been done sometime in the last 24 to 48 hours, and it's not something that was done a week ago that was scheduled to post at a certain time, which Hootsuite will do for you.

Sometimes that does happen. We do have some scheduled content to create like, “I want to do some videos around musculoskeletal ultrasound. Let's make sure we get those videos.” The majority of it is me and/or others in my clinic being followed by a video camera. The way that I get my content is I have a videographer that follows me about 4 to 6 hours a week. Based on that, he creates content off of the rides me working with my team, working with our patients doing our thing. It's extremely authentic. It's not like, “Let's sit down and let's rehearse what we want to say about this.” It's seldom that we do anything like that.

PTO 117 | Grow Using Social Media
Grow Using Social Media: As long as they have the intention, anybody who wants to use social media to niche and build their practice can.


What platforms are you on? To follow up, is that something you filter down to certain platforms after starting on a bunch or have you stayed on all of them? Where did you start and where are you now?

We started with simply Facebook because that’s the largest out there. However, when you start to look at some of the demographics, my avatar spends the majority of their time on Instagram. I do both. We put the majority of our stuff on Facebook and Instagram. I also do a personal page and an Apex page on LinkedIn, where I will reuse a lot of the same content or videos, but I would spin the messaging a little bit more knowing that I'm talking to another physical therapist or somebody savvier in my space versus talking to the general public about physical therapy.

In LinkedIn, you're talking to business professionals typically, and that's what they're looking for business-related stuff. You're sharing your story and what you're doing and I've seen many of your posts on LinkedIn and you do a great job. Do you also do stuff related to physical health and caring for certain injuries? That's a lot of what I don't see on your LinkedIn stuff. I'm wondering if you massage your content on Facebook and Instagram for injuries and diagnoses in particular as you're talking to your avatar.

Facebook and Instagram stuff is a lot more about like the last post I did. I was doing a contract relaxed technique with a runner's hip, but it was all talking about my youngest runners with hip pain, this is why it happened and this is what we do about it. It is basic.

You have a videographer, but for a guy who's maybe a smaller clinic size and treating quite a bit, when you first got started, was it simply you and Joe and an iPhone essentially?

We would be on the iPhone and we would be going throughout our day. I would look across the clinic and I would see a patient doing cool exercise and be like, “Let me pull my phone out.” Video fifteen seconds of that exercise, knowing that later, I'll post that and talk about what they're doing. I have a patient come in that I would have one of my CrossFitters. We were working on with the PVC pipe working on a lift and I'd say, “Let me video her or video me. I'm going to post that later.” It was not until within 2019 that I started having the videographer be with me.

Do you get consent from your patients to post those videos? Is that something that's part of the intake paperwork or do you let them know verbally ahead of time that this is going to get posted?

Yes, we have a video image release as part of our standard paperwork. On the days that he is there filming, they see that he's walking around or whatever, and I always make it a point to be like, “Is it okay that we get some of this on video?” I make sure I get that extra okay any time I do work with minors that are athletes as well. I always reask verbally mom or dad again to make sure everything is good. The cool thing about getting their consent and doing that is I make it a point whenever I'm posting about a certain athlete or there in my video to build that person up into talking about how they're inspiring this post and this is how awesome they have done.

I'm proud of them because that gives them a huge amount of value and self-esteem coming back at them. It's turned into, “That's cool. Apex posted my video.” It makes them feel good about themselves and their progress and that piece of it I love. Being able to tag them and say that is amazing for them. On the other side, it also drives business for us because then they will typically repost it with, “Thanks Apex. You guys are awesome or whatever.” Not that I'm looking for that, but when it happens, that's wonderful and I'm grateful for them to do that.

It's cool on two levels that you get to highlight these amazing people that come through your clinic and share how awesome they are because it's not all about Apex all the time. If you read, Building a StoryBrand, we are the guides in their hero story. The patient or us as we're looking at someone who can help us, we are the hero of our own story. We're looking for the guides to help us be better. That's what you're able to show in those videos. It's nice that you get some turnaround because these people who are more than likely your avatars are going to post on their websites to other avatars of yours with the people in your network that you would be able to treat as well. It's such a cool concept that you highlight them so much because a lot of what you see with PTs is, “This is what you do for your back. These are the stretches. Here's the anatomy.” That's not engaging. When you see other athletes performing, getting treated, exercises that they're doing, that’s somewhat engaging because you pulled into a little bit of a story there and that's cool.

I try to tell a little glimpse of each of their story, like, “She had this and now she has this. That's why we're working on this.” It brings it to real life.

Don't you use YouTube?

Friends and family are always huge referrals. Click To Tweet

We do, but I need to be better at it. I was told by a digital marketer that it becomes the second search engine behind Google. We need to become better at YouTube.

We got into the weeds there a little bit. You made it intentional to use social media to your advantage and grow in a different way than you were before. How has it changed your clinic by niching down and using social media?

It's been awesome. The two pain points that we went into Hurricane Irma with were marketing to the physician as well as seeing anybody and everybody. I treat two days a week. I love treating. If I choose to treat. My entire schedule that is all I treat. I treat is athletes and most of them are CrossFit athletes, but it has blended into, “If she knows how to CrossFit and she knows how to treat Spartan racers, and she does CrossFit and Spartan Race then I know she can help me because I am a baseball player.” That's amazing as well as my practice has been branded in our area as the place for athletes to go, which is super cool.

I've heard that from various physicians in talking and communicating. We are having a PA or a physician say something to a patient and the patient comes and tells me, “They told me because I golf and I need to get back to golfing. I'm an athlete so I need to go to Apex because that's where the athletes go.” To hear that is super rewarding. It has completely flip-flopped our marketing. We market 80% now direct-to-consumer and 20% of it is massaging the relationships and the rapport that we have built over the past years with the various medical people in our community.

To be honest, the coolest flip of the table is when I have a CrossFitter who hurt her wrist doing a lift, doing a clean. She bent her wrist all the way backward and was like, “This is bad news.” The way she contacts us is she direct messages us through Instagram. I want that to be a point there in that this opens up a new line of communication for people to get it. She didn't go to our website. She didn't call our number. She direct messaged us on Instagram and said, “Can you help me?” I was like, “Yes, come in today at such and such time and we'll help.” That's huge. She came in and talks about what was happening with her wrists and the other.

We ended up doing an MSK or Musculoskeletal Ultrasound to look at her wrist. We're super concerned. I didn't do the MSK. It was my husband’s ball. I can't remember exactly what his major concern was, but he had one and he said, “You need to hang on a second. We're going to get you to the orthopod. You do need to be screened by an orthopedic before we go any further because I'm concerned about it.” He text messages in orthopod that we have a great rapport with, “I have an athlete here needs to see you.” He’s like, “Send them over at whatever time.” We fed the orthopod the patient versus buying the $700 lunch and begging for patients. The patient went to the orthopod and was cleared. Everything looked good. She came back to us and did rehab a couple of visits. We had her right back to doing CrossFit and she was super grateful and blessed. Her turnaround was within two weeks that we had this whole process wrapped up, had her back doing her thing. That is the power of that social media connection because she follows us on Instagram.

That goes to show the value and the power behind a direct to consumer marketing. It's something that I was pushing for during the shutdowns of the pandemic is we can't rely on referrals sources anymore. This is an opportunity for us to change our marketing patterns and go direct to the consumer because that's where more of the people are. What is often the touted stat? That only 10% to 15% of the people that have musculoskeletal injuries get to physical therapy. That means we're fighting for 10% as we're going to physicians when there are 90% of the people out there who need us. As you've changed your marketing, has it significantly changed your numbers in terms of the types of patients that you see? You said you were 70% Medicare. Are you still at 70%?

No, which is fantastic. In the beginning, I complain about having the risk in Southwest Florida of a Medicare audit. That was a basket that we didn't want to put all of our eggs in. In the heart of our busy season, we do have where all of our snowbirds come down from January to April. We ride about 60% to 65% Medicare. Outside of the season, those numbers dropped significantly to maybe 40% to 50% at the most. We've been able to change that demographic and diversify that payer mix.

You've been purposeful about it. Thus, where do you get a majority of your patients from? I don't know if you knew your numbers beforehand, maybe 95% of your patients came from physician referral. How has that changed by using social media and whatever else you're using? How many patients do you get from physician referral now compared prior to the hurricane?

I'm going to say pre-COVID because a lot of things changed with that. I would say that from a physician referrals standpoint and in just that small percentage of massaging those relationships, those things didn't change all that much. Friends and family have always been a huge referral pattern for us. That has always been above 50% of our referrals that has held there significantly. Between social media and us going to actual PR events and going straight to the consumer marketing directly to them, whether that be at a gym, a CrossFit box, community events. Before when you could have a race or a CrossFit competition that has boosted up into close to 20% of getting that specific that people are coming into our practice.

This is an additional revenue on top of what you are already getting.

We have to not think about what happened with that, but pre that, we were on a tear. I'm grateful to where we've bounced back. We're in a good place but we were going into that season.

PTO 117 | Grow Using Social Media
Grow Using Social Media: What will make you successful is by giving people much value. Think about what they want and entertain them.


I think there might be a fear out there that if an owner is going to start niching down, that they are going to do so at the sacrifice of the other patients that know, like and trust them. Did you find some of that or did you find that this is simply expanded your scope by niching down?

That was my worry in the beginning. I thought the same way. I thought I only niche and market to this specific 30 to 40-year-old female CrossFit athletes like, “What the heck am I doing?” It expanded my practice. I realized number one, we did have a strong foundation of friends and family, to begin with. That foundation was key. I also think that in doing that and being able to serve that avatar person and serve them so well, they will still recommend their brother, sister, mom, dad, their grandma or grandpa, the other person at the gym. They're going to become your ambassador even more so. The CrossFit athlete has been my avatar, but I would say my schedule, I have with school season and track season starting, half of my schedule is full of cross-country runners.

You might not have seen these people before in the past.

My entire schedule would have been 65 and older Medicare.

Has that also affected your recruiting and the PTs that you've brought on board? Do you have a different type of PT that works with you now?

One of the taglines or hashtags that we use is #AthletesTreatingAthletes. Putting somebody in that space and recruiting a PT or a PTA to treat that caseload, they need to be like me from the standpoint of they live in that world. They talk that talk, they are an athlete, they understand injury, the pain and the mental of, “I'm injured and I can't play. I can't perform.” They've been there. That's hugely important.

You not only niched your patient load, but you also niched your team members.

That's true.

Some of the successful PTs I know out there like Sturdy McKee, he's got a practice in San Francisco. They won't hire a PT that hasn't played a team sport before. He thinks and their philosophy is that, “If you played a team sport, then you know how to work well with other people to be productive and achieve a goal.” That's one of their criteria. You might not necessarily have people on there that do CrossFit, but they need to be athletes. Is there anything else you want to share about niching down and how it's benefited you and your practice? You have shared a ton of great information already.

Coming from my story in 2015, it was the PPS Conference. I don't know if you were there Nathan, but we did the PPS Conference in Orlando. Gary Vaynerchuk was one of our keynotes. At that point, he asked everybody to raise their hand if they have Facebook. I was one of the five people in the room that didn't raise their hand because everybody had Facebook. I looked around and I was like, “I'm proud of this. I don't need that stupid Facebook. That's a waste of time.” To go from being that person to now seeing how powerful and utilizing this tool, it goes to show that if I can do it and use it to niche and build my practice, anybody can. Anybody that wants to do it and has the intention to do it, you can do it.

It takes work and you have to set aside time specifically for it. If you don't, it's going to easily fall through the cracks of your “busyness.” I'm sure you schedule the time, make sure you hit it every day. It's about consistency when you're talking about social media.

It is my habit.

When you're putting stuff online, just give value and entertain people. Click To Tweet

Do you post every day or do you post three times a week? What's your schedule?

If I count Instagram, Facebook and LinkedIn separately, including posts and stories, we do close to 100 posts in a week. I would like to even do more, but we didn't start that way by any means. This is building. We started with one post a day to multiple and multiple people doing it and posting stories and all of that.

It is cool to see how you've grown and used social media to your advantage as an owner, especially among physical therapy owners. I don't think that's utilized as much. Our profession is usually about a decade behind everyone else, so it's cool to see how you've used it, and thanks for sharing. If people wanted to follow you, what are some of your social media addresses?

Instagram is @ApexPhysicalTherapySWFL and Facebook is Apex Physical Therapy. Those are the two places that are the best to find us. It's Apex Physical Therapy on LinkedIn or me as Angie McGilvrey on LinkedIn as well. Thank you.

Is there anything else you want to share with us, Angie, before we sign off?

When you're putting stuff on there, give value and entertain people. That's what I try to do is give them as much value, think about what they want and entertain them. That's what has made it successful on my end.

It doesn't seem like they necessarily want to know all about physical therapy and every injury. I've had clients who have posted pictures of sunsets and I've gotten more engagement from the picture of a sunset than they did about anything else they posted. It's funny how it works. Thanks for your time and for sharing. Congratulations on the growth and all the great things that you do. I love seeing your posts on LinkedIn. They've been motivational and inspirational. It's awesome to see how you're using it to your advantage.

Thank you, Nathan. It was such a pleasure to be on. I appreciate you.

Important Links:

About Angie McGilvrey

PTO 117 | Grow Using Social MediaPhysical therapy and fitness is my passion! Leading my team at Apex, we empower athletes of all ages and levels to move better, feel better, and live better!





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PTO 98 | Social Media Marketing


Social media marketing and advertising may be new for many physical therapists, but amidst the COVID-19 crisis, it is a marketing avenue that physical therapy owners need to consider. Joining Nathan Shields today is Edric Zheng of Medical Patient Referrals. Edric provides some of the basics about the why, how, and what is best to do when it comes to marketing on Facebook. Stick to the end for useful strategies in making irresistible offers, generating good content, broadening your audience, building a database and many more.


Listen to the podcast here:

Facebook Marketing For The Physical Therapist With Edric Zheng Of Medical Patient Referrals

My guest is Edric Zheng out of New York. He is with Medical Patient Referrals and he is an expert on social media marketing. I thought it'd be appropriate to bring him on, as owners have the time to consider their digital presence, the marketing that they do digitally, especially as we've been forced in that direction with the Coronavirus pandemic. First of all, Edric, thanks for coming on.

Marketing is only as powerful as your sales process. Click To Tweet

Thank you, Nathan, for having me. I appreciate it.

Tell us a little bit about you, Edric and what you do for physical therapy owners, but also a little bit about your backstory and what got you to the point where you are now.

What I do is I set up a direct access patient generation system using Facebook ads to help them acquire new patients with social media and to take advantage of all this traffic they have available to them. My background is I've spent a few years in digital marketing, learning copywriting, running ads, and creating profitable campaigns. Also, spending a ton of my own money trying to figure things out for my eCommerce products as an affiliate in my previous life for other health companies and nutraceutical products. That's how I got good at Facebook ads. I’m using those skills and taking it to help physical therapy owners with their patient acquisition systems and processes.

You've been spending a lot of time trying this, trying that, and refining content when it comes to Facebook ads. Why specifically do you focus on Facebook ads? Why are Facebook ads beneficial for physical therapists?

The reason why I focus on Facebook ads in the past was there’s so much opportunity there. Almost everyone that I know is on Facebook. Probably the same for yourself as well.

PTO 98 | Social Media Marketing
Social Media Marketing: Facebook has around 2 billion users worldwide, and the biggest growing demographic on the platform are people over the age of 45.


It's probably two billion Facebook users or something like that on my side of the country?

People spend 30 minutes to two hours a day every single day on social media and the biggest growing demographics on Facebook are older people, over the age of 45. People are getting on so they could spend more time connecting with their family and look at photos of their children and things like that.

How did you utilize Facebook to drive direct access and patient generation?

What do for a client specifically or for my own company?

We want to be more PT specific. What do you do specifically for physical therapists to help them get direct access and patient generation? To some extent, we already have some direct access capabilities with physical therapy.

It all started with creating an irresistible offer for someone to want to come in and start a conversation with you. For example, it could start with maybe like a free consultation offer if you want to be super basic or free discovery visit, a second type of offer. It could be a workshop if you haven't experienced hosting those types of things. It could be something super unique that you do and that no one else has ever seen before, like a free laser therapy session or something like that. It all started with coming up with an irresistible offer and then putting that on Facebook.

Physical therapy only needs to be specific or at least have a niche in which they can offer or somehow be able to share some of their knowledge base in order to gain that traffic and that interest.

When it comes to paid advertising, all you need is an ad text and an offer and you can start promoting that to almost whoever you want. You can start showing your offers and what you have to offer, the value that you can provide. You can start showing that to thousands of people if you have a couple of bucks to spend on Facebook.

With the number of people on social media, especially Facebook, during the COVID-19 crisis, it's an opportunity to gain a bigger audience. Click To Tweet

When I consider Facebook and talking to some of the marketing specialists, you want to get that patient in front of that patient as much as possible so that they click and buy or sign up for whatever offer you're providing. There's added value in simply gaining an email address and that’s building your list so you can send them future offers.

Getting an email address means that this person is interested in what you have to offer. It means that this person has back pain, knee pain or maybe has been involved in a motor vehicle accident or just has gotten out of surgery. They’re looking for related content. They're looking around and they're trying to find out who they can trust. If they're on your email list, that means you have a line of communication with them where you can continuously provide value, educate them, and build that trust until they're ready to come in and start a conversation with you or get the help that they need.

How does someone go about creating a successful marketing campaign on Facebook? What process do you recommend they go through?

If you wanted to, physical therapy owners can look at the different clinics in their city. Go on their Facebook pages and look at their ads that they're currently running because that's all public information that Facebook has made available to all advertisers to promote transparency. Being able to reverse engineer what's already out there and what's been running for a long time is probably the best way to start to do what's already working.

How long do you recommend someone keep a Facebook ad up before they determine if it's successful or not? Do you give it 2 or 3 days or do you give it 2 or 3 weeks before you look back and assess what the statistics are?

PTO 98 | Social Media Marketing
Social Media Marketing: When it comes to paid advertising, all you really need is an ad, a text and an offer. Then you can start promoting whatever to almost whomever you want.


Since we have a lot of data already on Facebook ads, a KPI that physical therapy owners should look out for is the cost per lead metric. If they're seeing their cost per lead go above $20, pause that ad and then to try again. Try a different offer, image, video, and angle. You want to try and get your cost per lead to around $10 because that's where we know that you can have a lot of success if you can get there.

You're saying $20 is the point at which you want to reconsider what you're offering and what that looks like in the design and whatnot. When you say $20 per lead, that's not necessarily a converted lead. That's just simply $20 per lead.

That $20 is just someone who's seen your ad, who's given you their name, email, phone number, and is interested in whatever you have to offer on Facebook, be it a free consultation or a $21 evaluation or something like that.

You want to keep that number then below $10, is what you're saying?

Yes, if you can keep it around $10, that is ideal because you're not going to convert every single lead. That's why you want to have a good amount of leads coming in at a solid price.

What are some of the most successful things someone can do as they're setting up this strategy? What are some of the components of having a successful Facebook strategy?

For us, it always boils down to four things. Number one is your offer. What do you have to offer to get someone to want to come in or give you their information? That's probably the most important thing. Number two is your creativity, which could be your image, a video or a testimonial that you're attaching to that Facebook ad. That's the second thing that people pay attention to. The third thing is your headline. Does it stop people from scrolling on social media? Does it get them to pay attention to what you have to say? The fourth thing is your body text. It’s whatever else you want to put into the Facebook ad and things that you want to say to keep them reading in on your Facebook ad. Whatever you write in your ad, it has to be whatever the conversation that the person is already having in their head. If you can answer that conversation and you can put that in the text format, you're going to have a lot of success.

Do you find more success with video-based advertisements versus those that are simply text?

For sure. Video allows you to build a lot more rapport and a lot more trust that you can't do with photos or with text.

How long should a video like that be? Do you have any recommendations?

If you're going after an audience that doesn't know who you are yet and people around your city, it’s maybe around 3 to 5 minutes providing value and educating people so they know that they can trust you and they can use what you have to say.

It's an obvious answer but I'm sure in the body of the text, you're wanting to refer them over to the landing page and a YouTube channel that you might have generated or other social media as well?

If you take them to a landing page, you can sell them some more, you can provide some more testimonials, and you can tell them more about your product, whatever you have to offer. It gives you another chance to sell them again and to qualify someone before they come into your funnel.

Effective advertising starts with an irresistible offer for someone to want to come in and start a conversation with you. Click To Tweet

For me, creating content is my biggest fear. I can do it and I'd do it, but for someone who isn't into developing that content, how would you guide them to make an irresistible offer that gets that client or that potential lead to reach out?

You have to put yourself in the perspective of your end client or your end customer and think about what is it that they want and what they find valuable. Put yourself in their shoes and think about whatever it is they would find useful. I would test that as an offer or a content to give away.

One of the books that I refer to is called Building a StoryBrand by Donald Miller. Interestingly, he recommends the same thing. When you're advertising to somebody, you don't want to come across as the hero in their story. If you're advertising to somebody, they want to be the hero of their own story and you want to be essentially the guide like the Obi-Wan Kenobi that takes this person who doesn't know their strengths and what they're capable of and develops them. That way, they can become the true hero. That's good advice. What you're saying is that you want to talk to them as if you are the guide, but not the hero to their story. We have to remember as physical therapists that we can't use our jargon, our vocabulary, especially the specifics. You want to get down to their level and talk about, “Do you have back pain that's keeping you up at night?” Without getting into the technicalities of it, per se. “We have the four things that you need to do to sleep better.” Something like that. By saying that, do you find that content that has a list of the 4 or 5 things or how to blank that kind of thing? Is that helpful?

Yes. Those types of content always do well. A good way to know if your video content is doing well is there's a metric you can look at on Facebook ads. It's called Cost per ThruPlay, and that's how much it cost you to get a fifteen-second video view of your ad. If that's under $0.06, that piece of content is good because that's another good metric to look at in your Facebook ad.

These are all metrics that you manage via Medical Patient Referrals but it's something that people can also look at themselves if they are admins on their page?

Exactly. These are numbers that we've found over time to establish a good baseline for success.

When someone's considering Facebook ads, buying ads and putting them out there, should they have more than one going at a time or just stick with one and see how it goes? What kind of mindset should they have as they're considering purchasing Facebook ads?

PTO 98 | Social Media Marketing
Social Media Marketing: Video advertisements allow you to build a lot more rapport and a lot more trust.


They should definitely have more than one ad running at a time because this way, you can see what ad is performing better and why it's performing better. Let's say you run two ads at the same time. With one ad, you're using a picture of a knee and the second ad is you're talking about the back. Maybe the cost per lead with the back is half the price of the knee. You're getting more bang for your buck, then you’re going to focus more on the back end and do as much as you can with that.

Do you find that some of your clients are having more success with Facebook ads during the slowdown, COVID-19 because people are more engaged in social media and Facebook itself?

The cost of advertising is definitely cheaper because a lot of people have quit and dropped out of the race. That leaves room for people who are still willing to try, adapt, and do new things. It gives them more breathing space since everything is cheaper. We're still generating increases in new leads. We just have to change up the angle a little bit. Instead of advertising in-person consultation, what we're doing is we're advertising a free discovery call or a free phone conversation, which leads to a virtual evaluation, which leads to a virtual rehabilitation program.

What would be your tip or advice for people to get those leads to convert? Is there some secret or magic that you like to consider when it comes to converting those people?

Number one is the quality of your campaign. Having yourself on video, getting the patient testimonials on video and putting that into the ad. Also, calling out who it is you're looking for. The pain that they're having, putting down into the text, and stepping into their head and into the conversation that they're having will not get you that qualified increase. Number two is when you do generate that inquiry, you can't wait three days later to call them. You have to try and get to that inquiry right away. Setting up notifications when you generate that lead and having someone in charge of that process and calling them right away when they're still hot, still super interested in what you have to offer, and that conversation is still going on in their head.

The cool thing about you is we talked a lot about getting patient referrals and leads. Sometimes, those leads take multiple touchpoints. It's not common that you're successful with just one touchpoint and the patient converts. That's why it's cool that you recommend more than one going out at a time. You can get your Facebook ads down to a certain locale, community, and demographic. Once you develop that community, then you can hone in on the issues that are arising in that community. Your content and your output can be specific. That's when it seems like it's more powerful in the capabilities of converting the increase, would you say?

If you’re advertising to somebody, they want to be the hero of their own story and you want to be the guide. Click To Tweet


Have you also used any of this for recruiting purposes? Because I see the capability of physical therapy owners using Facebook ads to recruit for other physical therapists, especially when a lot of physical therapists are out of work to recruit physical therapists via Facebook ads. Have you done that in the past or do you see the possibility there?

I've done a little bit in the past as a small test but that didn't work out too well because we're just targeting like a small population. The cool thing with Facebook is you can target by what they put in their Facebook profile. If they put physical therapist, you can target specifically only physical therapists that live in this specific city within 30 to 40 years old, if that's the age range you're looking for.

Can you also advertise to a certain locale or can you advertise the multiple states in your region?

Yes, you can choose exactly where you want the ads to show and who you want to see the ads.

I bring that up because I see that as a potentiality, even though you haven't done a lot of it yourself. It's an easy crossover to say, “I can use this to not only get patients, at least leads and subsequent conversions, but I also could use Facebook ads for recruiting purposes and that would be cool to try out.”

You have to keep in mind that the person that does have that job title, physical therapist, is probably already with another company. You have to create an angle and an offer that would attract someone who's already working for someone else, and go from there.

You've shared with us a ton of stuff about Facebook ads specifically. Is there anything you want to add or anything that we didn't cover that you would recommend people consider when they're putting out Facebook ads?

Something that people can consider is number one, for $1,000 in marketing budget, they can generate about 100 phone numbers of people within five miles from their clinic who have things like back pain, neck pain or any or any type of chronic pain. They can get them interested in a consultation with one of the doctors at the clinic. The next time maybe someone thinks about buying coffee or buying a sandwich at a store, that $5 to $10 could be spent or invested into Facebook ads and could generate you a patient that's worth $1,500 or $2,000 and get you 2 or 3 more referrals. Keep that in the back of your mind. That's the power and the potential of what a Facebook ads has to offer for clinic owners.

PTO 98 | Social Media Marketing
Social Media Marketing: To create great content, put yourself in the shoes of your end clients to know what it is that they really want.


In Medical Patient Referrals, you don't just focus on Facebook ads, but you also have some back-end stuff, whether that's an email marketing campaign for every lead that comes through and also text messaging campaigns to past patients as well.

Marketing is only as powerful as your sales process. If your sales are weak and you're generating all these leads, but you have no idea what time these leads are coming in, not recording any of the calls, not getting back to them quick enough, and not following up, it's so much potential being wasted. What we've done is we've built out a solution where as soon as the lead is generated, it gets populated in your dashboard and your whole team gets notified. They get added into this email and text sequence where for the next 2 or 3 weeks, they're getting testimonials, content, and value sent out automatically.

If someone does schedule someone from Facebook for that evaluation in the office, then my system will know and then it'll send them reminders leading up to that evaluation. It helps with the no shows as well. After someone comes out of that evaluation, the system is going to know and it's going to send them follow up emails, asking them about their experience, how their visit went, and when they want to come back for a second visit. If they already got treatment, want to leave feedback, and leave a review. It's all automated. It makes things so much easier for the clinic.

It's great that you have that because you don't want to get their information and just leave them hanging, especially for three days at a time before you respond back to them. If you can push them into an email marketing funnel and have automatically generated emails that send out testimonials and whatnot, that's when the power comes through. It reminds them that they had some interest, to begin with, and hit those multiple touchpoints that are needed to eventually get them to convert. That's great that you guys automatically provide that. If people wanted to reach out to you and find out a little bit more about you and what you're able to provide, how are they able to do that?

As physical therapists, we can’t use our jargon in advertising. Click To Tweet

They can go to my website, Hit the live chat button and start a conversation with me. Get on a call. I can see what’s going on with their clinic and then I can show them the stuff that we have built out. Our campaigns, ads, and the success our clients have seen. If that's something they're interested in, we can work together.

I appreciate your time. Thanks so much for coming on, Edric.

Thank you so much, Nathan, for having me. I appreciate it.

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About Edric Zheng

PTO 98 | Social Media MarketingDropped out of school to start pursuing online marketing. Went from 0-15k a month in my first 3 months of online business, which was publishing books on amazon. Transitioned into affiliate marketing and selling pharmaceutical products (Skin creams, diet pills, muscle pills). Where I learned how to create profitable AD campaigns on Facebook & Google and spend over 2 million dollars in advertising profitably. Which later morphed into taking my ad buying skills and starting a marketing agency in the medical industry helping private practice owners create a profitable patient generation system on Facebook.

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PTO 97 | Marketing For Physical Therapy


The way physical therapists market has been affected and will be changed forever because of the COVID-19 pandemic; it's forced to go digital in the way we treat and connect. In today's episode of the Physical Therapy Owners Club, Nathan Shields talks to Tracy Repchuk, a multi-awarded pioneer in digital marketing who has worked with social media, branding, and websites for over 25 years. They discuss the ways physical therapists can market for the better and learn from this slowdown. It's time to turn our attention to digital.


Listen to the podcast here:

Marketing For Physical Therapy During The COVID-19 Crisis And Beyond With Tracy Repchuk

I'm excited to bring on Tracy Repchuk. She is a marketing expert and I've met her a couple of times and I've seen the work that she's done, especially at this time during the Coronavirus crisis. It's important to recognize the importance of the marketing that we're doing to sustain our clientele and stay in communication with them. I thought it'd be important to bring her on. Tracy, thanks for coming on. I appreciate it.  

Thank you, Nathan, for having me. I'm excited to be sharing what's happening out there.

If you could let us know a little bit about you, what you've been doing here and also what you're doing nowadays to help private practice owners with their marketing efforts?  

I started a software company at the age of nineteen in 1985. I've been in technology and in marketing my entire life. In 1994 before it was even the internet, that's when I was doing development for banks, JC Penney, Walmart, the Lottery Corporation and large corporations because they didn't know what this was. I knew when I saw it that it was a future, that everything was becoming this. I was an extremely early adopter. In 2006, I went all-in on internet marketing and exploded. I moved from Toronto, Canada to California because I knew this is where the market was at that time. It had not been accepted yet in Canada. It's interesting though because this is an example, what we're going through, in a way was going to happen. The virus accelerated it, is what ended up happening. We were all going to be online in some bigger way. It rushed it by 5 or 10 years. It's turned into a disrupter. Uber and Lyft was a disrupter for taxis, Redbox and Netflix blew away Blockbuster. By the time 2000 came around, those that did not adapt to the new technologies, clung to the Yellow Pages, they perished. They're gone.

Normally, this type of thing has been localized or niche-specific. In this quite case, it's global. It's a planetary reboot. The world will be new. You're going to need to adapt rapidly. That's my excitement quite frankly because everything I've been trained for is happening and what I can do for companies, restaurants, retail, physical therapists, chiropractors, yoga, Pilates. Anyone with a physical location, it's time to take a look at where to go. I've been talking about what you do and where you go for years now. We're right and ready to move into this new era.

It's interesting because this shouldn't necessarily be a pause for a lot of the business owners out there, but rather a reset and consider what you've done and what you need to do differently in the future. If your business is the same coming out of this as it was going into it, then you've not taken advantage of the opportunity. I don't know how well you'll survive going forward. It's a great message to share like you're talking about for physical therapy owners to consider how they can take advantage of telehealth services. How can they sell their services on digital platforms and social media platforms? There's a lot of effort that should be looked into putting our businesses more digital and not rely on the brick and mortar. That's hard because as physical therapists, we want to be manually engaged. We have to recognize that there is a market out there for the other things and we can take advantage of it, frankly.  

PTO 97 | Marketing For Physical Therapy
Marketing For Physical Therapy: We can add all of the technologies that exist for us to leverage and build a more systematized and streamlined infrastructure online.


What's interesting is one of my specialties is to systemize, streamline and scale. When you only have a brick and mortar environment, scaling often involves high costs and expense as well and you're carrying huge debt loads. The beautiful part I'll say about what is occurring is we can add all of the technologies that exist for us to leverage. We can build a more systemized and streamlined infrastructure online. That's going to help you scale and make more money without necessarily adding buildings or offices unless you want to. It's great when that is a choice and not the only route so that you can figure out what you want to do. How do you want to make money going forward and how do you expand?

To me, I know it's an extremely exciting time because it's making companies think out of the box. What I love about physical therapists is you are built for health. You want to help people. You want to make sure that they understand how they can repair an injury or how they can get more mobility, especially without drugs. It's the savior of the planet from what's happening now. Two things the online environment can give us, and one is exposure. Instead of us having that localized message office by office, when the entire PT industry or people start to shout it from the rooftops what you do. It's an ambiguous think quite frankly, and people think it's specialized that it's not for them.

I came into the physical therapy world when my mom had a huge incident that resulted in her entire back crumbling. She had the entire thing repaired with pins and rods and through numerous surgeries and then ended up in the hospital for seven months doing physical therapy, during which time I stayed and assisted her. Hence, the beautiful part that I had an online business and could do that has that gift of time. The other part was what respect I built for what you did. That's where my passion became, I need to get out the message about what you do. That's where I entered into the physical therapy arena and started to help physical therapists to move online. This is what we'd be doing, but now it's game over. Get on now.

I like the points that you brought up and that is number one that spreading your message or at least relying on the office space to grow your business can be much more expensive and time-consuming and energy-consuming. Whereas, if you expand more digitally, it doesn't cost as much to expand and grow. Number two, we can market directly to the consumer if we take advantage of it the right way and not rely so much on physician referrals but rather go directly to the consumer because all 50 states have direct access in some form or another at this time. We can bypass the physician referrals and go directly to the consumer and say, "If you have an acute injury to your back, because you're a weekend warrior, come and see us.” For some reason, chiropractors are able to get that message out, but physical therapy hasn't been able to do that. If we work together as a group during and after this crisis, we can get that message out via social media, through digital marketing, what you have it, and help people understand that you don't have to go to see a doctor to see us. You don't have to have gone through surgery to see us. We can see you right now. That's a message that you can get out even for those people who aren't affected by the virus and then sustained as we ramp back up.  

We were all going to be online in some bigger way. The virus just accelerated the process. Click To Tweet

To me, this is part and parcel of a combination of how do you get people no longer addicted to opioids by spreading the message that there is an alternative. You can get natural-based therapies that most people are not aware of. This is the reason that prescription drug abuse, in particular, happens because people don't know. "If I get adjustments or if I do this or get a correction on an injury, I don't need to be in that pain." The biggest problem is when they choose that the alternative route is they don't want to end up out of pain. All they end up is masking it and it never gets repaired. It's important. Honestly, this is the greatest catalyst you’ve got for the PT industry and my other passion is nutrition response testing. Anything that deals with making the world a better place and helping a person to get healthier without any introduction of alternative elements other than your own body telling you how to heal.

I like how you brought that up because it made me think of two things. I thought this is going to be good for our profession in that it's going to force our hand into telehealth services. Our profession is going to be changed forever because of that. We've been forced into some telehealth services to a greater extent than we were before. Number two, this is going to force us to get our message out digitally that physical therapy owners, in general, are behind the curve when it comes to modern technology use and social media use. Some people have done it well, but I would go out on a limb and I  think it's a big limb and that I don't think we've used it to our capabilities to push the message that we can see you directly, that your acute issues can come to us directly. We can see you without a doctor's referral that is forcing our hand in direct to consumer marketing. I don't think I realized that before talking to you. I did regarding the telehealth, but it's going to force out the physical therapy owner's hand to be more aware of their direct to consumer/digital approach. As you're working with somebody, where do you start? Do you start with the website? Do you start with their Facebook accounts or their Instagram or all of the above? Where do you start initially? 

I’ll tell you where I normally start and then I’ll tell you the COVID-19 start. It's an important piece and I'd be talking about that again for years. It’s with the landing page and the list building. We need to focus on accumulating the database because that is going to be your greatest asset. It's also the reason that it's important is as you're now going to expand through social media, we don't want to expand through social media unless we have somewhere to send them. It has to be the landing page. We have to be list building so that we can do email marketing. Why is that important? It still has the highest return on investment. It is the way that I'm advising clients now is to get emails out to your database and triple your communication to them so they feel heard and taken care of. They're in worry as well, especially if they do have injuries. They know that they should be doing something and they feel like they can't.

PTO 97 | Marketing For Physical Therapy
Marketing For Physical Therapy: We can get more people no longer addicted to opioids by spreading the message that there are alternative, natural therapies which most people are not aware of.


It's one of the original technologies that have to become stable and should have been years ago. The other reason I love landing page technology, especially for PT's, is how we can create what we call the lead magnet. This gift, which I've been creating for many physical therapists now, is an educational tool and that's what they need. The five ways to whatever to get off of opioids or the five best strategies for pain reduction of your back, your knee. We pick the target market, we create an asset to give. The beautiful part about where we have gone is all of that marketing at that time was kept local.

You can grow at a certain rate. There are only so many people that might need you. Now with the introduction of this global pandemic and the fact that we should be out in a bigger way, it doesn't have to be local. It's great when it's local. I do a lot of the strategies to focus on that, but the bigger picture is the more people that have this gift or guide and content in their hand, the more people will understand what physical therapy as a whole is. This is how we elevate the entire industry at the same time as you're moving into a position of leadership and authority because you're the one delivering this information. We add fuel, which is social media. We start on Instagram and then we start on Facebook.

We create a community on Facebook. What I love about Facebook is it is the platform for community building. You can become a leader, not only in your community, which is wonderful, but overall for maybe a specific thing you deal with. I have physical therapists, some focus on sports injuries, some focus on back injuries. If you have specific needs then you can build an entire platform around that and attract all people. There are two billion people on Facebook. There's your entire market. You have many people to draw from. This is how we're going to educate.

I say, "Let's get the landing page and list building in place." What I'm saying to people now is we need to get the Zoom technology in. We need to get you in front of it and have you doing Facebook Live and we need to start talking telehealth. Both of these pieces have to get in rapidly so cashflow continues and you become the stable datum in your marketplace as that person of authority that says, "Welcome, everybody. I understand." Originally you're talking to people that are in your community, but as you grow and as you start to do more Facebook Lives, you can say, "We're going to be talking about how to remove or eliminate a back pain that you have from sitting too much."

You can start joking with things. "We're going to help you with your Netflix knee." I don't care what you're talking about. Don't be afraid to connect it to what most people are ending up doing and start to outflow. The beautiful part is if we do this in conjunction with the landing page, we're database list building at the same time. I have even, not just for my clients but for myself, quadrupled my outflow. I've been doing a Facebook Live almost every single day since we were put into lockdown and quarantined and my numbers have exploded. That's what can happen for every business that turns around and does it.

We are experiencing a planetary reboot. We need to adapt rapidly as the world changes. Click To Tweet

I've been pushing my clients and my readers to make sure that their promotion and marketing don't suffer and decrease. That's the last expense line you want to rid of. I like how you're saying at this point where you would typically have them go through a landing page process and develop that all out. It's time to move fast and quick. The best way to do that is to get onto social media, develop your community. When you say list building, you mean collecting email addresses essentially. Probably the quickest way to do that is to create that Facebook page or the community. You should have a list of past patients that you can invite to it. You can maybe boost the page or something like that if you want to, but develop that immediately with your past patient email list, that database to begin with. Then build on that by inviting more people and get them to create more data or more content if you will and start developing more and more lists. That's a way that you can immediately start building up that list of subscribers. 

Here's the cool part. As you do a Facebook Live, especially if it's content-driven, you're going to talk about the knee, the back, the shoulder, whatever. Now you have content. The average Facebook Live, let's say it's 20 and 30 minutes, you can break that apart into over 200 pieces of content. Even if we only do one thing and that one thing is to take the whole video and move it into YouTube. If you move it into YouTube and you do the necessary keyword optimization, here's the reality of YouTube. All of the deals in the world aren't going to be found if you do not search engine optimize with keywords. It's a critical and key part. It's exactly what I've been doing with my client. All we're doing is taking their content to YouTube and we're keywording it.

In general, I'm getting on page one of YouTube for searches in the top four spots when it's properly keyworded right off the bat. There is no loss in that content. Let's say you did a Facebook Live and you're like, "Nobody was there." No worries. One is going to replay on Facebook. Facebook Lives, it's going to continue to replay it for you and then we're going to take it and now build an asset from that. That content, we can pare it down even smaller. You can start thinking membership site. You can start thinking added-value for clients. That's what we're doing with one of my clients, which is a Pilates studio.

When we were shut down in California and she was shut down, she was like, "How on earth do I pay my rent, pay my mortgage?" She had eight staff. The rent on her studio was enormous. For some of the PT's, you're in the same boat, you have the equipment, you have studios and you have staff. We went into crisis management at that point and that is, how can we get money in this studio? The immediate answer was getting a Zoom camera in front of her and build out the website so that she could take money for classes immediately. We were recording those classes by Zoom.

PTO 97 | Marketing For Physical Therapy
Marketing For Physical Therapy: We don’t want to expand to social media unless we have somewhere to send them. That’s where the landing page and database building come to the picture.


They were going out there and then we were taking that same class, putting it into a replay page as an added bonus for purchasers and then we were taking that class and putting it into a membership site. Now, as people go through, they can buy a week's class, they can buy a one month class and/or they can buy access to the membership, which means they get access to every replay on Pilates in this situation. It has exploded. She went from, "How am I going to live?" to one week later, she had 65 people going through her classes, which was more than the physical studio because of the volume you can deliver to in that situation. It's great when you, one, know that you have the technology to help somebody in that situation, but two, you can see somebody who was extremely distraught. I'm sure there are many people out there like that. This technology will work for you, we just have to think out of the box on how.

How does that cross over to physical therapists? What could they do? What content do you recommend that they come up with that kind of growth if you will or accelerate maybe their digital presence or their online content?

We have physical therapists that are leveraging Zoom for telehealth. They're leveraging Zoom for Facebook Live. At first, your Facebook Lives are targeted at your current database and they're like, "This is what we're doing. This is what the office looks like." After that, you want to start taking a look at what is a niche you can talk about. Generally, to make money, you need to go nine miles deep and an inch wide. You'll come out as a physical therapist and let's say you specialize in athletic rehab. Let's say you specialize in back, sports, shoulder or golf, whatever it is. If you have that particular niche, I will start to talk about that. That's how you're going to attract not just your PT client-base, which you've already moved into there, but now you're going to attract those people that are interested in that particular topic. How you do that is not just through Facebook Live. You'll set up events because events on Facebook get promoted. Somebody sees, "Here's an event coming up on Facebook and it's on the three tips to increase your running speed." "Great, I want to know that." The PT can talk about that.

In the beginning, that is a lot of outflow without monetary income except for telehealth, but what I like about that is the power of positioning and the power of educating on what physical therapy is. Plus now, as the people start to follow you and you get 40, 60, 100, 200 followers on Facebook in your community, all you have to do at that point, and I always pilot everything before we build it and say, "What if I opened up out a community, a membership and you paid $47 a month and I would continue to do education and assessments, whatever you want to put in there? Who is interested?" If you get ten people that say, "I would like that. That's great." I always do it based on ten. You get ten people that say, "Yes," then you start to build and honestly the build starts simple. You don't have to fill it with 52 months of content. You're going to be building the content as they're in it. They're going to pay you to build the content. This is where social media starts to come into play. Before, more social media, more followers, we couldn't capitalize on monetization at that point yet, but we sure can when we have a membership site built. Now, we can funnel them in through that and start to build up a community of people that want our results that are running, better golf, health, out of pain, whatever it is that their goal is. This is what your membership community will start to focus on.

Digital marketing will work for you. You just have to think outside the box on how. Click To Tweet

The alternative to that is building a course. You want to build a five-module course on that. Whatever route you choose, the beauty is it's scalable, salable and evergreen, which means Facebook Ads, Instagram Ads. More content to drive to this marketing media that you're building is the ability to create six figures without any extra cost to whether it be your office infrastructure or more staff. It's what I call a plan B. Plan B means if you were pulled out of the workplace, if you had to take care of your parents, like what happened to me, or if you had to take care of a family member, whatever. If you had to stop, would it be sustainable? With that infrastructure of the digital environment in place, the answer is yes. If we build this and rapidly and something like this occurs again. It's occurred how many times now? At least seven. I was in Toronto during the SARS. It was similar to this only it wasn't a global pandemic. It was in Toronto. We were the ones that were shut down and into lockdown. My business already went through a year of what we're going through right now. I knew and I did at the same time make these assessments and that's why I have so much experience on how the heck do you go digital because I needed plan B way back then and that's when I started talking about it. It's time to get plan B in place. I love to help people do those.

My biggest issue has always been creating content. I'm not one that can spin out content. Is that something that we would expect out of you or any marketing specialists that we hire on at this time?  

You don't need us to create the content. You need us to take that video, SEO it on YouTube, and then build a membership site, put the video in the membership site, maintain the infrastructure, the communications, and email marketing. You have the PT knowledge that already your marketplace is waiting for. All you do is seven bullet points before you start talking and you already know what you're going to say and there is the training that you're giving them within the membership site. There is no need to get nervous about the content you're going to give or whether you know what you're doing. You know what you're doing. You can demonstrate things on a doll, whatever it is you’ve got to do to show somebody how to do something that can help them with whatever outcome that they're looking for. The knowledge is all in you. The marketing and technology are not and that is a piece we handle.

It seems like it goes without saying that you're pushing video over written, a blog or anything like that.

It is 2020 and beyond blowout. More video is consumed and uploaded than in the last 30 years of all three major networks. All search is coming through the video line. People are even bypassing Google now because they don't want to read. They want to watch a video because five billion people are watching on their phone and consuming content and reading is a pain in the butt on the phone. We are media watching junkies, Netflix, Hulu, Amazon Prime. That's what's happening. Media is key and the good video combined with what Google is looking for and what the YouTube search engine is looking for, which is keywords, is your secret sauce. That's where you're going to punch to the top for everything someone's looking for. That's it. Once you've done that, you can start to embed selling in your videos that are on YouTube by saying things like, "Go to my landing page, go to my channel, go here,” everything. There's this circular way of optimizing every piece of content you produce, driving them ultimately to a membership or a course.

PTO 97 | Marketing For Physical Therapy
Marketing For Physical Therapy: If you have a specific niche, you can build an entire platform around that and attract all sorts of people there.


Not to get too much into the details in regards to video, but is there a certain amount of time that is optimal, as a 15-minute versus a 30-minute video? Backgrounds like this, does that matter too much? I'm wondering about any details that you recommend if someone is to post a video on social media?  

It depends on which social media platform. On Facebook, they like the longer the better. That's how you can get more people watching because you're constantly going to be fed through the news feed while you're still on. If you're a blip on the news feed and you're off, that was it. That was your shot. The longer is better on Facebook. Why? Let's say you're doing a training video on YouTube because we're going to take that content. Thirty minutes is fine on YouTube. The average person is consuming 40 minutes at a time on the YouTube platform. This is only going to go up during this time. That was before.

We know on average we can do 40 minutes. My videos are 40 minutes. YouTube wants over ten minutes. If you have a quick key tip, then that's 3 to 5 minutes, something fast. Let's say somebody had a headache and you're like, "How to get rid of your headache in two minutes?" That could be a video. You touch here and you do this and you put whatever. I only know how to translate it so someone pays for it. It all depends on what you're doing. To me, most of mine are longer and highly consumed from that perspective. You've got content. What do we do? Now we take that video and we embed it in the blog post, we're hitting another platform, then we do have Instagram on it. We do a LinkedIn on it, and then we do a Facebook promo on it.

It's a constant circle of leveraging content that you've already created and making sure that it can get consumed wherever your person might be. It’s because LinkedIn is B2B, it doesn't mean there are a lot of people incorporate suffering from physical therapy needs. It's interesting. It’s the same with Instagram. Even though that's the younger platform doesn't mean that a Millennial who's been jogging or playing tennis doesn't need a physical therapist. That's the beauty of what you do. Cross-platform promotion needs to happen so we can find the sweet spot. Once we know it, that's where the fuel pours in that area.

That's why I'm glad there are people like you out there because doing all of that blows my mind. I don't want to touch it. I don't want to put in all the keywords. I want to do my thing and then give it to someone to work with. Either that person is on your staff or you hire it out to someone like you who's a specialist at it. I'm sure the dollar put into you will go a lot further than having someone in the house through it unless they are super expert.  

This is not a time to shrink and go into survival mode. You need to market and promote more than you ever have to rise to the top. Click To Tweet

There's the other thing. Let's say you had a social media person on staff. We can work with people like that because what they're often missing is strategy. They're like, "I'll do this or this is a cute post." We're watching too. We have to know what all the trending keywords are, what all the trending hashtags are and we need to make sure that all posts optimize five different sets of hashtags for everything that's going on. They may not know that, but when they're talking about that, then there's like, "I understand what I need to do." That helps the office as well. For those of you who do have staff, but perhaps they need a little more guidance, that's where we often come in. We teach them specifically on what they're doing to help you and then we move either to another part of the company or you don't need this anymore, whichever happens.

A lot of times you lean on that social media person to be your strategist when maybe they're saying, "Here's a cute video. I'll post that. Here's a recipe that our audience might like,” and post that. It's what anything that we put out there is okay mentality instead of being strategic and focused on the content that they produce.  

That goes to part and parcel of increasing your conversions, increasing your brand and your elevation of authority and influence comes strictly from the strategy that goes behind the post.

If people wanted to get in touch with you and see what you provide and how you can help them, how would they do that?  

There are two ways. You can check me out at You can check any social media platform with /TracyRepchuk or you can take a look at the funnel, what I want you to have. My landing page, which is and you'll see the process. I bring people in, I give you a gift. At that point, if you need to schedule a strategy call so I can take a look at what you've got, where you're bleeding and how we can help repair it, then that can happen immediately. You click and schedule.

Thank you for your time. Is there anything else you want to share with the audience? 

The thing I would share as a final note is you need to market and promote more than you ever have. You said it at the beginning, Nathan, and that this is not a time to shrink. This is not a time to go into survival mode or hunkered down. You have to do the opposite of what everyone else is doing so that you're the one that rises to the top and becomes the cream. The only way to do it is to get out there bigger than you ever thought you would.

PTO 97 | Marketing For Physical Therapy
Marketing For Physical Therapy: Keywords are the key to social media marketing. That’s where you’re going to punch to the top for everything someone’s looking for.


Maybe a lot of market owners have time now if they have slowed down and/or shutdown. If you've got time, now is the time to consider maybe your digital presence and that strategy a lot more.  Thank you for your time, Tracy. I appreciate it.

Thank you, Nathan. It's been great.

Important Links:

About Tracy Repchuk

PTO 97 | Marketing For Physical TherapyTracy Repchuk leads and empowers you to develop a freedom-based business by systemizing, streamlining and scaling to success

> 7 Time #1International Bestselling Author including 31 Days to Millionaire Marketing Miracles from Wiley Publishing

> World-renowned speaker in over 37 countries including China, Dubai, Brazil, Africa, Australia, Singapore, UK and more

> Award winning entrepreneur, writer and speaker since 1985 when at the age of 19 she started her software company

> Over 20 awards including from Senate, Assembly, the White House and President Obama

> Pioneer on the internet developing brands, websites, SEO and now social media since 1994 and currently serving on the Forbes Coaching Council, Amazon Influencer, and Linkedin Advisor programs

> Featured expert in over 22 National and Local TV as a trusted resource for technology, internet and social media including ABC, NBC, CBS, FOX and featured in 3 motivational movies

> Runs her own 501c3 foundation to help underprivileged women to gain life and business skills so they can be independent and run a business from anywhere with confidence

> Global leader in strategic thinking for increased market reach serving thousands of clients around the world to help you reach millions with your message.

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PTO 20 | Digital Marketing


If you aren't routinely working on your online presence, you're falling behind. That's why people like David Straight at exist - to let you know what you need to do, what works best, what the current trends are, how to present yourself, then monitor your efforts. It takes some effort and, depending on the size of your practice, will take some time. If you're looking to compete against hospital networks and physician-owned practices who have a sizable budget for marketing, you've got to stay on top of your presence. Besides, nowadays, who doesn't look up a company on Google when first getting a referral? Very few, I assume. Assess or re-assess what you're putting out there, and stay on top of digital trends going forward. David provides some good insight on how to do just that.


Listen to the podcast here:

The Basics Of Digital Marketing for PT's: How To Create An Online Presence with David Straight

PTO 19 | Digital MarketingMy guest is David Straight. He’s a physical therapist and Co-Owner of, a digital marketing company. To tell you a little bit about David, he's a fellowship trained Doctor of Physical Therapy and has treated patients for over fifteen years. He's also an author, a speaker, a marketing expert, the marketing director of a seven-location private practice and the co-owner of David and his business partner own and operate a digital marketing agency that serves the physical therapy private practice market. He and his company provide custom websites, high-value email marketing, local SEO, reputation marketing and not just management, affordable video marketing, and consistent social media marketing for over 1,600 locations across North America. He's the author of a book called Booked Solid: The Fast, Easy and Affordable Way to Use the Internet to Drive more Patients in the Door, and he’s coming out with his second edition soon.

He has presented at multiple national, state and local professional conferences as well. His passion is to help people understand that physical therapy is the best first choice for neuro-musculoskeletal conditions. I broke David's interview into two parts because we talked a lot about digital marketing on the front end but also slid into creating a generalized marketing strategy that incorporates not only digital marketing but also reminds us not to neglect that physician relationship that we have with our community physicians. I broke this up into that second part to cover that part of it, but in this one, we talked specifically about the best practices and some of the basics of digital marketing. One thing I want you to find out is he shares a secret as to the number of online reviews are needed to influence a customer's decision and make an online impact to choose you.

The second thing is he talks about how there are three parts to marketing. There's number one, ensuring that you have clinical excellence, number two, excellent customer service and number three, building the reputation in your community. Now you can have number one and number two and things are going great, but that's not going to ensure the success of your business unless you have number three, building that reputation that sets you apart from the hospital networks and the physician on practices. You have to promote your customer service and your clinical excellence in order to set yourselves apart and compete against those others and if you're not, you're trending in the wrong direction. I hope you enjoy part one and part two. You'll see that I ended regretfully here in the middle of our interview. Nonetheless, look out for part two as well where we cover some more interesting topics. I hope you get a lot of it.


Thanks for joining me, David. I appreciate you taking the time coming in and talking to us a little bit about our online marketing presence and how important it is. Do you mind sharing your story and where you came from and what got you to where you are?

PTO 19 | Digital Marketing
The E-Myth Revisited: Why Most Small Businesses Don't Work and What to Do About It

Thanks, Nathan, for having me on and the opportunity to speak with you about some of these issues and opportunities that private practices are facing and can take advantage of. My story is such a classic. If anybody has ever read the E-Myth by Michael Gerber, I was a physical therapist at a POPS clinic, but I didn't know what the POPS was. I decided to go to PT school and it was after going through some registry physical therapy that I realized I wanted to have my own business. I thought there was a good opportunity to do a better job of it. After a couple of years of doing that, I worked at a hospital for two years. I opened up private practice, but I didn't have any idea what I was doing. I didn't understand business whatsoever. I ended up failing. It depends on how you define failure.

What do you mean by fail? What happened?

I was working too many hours. I did make money, but I was working too many hours. I ended up partnering with a gentleman by the name of Paul Gaspar and then from there, we grew our clinics. All along I always enjoyed using the internet. One of the things that I held at the forefront of my treatment approach was education. The internet's all about education information. I thought it’s a wonderful tool. I created an online exercise program in 1999 where you could program in. We had these little animated GIFs and stuff. It was well received.

What happened to us is we lost 49% of our business to physician-owned clinics within six months. We went from treating the doctors, the doctors' wives and families, the most powerful people in the community to, “You don't know what you're doing and your physical therapy sucks.” Literally, one month we were on the schedule to author a chapter for an orthopedist that was writing a book on orthopedic medicine. We're going to author the rehab section. We wrote the protocols for ProDisc rehabilitation. The next month when the money mattered more than anything else, loyal patients came back to us and said, “The doctor’s saying that you're no good and that you don't know what you're doing.” We’re in a panic but we have to learn how to market really quick and more than marketing, selling, we need seller services.

I always enjoyed the internet. I built websites for our practices since the mid-‘90s. It wasn't more of just education and information, it was about marketing and selling. That's my backstory and then around 2003, I realized that none of our other colleagues had a good online presence and needed help in that area. That's when I started in E-Rehab. We’re building websites, we were the first company to do it for a physical therapy private practice. It's always fun that as your business goes through these phases, some leaders in the industry that were well-respected, we reached out to them and said, “What do you think about this and how can we do a better job?” They thought we were going to fail miserably, because what referral business needs a website or a newsletter?

They didn't see the trends coming. You had a little bit ahead in the sand there.

I would say part of it was just good luck, but also having a passion for private practice and also identifying a need. I found an awesome partner, a wonderful guy. He has been my partner ever since and he's the technical side of things and so my job is to help find people that we can serve. His job is to build the systems and stuff. It's been a great ride and we've enjoyed it and to this day I still have a ton of passion for it. That's our story.

You’ve mentioned E-Myth and E-Myth Revisited. Is that a book that you used back then when you're going through your trials and even now with your business?

I read that book back in the early 2000 and then I went and took a course with Michael Gerber. A lot of his stuff resonated with me and it was the situation that a lot of small business owners go through. You want to McDonaldize your practice. It's the way he presented the stories he told.

It's nothing specific to PT. It's the responsibility or the bane of our existence as small business owners that we have to learn how to set up policy or procedures and systems and that's what gets us over the hump.

The market is so competitive now. Marketing isn’t optional anymore; it’s a necessity. Click To Tweet

That goes for marketing too. I would say that a lot of specialists and professionals, a good percentage of them resent marketing. The idea is they spend all this time and this money and they learned to provide a valuable service, whether it be a CPA, endodontists or physical therapists. They expect when they graduate that patients are going to come to them. In physical therapy, the market is so competitive now, that isn't the case. They don't realize. As we were speaking about, physician referrals are decreasing. There’s a PT now on every corner it seems like. Marketing isn’t optional anymore and in fact, it's a necessity. There are plenty of opportunities still because there’s such a great demand for our services, but you have to learn how to do good business. They credit to you for creating this information resource for people so that they can learn more about how to run a business.

That's the important thing I want to share with people in bringing on guests like you who provide this service for physical therapist specifically. A lot of times, as the business owners, we feel like we have to do everything and thus, we have to know everything. When we do that, we become average or mediocre or worse and add everything and not focus on what we are experts at specifically. There's 90% of the population out there that hasn't used physical therapy or isn't being referred to physical therapy. Now that physician referrals are declining, we have to learn how to get ourselves out there digitally in the ways in which we can hit directly to the consumer and that's important. When you're talking to the guy who's seeing a full-time load of patients or even a part-time load of patients and trying to run his business at the same time, trying to get a digital marketing presence out there can be difficult if they try to do it themselves. Having a company like you that can help with that is extremely beneficial.

I would agree with that for sure. I think about all of the responsibilities and it reminds me of a quote from Richard Branson when he said, “Most business owners will become more successful or can get to the next level if they end up doing less, not doing more.” Physical therapist goes through different stages through the life cycle of their business. One of the stages you have to go through is first, you’ve got to get people in the door and in order to do that nowadays, you've got to have a great online presence. When I was in business, I went through a bunch of the courses online and offline and the different companies that provided those. At the end of the day, I was highly motivated when I got back, but I didn't have any more time.

It became, to a great degree, a waste of my time and money to do those things. I didn't realize, “I can be smart but if I don't execute, it doesn't matter.” When my creativity rehab from those experiences, I wanted to be a service business where I can essentially teach them why they needed the tools, but more importantly, deliver the tools and services for them because they didn't have time to do it. We think about when I consult with people to find out if they're a good fit for our services, we only work with small practice owners. The first thing I talk about is marketing. We talk strategy. What is marketing? We define marketing as getting someone who has a need for physical therapy to know, like and trust you.

If there's somebody in your community that needs physical therapy and they know, like and trust you, there's a high likelihood they're going to try you out. That is a simple definition of marketing, not mine, it's John Jantsch’s Duct Tape Marketing definition. That's something that everybody seems to understand. We want to make sure that they understand as well that online marketing is tactical and you have to look at the bigger picture and have a marketing strategy. What you want to do is identify who you are and who your ideal target audience is. What your message is, what your platform is, and then from there, you can implement tactics to disseminate that message. That comes from for example, a total online presence. There are other aspects of a complete marketing strategy that would include things like advertising.

Many people think of advertising as what marketing is like a newspaper ad, Google Adwords, Facebook advertising, radio, television, magazines, but that's only a tiny part of marketing. There's also the PR part of things and then of course, you need to have a referral marketing strategy. To develop that marketing plan out more, you have to be able to measure the outcome of your efforts and then you have to define a calendar. The cornerstone of marketing is repetition. That's a challenge for a small business, for the chief cook and bottle washer to try to do all those things. There’s a lot there and most of them don't do it. They jump right through to, “I need a business card, I need a referral pad and I need a website.”

Clinical excellence and great customer service mean nothing if you don't promote and build a reputation. Those three things, working together, will set you apart to succeed. Click To Tweet

What we provide are things that we feel in almost all cases would be necessary tactical tools to do a good job of marketing to your community. The other way that we sell it that I love to share with people is you've heard of funnels. Most people have heard of funnels, but we don't think of it that way. We think of it as two funnels. When you put the one on top of the other and you flip one upside down, it looks like an hourglass. We call it a marketing hourglass and the relationship that all of your patients go through is they know, like and trust you. They buy, they repeat, and you hope you can get them to repeat and refer. The buy, repeat and refer at the bottom of the hourglass. The reason we define it that way is that we want to make sure there is adequate emphasis on the buy, repeat, and refer.

Most marketing funnels, it’s all about lead generation, lead conversion, nurturing and sale. We think of it in a broader sense and then we talk about how you can use digital tactics to optimize all of those steps in the patient life cycle. The other thing that we utilized way back when we started was a term that was very rarely used, patient relationship management. Each one of those steps is an opportunity for you to enhance that relationship, develop new relationships, nurture those relationships, and get people in. Those are the ways that we like to describe how we can apply these tactics and then, therefore, get more people into the business.

Some of your clients are successful physical therapists. What are they doing to make sure they cover all those bases? You listed a bunch of them and I know most PTs won't have the time and some of them may not have the energy to do all that stuff. What do you recommend that most successful PTs do?

The most successful ones, they realize they have received a business education. They’ve got the business education so they understand that their business goes through different phases. In any business life cycle, it goes through different phases. That's important to understand that during different phases of your business development, there are different things you need to do. One of the core things that we discuss often is we like to use data to drive our decisions. We don't like to use whatever the latest and greatest bright and shiny object or silver bullet is. You don't gravitate towards that. We don't provide a Twitter strategy. We don't provide a Snapchat strategy. This is not about Instagram, even though it's a rapidly growing network. These things are not a way that consumers get to physical therapy. Now, I'm saying mostly. If we looked at the bell curve of the vast majority, don't use Instagram.

PTO 19 | Digital Marketing
Digital Marketing: The most successful business owners realize they have received business education.


In fact, Google did a good presentation where they shared that 99% of consumers use anything but a social network to find information or to find out about a particular service or a particular provider. They use Google. Then they use specialty websites like WebMD and Mayo Clinic or Harvard. They use Wikis to look up definitions and stuff, and then only a small percentage ever look on social media. I ask people, “When's the last time you looked up your plumber, your locksmith, your physical therapist, your endodontist or your cardiologist on Facebook when you have that immediate need the first time?” Everybody says, “I never did.”

They're going to go straight to Google.

You’ll get a referral or find out from friends, family members, word of mouth, those are the things. While those social media strategies are important, we provide some of those things. When you're starting off and when you're a small practice, it shouldn't be your top priority. It's thinking about who your market is, the people that you're going to see and the media you're going to use, how are you going to disseminate your message, and then what exactly that message is going to be.

We talk about having a great website. Make sure that you rank well on the search engines. Make sure that when we think about know, like and trust, you're getting ranked on the search engines helps people to know you. Having a great website, making great presentations, people judge what they can't see based on what they can see. In fact, I was talking to some people that are putting together a network and the way they were judging whether or not they should contact somebody was based on how their website looks, which I thought was very curious. After that, how do you get people to trust you?

That's where we say build your reputation, and that's a lead conversion strategy. You're not going to have more people learn about you because you have a great reputation. That's going to help people make the decision as to whether they should choose you. Somebody might refer because you have a great reputation, but the first time somebody gets to know you, word of mouth or online, there’s a lot of referrals, it's ranking on Google or having somebody verbalize your brand name, your practice name, and then after that, they might go to your website. A majority of people go to Google. Google's the home page for a majority of people that visit the website. That's where you want to present your reputation.

The internet is all about education and information. Click To Tweet

Do you find that reviews and testimonials do quite a bit for not only putting you up there but also increase your SEO?

There are seven major factors that have been identified in our SEO profession. Ratings and reviews are certainly something you can’t control, but if it was the only factor that mattered with search rankings, number one, you'd always see somebody with the highest reputation ranking number one. More importantly, Google knows this and everybody was trying to game the system. There are over 200 factors that are taken out by the algorithm when they decide who ranks where. Nevertheless, reputation is a multiplier because it helps you rank higher and also for all those people that are seeing your business on Google and your website. Having a great reputation helps convert people. I've had people that it saved their business, believe it or not.

We had people that were surrounded by narrow networks hospital-based systems and POPS and were dying and we got them ranked. We built their reputation and then all of a sudden, it has revitalized them. Sadly enough, small practice owners, especially if they're just starting, they don't understand that 90%, it's 80% something, I don't remember the exact number but after they're referred, will go look you up online. If you have no web presence or a very poor web presence, then it's a reflection of the type of business you do. That's the way people think and may be the case.

You have to recognize that it's so competitive. There are PTs are all over the place and now you're not just going up against other physical therapy owners that might be just as busy as you are. You're going up against hospital networks and physicians, physical therapy practice that do have a budget for this stuff. You've got to be able to get up to par.

That's a great point. We live in ratings nowadays, even ten years ago. Back in the late ‘90s is when Amazon started its ratings and reviews system. Back there, they're always way ahead of the times and then Google came around and Yelp developed the business model for Yelp, ratings and reviews. Since about 2008, we were trying to help people get ratings and reviews because we had this notion that in a review society, people don't just look at your name anymore and they don't trust word of mouth completely anymore. If they don't have word of mouth but they think they need a service, but they're not sure who to go to, especially the Millennial generation, 96% of those people trust ratings and reviews as much as they do a word of mouth referral.

For years, we tried to help people get ratings and reviews and we failed. When we finally figured out a system to help people get ratings and reviews because such a high percentage people are looking at these things, it certainly can make a difference when you're competing against hospitals and POPS. As to your point exactly, how do you compete against ATI or these big select therapy when they have whole departments and staff members in six and seven-figure budgets nationally for the market. How do you compete? Curiously enough, one of the ways you can absolutely compete and differentiate yourself, which is what we're always looking for, is through reputation. In my experience, there are only a couple of things small practices can differentiate on and it's customer service and clinical excellence. If you do those things well and you disseminate that information through the conduit that people are using to decide whether or not they should go to you, therefore, reputation ratings and reviews, you can create a distinct competitive advantage.

One of the great tests that I like to execute with people is who else has a great reputation in your market will find in physical therapy still to this day? Very few people in a lot of markets have implemented it as part of their culture and therefore have an understanding of the value of ongoing ratings and reviews. That's what we try to help them understand and if they follow through with it, it has so many side benefits to it. When you build a great reputation somewhere past 35 to 40 reviews, people start to verbalize, “I checked you out and I saw that you had a great reputation, so I chose you.”

Business owners will become more successful if they end up doing less, not doing more. Click To Tweet

Not only when you have a great reputation does it get more people in the door, but it's a great way for your therapist and your staff to get feedback about the fact that they do a great job. When you're a small practice, you don't have a lot of peers out there and you wonder. When I first started, I always wondered, “Why didn't the patient come back? Did I do something wrong? What happened?” I studied that across our practice and found that there was a myriad of reasons why people don't come back and in most cases, it had nothing to do with me. When you get ratings and reviews and you get that great feedback. It's positive reinforcement in a profession that can be a burnout profession.

You're always getting positive accolades back, that helps reinforce your company's culture and that you're doing a great job and the people are benefiting from your service. The other things we find that it helps with ratings and reviews is when people get to the stage where they want to grow and one of the main ways you grow is to hire people to do the work for you. PTs want to work for practices that have great reputations. When you build a great reputation online, which given there are so many choices now because there are so many key practices, how does a potential employee differentiate things? If I'm a developing therapist, I want to work in an environment that's a great environment and reputation is a reflection of that.

PTO 19 | Digital Marketing
Digital Marketing: One of the main ways you grow is hire people to do the work for you.


I'd never made the connection that possibly the ratings and reviews that you have on Google could be a great recruiting tool. You and I both know that if we're considering going with a company, physical therapy or not, but if we're thinking about this possibly being a future employer for me, I'm going to go check out their website. I'm going to see how active it is and see if there are reviews and testimonials. Going back in that, if you are clinically excellent and you provide great customer service, but you're not getting that out to the public, especially digitally, then it's useless. You’ve got to promote what you're doing and that's how you can set yourself apart.

Gary Vee, he made the famous statement a few years ago that all businesses are media businesses now. There's some truth to that. People tend to extrapolate statements from influencers don't necessarily apply, but you certainly can have an opportunity to use digital media to influence people in your community. If they're considering you or maybe even help you push out a lot of it, maybe even choose you when they're not thinking about it. You’ve got to have a marketing strategy in place.

What are PTs budgeting for their digital online presence and for their marketing strategies?    

I get that question a ton and now as we're speaking before, there's good data and reports out there that say that about half of PT practices have no budget at all. They haven't even planned for it at all and everybody's looking for a number. My answer is a little bit different. My answer is it depends on the stage your business is in as to how much you would budget. It also depends on what your business plan is. Curiously enough, some practices are happy where they're at and that's okay. If you are just starting off, then you're going to have more time than money and so you're going to do more guerrilla-type marketing where you're building relationships and you need some basic tools while you're doing that.

At the same time, you’ve got to have a consistent budget because you can't do all the work yourself. You can't treat patients and grow your practice when you're starting. You’ve got to have a decent budget. I actually wrote a book on this. The key that has resonated with the people I've spoken with is once they realize that they're profitable or they've reached breakeven and then they have empty scheduled spots on their schedule they're not utilizing, it's all about booking your practice solid. Once you breakeven that every slot that you're not billing is lost profit. You're still going to pay your staff and you're still going to pay your rent, which are your two biggest cost centers and there are tons. There are small variable costs, not too many. Once you go past breakeven, you start to become profitable. Then the key is not to say, “Now I put all the money in my pocket.” That's a little bit shortsighted. The idea is to start stepping on the gas and then trying to book your practice solids. What is in your practice? What's the maximum capacity that you work at?

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Ours is based on the size of the clinic. I know that works in a lot of situations. If it's a 3,000 square foot clinic, then we would expect our maximum capacity would be about 80% to 90% of 10% of that. 300 visits a week and the 80%, 90% of that. With a 3,000 square foot clinic, you'd expect to get max capacity up to 250 visits a week, 270 visits a week.

Then somewhere along the line as you're collecting the revenue for that, you reach your breakeven and then you have to empty time slots. That's where you want to take some of that profit and of course, put it in your pocket. That is the function of why you opened the business in the first place, but then put more of that money back into marketing so that you can fill every slot on your schedule and get to as close to maximum capacity as you can. Your business will be maximally profitable and then you face a curious new decision in your business, “I need to scale.”

The challenge then is now you're in a different stage of your business. You need more room and you need more staff and you have to adjust your budget there. This is where having a marketing plan and a business plan is critical rather than just, “I need social media, I need search rankings or I need to do a newsletter.” These are just tactics. Many of the clients, small practice owners that I work with, they go from one silver bullet to the other and they waste a lot of time and money. They never understand their business and they never understand a marketing strategy and budgeting. Budgeting depends on where they are in the life cycle of their business. There are times when you keep and you save and there are other times where you have to wrap more money to get the next. That's right, ramp it up, you get to the next stage. That's a long-winded explanation of how I explain what somebody should do when it comes to deciding once they’re going to budget.

How much time are the more successful PTs setting aside for staying on top of their marketing efforts on a week to week basis? I know initially a lot of effort's going to be put in strategizing and putting together that plan. I'm sure you work with the physical therapists in that regard, but then going forward, how much time would you recommend they set aside each week for marketing specifically?

It depends on what their strategies are. If it’s online marketing, you have to have ways to track your efforts. It depends on your budget. If you're talking about the foundational strategies that we provide where somebody might be paying $500 a month, I tell them to spend very little time on monitoring that. The time that you spend to try to figure out what you're monetizing from that investment is more expensive than trying not do it at all. When you get to the four digits a month or five digits a month, you're spending, then you have to have key performance indicators. KPI is the term that we all use, that’s to what's working. With our services, we help you get a website and email marketing campaign, rank on the search engines, build a reputation, do video and social media for $500. Whether it's us or any other people out there, you just do it. You can trust that you're going to get half a patient a month. It's almost impossible for that not to happen.

When you're spending $4,000 or $5,000 a month, then you need to have ways through tracking phone numbers and other indicators to know how many people you're converting. In most cases, another mistake people make is they think it's an all or none situation. They're going to spend $4,000 and they’re going to get nothing and wasted $4,000. You spend $40,000 in marketing, chances are good that you're going to get something out of it, but then it becomes a question of opportunity costs, which is a fancy way of saying, “Can I get more out of my investment by doing something else rather than spending $4,000 here?”

PTO 19 | Digital Marketing
Digital Marketing: Another mistake people make is they think it’s an all or none situation.


Look at your conversions because that way you can ask yourself the question, “Should I still be spending the money with online advertising or maybe I need to shift that to try to get a better return?” Those are the times when you need help and a lot of practices are hiring people to help them in that capacity. Unfortunately, a lot of people, this is not necessarily a knock on those people, but they can't afford to hire somebody who has a business background and a true marketing experience or education. They ended up hiring somebody that is an expert in sales, not marketing, somebody who can disseminate information and usually somebody that can push buttons. A lot of practice owner say, “I just don't know how to do social media.” They hire somebody that knows how to push the buttons. They abdicate the responsibility to them but that person has no idea about business or marketing strategy. They know how to implement tactics.

They end up spinning their wheels there, “I have got an awesome Instagram strategy. I'm pumping out all kinds of YouTube videos about how to do stretches and exercises.” A sidelight to me, that always bothers me. It's like, “Why are you showing what people could be doing with exercise? That's what personal trainers do. Why not discuss how you can help people with particular diagnoses?” That's more if you have a true marketing background and business plan, that's the strategy part. If you hire for $15 to $20 an hour, oftentimes they don't have that skillset. If they find that diamond in the rough, then they're off and running. They're going to take you in the direction that's best for them and not necessarily what's best for your practice.

Your marketing strategy begins with identifying who you are, who your ideal target audience is, and what your message and platform is. Click To Tweet

You see that a lot with Ad words. People pay a lot of money for Google Ad words and they’ll search for physical therapy in Phoenix, Arizona. I see their ad in San Diego and it's like, that just showed up as somebody that you would think is looking for your practice, but I'm searching from Carlsbad, California. Why is your ad showing in Carlsbad, California? It's because it's in the best interest for the people that are selling your ads to show you that there's lots of activity, but it's not in the best interests of the practice that's advertising to somebody in Carlsbad. That's because you have to understand, you’ve got to be the captain of your ship. Abdicating that completely. In our business, we'd like to compliment them and understand things.

We had to break up this interview into two separate parts because David has a ton to share. We'll wrap up here with the basics to digital marketing and then look forward for the next episode, the continuation of my interview with David Straight, where we talk about developing your marketing strategy not only online, but also reminding you that improving physician relationships is vital to also increase your new patient arrivals and he shares some techniques in what you can do that. I look forward to next week's episode and we'll see you then.

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About David Straight

PTO 19 | Digital Marketing

David Straight is a fellowship-trained doctor of physical therapy, has treated patients for over 15 years, as well as an author, speaker, marketing expert, marketing director of a 7 location private practice, and co-owner of David and his business partner own and operate a digital marketing agency that serves the physical therapy private practice market. He and his company provide custom websites, high-value email marketing, local SEO, reputation marketing (not just management), affordable video marketing and consistent social media marketing for over 1600 locations across North America. He’s the author of Booked Solid: The Fast, Easy, & Affordable Way to Use the Internet to Drive More Patients in the Door. He has presented multiple national, state, and local professional conferences as well. His passion is to help people understand that physical therapy is the best first choice for neuromusculoskeletal conditions.

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