4 Signs Your Staff Clinician Has a Money Mindset Problem (And How It’s Hurting Your Clinic)

In a cash-based practice, patient experience is everything.

While other clinics are stepping out to finish notes or staying late to document, the most successful practices stay engaged, follow up with patients, and plan care proactively. That difference shows up in retention, outcomes, and revenue.

But even with great systems, many clinics hit an invisible ceiling. And one of the most common reasons is something most owners don’t spot right away.

A money mindset problem within the clinical team.

Why This Happens So Often in Physical Therapy

Most clinicians go into physical therapy because they want to help people. They get deep satisfaction from seeing patients recover, return to sport, or live without pain.

That’s a good thing.

But it also creates a distorted relationship with money, especially in cash-based care where clinicians must clearly communicate value and cost.

Owners tend to work through this faster because revenue directly impacts their livelihood. Staff clinicians don’t feel that same pressure. They’re salaried. They don’t see the full financial picture. And because of that, money avoidance can quietly bleed a business dry.

Here are four clear signs it’s happening in your clinic.

1. They Decide What a Patient Can Afford Instead of What They Need

This is one of the biggest red flags.

A clinician looks at a patient’s job, car, clothing, or family situation and quietly decides what that person can afford. Then they recommend a downgraded plan before ever presenting the clinically appropriate option.

That’s not being considerate. It’s being disrespectful.

Your job as a clinician is to diagnose the problem, determine the prognosis, and recommend the plan of care required to achieve the patient’s goals. It is not your job to decide someone’s budget for them.

Patients will tell you if affordability is an issue. Let them make that choice.

2. They Apologize for Pricing

The moment a clinician says, “I know this is expensive,” authority is gone.

Apologizing for pricing instantly signals uncertainty and lowers perceived value. It makes patients uncomfortable and forces them to question whether the service is worth it.

Great clinicians don’t justify their pricing. They explain outcomes.

If someone asks why care costs what it costs, the answer is simple: expertise, results, and experience. Patients are not paying for time. They’re paying for certainty, guidance, and outcomes they can’t achieve on their own.

3. They Downgrade Plans Without Clinical Justification

This one quietly destroys revenue and burns out staff.

A clinician knows a patient needs six months of care but sells a smaller package and stretches it out with extra home programs, remote check-ins, and unpaid work in between visits.

They think they’re helping.

In reality:

• The patient gets suboptimal care

• The clinician does more work for less pay

• The clinic loses tens of thousands in revenue annually

Multiply that behavior across multiple patients and months and the financial impact is massive.

4. They Make Up Stories About Patients’ Finances

“This patient has kids.”
“This person’s a teacher.”
“They probably can’t afford it.”

These stories feel empathetic, but they’re fictional.

You don’t know a patient’s household income, savings, priorities, or support system. People spend money on what they value most. Your job is to explain why care matters and let them decide.

When clinicians project their own fears about money onto patients, they limit outcomes for everyone involved.

Why This Is a Silent Killer for Clinics

Money mindset issues don’t show up on reports. They don’t trigger alerts. But they quietly cap growth.

Clinics with this problem:

• Under-prescribe care

• Miss revenue targets

• Burn out staff with unpaid labor

• Struggle to scale sustainably

And it doesn’t fix itself.

How Owners Should Address This

You have to talk about it directly.

Help your clinicians:

• Understand the true value of what they do

• Reframe pricing as outcomes, not cost

• Share patient success stories regularly

• See how under-selling hurts patients and the clinic

If you don’t address this, you’ll continue bleeding potential without ever knowing why.

Create Space for Better Conversations

Many owners never even realize this is happening because they’re buried in documentation and admin work.

That’s where Claire helps.

Claire is an AI scribe trained specifically for physical therapists. It handles documentation instantly so clinicians can stay present with patients and owners can focus on leadership, training, and growth.

Try Claire free for 7 days

Final Thought

Money mindset issues don’t mean someone is a bad clinician. They usually come from a good place.

But left unchecked, they will limit your clinic’s impact, income, and ability to grow.

If you see these signs, address them. The health of your business depends on it.

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: 

[00:00:00] Hey, what's going on, doc Danny here with the PT Entrepreneur Podcast, and today we're talking [00:00:05] about the four signs that your staff clinician has a money mindset [00:00:10] problem. This is something that [00:00:15] I, I think is incredibly common in our profession, just healthcare in general, that [00:00:20] we end up having a lot of issues with.

Money and our [00:00:25] relationship with money and our relationship with, uh, selling services that we have for money. [00:00:30] Um, because number one, this is like, you know, we're helping people with injuries. Uh, [00:00:35] we get a lot of personal satisfaction outta doing that. We would do it for free if we could. It comes from a good [00:00:40] place.

Okay? So this, this is a problem that comes from a good place. Doesn't mean it's not so a problem in your business. And this is [00:00:45] something that you have to address yourself first. And usually for the business owner, they tend to address this far [00:00:50] better because. It legitimately is how they're, you know, paying for their livelihood.[00:00:55]

Like, and it's, it directly reflects that. So if you have a money mindset problem and you're [00:01:00] unable to talk to people about. The plan of care they need to do because of the [00:01:05] cost of it. Uh, you're just shooting yourself in the foot and you go home every day and you see your, [00:01:10] your kids, you see your family, you see the mortgage that you have, the groceries you have to buy, and you get over that shit pretty fucking [00:01:15] fast because it directly affects you.

And you start to realize, damn. [00:01:20] I gotta stop being a little punk about this, and I gotta start facing the fact that this is some, a fear that I [00:01:25] have to talk to people about money and it, it is going to be how I provide for [00:01:30] my family, so I better get over this. That is very different when you have a staff provider, a staff [00:01:35] clinician, because you're paying them a salary.

Right. They don't necessarily see the inputs and the outputs in the [00:01:40] business the same way. They don't take the risk that you took, and it doesn't reflect on them the same [00:01:45] way. So this can be a silent killer in businesses. And in fact, I see this be a [00:01:50] huge issue in clinics far more than it is that, that people come in and they have a, [00:01:55] uh, a healthy mindset around the services that they're providing.

In fact, I almost never see that. [00:02:00] Um, there's always some amount of, you know, education that has to happen with people that move into a cash [00:02:05] based setting. Because they have to have conversations with people about money. [00:02:10] And it's because you're the one deciding on their plan of care. Um, you know, it could be like, uh, my, [00:02:15] my friend went to a veterinarian and the veterinarian said that their dog needed some sort [00:02:20] of, um, you know, uh, shots to be able to be boarded at a, uh, [00:02:25] daycare facility, uh, like a doggy daycare facility when they'd go outta town.

And my friend was like, dude, like [00:02:30] what does that, you know, so what does that cost? And the veterinarian was like, I don't talk about money. You can go talk to them at the front desk, which I think [00:02:35] is. A really bad approach, honestly, because that makes it weird for [00:02:40] everybody versus for you to just say like, oh yeah, it's, this is what it costs, and be cool with [00:02:45] that.

Like just be fine and normal with what you're telling them it costs because they actually need it. [00:02:50] So like what's the what? Why feel weird about telling somebody what [00:02:55] something's gonna cost if they actually need it? That's just. That should be very, very, you know, clean, [00:03:00] normal, should feel normal. And if it does, then the provider, the, the, the patient or the [00:03:05] client in this example is gonna feel normal as well.

But when you fumble things and you make it feel weird, it [00:03:10] makes them feel weird. So here are four signs that your staff clinician [00:03:15] is, um, is struggling with a money mindset issue that you need to address and you need to [00:03:20] talk to 'em about. So number one, they're deciding on affordability for patients, [00:03:25] you know, versus deciding what, what people actually need.

So, uh, I'll give [00:03:30] you a good example. Um. You know, they'll, they'll decide [00:03:35] based on many, many different factors what that person's driving, what their [00:03:40] job is, um, but they're associating what somebody can afford. [00:03:45] Versus what they actually need. So this idea of like, oh, I think they can probably [00:03:50] only afford, you know, to come in visit to visit, versus they need to come in for [00:03:55] three months to solve this problem for, you know, whatever the diagnosis is, be [00:04:00] agnostic to what you think people have access to or not let that is [00:04:05] disrespectful.

That's, it's, it's, it's just the wrong way to look at it. Like you're [00:04:10] basically saying based on. Someone's occupation, [00:04:15] the way they dress their vehicle, um, that you're [00:04:20] deciding for them what they can afford versus they're obviously here. [00:04:25] They're, they want to get better. What do they need to do? What is that?

And then [00:04:30] if they do need to downgrade to other things because of true affordability issues, we can always [00:04:35] do that. Don't start with that. Don't, uh, like [00:04:40] position something for them based on your per, you know, preconceived notions that are in many cases [00:04:45] inaccurate. And I mean, I've talked about this a lot as far as like patients that.

You [00:04:50] may not think and afford what you do, but obviously can for a number of other reasons. You [00:04:55] don't know what their family dynamic is like. You don't know what kind of access to resources you have. You don't know how much they value [00:05:00] this and how important it's to them. People will spend money on the things that they value the most.

They [00:05:05] may have zero value in other things that maybe you assign value to, but it's not your job to assign that to them. [00:05:10] Two, they apologize for pricing. [00:05:15] If your staff is saying, look, I know this is expensive. That is you're dead in the [00:05:20] water. That is not good. Like you don't justify your [00:05:25] pricing. If somebody asks, why is [00:05:30] this more expensive?

It's because we're the best at what we do. [00:05:35] That's why we're unicorns when it comes to this stuff. [00:05:40] We're the best in the area by a mile. We have the, the best outcomes, [00:05:45] the best experience. You know, we, we have the best processes to get you where you, where you wanna go. How [00:05:50] important is the outcome to you?

Do you wanna work with the best or do you wanna work with the cheapest option [00:05:55] for your vehicle in life? Your body don't lose your authority [00:06:00] for your own expertise. And I see this constantly. People who are [00:06:05] legitimately, they're world-class clinicians, they [00:06:10] justify their pricing. Two people and it makes it less valuable than if they didn't [00:06:15] justify it at all.

When people are like, why is, why does it cost X amount to work with PT [00:06:20] bs? Because we've worked with a thousand clinics, we have an incredibly strong track record. [00:06:25] You know, we have a reputation where of people that trust us, we have high [00:06:30] outcomes that are documented, and we've changed the profession.

We've added hundreds of millions of dollars in recurring [00:06:35] revenue to the cash base. World. That's why it costs us to work with us because [00:06:40] it's certainty of the outcome, because we have world class people that work with us, that help people get the outcomes that they [00:06:45] want, that directly changes their ability to create time and financial freedom for themself and for their family.[00:06:50]

You don't have to compare that to somebody else. It is what it is because we're the best at what we do. If [00:06:55] you're the best at what you do, do not apologize for what you charge. In fact, for what [00:07:00] you do is probably a steal. To other people and with the way that they, they associate [00:07:05] value and it's far more valuable than many things that people pay a lot of money for already.[00:07:10]

Don't justify it, don't try and, uh, apologize at that. Like, I'm, you know, [00:07:15] I'm sorry. It's this much, this is the way the clinic has it set up. Like, what the hell? And I've seen all these things [00:07:20] happen. Like that is killing your clinic if that's happening. If somebody's struggling, you know, [00:07:25] to uh, see value in what they do, you have to have a conversation with them.

About, like what [00:07:30] is it worth to have somebody be able to throw, you know, a baseball with their son when they're [00:07:35] coaching their team and they're unable to do that? What is it, what is it worth for somebody to be able to hike up, you know, [00:07:40] this whatever mountain with their, with their kids or their grandkids?

You know, what, what is it worth for somebody to be [00:07:45] able to participate in this sports that they do, where their community is there, they travel with them. It, [00:07:50] it adds just so much joy to their life. Like, what is that worth? What is it worth for them to be able to take care of their body [00:07:55] long term and understand and learn from you to be able to take care of this?

This, you know, very, very [00:08:00] precious asset that they have that is their, their body and in a limited amount of time that we have, like, what [00:08:05] is that worth? It's incredibly valuable when you put it in the right context. And for a lot of [00:08:10] your providers, they're not really viewing it that way. And what they've learned is what the insurance companies have told 'em that they're [00:08:15] worth what the, you know, general sort of like PT profession, things that they're worth.

And what you're [00:08:20] worth is what somebody's willing to pay you. All right. And if you're really good at what you do, you should charge, you know, for what [00:08:25] that is. But your staff doesn't feel the same way as you because it's not their business. So you're going to have to have conversations with them [00:08:30] about that.

And these are signs that that's somebody that you're gonna have to have a conversation with. Okay? [00:08:35] Um, if they are downgrading plans [00:08:40] without clinical justification, so here's a, here's an example. Um, let's [00:08:45] say they need to see somebody [00:08:50] for. Three months, uh, or, or in this [00:08:55] example, let's use visits. Let's say that they need to see somebody for six months, [00:09:00] and normally that would be maybe a 20 visit package that they would purchase [00:09:05] to work with somebody over a six month period.

But [00:09:10] instead of them actually. Recommending what they need. [00:09:15] They decide that they're going to, uh, have them buy a 10 visit package, but they're just gonna [00:09:20] space these visits out as long as they possibly can. And in between they're gonna do a lot of remote management, a [00:09:25] a lot of HEP design and, and redesign, uh, program design, potentially by the end.[00:09:30]

And they're just gonna space those visits out. So for something that's, let's say it's. [00:09:35] $1,500 for a 10 visit package versus a a 20 is 3000. They're [00:09:40] deciding for this person that they're going to then have them take this option [00:09:45] that is less expensive. But keep in mind it is going to be [00:09:50] more work on the provider in between sessions [00:09:55] and they're gonna work with them for longer so that they can space this out.

I'm not saying this is a bad decision if [00:10:00] people, uh, cannot. Truly afford what they need to do, but [00:10:05] to start there, to go there and to do that on behalf of the patient without actually letting [00:10:10] them make a decision of whether they want to commit to what would be best or to what is going to [00:10:15] be not as good, but also a lot more work on the provider in between [00:10:20] without any additional, you know, payment for that.

That is not up to the, the staff [00:10:25] clinician. The staff clinician should. Give somebody a recommendation based on what their [00:10:30] evaluation shows, the diagnosis and prognosis that they have, period. And if that person needs to [00:10:35] come in for six months and see you 20 times, then that's what you need to tell them and let them [00:10:40] make a decision that they can't do that.

And then we can start to try to figure out how to be as [00:10:45] creative as we can to work with them. But the reality is you don't start there. [00:10:50] And I've seen this on many occasions and if, if you have [00:10:55] staff, clinicians. I bet you this is happening in your own clinic right now where they're saying, [00:11:00] Hmm, like that's, this is less money.

I feel more comfortable here. I'm gonna sell this, but then I'm gonna [00:11:05] space it out. If somebody is, is doing, let's say a 10 visit package, that's really something that should be [00:11:10] completed in three months, somewhere in that range. If somebody needs to see you for six [00:11:15] months, you really need to give them the option that is appropriate for them.

Regardless of what the cost is, and again, this [00:11:20] comes back to you like you're making, buying decisions based on what the provi or what the patient, [00:11:25] uh, you know, should make the decision for. Like, it's not up to you to, to make [00:11:30] the decision for them. It's up to you to give them the, the, the, the, the diagnosis and the [00:11:35] prognosis and the corresponding plan necessary to achieve the goal they have.

And it's up to them to [00:11:40] decide whether that is something they can do or not. Not for you to decide that on their behalf, and [00:11:45] this is a absolute silent killer in your business. If you think about this, let's just say you have five [00:11:50] people a month that this provider is seeing that should be doing [00:11:55] something that is twice as expensive in your business and they're, they're, they're doing it for half as much.

So [00:12:00] $1,500 versus 3000. That's a $1,500 difference times five. That's [00:12:05] $7,500. That's $90,000 in revenue difference. In a [00:12:10] year, if that number was to be the same every single month, just by them making a buying decision [00:12:15] for the patient and not based on what they need first. [00:12:20] It, it, it, it is a, a massive difference maker in your business and something that needs to be addressed [00:12:25] because it's not fair for that person to make the decision for the patient.

It's also not fair on them to [00:12:30] have to do all this, all this additional work that they space out over a longer period of time than they, they should, [00:12:35] that they're not getting compensated for. Because if they're not generating the revenue for the clinic, we [00:12:40] can't increase their compensation even though they're putting additional work in, and it leads to more burnout, burnout [00:12:45] on their behalf just because they think they're doing the right thing for somebody.

So it's this. Really bad, sort of catch 22 [00:12:50] that like they're, they think they're doing the right thing, but in fact they're actually kinda shooting themselves in the foot and they're shooting the [00:12:55] clinic in the foot. So if you're noticing this, make sure you're having these conversations with them. The last thing [00:13:00] they're making up stories about people, like, this person has three kids, so I know [00:13:05] money is tight, right?

Like, this person is doing X, Y, and z. I've had people that I've done this [00:13:10] with myself, um, I've done this with like. Police officers. Right? I mean, I, I [00:13:15] had, um, a lot of law enforcement that I would work with, uh, whether it be, you know. [00:13:20] Different law enforcement groups in Atlanta or federal agencies, they would come and work to me just because of my experience in the [00:13:25] tactical world and still having a lot of, uh, I was doing a lot of education in the tactical world for, [00:13:30] um, the, for Kelly Retz group.

And so I would get federal, even [00:13:35] active duty folks who would come in from around the Southeast as well as, uh, local law enforcement. [00:13:40] And it used to be like, man, I was like, dude, I, I've, I've gotta, you know, really, um, [00:13:45] be efficient with these folks. You know, I'm, I'm doing all this additional work, [00:13:50] uh, all this like program design that's taken me a really long time.

I'm not charging them for, for anything. [00:13:55] And what happened was it started to really detract from my ability to, [00:14:00] uh, grow the business, to focus on the business. It was taking time away from, from me whenever I was, [00:14:05] should be done and, and either able to like, take care of myself and train or. [00:14:10] My family and spend time with them.

So I was pouring all this additional time into things that I [00:14:15] thought I thought was the right thing. And in actuality, like I was just making these decisions on behalf of these folks. [00:14:20] And as I started to pick. The decisions that were like appropriate for them, [00:14:25] right? The, the packages, the plans that they needed to do, things like that.

I, the vast majority of people didn't even bat an [00:14:30] eye at that because you don't know, okay, somebody could be a police officer. What does their spouse do? What does their [00:14:35] family dynamic look like? You know, you have no idea what other, you know, assets they have [00:14:40] and, and cash flow they have and, and resources they have.

You have no idea, and it's not fair for you to try to [00:14:45] like pigeonhole people. If you don't make up stories for people about, yeah, they have [00:14:50] three kids and if they do this, then they're not gonna be able to buy groceries for themself. You know, [00:14:55] like people are not gonna choose their lower back pain over groceries.

That's not happening. But yet we tell ourself that, [00:15:00] right? So if you're seeing signs of this, if you're seeing, uh, you know, your clinicians [00:15:05] really show signs of having money, mindset issues, you've gotta address it. And you have to have an honest [00:15:10] conversation with them about the fact that what they do is really valuable.

This is usually where the [00:15:15] drop off is. People, they, they think that it is valuable, but when they look at [00:15:20] it, they say, I don't know if I would pay for this myself. Of course you wouldn't pay for this for yourself. You already know [00:15:25] this information. You already know. Y you think it's less valuable than it [00:15:30] is because it's something that you are an expert in.

That's a bias. That's all it is. [00:15:35] Whereas plenty of other people will pay a lot of money for that. If I'm an [00:15:40] attorney, I'm not gonna pay another attorney a bunch of money to put contractual agreements together for [00:15:45] me. We're not gonna just do it myself. I don't see the same value in that. But yet they see a [00:15:50] lot of value in you helping them with their back pain or whatever it is.

And you don't see as much value in it. 'cause you think everybody [00:15:55] just understand. You think it's simple. You think this is like basic information that everybody knows. They do not. They do not. And they [00:16:00] also do not have the accountability and the expertise from somebody in person that can help guide them through to the next [00:16:05] steps.

And they're frustrated and they see a lot of value in you helping them get the outcome that they want. So you have to [00:16:10] have conversations with your staff about just how valuable it's, and some of this comes down to just [00:16:15] patient stories. You know, tell me a story of a patient that you helped get back, you know, have an amazing [00:16:20] outcome and get back something really cool that was meaningful to them.

They have so many of these examples. We [00:16:25] literally perform these mini miracles with people every single day, week, month. [00:16:30] Like the things that we help people do are amazing. We, and we help 'em avoid way more [00:16:35] expensive and way more invasive things like surgeries. Like what is it, what is the value of [00:16:40] helping somebody avoid shoulder surgery that they didn't need yet?

They were gonna go and get anyway. Think about how many. [00:16:45] Uh, surgeries are done, are not even truly necessary. It's many. If you help somebody avoid [00:16:50] that, what is the cost of that? What's the risk of, you know, going under anesthesia? You know, what's the [00:16:55] rehab process look like? All of that, and maybe they don't even get to have an outcome any better after the fact.

We [00:17:00] see this constantly. What is that worth? These are the things you need to make sure you're having conversations with your [00:17:05] staff about. And if you are struggling with this, still take this as your own advice. [00:17:10] If you can't fix this, how are you supposed to help your staff address, uh, address this? And if your staff [00:17:15] doesn't address this, it's gonna kill your business because they're not gonna be able to grow the way that it should.

You're not gonna hit [00:17:20] the numbers that you should. Uh, it's, it's basically like internally you just see this slow bleeding out [00:17:25] of the potential of what the clinic should be doing. So these are the signs that your staff member has a money mindset [00:17:30] issue. That's what you do about it. If you see it, address it, it's not going away on its [00:17:35] own.