Why Underpricing Is Killing Your Cash-Based PT Clinic

If you're running a cash-based or hybrid PT clinic and still charging $100–$150 per session, you may be doing more harm than good—to your business and your patients.

In this post, Doc Danny, founder of Physical Therapy Biz, breaks down why pricing isn’t just about fairness—it's about growth, sustainability, and long-term scale. Whether you’re new to cash-pay or a few years in, this pricing mindset shift could be the most profitable change you make all year.

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The Power of Perceived Value

Patients make assumptions based on price.

Just like you’d assume a $500/hour lawyer is better than a $100/hour one, your patients use pricing as a shortcut for quality. If you’re great at what you do—but you’re still charging like you’re mediocre—people will assume you are mediocre.

Real Talk: If you’re charging $100 per session, you're not positioning yourself as premium—even if you’re world-class.

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Low Prices = Low Profit = No Growth

Let’s talk numbers.

• Gross Revenue is what your clinic makes.

• Net Profit is what you keep.

If you’re undercharging, your net shrinks fast. That means you can’t:

• Pay yourself well

• Reinvest in marketing

• Upgrade your space

• Attract and retain top-tier staff

It’s simple math. A PT charging $225/session in your same city is walking away with way more profit per hour—without seeing more patients.

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$200+/Hour: The Magic Number

If your clinic’s average hourly rate is below $200, scaling becomes a grind. To hit your goals, you’ll either need:

1. High patient volume per provider (hello, burnout)

2. More providers working for less (more overhead, more stress)

But there’s a better way: Charge more. Work smarter. Build margin.

When you raise your rates:

• You can pay fewer, better PTs more money

• You deal with less staff drama

• You create more time freedom

• You build a stronger culture

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Want to Sell Your Clinic One Day?

Then you must build margin.

Why? Because scaling—or selling—requires mid-level leadership like clinic directors, managers, and eventually operators. These roles aren’t cheap.

Without the profit to pay them, your clinic is just a job… not a business anyone wants to buy.

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Here’s the Good News

You don’t need permission from an insurance company to raise your rates. In a cash-based model, you decide.

That’s the blessing and the curse. Most clinicians undervalue themselves. That mindset bleeds into the business and holds them back from everything they want—better income, more time, and true freedom.

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Final Thought

You're not just selling sessions. You’re giving people their health, their hobbies, their life back. Charge like it.

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Want Help Pricing with Confidence?

We’ve helped over 1,000 clinics optimize their pricing, raise their rates, and scale with clarity. You don’t need to guess—we’ve got the playbook.

✅ Join our free 5-Day Challenge
✅ Book a free advisor call
✅ Check out our book for real-world pricing tactics
✅ Want to sell your value better? Try Clare AI

Do you enjoy the podcast?  If so, leave us a 5-star review on iTunes and tell a friend to do the same!

Ready to elevate your practice? Book a call at the link below with one of our expert consultants today and start your journey to delivering unparalleled physical therapy.

Podcast Transcript

Danny: 

 Now, it's no secret I didn't like writing notes whenever I was a clinician, but what I really didn't like was babysitting my staff and getting them to write their notes. And as odd as it might sound, it's a real problem when you're trying to get your staff to stay up to date on their notes and they're just trying to catch up on it 'cause they're busy with everything else.

Well. You don't need to babysit your staff anymore. We have created a tool called Claire. And Claire is a AI scribe tool that will literally write your notes for you. It listens to your interactions, it writes your notes for you, and now your staff has no reason to tell you why they didn't have time to write their notes.

You don't have to babysit 'em anymore. They just get a chance to pay attention to their patients, you know, be more in the visit with them, human to human, and let AI take care of actually writing and documenting for them so all their excuses for not writing their notes are gone. We just saved you a bunch of time and awkward, weird conversations you have to have with your staff about being an adult and actually writing their notes are now gone.

You're welcome. And to meet claire.ai, get 10 free notes to check this out for yourself and see how your staff can use this to stay compliance as well as save you from having to audit their notes on an ongoing basis.

Hey, are you a physical therapist looking to leverage your skillset in a way that helps you create time and financial freedom for yourself and your family? If so, you're in the right spot. My name's Danny Matta, and over the last 15 years, I've done pretty much everything you can in the profession. I've been a staff, ut I've been an active duty military officer, physical therapist.

I've started my own cash practice, I've sold that cash practice and to date my company, physical therapy has helped over a thousand clinicians start growing and scale their own cash practices. So if this sounds like something you wanna do, listen up 'cause I'm here to help you. What's going on? Danny Matta here, founder of PT Biz, and today we're gonna talk about how you can nail the first visit.

So one of the most important touch points you're gonna have in your business. Is going to be the first visit you have with a patient when they come in. And for many of you, you come out of the world of in-network physical therapy, uh, you know, you don't have that much time with people. You might have two other people that are out working with, uh, you know, maybe a tech in the gym as you're going through an evaluation.

And the amount of time that you get in these low volume cash-based clinics in comparison to a high volume in-network clinic is so different. And it allows us to structure a evaluation in a really unique way, a really helpful way for the patient. But also, I'm gonna walk you through the, the best way to structure a visit for you as well, not necessarily to get buy-in from your patient in terms of, you know, wanting to work with you and, um.

And wanting to commit to solving a problem with you financially, but also how to really get clarity for them so that they know what's going on and they feel very clear about what the next steps are and the work that they're gonna need to put in, right? Because in the end, we wanna get them the result that they want and they wanna get the result they want.

And the number one thing, and this is super, super important, it's probably the most important thing that I'm gonna say. The first visit is not about you trying to prove some to somebody that they made the right decision. The first visit is about clarity. People lack clarity, especially with their body like health and wellness and injuries.

So confusing. There's so many different opinions, what's going on, and if they can have clarity about what's going on and the path to resolution of that, to solving that. They're going to trust you and they're going to do what you say in terms of your home exercise plan, compliance, all that, be so much better as well as be very clear about, um, you know, what it, what it takes and why they might wanna work with you to solve that problem.

Which means you know, them actually, you know, investing in, in, um, in working with you to do so. So the common misconception for most people is that all you have to do is just give 'em a bunch of stuff, right? Do a bunch of tests, throw a bunch of, uh, confusing words at them. Make, make it seem like you're smart, and then you're good to go.

Right? And that is actually not the case at all. The, the truth is, clarity is what people need. So remember that it's not about trying to jam everything into one visit. It's about trying to actually create clarity for somebody. And there's a, there's a very specific way we can go about doing this, and I'm gonna talk through the different portions of the initial evaluation and what you can do that really drives home, um, a, a fantastic outcome.

Right? So let's do this. Let's go to the, uh. To the, to the iPad, and we're gonna draw some of this stuff out. So, okay, number one. So we have our first visit. They've decided they want to come in and work with you. That's step number one. That's obviously huge. Um, and if you. If you wanna know how to, you know, why the first call is so important, like we will link to, uh, to a video I did on that as well because it, obviously, they have to get here through probably an initial conversation with you, and that's a very important conversation as well.

But this is once they're in your office, right? And this is now you get a time, your time to shine, right? You're a fantastic clinician. You get, show 'em what, what, you know. So when we look at, uh, easy wins, easy wins really come down to the, the beginning of the visit. So these easy wins. Are a few things.

Number one, you are on time. These easy wins are free by the way, but you're on time as best as you possibly can, and. The thing is, yeah, things pop up, whatever, but you can control your schedule much better than you think, especially with low volume. So being on time and being punctual shows that you respect other people's time.

And if you wanna differentiate yourself from a traditional medical visit, I. Be on time. How many times have you gone to the doctor, dentist, physical therapist, and they're late to see you? Like, don't do that. This is an easy win. It makes you look really good. Uh, number two is, uh, rapport. So you have time to talk to somebody.

Hey, how's it going? How's your day? What'd you do this weekend? You know, what part of the city do you live in? Talking to 'em about themselves, about how they got there. And, and very importantly, don't forget this question. How did you hear about us? This is actually super, super important. How did you hear about us?

I would love to thank someone if they sent you our way, and I would love to know how you heard about us and ended up in my office. Maybe it was a Google search, maybe they saw an ad. Maybe they saw something on Instagram, maybe a friend told them about that. And if it did, you always wanna make sure that you know who that friend was and you thank that person via email, text next time they're in the office, whatever it is.

How did you hear about us? Great. I would love to thank that person, you know, for, for recommending us. That's huge. And that will help you snowball more and more of these word of mouth referrals. And the last thing, and this is another super free, easy thing to do, is use their name. Everybody loves their name.

Everybody loves it when you say their name, right? If somebody comes in, you say, Hey, Brian, nice to meet you. So excited to work with you. You know, the, the, the person's name goes a long way and it's on your freaking EMR, like, it's right there. You don't have to remember their name. You don't have to remember everybody's name.

It's, it's literally on your, your EMR. You see it on your schedule. Use their name, okay? These are easy wins. This is not even a part of the visit. Really. It struck, uh, formally. But it's a huge part of building rapport and starting off with a good first impression. Okay, so let's talk about the subjective.

So, in the subjective, I'm not gonna tell you how to actually, you know, run a subjective visit from a clinical standpoint. I expect that you already know that. Um, but what I'm gonna talk about is the elements of things you wanna have in your subjective. They're gonna help you get, uh, buy-in clarity and really, uh, put yourself in a position to have your, uh, medical, medical opinion.

Be taken, you know, very seriously in terms of what the plan of care is and why someone would want to commit to that. So in the subjective, you want to make sure that you are listening, okay? You are not talking the whole time you are listening to them. You are asking them, obviously, the pertinent questions about how this started and the symptoms, and you're ruling out red flags and, and, and the things that you need to do from a, from an actual, you know, medical standpoint.

You're listening to them and you're allowing them to tell their story and in some cases, to air their frustrations, to, to get them out about all the crap that they've been dealing with and the things they've had to avoid and the things they've tried and why it's not working, and it's, it's so frustrating for people to have.

Injuries that stop them from doing things they wanna do, and also to kind of get stuck in the, the, the healthcare loop that can be frustrating and they get bounced around and referred to other people that don't seem to really help them. So listen to them. Let them air their frustrations, let let them get it out.

It's not a waste of your time. And when we're in clinic in a high volume setting, it can feel like a big waste of time. 'cause you're like, oh yeah, okay, we gotta get, we gotta move on 'cause I don't have that much time. Right? Like, okay, cool, let's, let's just skip that part and let's, let's get right into these things I have to check off and then get into the objectives so we can get an idea what's going on and figure out how we can help you, you know, resolve that.

But we're missing out on building this trust with a patient that's so, so important. And allowing them to have the time to be able to express what's going on makes a huge difference. So let them talk about what's going on. Let them explain their story, and then you wanna make sure that you are asking why, okay?

Not just not, not, not necessarily just why are we here? Right? Or what? What are your goals, but why is it important to you? So for instance, I had a patient one time and she came in because she had a knee problem from running. Okay. So the problem was, I. Running pain right in the knee. Now this is, why are we here?

I have pain in my knee when I run. Okay. Why is running important to you? It's how I manage weight.

Okay. That makes sense. This is how you manage your weight. It's how you get your conditioning in. Um, well, why is the management of your weight important to you right now? Like it, do you feel like there's some health stuff you need to work on? Is there something important coming? Coming up? I. Yes, actually I'm in a wedding in two months and I run to manage weight and I have to fit into a bridesmaid's dress in two months.

That right now it's a little bit, a little bit tight and I gotta make sure that you know, I can do that. I don't want to be embarrassed by that. This is a different level of communication we're talking about. If I just left it here at, you have Knee pain when you run. Great. We help people with this all the time.

I could have done that, but instead I wanna know, well, why is running important to you? Is it your community? Is it, uh, a way that you manage stress? In this scenario, it's how she managed her weight and she wasn't in my office because. Uh, of knee pain. She was in my office because she had two months to fit into a bridesmaid's dress that, uh, she was worried she wouldn't be able to look good in.

That is a different level of understanding why somebody is doing things, and that helps me tie the things that I'm gonna ask her to do. 'cause I might say, cool, let's just, let's not just talk about running. Let's look at some simple things we can do to help manage inflammation as well as. Uh, manage weight, that that can be, you know, easy low hanging fruit, things they can also help us heal and help us, uh, you know, lose some weight at the same time.

Now I can tie these things back in together because I understand her why. So one of the biggest mistakes that I see is people do not actually ask people about their why. They just ask, why are we here? And they leave it at that. And you don't go 2, 3, 4, 5 levels deep to understand why somebody's actually wanting to work with you.

And then make sure that they're actually going to stick to that. Okay, so that is, uh, that's the subjective, a big portion of subjective is asking the right questions, asking the why questions and listening to them. The other thing is you can slow down. Again, you have the time, slow down. You have the time to make sure that you're listening to people, that you're letting them tell their story, and that you can actually ask these questions and build some rapport.

Right. And, and they, they finally have a chance to let this out. And it can be a huge reliever. In fact, this is the area of the visit where most people are. If they're gonna get emotional about why they're there, this is where they're gonna do it. And honestly, people getting emotional in your office about frustrations they have is a good thing.

What a great thing to let them, you know, let those things out to, to, to not have to hold those in, to not have to hold in these fears and frustrations that maybe nobody's listening to them about. And that's a great place for you to be because you are helping this human being in front of you who's obviously stressed out, be able to finally get that off their chest.

And that affects them in a really positive way. In other ways as well, not necessarily just with our plan of care that we're gonna, you know, try to help them through. So that's the subjective listen and ask the why questions. Now when we look at objective. You are obviously gonna go through your, your tests of whatever you think is going on.

You're gonna, it depends on, you know, what, what's your, whatever your, your background is in, right? If you're, if you're, uh, you know, kind of come from my camp where I come more from like the, the ready state kind of Kelly stare approach. A lot of tests and retests, I really like a lot. If you're coming from, you know, the PRI camp, if you're coming from more of a manual camp, you know, you're a Maitland based, doesn't really matter, right?

I, I don't really care what your background is. Here's what I can tell you that is going to help you, uh, get buy-in and clarity with somebody. And that is being thorough and explaining to them what's going on throughout the process. And for me, this always came down to tests and retests. All right? And the reason I like these is because seeing is believing.

Okay? When people can see that something is improving. That symptoms are, maybe they're getting worse with certain things, getting better with certain things. Range of motion is improving temporarily. We know that like if I do breathing drills with somebody. I can improve a forward, uh, bent by, you know, inches sometimes, right?

Uh, you, you can literally do things that don't, people don't think correlate. You can have somebody, you know, mobilize the bottom of their foot with low cross ball and improve a forward bent. He, here's the point with this. Yes, these are transient and maybe these have nothing to do with their treatment plan, but for me, if I know, okay, if I can get somebody to do some breathing work and that improves their forward bend, it's obviously something I want to imp.

Include in part of my treatment plan, but if they see that I can literally have them do some positional breathing and all of a sudden they can bend forward further and their back doesn't hurt as much. Now when I tell them that we need to do these weird little breathing exercises, they're far more likely to do it.

Not only that, they think you're some kind of a magician because you've now helped improve a pattern that they literally had pain with for who knows how long. This is something that is very powerful when it comes down to somebody committing to solving a problem with you and thinking you're the right person.

Keep in mind, you may be battling the, the ghosts of who knows how many other, uh, healthcare providers they have worked with that hasn't worked out, that have told them, oh, I can help you with this or that, or whatever it might be. We used to always think of ourself as like, we're like the cleanup person.

Very rarely are we the first person that somebody has seen, like they're gonna go to. Any number of other people that, that are a probably cost less. That are, that are gonna be in network or are going to be, you know, recommended by their physician or something like that, that they saw first. So we are having to show that we know what we're talking about and one of the best ways to do that is to test and retest things.

So test something, retest something. It also shows that you have a system in which you are actually following to work with somebody. So whatever it is that you do, make sure that you follow a system, make sure that that approach is repeatable and that you're communicating along the way. With what, what is actually going on with that person, right?

And, and for them to understand that, and when they see and feel a difference in something that's very, very powerful for you because it shows them that seeing is believing. This person not only listen to me, now they're testing things. I'm starting to feel better, I'm starting to move better. Like I'm starting to, uh, feel confident that I can make this change that maybe I thought I didn't, I wouldn't be able to ever do again.

Right? Like that's what people are thinking and you're helping them break those false beliefs so that then they can actually get back to the things that they really wanna do. So in the objective, it's really important you do your thorough assessment, you're dialing in what's actually going on, but along the way, you're educating them by doing tests and retest.

The other thing, and this is really important. Is you have to educate, and one of the best ways to do that is to draw, okay, so this is something that I picked up working for the ettes through the Ready State program, and this is something called the I three model. Okay? So this is the I three, and this is something that I would draw out for basically every single patient that I would see.

There was a new patient. So the I three model, and you can feel free to steal this, I didn't come up with it. This is from Kelly Stare. Um, this is how we would explain why we have things going on. Uh, in particular people that had, uh, injuries that were associated with minor things, like let's say somebody hurt their back, picking up a pillow or something really light.

Okay, so I three is this, it's incomplete mechanics. All right. Incomplete mechanics is number one. And by the way, if you're listening to this on the podcast and you want to see the video version of this head to YouTube, to the PT Bs channel, we're putting a lot more resources into educating there so that, that we can actually have a more, uh, profound education platform.

And you can see some of these things as we're actually like drawing these out. So, uh, incomplete mechanics is number one. All right. Then we have incidents, all right? And then we have injury. Okay, so this is the I three. Now, here's how I would explain these things, and I would draw these out. I would draw these out and actually explain this as I was going through this on a whiteboard or a piece of paper or whatever it's that you have.

Okay, so let's say somebody comes in and they hurt their back, picking up something really insignificant, a pillow, a a, a Amazon box, whatever, and you say, okay. Here's where we're at. You have an injury, so you're here. Okay? You, you now have an injury. But what happens is that injury happens off the back of incidents, okay?

Now incidents. Think of incidents as minor irritations that happen because of, you know, things that were, uh, were stressing because of either lack of strength, lack of control, a combination of the two things, lack of mobility, um, whatever it might be. And you're finding these things on your. Objective assessment, by the way.

So you're taking your findings from your objective assessment and you're now layering this into your I three model to show them where this fits. And the things we find in our objective assessment are the incomplete mechanics. So if I'm talking to somebody and I say, listen, you hurt your back picking up a pillow, I.

The pillow's not the problem, right? Don't be afraid of pillows for the rest of your life. You have an injury, now you have hurt your back. But that injury comes from incidents. So we're here, these incidents are minor, minor aggravations. You have to the, you know, uh, musculoskeletal system, the nervous system, whatever it might be that are, they're not, they're not major, but they're compounding.

And what we don't know is how many incidents do you get before you have an injury? Don't know. Everybody's different genetically. Everybody's moving patterns, different. Everybody's connective tissue, you know, resiliency can be different. There's who knows? All we know is everybody has a number. Whatever that number might be.

You hit your number when you picked up the pillow. That was the last straw event. That last straw event created. The last straw that led to the injury, the symptoms you're feeling right now, and all the frustrating things you're dealing with, but the, the root cause. Is the incomplete mechanics, it's here.

And that's because you have lay it out for 'em. You have super stiff hips. You sit all day long. You, you have no ability to, you know, access your hips, uh, when you're, when you're lifting things. So your back is having to be used as your hip, right? And what we need to do is we need to get your hips moving, like your hips, and we need to get your back.

Uh, you being used like your back and not, not have your back be your hips because it's not designed to be like that. And if you keep doing it, you're gonna continue to have problems here. So we need to fix this. We need to fix the incomplete mechanics, right? Because if we don't, here's what's gonna happen.

I will help you reduce symptoms and pain. And then essentially we are resetting this area here. So you're going back to, uh, now you, you've, you've reduced your incident clock down to a lower number, but it will start to compound again, and eventually we'll be right back here with another injury and we don't want that.

So in order for us to stop the injury from happening, we have to fix the incomplete mechanics, which we've now found and we have, uh, assessed and, and, uh, and narrow down what is going on. So that we can fix the in incomplete mechanics, which stop the incidents from occurring, which stop the injury from occurring after that.

Does that make sense? Hey, sorry to interrupt the podcast, but I have a huge favor to ask of you. If you are a longtime listener or a new listener and you're finding value in this podcast, please head over to iTunes or Spotify or wherever you listen to the podcast and please leave a rating and review.

This is actually very helpful for us to get this podcast in front of more clinicians and really help them develop. Time and financial freedom. So if you would do that, I would greatly appreciate it. Now back to the podcast.

I have said this same example to over, I don't even know, literally thousands of people, and it works really well for them to understand. Oh. This is why I'm having a problem, the root cause. And how, how many times is it that we see somebody that has a knee problem and is not their knee, it's their foot and ankle, it's their hip, it's their, it's their spine, whatever.

But to the average person, that is a hard cell. You know, like you're, no, my knee hurts. You're telling me my knee is actually fine and that I have a bad ankle or whatever that needs to be addressed. That's a tough sell, okay? For the average person, but it might be the truth, it might be exactly what they need to do.

So if you can dial that in for them and you can help them learn this, you are buy skyrockets. Okay? And people learn really well from this. There's actually a book it's called, uh, back of the Napkin, and it's about how you can use. Uh, images and drawings and, and examples like this to help, uh, with buy-in and education and it's massively helpful.

Most people are visual learners. They see these things. They're like, oh, that makes sense. Versus if you just said this out loud, it probably would make sense, but not nearly as much and it wouldn't have as much of a sticking factor as people that you draw this out for. So draw things out for people. Use a whiteboard, use a piece of paper.

This is so big and it really. It doesn't take that much time, and it really helps you dial in what's going on in the objective side of things that you've now just gone through to then bring that back to what you're gonna have somebody do, which is gonna be your home exercise plan. Right? So when you give them their HEP, here is a huge mistake that I used to make, that I hope that you don't make.

And, and hopefully listening to this, you stop doing this, uh, if, if you're, if you're doing it right now, and that is, you have to make this really simple. Okay, on the first visit. I'm talking one, maybe two exercises. That's it. Not any more than that. What I used to do is I used to think the more stuff I could give people, the more value I'm giving them, right?

So I would rush through the subjective rush through the objective, do it as much hands-on work as I possibly could with somebody, and then I would give them like six weeks of a program that I would write out that would literally take me like over an hour to put together after they left. Now, just think about that for a second.

If you are the patient and you're coming in and you have no really, like, you know, medical understanding of what's going on, and I do all that, I, uh, give you a ton of information and then I give you six weeks worth of stuff with progressions that you need to do on your own. How good of an outcome do you think that person's gonna get?

Like, that person has to be super dialed in very, very, um, you know, like strong compliance on their own and an at least some understanding of movements in order to do everything correctly. The average person is not gonna do well with that. What the average person needs is clarity and simplicity. They need clear on what's going on.

Here's the next step. Strip it down, do less. Okay. Like you, you ever seen forgetting Sarah Marshall where, uh, they're like going out to the surf lesson and, and uh, uh, Paul Rudd is like teaching him how to, how to surf, and he's just like, no, no. Do less, do less. Like that's what you need to think of. Like, and Ian, throw the clip in here.

Like, that's, that's what you need to think of is do less, do less than you think, and be clear about what's going on. So one, maybe two things. You're gonna show somebody how to do this. Okay, you're gonna make sure they understand what's going on, and then we're gonna follow up with that to make sure that they, they actually understand.

So do less one to two exercises. That's it. Keep it very simple. And then what you're gonna do is you are going to give them a pop quiz.

So pop quiz, what are you gonna tell your significant other? What are you gonna tell your brother? Whatcha gonna tell your friend? What do you tell your roommate that's going on with your, with your back in this scenario, right? Why are you having back pain? What's going on and what do you need to do to resolve that?

I'm gonna ask them this before they leave my office, and if they can't tell me what's going on, they're not leaving until I know that they understand what's happening. Because I need to understand that they, that I got through to them, that they understand what the heck is going on with their body because the reality is.

They've gone probably lots of other places and no one's ever explained it to 'em. Now all of a sudden it's very, very important that you quiz them and say, tell me how you're gonna tell your spouse. Uh, you know, what, what, what's going on with your back and how we're gonna resolve it? Cool. Let them explain it, and if it's spot on.

Perfect. Awesome. Here's the deal. I'm gonna follow up after today with an email. And this is really important. So you wanna follow up email that gives them a summary of what's going on, uh, what's going on, as well as whatever it is that they need to do for their homework. Or if you're gonna manage that in a separate, you know, home exercise plan app, that's fine.

Whatever you're gonna do, explaining all that stuff in an email. So listen. Great job on the pop quiz you passed. You don't have to actually remember anything because I'm gonna follow up with a detailed email that's gonna be very simple, but very, very well laid out. So your significant other could even just read that, right, and you're going to know exactly what's going on as well as what the next steps are.

Because in that email I want to summary. I want their HEP or however they're gonna access their HEP. And then I want the next steps. The other thing you wanna make sure you're doing is you're pre-framing

anything that might be a step backwards. So let's say that you dry needle somebody. On day one, we know they're gonna be sore, right? They're gonna be sore for man. Uh, could be a couple days. So I wanna make sure I tell them in the office and in the, in the email, I wanna say, Hey, just like we talked about, don't forget, you're probably gonna be pretty sore.

That's normal. That's normal when we do this, you're probably gonna be sore for the next 48 hours after that. We expect this is gonna feel a lot better. And if you don't say that and they're just like, oh, this is getting worse, I think, I think he messed messed me up. I don't know if I did the right things.

I dunno if it's the right, right, uh, person to help me. Like you leave it open for interpretation versus making sure they know, hey, I fully expect you're gonna be sore for the next two days. Okay. Just so you know, like that's normal. If you need anything, this is how, just reach me, email me right back here.

I'm gonna send you a homework summary of what's going on and they're gonna have a lot of clarity around what that is, as long as, as well as what the next steps are. Okay? So let 'em know, I'm gonna send you this. You send it to 'em after the visit, and then the last thing, or last part of the visit is really the solution.

Okay? And this is where everybody actually starts to feel really weird. Like when you start to talk to somebody about what it, like, what it costs to work with you. Uh. Money makes everybody feel weird as clinicians. Okay. But here's the thing, I don't want you to think about it as what is this gonna cost? I want you to think about this as what do we need to do to get the sol, uh, the, the outcome that you want?

What, like, what's the solution to this problem? I. Okay, so if I say, listen, Brian, you have, you know, back pain that has been, it's, it's like pretty bad right now, but it's, it's chronic. It's been going on for a long time, and you have these sort of bouts where it comes and goes and, and for, you know, for a month or so at a time, it really restricts you.

So this is what we consider a chronic problem with these acute bouts that are occurring. This is something that is not gonna be fixed overnight. I'm not gonna see you one or two times and this is gonna go away. This is not a simple problem. We literally have decades of stuff that you have been doing that we need to help you, correct?

And we need to make sure that you, uh, make those changes for the long term and we fix the incomplete mechanics and the root cause of what's going on. I've seen a lot of people that have had this similar problem in my experience. Here's what I see. It takes about three months for us to resolve this problem.

In the first month, we're gonna see you probably once a week, ideally, right? There's a lot of hands-on work that I'm gonna need to do to really start to, uh, alleviate some of the pain you're feeling and really help you move better and start feeling a lot better, which is gonna allow us to do a lot more of the hard work we need to do, which is gonna be certain exercises that I'm gonna build out for you, where it's gonna start to feel almost like a mini workout.

And once we do that. You're gonna start to spread your visits out a little bit. So instead of every single week, maybe it's, you know, every week and a half to two weeks as we give you more time to build up your exercises and we have you come back in so we can do more hands on work and we can progress your exercise and make sure we're coaching up and do everything, uh, appropriately, as well as holding you accountable to these changes you're gonna have to make.

'cause we're also gonna talk about. How do we improve some of your sleep, which we need to do? How do we improve some hydration you have going on? How do we manage some of the stress rather better, like the breathing stuff that we worked on? It's a huge part of what we talked about. These are all things that I wanna be able to teach you and educate you on that are going to help make a meaningful difference in your health and eliminate your back pain long term.

Okay. In order to do that, we're looking at about three months and probably somewhere around, you know, eight or 10 visits. My, uh, suggestion for you is that you do a 10 visit package with us. It's gonna be the best, uh, like price per session for you, and it's gonna allow us to actually build out our entire plan of care and hold you accountable to sticking to that actual plan of care, which I wanna make sure that you do.

'cause most people what happens is we're pretty good with our hands and after the first couple sessions. Your back pain's probably gonna be pretty much gone and you might think, oh, problem solved. This guy's amazing. But the reality is, it's not, I've just resolved some of the symptoms. I haven't actually created a long-term problem because, uh, I, or, or solved your long-term problem.

I, 'cause I can't do your exercises for you. Like I can't go to the gym and bench press for you and get your arms bigger, right? Like you have to do that. You have to do this work and we have to build the right things for you, which we're really good at. And we have a great track record with this. But this is my recommendation.

And then just be quiet and say, this is what I recommend. This is what's gonna get you the best, uh, the best outcome. Don't, don't think about can they afford this? Like, can they, uh, can you know what, what's the, uh, all these other, you know, circumstances that you might have running through your head and you start to feel weird about it.

What is your medical opinion of what this person should do? That is the recommendation you give them and then be quiet and let them make the decision. Don't make the decision for them. Don't talk them out of it. And this is a huge problem that I see where people are like, well, we could do this or that, or like, you know, let's just see how it goes, and then we can decide from there.

It's like, no dude, be a professional. If you have worked with people like this, what is your opinion? Tell me what I need to do. I do not want somebody who's wishy-washy and, ah, I might maybe, I don't know. It could be this or whatever. Just keep, remember this. Confidence without humility is arrogance, but people want a confident medical provider.

They do not want somebody that is unsure. They, and, and if you're unsure. Refer them to where they should go. If you're unsure because you're like, Ooh, we're getting some weird caught, some weird stuff. I really think it would be best if we got you over to this provider first. Here's why. We wanna make sure it's not any sort of underlying thing that's going on.

Then you shouldn't be here because maybe it's symptoms coming from something systemic, which happens. And I've sent plenty of people away. That I needed them to make sure they didn't have some sort of systemic thing going on. 'cause they showed some red and yellow flags that, you know, they didn't belong in my office.

That is called being a good provider, right? That's called being a primary skeletal, you know, musculoskeletal healthcare provider, and that's what you want. Awesome. Then act like it. But if they're not inappropriate for your clinic, then be a professional and tell them what your opinion is of what they should do, and then shut the hell up.

Don't talk so much at the end of your visit, tell 'em your opinion. Be quiet. Let them decide on what they wanna do, and then you can talk to 'em about what their options might be. But don't talk 'em out of making a decision. So that is the the solution, right? You're selling the solution. You are not selling.

The the plan. You're not, you're not selling the package of visits. You're selling the why. Okay, why? What do we need to do? We need to get you back to running and help you manage weight so you can look great in your bridesmaid's dress. I. Here's what I see, okay? It's probably gonna be two months, which is basically what it's gonna take up until the wedding for us to get this, this pretty simple issue resolved.

I expect to see you this many times during that time. We're gonna work on these things, uh, for you at home. We're gonna talk to you about these things in the office. I'm gonna hold you accountable to making some of these changes 'cause they can be kind of hard. So I'm gonna be your accountability partner, which is dramatically increase the likelihood that you actually do it, and we're gonna get you there.

Your knee's gonna feel great, you're gonna look great. This is what it looks like. That's it. You're selling them on the why that they have with the appropriate solution to their problem, and it's very important that you go down the route of plans of care and getting people to commit to a plan of care.

Because in our experience, if somebody's gonna drop off, it's usually gonna be between visit two and three. And go figure. If you're pretty good with your hands, you're probably gonna have significant symptom reduction after two to three sessions. And this is where somebody who is the average consumer, not a medical provider, they think this person's awesome.

They solve my pain in like a couple visits. I'm good to go. I have nothing else to do. Like, fantastic. But we know the problem is not solved. So when it inevitably comes back, they're gonna think, oh, this person only got me like temporary relief. Like they, they really weren't that good. Um, and yet you didn't have a chance to actually finish the drill.

You never finished the plan like that is what's frustrating about not being able to have somebody commit to a plan of care. So getting over the, the frustration of the, of the sales process and the fear of that is something that's very important for you to do, not just for your business, but for the outcome of this person if they're saying they wanna do this.

And for many of the people that come and see us, like I said, they've seen other people and they have not got the outcome that they wanted. That is something that you gotta pin them down. You gotta get them to say, this is what's going on and I'm gonna make this change and I'm gonna be held accountable.

'cause when you pay, you pay attention and when you have somebody that is laying it out for you and being a part of that accountability process, which is a big part of what we do and what people will pay for, by the way, people find a lot of value. In accountability, they do not find a lot of value in you spewing a bunch of information at them and just giving them an overwhelming amount of crap.

That's what you think that they find value in, but it is not. They find value in clarity, accountability, and simplicity. And if you can take them through that process, you are gonna have so many people get amazing outcomes. It is going to. Catapult your business because they're gonna tell all their friends and family about you.

It's gonna make marketing very easy, and it all comes down to you getting buy-in on the first visit and them actually understanding what's going on. It's the most important visit. It's like there's no other visit as important as the first visit, and you even have to do that much like hands-on stuff, teaching exercises.

I've had plenty of visits where I literally didn't do anything besides listen to somebody in this subjective, do a very thorough objective assessment and educate them on what's going on. And then it was like, look, today I. We, we got deep into what's going on. We, we, we narrowed down the root cause and here's what we need to do to fix it, and this is what we're gonna do the next couple sessions, and here's what we do in the next couple sessions.

You can lay that out for them as to what they can expect. Right? And that's very, very good for them to understand what the path forward looks like. And when someone is clear, they're down to commit. And when somebody's confused, they're not right. And that, and that's just the way somebody makes buying decisions.

Imagine if you're confused. What if you're gonna buy a new car and you're confused as you're like. Uh, how many seats does this have? Uh, what kind of engine is this like? What are my financing options? Like if it's not clear, they're not gonna buy it. Anything, whatever. It's, and the medical process is even more confusing 'cause people don't know what's going on.

You know, you're talking to, you know, teachers and accountants and you know, people that work in sales. You're not talking to other medical providers. You. Gotta keep in mind this, you have to keep it so simple and clarify things for people. Clarity, simplicity, accountability. These are huge things that are so, so valuable, valuable, and important.

And they're not the medical things that you've been taught to do on an assessment so much, but, but yet, you're already gonna do those things. Just make sure you don't put too much weight. On your, you know, 20 exercises you want to give this person from the get go or however many different manual therapy techniques you wanna do.

Like you can save that, spread it out. Don't do so much upfront. Okay, so in summary, let's go back through this real quick. Alright, so number one, take the easy wins. Use their name, show up on time, build rapport, you know, talk to 'em about it, uh, about how they got there, where they live, their family, like little things like that, that, that it's a human to human connection.

Okay? Get to know the human a little bit. Don't forget to ask 'em how they ended up in your office. Who, who told you about us? How'd you hear about us? That's huge for you to help with your marketing, to know what's working and to reach out to somebody if they refer them to you. To thank that person to write that person a handwritten card.

By the way, thank you so much for sending. Brian to see me. I, I, I really appreciate. We're a small business. We don't have a big marketing budget. This means a lot to us. Thank you. That goes a long freaking way for God's sakes. Like you wanna get more referrals? Do that shit and see how many referrals you actually get.

Subjective. Listen to the person in front of you. Alright? Let them tell their story. Let them get the frustrations they have out. Ask why questions. Go a couple levels deep. Make sure you're asking them why. Why is that important to you? Why now? Like, why, why is this, uh, timing important? What's going on? And they'll tell you, and now you know what you can actually talk to 'em about that reiterates why they need to do the hard work they're gonna have to do with us.

Because physical therapy, delayed gratification, painful hands-on exercises, weird little exercises, you know, or painful hand, hands-on, manual therapy, weird little exercises, and then delayed gratification to get the outcome that they want. That's hard to sell. Okay? So you gotta know what you're tying that back to in order to get them to do that.

On the objective. Be thorough like you would normally do. Test, retest are a great way to dial in. Uh, you know, what's going on with somebody and seeing is believing. If they can see something change, for better or worse, if they can see range of motion improve, even though we know it's temporary, like we're not trying to sell somebody.

Snake oil or whatever. We're trying to show them that, that we understand the human body enough to be able to make these temporary changes and it gives us a better idea as to what things we need to work on with them long-term to make these long-term changes where we can improve their symptoms in their range of motion.

Educate, use something to draw right. The I three model. Take it, like, steal it, please. This, this works like a charm and it'll help your sales process, but more than anything, it'll help with you getting buy-in and, and people actually understand what's going on. And isn't that like the most important part?

Like somebody actually understanding what's going on and, and being clear about that is so rare in the medical community. And if you can do that, you set your throat yourself from everybody, like everybody that they've ever seen. It, it, there's gonna be a huge difference in terms of their experience with you, their customer experience, the way you made them feel.

People remember that. So the I three model, incomplete mechanics lead to incidents, which then lead to injuries, explaining that to somebody or whatever. Use whatever terminology you want. I don't really care. Like whatever you do, if you wanna split hairs and physical therapy, which we love doing this shit and telling each other why we're wrong about randomized control trials is whatever bullshit you wanna say, I don't care.

Put whatever you want in here that's gonna make sense to you and your methodology so that you know, we're not in different camps of how you're gonna explain this stuff, but this is how I like to explain it, and this makes a lot of sense to the average person. Okay, so incomplete mechanics leads to incidents.

Incidents leads to an injury. In order for us to stop these small injuries or incidents from occurring, we have to fix incomplete mechanics. Here's what we found that are your incomplete mechanics. Once we solve those, we resolve the injuries long term. Make sense? Cool. Home exercise plan. No more than one to two exercises.

That's it. You can't do more than one to two. Don't give them three. Give them one to two, ideally, one. Give you one thing to work on. Okay? Here's what we're gonna have you work on. Get really good at this. We're gonna make sure you understand this, and when we come back together next week, we're gonna layer on from there.

We're gonna build on top of that, right? This is the foundation. Give 'em a pop quiz. Okay, when you get home, whatcha gonna tell your significant others going on? How are you gonna explain it to them? Because they also are gonna have to explain to them why they probably just spent $2,000 with this person to solve a problem.

And it sure as hell helps with buyer's remorse. Uh, when you follow up with a homework email, which we'll talk about in just a second, like a homework email that reiterates this as well as, uh, making sure that they can articulate that to you and they understand what's going on. So, follow up with a homework exercise or a homework email that's details with the visit, uh, whenever what you found, what the next steps are.

And gives them, you know, whatever the, or maybe it's the home exercise that you showed them, or it's like access to, you know, a, uh, a, a a a app that you use for homework exercises, whatever you're doing to actually implement that. Everything is in there. You're following up with, uh, a summary of what's going on and then what the next steps are and how they can do the, the things that are their homework, right?

And then the last thing is make sure that you are talking to 'em about the solution to their problem. And you're not talking to 'em about, you know, the, the actual, like packages that you have necessarily you're talking to 'em about what your medical opinion is of what they should do and why, and why they might want to actually commit to a plan of care if it's appropriate for them.

That's the other thing. It should be appropriate. If it's not appropriate, then don't bring it up. Right? Like be ethical with your sales process. And the the truth is the vast majority of people that come to see us. They don't have something like super simple going on that's going away in a couple visits.

They probably do need to work with us in a plan of care. 'cause it makes the most sense for both parties. But if they aren't, then don't bring it up. Okay? You have to be, you know, consistent with, with what you're doing. And it should be based on your medical opinion of what they should do, not necessarily on what business, you know, solution you want.

And this is gonna make a lot of sense too. When you have staff that you bring on, you have to be consistent with them about like what you expect as far as ethics are concerned. And there can be some lines blurred here with businesses where it's like, yeah, this is better for the business, but this is, this is maybe better as a, as a clinician and what the patient wants.

As always, pick what's best for the patient, period. Okay, but don't. Don't undervalue what your worth is either, because I can tell you for a lot of clinicians, just because they don't know what to do with somebody long term, when they're not in pain, it doesn't mean there's not a lot of value there. So that comes down to education with you and your staff, but always make a decision based on your honest medical opinion of what they should do.

Be agnostic. To the cost of it. Okay? This is what I recommend. Here's why. Here, here's your options. Which would you like to do? Don't talk them out of the of the sale. Don't talk them out of the decision. Let them make the decision. And that's it. All right. So if you do these things, there's very few things that I can teach that I think will improve your business more than a rock solid first visit.

The way you set it up, the way you follow up with that person and teeing up the next visit, because this is gonna help your outcomes as far as your patients are concerned, this is gonna, uh, help your, uh, sales percentage dramatically. Okay. We didn't even talk about sales, sales processes or, or sales training or anything like that.

If you do the first visit, right? It's sales easy. It's so easy. And this is like so paramount. This is a foundation to everything else you're gonna do with this person and any other interaction you're ever gonna have with them. For the lifecycle of them working with you. They're gonna remember this and you're either gonna leave a great impression on that person or it's gonna be, nah, it's okay, right?

You don't want to be in the middle. It's probably not gonna be so bad. They're gonna tell everybody that you're terrible, but you wanna be light years better than any other health ex uh, health uh, interaction they've ever had, which is not hard to do 'cause most healthcare experiences suck. So you doing this is gonna put you in a, like top 1% they'll ever experience in healthcare.

And if you can do that, this is going to be a massive, massive improvement for your business, a huge win for you and your staff. And it's a process you continue to follow, uh, and improve in your own business in, in a way that makes you know the most sense to you. But this is a great outline to follow. So I hope this helps you.

I hope that you find value in this if this is something that you know, you find valuable. I would a hundred percent recommend going to physical therapy biz.com and take a look at other resources that we have there. Uh, learn a little bit more about our team, learn about how we're helping literally hundreds of clinicians all across the country and how we've added literally hundreds of millions of dollars of revenue to cash-based clinics across the country over the last few years.

The stuff we talk about works, the stuff we talk about comes from our own practice and our own experience as clinicians. Like I've treated many patients this way. I have a degree. It's right there. Like this is my world and I just so happened to open a business and found that this is an interesting thing that I actually really enjoy and I enjoy being able to help a lot more clinicians be able to do this well, but.

If you want to ex really experience what it looks like to work with a group that has helped thousands of clinicians and is teaching things that are not only ethical, but also very effective, go to physical therapy biz.com. Take a look at what we have going on, and if it makes sense, pick a time to chat with one of our advisors and they can dig into your business with you.

You wanna see where you benchmark across all these different business metrics that we look at compared to the hundreds of clinics that we work with. We take you through our Business Bloodhound assessment and we show you exactly where you're doing well and exactly what you need to improve, and you can leave that call with so much fantastic information.

So. That's it. I appreciate you watching this and listening to this. Danny Te here again, founder of PT Biz. Until next time, you know, enjoy this information, apply it, and hope it helps your business.

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