Is It Worth It? Danny on Why Ongoing Visits Matter in Cash-Based PT

If you've ever questioned whether you're truly delivering enough value during ongoing visits—or if you’ve wondered whether clients are just coming back because they like you—this is the blog you need to read.

Dan Matei, founder of PT Biz, recently tackled this exact question after one of his longtime clients asked:
“Am I really worth $200 an hour just to help people maintain their progress?”

It’s a question many cash-based clinicians quietly ask themselves. The answer? Yes—if you understand the value of continuity.

What Is Continuity (And Why It Matters)

Continuity—also known as recurring or ongoing care—is the part of your business that continues long after a patient’s acute issue is resolved. Most traditional PTs were never trained to think this way because insurance tells us to discharge patients as soon as the pain is gone.

But in the cash-based world, continuity isn’t just allowed—it’s critical.

Whether you’re helping someone stay out of pain, improve performance, or simply feel supported in their health journey, recurring care is where long-term transformation (and revenue) happens.

Why Most PTs Struggle With This

Many clinicians struggle with recurring care because of one simple reason: they underestimate the value of what they know.

Dan shares the story of helping his training partner with a jammed toe—something he fixed in 15 minutes. His friend was amazed. But to Dan, it was just another day.

“We assume everyone knows what we know. But they don’t.”

Your skills, your knowledge, your guidance—it’s not common sense. It’s incredibly valuable.

Two Paths for Ongoing Visits

Dan outlines two main tracks for ongoing client work:

1. The Hands-On Path

If you’re a great manual therapist, lean into that. People feel better with your hands-on care. Whether it’s soft tissue, joint work, dry needling, or just helping them move better, many clients will gladly pay for how you make them feel week after week.

2. The Consultant Path

Think of yourself as a "human body consultant." You're helping with movement, sleep, nutrition, stress, recovery—all the things your clients are constantly bombarded with online but don’t know how to sift through. You’re their trusted guide in a noisy world.

Often, the best care is a blend of both.

Real-Life Impact (Beyond the Clinic)

Dan shares a story about a patient who worked with him every Monday for over a year—long after his back pain was resolved. They’d warm up together, lift, do some manual work, and talk about life. That man ended up in better shape in his 50s than his 20s.

“The only reason he stopped was because I stopped seeing patients.”

That’s the power of long-term trust, accountability, and real transformation.

Why You're Undervaluing Yourself

Here’s the truth: the only person doubting the value of your ongoing visits is probably you.

Clients don’t think like you. They don’t assign value based on complexity or novelty—they assign value based on how they feel, how they move, and how supported they are in their lives.

And when it comes to their body, their health, their performance… most people don’t want to DIY it.

Train Your Staff to Think This Way Too

If you run a clinic with a team, this is even more important. Your staff will model your beliefs. If you don’t believe in the value of continuity, how can they confidently guide patients beyond discharge?

This is an opportunity to expand your team’s mindset—and your business.

So… Is It Worth It?

Yes.

It’s worth it because:

• People feel better when they work with you regularly.

• You help them stay active, healthy, and pain-free.

• You provide clarity in a world full of noise.

• You build trust that leads to lasting change.

“You’re not just a fixer. You’re a guide. A consultant. A partner in health.”

And that, more than any one session, is the real value.

Want Help Building a Recurring Model in Your Practice?

If you’re ready to start building recurring revenue and lifelong relationships in your cash-based PT practice, check out our 5-Day Challenge or get our PT Biz Book to see how 240+ clinicians have built scalable practices with real impact.

Want help navigating these phases?
Visit physicaltherapybiz.com or book a free strategy call to talk through your goals with someone who’s helped over 1,000 practices do the same.

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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: [00:00:00] Let's talk about continuity, people coming back to see you on an ongoing basis and if it's actually worth what you're charging people. I'm Danny Matta, I'm the founder of PT Biz, and today we're gonna talk about ongoing visits, not just what to do or, or, or how to sell these and all that stuff. We, we talk about that a lot.

This, this is what we call continuity or recurring services. And this is a really important part of a business, incredibly important part of a practice. And in the physical therapy profession in particular, we're really bad at this, very bad at this. Um, and mostly it's because you never really learned what to do with people after insurance told you that it was time to discharge him.

So knowing that and knowing that it's a big part of our. Business success, long term building this recurring volume. We have to take a step back and we have to look at the hurdles you're gonna hit when you're trying to build [00:01:00] this type of your business up or this portion of the business up. And I recently got a message from one of my favorite clients.

This is a, just a incredibly, you know, uh, positive person that we've had a chance to work with for a few years. And, and, um, he basically messaged me and, and asked me if what he was doing with people ongoing. Was worth $200 an hour. Basically, right now, he has about 70% of his clients that are just coming back to see him in an ongoing basis.

And, uh, he's essentially asking that, you know, am I making a meaningful difference or are they just coming back because they like me and. I thought that this was an interesting question and kind of a kind of funny thing to see from the outside because I remember feeling very similar when I was in clinic and I was seeing people that were coming back to see me for all kinds of things.

Right? And in fact, early on in my career, I would, um. Essentially fire [00:02:00] clients. You know, I was, I was like, look, this isn't a maintenance place. We solve real problems. Um, you know, once we're done with, uh, with solving your problem, you're outta here. Right? You don't need me anymore. I need to, I need to save my time to teach people, you know, that are, that are that need to learn how to take care of themself, right?

I wanna empower you to take care of yourself. And that's cool. And I think there's a place for that. And I still strongly believe that people need to take a, they need to take ownership over their own health and wellness, but. At the same time, there a is a lot, there's a lot of value in what we do on an ongoing basis, in a number of different ways that we take for granted.

And I'll tell you why. It's because this information that we know how to deal with injuries, how to help people with, you know, physical goals that they might have, um. We just assume everybody knows this, right? We think that that's just normal. And, and I'll give you an example. My training partners, I have a, a buddy that I [00:03:00] work out with every morning, not, not a, not in the health and wellness field, none of that.

He, um, he basically jammed his toe really bad and. Uh, so I took a look at it. Uh, after we had done training, uh, that day I, uh, basically, uh, got the joint moving again. I threw some Kinesio tape on there, uh, and stabilized it with the toe next to it. And he messaged me later and he was like, dude, I don't know what kind of.

Voodoo you just did to my foot, but it doesn't really hurt at all anymore. And I'm not limping walking around to my meetings today and, you know, took me about 15 minutes. Uh, I completely dismissed as just normal. But in actuality, uh, what we do is incredibly valuable. Incredibly valuable, you know, and, uh, we just take it for granted.

Now, think about people that are coming back to see you on an ongoing basis. A, do you think that it is our place to [00:04:00] assign value to what other people wanna spend their money on, right. Or what they see value in? Do you think it's our place to say, yeah, I don't think that you should do this anymore and here's why.

And I don't think that that's the right lens in which we need to make decisions for other people. Like people buy all kinds of things. People spend money on all kinds of things, and it depends what they see value in. You know, and there's lots of things that are far less valuable than what we do on an ongoing basis.

And in, in fact, what we do is incredibly valuable. If you really think about it, you know, you're somebody that can help somebody live a more active, pain-free, enjoyable life. What the heck is that worth? What? Do me a favor, put a monetary value on the ability to live a longer, healthier, more active life with your loved ones.

I'll wait. What do you think that's worth? Like what would you assign that to? Is that more valuable than a new tv? Is that more valuable than all the supplements that people buy on a monthly basis? Is that [00:05:00] more valuable than, you know, a $500 bottle of wine is that, that's probably more valuable than damn near anything that people actually can help somebody with because your body's your vehicle in life.

And what we dismiss is the fact that people find spending an hour with us. Incredibly helpful from an accountability standpoint, from a motivation standpoint, shit, sometimes they want to come in and just have somebody listen to them while you work on their whatever area that gets tight and do manual therapy.

And they assigned so much value to that, that they independently want to come back and see you forever. I had a patient that had hurt his back really bad, uh, doing like barbell movements, and I got him back to the point where he, he wasn't, you know, in pain. He was able to move around. Um, and he really wanted to get, you know, back to training, but he was very concerned about, uh, lifting again.

And we, you know, we did a bunch of stuff to progress him to the point where he could. [00:06:00] Really exercise and do whatever it's that he wanted to do again. But for some reason he still wanted to come in, and this was every Monday. He wanted to come in on Mondays and have me go through a warm warmup with him, and he just wanted to bench press and do rack poles with me, you know, assessing that, and then basically doing some manual therapy work afterward.

And I remember thinking like I would never pay somebody $200 an hour, which is what we're charging at a time, $200 an hour to warm me up, watch me do bench press and rack pulls, and then, you know. Whatever, do, do some manual therapy to my back. Um, but I've never had a debilitating injury the way this guy had where he couldn't walk his dogs, he couldn't help his wife around his house.

Like he couldn't do basically much of anything. And he was really concerned that that would happen again. And, and he wanted to have somebody that he trusted that could help him work through that. And here's the net. End result of that. By the way, I saw this guy for well over a year. Once a week. He, and, and early on it was obviously we're solving a problem, but a [00:07:00] lot of it was we were actually working on health and wellness goals, and we would talk about things that he had questions about from a health and wellness standpoint.

While he was in the office. So as we're resting and we're talking about what to think about as he's going through his lifts and different warmups that we would go through, he's learning new movement patterns. We would talk about food and sleep and stress management and all these other things. And, and I also referred him to a personal trainer that he wanted to work with on a more regular basis.

And it, by the end of the year, year and a half, ended up working with this guy he was in better shape at, in his mid fifties than he was in his mid twenties. And the only reason, the only reason this guy stopped working with me was because I stopped seeing patients like I just left patient care to essentially focus on running the business and helping people in PT bs.

And if it wasn't for that, he probably would still want to come back and see me. Now, would I do that? No, but I also know what I'm doing. I understand that. And we assume that because we know it, it's less valuable. How about this? [00:08:00] My air conditioner broke. It's hot as shit. In Atlanta. My air conditioner broke.

The tech that came out had to fix it. It was a couple hundred bucks. I don't freaking know. The first thing about fixing an air conditioning unit, do you think that person feels bad about it? Absolutely not. They're just doing their job. My air conditioner works now. I paid them, they're happy for that. And they don't feel bad.

One bit about coming back, you know, to do maintenance work on these units to make sure that they work like, and I see a lot of value in that because I want my house to have like, you know, not be 95 degrees. So the first thing we have to realize is because we understand something, it doesn't mean that it's not valuable.

In fact, you have to look at it from the lens of someone who is coming to you as a patient because they don't know this information. But I tell you this much, somebody being able to use their body in the world is a hell of a lot more important than air conditioning. Like, not even close, not even close.

And yet, you know, we feel bad about people working with [00:09:00] us ongoing if we don't feel like we're making these world changing. You know, like, uh, changing progress and whatever it is that they're dealing with. And once you get past that stage, a lot of us don't know what to do with people or maybe don't know why they want to come back.

And again, they come back because they like you, you make them feel better. You make them move better. You hold them accountable. They learn things from you. You help curate the right information from them. Or for them, think about how much bullshit is on the internet when it comes to health and wellness.

Like you. Just being able to curate that for people is huge. And I would tell you there's two main areas that I see people move into. Continuity or ongoing visit paths. Paths that one might fit better for you than the other, or maybe it's a mixture of both, which is kind of what I did. Number one, you're a great manual therapist.

Look, people come in, you put your hands on them. It makes them feel better. It makes them move better. You know, like it makes them more confident what things they're gonna do. Sports are gonna, they're, they're gonna do activities around their house, with their family, whatever. Think about how many professions do [00:10:00] ongoing.

Work with people and they feel better because of it. You know, massage therapy, chiropractic, acupuncture, you know, physical therapy, like traditionally we don't do that, but we have a strong skillset. If you are into manual therapy, you're a strong manual therapist and people feel great, I guarantee you have a line out the door.

People that wanna come back and keep seeing you because of that. That's one path you can take using your hands to help people feel better. There's just something so. Profound and important about human touch, and it makes a big, big difference. The other thing that you have to keep in mind is the fact that the second track is you can take the consultant path and, and I would kind of consider myself a, a human body consultant.

This, when people would ask me what I did, you know, I was like, yeah, I'm a physical therapist, but really I'm more of a consultant for the human body. I help people with these things, you know, uh, movement, sleep, nutrition, stress management, and we, we take those four variables and we help them live a high performance, pain free life.

And I would help people with all of those. I would adjust programming. Sometimes I would do their programming. [00:11:00] I would overlay things on top of programming that they had a coach. Do you know, we would actually have them go through movement patterns. We would actually have them train in some cases, like this one patient that I had, sometimes they would come in and we would talk for 30 minutes, and then I would do some manual therapy work on an area that was feeling tight, or if they've been in a position for a long period of time because they just got back from a long flight and we helped them kind of move a little bit better and, and get moving and you know, look.

I haven't looked at research in a long time. Okay? I'm not gonna be the first person to tell you that this article says this river. I'm sure you can find plenty of things that are gonna point to the, either the benefits or the lack of benefits for manual therapy. I don't know, but here's what I can tell you.

I feel better if somebody gets, you know, their hands on me and, and does a number of different things, whether it be dry needling or soft tissue work, or joint manipulation or mobilizations or whatever it is, it might be plenty of people do. If you are okay with that and the people that you're working with feel good about that.

Why would you not wanna do that? Right? Like, and if you're against it, then cool. Then don't do it. Then focus more on the human body consulting side of things. Educate [00:12:00] people and you can teach 'em so much and you can hold them accountable. And accountability pay people will pay a lot of money for accountability because it's helping them achieve the goals that they have.

So when we look at this ongoing visit, the only person that's going to. Not think it's very valuable. In many cases, it's gonna be you. It's gonna be you. And if you don't think it's valuable, because you're looking at it from this bias lens of like, well, how hard could this be? Like I just fixed this guy's toe.

Like everybody can do this, right? No, people can't fucking do that. That's my point. People don't know what to do if they think they broke their toe and then they waste their time in the hospital instead of talking to a physical therapist that understands musculoskeletal injuries that they can directly talk to.

Boom, problem solved. It's a hell of a lot easier if they have an ongoing relationship with that person that they're using as their consultant essentially quarterbacking their health and wellness. That's what I'm talking about. You're undervaluing what you're doing for people because you think everybody knows how to do that, and that's not the case.

That's not the case. You have [00:13:00] to truly have a belief, a deep belief that what you do is valuable because other people will assign value to it, A lot of value to it, but if you don't. Then they're not going to want to come and see you. Many of them won't. Some of 'em are still gonna come and see you 'cause they don't actually care what you think.

You make them feel better. But if you want your staff now, this is, this is where it gets even harder. If you want your staff to continue to follow a path of not just. Get 'em in discharge. Get 'em in. Discharge is traditionally what our profession does and it is a bitch of a business to run and it doesn't allow you to build long-term health and wellness relationships with people that make a massive difference in their life over an extended period of time.

If you don't believe that, how do you expect your staff to sell that? How do you expect your staff to then have people come back in and maybe they don't know the skills for that? Great. Most of us are big nerds. This gives us a great opportunity to learn about how to get into these different variables, understand these different things, dip into lifestyle medicine a little bit more.

Understand other manual therapy techniques that maybe you don't know yet, like lifelong learning's a real [00:14:00] thing. It's a great place to do that, and it forces you to expand your scope, your aperture widens for the skills that you have as a clinician so that you can now focus on helping other people over a much more extended period of time and achieving goals and and outcomes that you didn't even know were possible or they didn't even know were possible.

And that's a really cool place to be. And that's the area that I really, really found fantastic when it came to a cash-based practice was that I could. Really get to know these people. I could build a lot of trust with them. They would like listen to what I had to say. They would make changes in their life.

I knew about their friends, their family, their, their work. I knew all these things. They, they were trusting enough to tell me when something was bothering them, and we could kind of work through different things and different strategies. From a stress management standpoint, all these things are just part of being a freaking human that doesn't know what to do with those.

We get a chance to then work on those areas with people. And make this massive change in their life and many, many variables that that affect their, their life in, in a positive or negative way. And that's a really cool place to be. Not only is that a cool place to [00:15:00] be, that's a really great place for you to be as a business owner.

So if you ever question about, you know, whether you're worth it or not, the only person questioning that, it's probably you.