E226 | It's Not All About New Patients

Sep 24, 2019
cash based physical therapy, danny matta, physical therapy biz, ptbiz, cash-based practice, cash based, physical therapy

On episode 226 of The PT Entrepreneur Podcast, I want PT entrepreneurs to understand that there are variations of revenue.  You don't need to feel like chasing down new patients is the only way to run your business and I get into what these other streams of revenue can look like for you.

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Episode Transcription:

Hey, what's going on, guys? Doc Danny here with the PT Entrepreneur Podcast and I'm excited to have you back on the podcast with me again so I can help you out with something that I think is, one of them, the most significant pros when it comes to deciding that you don't want to be in-network with insurance companies necessarily, and that is a flexibility to do many other things outside of your organization in particular on the backend that you as you could do in their work practice.

But oftentimes. They're overlooked because all they focus on is patients, patients, patients, patients, and in particular new patients, discharge, new patients, discharge. And it is a frustrating business to own. I, I think, is the best way to put it. Now. What I want you to understand is that there are different kinds of revenue and revenue where you are always having to sort of eating what you kill is.

It's a variation of revenue that a lot of companies have and can successfully do. So, but it's one of the more stressful ways to run a business versus what we consider recurring or reoccurring revenue. As much better where you already have people, and you're keeping them happy for an extended period, helping them solve a problem or, you know, create a solution, achieve something as a goal of some sort.

And, and that, that revenue is much more predictable, and you don't have to necessarily go and try to chase down new people all the time. So what I want to do is be able to get into a topic that I kind of consider, this idea that it's not all about. Patients, and in particular, it's not all about new patients.

And I want to talk to you about some of the ways that, you know, people within our, our mastermind group, our company, and plenty of other smart companies out there in the, you know, health and wellness, practitioner realm are using their skill set to develop additional revenue streams that help stabilize the business.

PR creates opportunities for providers that help break up some of the monotony of just clinic hours all day. And, and look, I, I've been there, if you're a younger practitioner, you know, you probably, are there right now, and I think many of us would prefer to do a little bit less clinical work and a little bit more variance of, of what your day looks like, whether that be.

Coaching or teaching or, we know working on, you know, some digital variation of, of, you know, something that could help the practice. But to be able to have that variance in your day can be a healthy thing and, and break up the monotony of your day to day. And not just for a PT profession, but really for.

Anybody that has a job, if they just do the same thing every single day, it can start to feel a little bit like Groundhog's Day, and they get burned out. And that is a problem within our profession. So here's what to do. I'm going to get into a few areas where I'm, and I see people effectively being able to create additional revenue streams.

And hopefully, this gives you an idea of what you can do within, within your practice as well, or, or, or add some of these in, or think maybe it's not the right fit for you, but. But, some of them may be an excellent fit for your practice. So. Number one is corporate workshops and wellness programs. So we have a handful of people in our mastermind group that do an excellent job with this.

And a lot of this, that really, this is where they go in, and they provide primarily wellness-based services, whether it be, a series of workshops where they're like—educating these people that work at these different companies. It doesn't always have to be massive companies. It can be small.

We've done this with tech companies, smaller tech companies here in Atlanta where we come in and over, you know, three to six, sometimes 12 months. We have this ongoing cadence with them of workshops that we're teaching to help educate their staff on how to take care of themselves and, and really, be very proactive about their health.

The owners like this because. Cuts down on usually sick days, as well as, you know, where theirs is good for morale, for you to bring somebody in. And, and for them to learn something applicable to their, to their health. Some people don't care. They sit there, and you know, they're, they almost fall asleep on you.

But lots of people like to be informed about how they can live healthier, you know, like less, less painful, more active. Life. And, that's a straightforward way to kind of start out, is looking at, you know, can you come in and teach these, lunch and learns to start with? And does that turn to something a little bit more formal where maybe you have a series of things you're going over for, let's just call it desk-bound, athletes, which is something that we present a lot on.

Now, this could also turn into what's considered as corporate wellness programs. So this could be structured times where you come in and actually. Train the staff, you know, run them through a workout, do different assessments on-site and work with their, their, their team on site. In many cases, this is a very performance

-based approach. Sometimes this is insurance-based, right? So, one of our docs used to work at a clinic down in Mississippi, and they had a satellite office inside of a, it was like a, I guess it was a shipping company, right there on the water. And. They would work with people that were work comp clients on-site, and it was super convenient for the company.

You know, if, if that's the population you want to work with, you know, cool. For us, that's not necessarily what we work with. But this is an example of, you know, bringing service to a company in this sort of corporate, treatment or corporate wellness program. We've had people that have gone in successfully and started running, you know, these training sessions.

These evaluations that they haven't had been able to add permanently, you know, 20 to 50% increase in revenue in some cases to their clinics. You know, sort of a monthly income just by adding this other stream in that is not covered by insurance at all. And it is, is, a unique—utilization of our skillset as a performance base provider in particular.

So if you have any connections with companies, organizations, and often it's like a warm introduction to somebody that that is a decision-maker. It's worth looking at if you enjoy teaching, coaching, and doing so in a corporate environment, as well can be a perfect way to go about it.

Cause typically, more prominent companies have more funds to reinvest in their people. That's the way they look at it in many cases. And it's a great place to start to stabilize revenue with these additional revenue streams. Now let's talk about a couple of other options—one of those being coaching and or training.

So I think this is an excellent utilization of these sort of performance clinicians skillset. Many people are doing this, but I believe they are doing it. I, I, I get a little bit, frustrated sometimes when I see people that are like, let's say you're seeing somebody as a PT, it's $200 an hour and then you're, you're seeing somebody as a personal trainer and.

It's a hundred dollars an hour, yet you still have that same degree. You still have that knowledge base. It's not much of a difference between what you're going to do with them. Aside from probably not doing any hands-on work, but even still, that's not a that doesn't warrant half the price.

But I do think a lot of people do want that. That, that coaching, that more performance kind of, training, elements and, and are willing to pay for it as well. And especially if you don't undervalue yourself, it can be an excellent way for you too, you know, add additional revenue to the practice.

Now, this could be specific to a niche that you're good with. So let's say you're a runner and you know, you're good at helping people. You know, train for and achieve completing their first marathon. Right? Let's say that's your thing, and you're good with newer runners that are trying to achieve that goal.

Well, you could set up a coaching program specifically for that, where you see somebody less call it like once a week. You know, when you have some sort of a coaching cadence with them, with what they're doing for their running, and also you're teaching them how to stay healthy and, and recover. From the miles that they're going to put in right now.

This isn't necessarily directly patient care where you're saying, Hey, you know, you have a knee problem from running. Let's fix that so that you can get back to running. This is, Hey, you want to be able to do this thing that often, you know, many people get hurt in preparation for, and that is something that we can avoid and help you do this.

Not just successfully, but also faster, with least likelihood of injury, that we can, you know, actually have. And, and that's something that a lot of people see value in. So think of it as what are your skills or what's your skillset? What's the niche you do well with? That's an example for running, but it really could be any variation of, you know, a performance-based slot that you do good work with and that you enjoy.

Working with, so looking outside or kind of like taking a step out and looking at what other options do I have besides just seeing patients. It's a natural fit for many of you who have a background in coaching, to begin with, as I do, and also enjoy this element of working with people where it's less about solving, kind of like pain injury and more about achieving performance and longterm changes in this activity that they like so much.

Now this sort of rolls right into. And another variation that I think is becoming more and more popular. I don't think it is becoming more and more popular, and that is digital programming. So many of you, when you, when you say programming, people think of like, you know, coding and programming on a computer.

That's not what this is. Digital programming is you creating a customized program and or blanket program. For someone to achieve a specific health and wellness goal. Now, there are two ways to take this. Let's talk about a blanket program, right? So, okay. One of my business partners has a group, and he's not a practitioner, by the way.

But he does all the kind of marketing support and tech support for the people in our mastermind group. And he owns a platform called garage gym athletes. Now, garage gym athlete is, you know, anything is anywhere between 25 and $45 a month. But it's very scalable in individual senses. So there are thousands of athletes on this platform.

They create, you know, one or two programs that lots of people follow and it, and it sort of solves, You know, the, the problem of what do I do if I train at home in my home gym in a garage. But it's not individualized and specific to one person. It's sort of training to the masses. So if you think of a bell curve, you're short trying to catch that.

80% of people in the middle, the people that are on that upper-end bottom sort of 10% of the scale. Well, they may, they may not be the right fit for that, but that's okay because there's a lot of people in that 80%. So people will do this with plenty of things, not just performance program, but even something like, let's say, you know, you have this excellent protocol program for people to have knee issues.

So, all right, well, he can create a custom or a program for that's template-based, and then you can have somebody follow that. It's very hands-off, can be sold. As well, you know, anytime throughout the, during the day or night as a digital program. And there's a lot of appeal to that. I will say that.

It is, it is one of the harder things to sell compared to, you know, someone working with you in person or creating a custom program for them. Even though a custom program is going to be a lot more expensive. And part of it is that people don't see quite as much value, in that there's not as much of a buy-in factor.

And the retention rates are pretty low, for, for those typically there are anywhere between. Two and four months. If you're doing well with the, like sort of lower ticket, online blanket program and you're, if, let's say you're at six to eight months of retention like that's good.

So meaning usually after two to three months, people are leaving, right? And then you have your, and you're in this cycle of always having to find new customers. But if you can do an excellent job with retention and you can make sure that you're getting enough new people in the door, it can be a profitable, mobile, business that you, you can own, based on what again, what your niche is and what you're solving. Like, so if Jared had written a program that was like, Hey, it's a program for everyone to get fit, it's, it's probably not going to sell well because it's so generalized to anybody that it doesn't appeal to anyone.

So, so you. Alienated everybody had by trying to appeal to everyone, and it sounds kind of weird, but the more niche-specific you can be and the more repetition you can use specific to that kind of population. The more likely it is, they feel like it's going to be the right fit for them, and they're probably going to want to join that program.

Now on the flip side of this, I would say individual program. Design is another very viable way to start to add more. Kind of cash-based non-insurance, nonpatient, in particular, directed revenue to the practice and a digital revenue or digital programming, can be a perfect way to do that.

Now, it's not as automated necessarily, and, you know, you can't create one program that men, a thousand people follow. But you know, you can typically charge ten times as much for an individual program than you can for a monthly recurring plan. You know, in terms of what you can yet for your time.

So, for instance, if Jerred's program is, let's say, $25, then you know, if, if you're. If you know what you're doing and you can help somebody with developing a custom program, you should be able to charge two to 300 you know, some people a lot more than that, depending on, you know, how niche-specific they are and their, their skill set, how well they're known.

But even, you know, practices that are not, don't have this big sort of a mini-celebrity presence. They can charge somewhere between one 50 and two 50 per month for a customized digital program. Now, again, with all of this stuff, I'm giving you ideas of other things you can do to add revenue to the company.

The idea of like, I guess the details of selling those things, gets a lot more complicated than what we're going to be able to cover on this, on this podcast. Right. Because ideas aren't worth shit. The implementation of those is, is, really, important. And what I want you to realize is like, if you have a unique skill set in some of these areas, you should try to dive into them and implement and figure that figured out along the way.

The sales side of it can be the hardest part. And I get this, a lot of people are like, how do you get people to pay, you know, for programming that just doesn't seem like anybody would do that when they could follow some bro some blanket program online. Well. I guess, but if you can have an informed conversation with them about the limitations that they have, the change they're trying to get, and the solution you can create for them, it's a straightforward thing to sell.

So just depends on how you position that. But if you look at it, I had a, I mean, I had a conversation with a guy in our mastermind the other day, that we, we, we're, we're doing a one on one call and, you know, checking in on his business, doing well and primarily just doing sort of patient visits and some performance coaching in clinic.

But, I asked him about some digital stuff and if what he was doing for that, and he said, yeah, I've got about six people that I'm programming for. It's, averages about $300 a month. And, none of these people are patients that he's seen previous patients you've seen. They're all, and just, I had reached out to him via Instagram.

Or connected through somebody that had never, you know, they're, they're all people he'd never seen in person. And so he has these six people that he was programming for is taking them about like 45 minutes per month to manage each of these people. So really his hourly is higher than 300. And, and for what his average clinic rate was about 200.

And I asked him, I was like, man, well, why. That's the difference. And you like doing this. And he did. And he's an excellent strength coach, before going back to PT school and had just continued to focus on that area. And so I had a unique skill set, like many of us in this performance realm.

I asked him, I was like, well, why haven't you tried to get any of the people that you've already seen to do programming with you? Do you think like some of them would be a good fit for it? And he was like, yeah. He goes, I just never even really thought about doing it. And you know, if you do the math on that, and let's say he can.

You know, bring it up to 20 people, which is possible for somebody to manage that, especially if you look at being efficient with your time. If it's taking you 45 to 60 minutes per month, then you know he's going to add, he'll have $6,000 of recurring revenue added to his practice just from something he can do when he's not even.

At his office. Right? And, and, that's a pretty unique place for a PT to be. And it's also a great way to stabilize your revenue because he does enjoy working with people in the clinic. And this just allows him then to have this additional impact on people outside of that, you know, Hey, let's solve this.

This pain problem. Let's get you back to this thing. And then it's like, let's get you better at this thing. You know, we do this for people all over the country. You know, a good example would be one of the people that we work with is, sounds kind of odd to say this out loud, but she's like an ultimate Frisbee player, but it's a club.

It's a popular club sport. Not, not something that I played when I was in high school, but it's becoming much, much more accessible. Some of you probably just like, yeah, no, ultimate Frisbee is awesome. It is. It's a great workout, and it's, it's super fun. But this is a very competitive, ultimate player.

Like she plays on one of the best college club teams in the country. She's from Atlanta. And the issue with it is her school, you know, it doesn't care about club girls, ultimate Frisbee. They don't have any sort of strength coach assigned to them, but they play a ton of games. They practice a considerable volume.

And. They're very competitive. They take it very seriously. So she's putting in, you know, necessarily division one time practice, and. Games. And she doesn't have any idea what to do to support that from a performance standpoint. So it's a natural fit for us to say, cool, well, let us, you know, program what you should do.

You're motivated to do so you have access to this, you know, the schools, athletic, you know, whatever gym and, and all the resources, you just don't have any coaching. So we seem to see what you have, what your goals are, what your sport domain is, and then we create a program for you. And. We can hold you accountable for that.

And we can change things based on how you're feeling. And you know, that's an exciting way for us to have this compounding effect on somebody that we've already helped with this injury. Get over that and then get back to high-level performance. But also to create these ongoing service, you know, streams that support the business be very sustainable and not have to try to find these new people to help continually, you know, be a profitable business each month.

And so I want you to think. What else can you do? Outside of finding new patients, helping new patients, I'll be in pain more and then telling them goodbye, you know, and discharging them, which is really what many people do to how you can have this ongoing relationship where you're still providing value.

Like we don't want to have people just come back or, or to follow a service that we have without any sort of reason to do so. But if we can help people. In these other ways. And, you know, they, they, they want our help in these ways. It's a natural, a natural fit. The other piece, along with this, with digital programming, would be something like nutrition coaching.

We get this a lot with people, especially if they're diving into, you know, getting into macros. The people, you know, helping them develop intermittent fasting protocols, you know, or it could just be legitimately behavioral changes associated with nutrition. I mean, I think that's probably. The most significant barrier for a lot of people with diet is there's a, and there's an emotional, part of it, a substantial sensitive part of it in terms of comfort food and stress eating.

And, you know, why do you feel like you need to do this, you know, or eat this type of food? And it is drawn back to a lot of other things besides just the desire to eat food. Right? So. Having a coach be able to help you with that. And many of the people in our profession are very interested in, you know, all aspect of health and wellness and nutrition is a big part of that.

So being able to do nutrition coaching is a, is, is very viable. You know, again, that's something that people are paying anywhere between a hundred and $300 a month for, depending on how hands-on you are with somebody and check-ins and all that stuff. But again, some of you can do from really anywhere if you have unique.

Desire to do so, skillset. And you can have a conversation and intelligent conversation with somebody about what they're trying to achieve and how you can help them, they get there. I've even seen people that do custom breathing, programming for, for like a couple of hundred bucks a month. There are a few different groups that do this, and they just built-in.

A custom breeding program based on many cases like CO2 tolerance testing if they do a and coaching with breathing. Talk about a niche man like. That's pretty damn niche-specific, but people are, we'll do it if that's something that, you know, really provides value to them and something that they need.

So think outside the box a little bit with this. These are a few options that you have. Get out of the, and I would say this sort of old-fashioned mindset of new patients discharged new patients discharge that has been ingrained in many of us via what insurance thinks we can and can't do based on what they're willing to pay us for versus, Hey, what are your skill sets.

What do you enjoy doing? What can you help people do more or get better at? And then how do you have services or products that you can position in a, in a way that is, complementary to that and that you can generate these ongoing recurring revenue streams, you know, for your business with that helps stabilize the market, but also help you get better longterm outcomes for the people that.

You know, have already worked with you, and we'd love nothing more than to continue to work with you. They just don't know what else you can do, you know? And, and, there's the only kind of two reasons that people stop buying from you. Number one, they just, you don't give them anything else to buy. And number two, you've pissed them off.

Like they just, okay. They just don't think they need anything else from you, you know, or, or they, they, they just don't know what else you have to offer and why it's essential. So, you know, which one is it? Is it that you just haven't given them anything else to buy? If so, you might be sitting on a massive amount of potential revenue that you're just not even realizing.

And if you piss them off and why, what'd you do. No, you can't make everybody happy. But I mean, that's a legit reason as well, that we tend to see people just not come back. So something to think about as well. But that's it, guys. I think about, can you do corporate wellness and, and, workshops, things like that.

Can you do performance training? You know, where you're coaching people in, and you're using your skillset with a sport that maybe, you know, you have a solid background in. And then on the digital side, the world's a prominent place. It's not just the people in our office. That is a comfortable place to start.

But, You know, programming for health and wellness and then nutrition, breathing, whatever it is that you're good at and you feel like you can help somebody with, that's a great place to start. That's a great place to begin to add a recurring digital element to your business that can give you some flexibility of where you can work, which is pretty unique for our profession.

There's not a lot of options like that because we're so, one-on-one like we're in the clinic, multiple people, and we're tied to a rigorous schedule. And, and this gives us some flexibility, at least part of our, a week where we can do this from. You know, somewhere else. And still use our skills, our skillset in a unique way.

So I hope this helps. I love it when people start to look at their business from a different lens and take a step back and think, all right, well, what else can I do to add value to people? What unique skill set do I have? And then where do those align so that you can then start to build your business in a much more balanced way versus just relying on.

The one thing that everybody thinks about, which is new patients, and if you're in insurance practice, you've also got to realize, you know, every year for who knows how long reimbursement. It's pretty much gone down somewhat. And I don't know about you, but I, it's highly unlikely. Then all of a sudden, you know, United and whoever else, blue cross say, you know what?

We have been assholes. We're going to start paying you guys more. You deserve it. Like you think that's going to happen? Probably not. So being able to add in some sort of non-insurance-based revenue stream to your practice can help insulate it from a lot of changes that are probably going to continue to occur going forward and, and, and allow you to, you know, employ a lot of people.

That's, that's. The key, right? Like we have these businesses because we want to help people, but also provide jobs for other people so that they can, you know, live their lives, and they can provide for their family. And you can't do that if you don't have enough revenue to keep the lights on. So, as always, guys, I appreciate you listening.

Thanks for everything, and we'll catch you next time.

Do you want more cash, PT, biz help? If so, get a copy of my book. Fuck Insurance. It's your playbook—for a successful performance, PT practice, and never having to deal with insurance again. You can get a free copy at Inside this book, you'll learn the direct techniques that we've used to become one of the fastest 100% cash PT practices in the country.