As a physical therapist, balance is intrinsic to your job—whether that be striking a balance between motivating patients and not pushing them too hard or treating patients for literal balance issues. And PTs have to find balance for themselves, too—though maybe not as literally as vestibular patients. In 2017, we surveyed thousands of rehab therapy professionals across all specialties, job roles, and clinic sizes and asked folks about everything from reimbursement rates to frustrations and motivations with their profession. In many cases, we found a lot of consistency in the responses—with some variation based on practice size. However, there were a few exceptions, including the question, “How many patients do you see per day?” Responses for this particular question were more or less all over the board, and that made us wonder: how many patients should a physical therapist see per day in order to strike a perfect balance? Here’s what we learned:
Why is there so much variation?
Physical therapy isn’t a cookie-cutter profession. In fact, if you had a room full of physical therapists, each provider would likely report a very different day-to-day experience. There are many factors that contribute to this variation—all of which impact how many patients any given provider can realistically treat in a single day. While it’s tough to quantify these forces across every PT setting, these are the main overarching factors that influence the number of patients a PT sees in a day:
One of the many perks that come with being a PT is the flexibility it affords. (Not that kind of flexibility, although I have known some yogi physical therapists.) PTs can choose to work full time, part time, or per diem. And, of course, the number of hours a PT works in a day will directly affect the number of patients he or she is able to see.
Many practices make use of physical therapist assistants, therapy techs, athletic trainers, and other support personnel. So, a PT may technically see a large number of patients in a day, but that volume may not be sustainable or realistic without the help of such extenders.
Payer Rule Variation
Even if your practice is totally cash-based, you’re likely familiar with the restrictions some payers impose on the duration and manner of therapy treatment. Some payers even require that patients be seen by therapists only—thus eliminating the opportunity to use PTAs or techs. And that, of course, can decrease the number of patients a PT is able to see in a day.
Like many other healthcare professions, physical therapy features a wide array of specialties. From sports therapy and pelvic health to cardiovascular and pulmonary rehab, there’s a plethora of niches a PT can pursue, and each one has unique characteristics that can impact a therapist’s daily patient volume.
Does your team strive for quality over quantity? Does your practice use specialized modalities or treatment methods? That fact is, no two clinics have an identical culture. And depending on the culture of your clinic, PTs may spend more or less time with each individual patient. Furthermore, if—as mentioned above—a practice leverages extenders, thus leaving therapists to primarily conduct evaluations, then that could also impact the number of patients a therapist sees in a day, as evaluative visits generally take longer and require more one-on-one time than standard treatment visits do.
Reimbursement amounts vary by state, which means many PTs in one state might feel pressured to see more patients in a day than their peers across state lines. For example, a provider in New York City may feel compelled to treat more patients in a day than his or her peers across the river in Newark due to differences in payment and cost of living.
How do you know if you’re seeing the right number of patients?
Clearly, the number of patients a PT should have on his or her daily schedule depends on a number of factors. But, the number of patients you physically can see won’t always align with the number of patients you should see. Ultimately, that number boils down to what you can comfortably manage without sacrificing care quality. So, perhaps a better question might be, how do you know when you’ve hit the sweet spot? Here are some signs:
You’re busy, but not burnt out.
Nobody likes to sit around the clinic with nothing to do, but at the same time, your work life shouldn’t be so jam-packed that it creeps into your after-work life. Striking that balance is often easier said than done. After all, if you’re busy treating patients, you might not have much time for things like completing documentation between sessions—and you could end up bringing that work home with you. It’s not unusual for this to occur every once in a while after a busy day. But, if you find yourself routinely saddled with homework—particularly if you’re starting to dread or resent it—then you might’ve crossed the threshold from “busy” to “overworked.” And eventually, that could morph into “burnt out.”
Your patient outcome scores are on par with your peers’.
If you’re devoting the right amount of time to each patient, then it stands to reason that your patients will reach—and in some cases, surpass—their therapy goals. And if you use a patient outcomes-tracking tool (like outcomes data for all of your patients and see how the results you deliver compare to averages for your clinic as well as clinics across the nation. This may seem like a no-brainer, but providers don’t always link poor patient outcome scores to an overloaded schedule. Of course, there are many reasons why a patient may not be achieving his or her outcome goals, such as the patient’s inability to complete home exercises or lack of investment in therapy. However, as the provider, it’s your responsibility to notice any blockers—and find resolutions to them.
Satisfaction scores are maintaining—or even improving.
You're not the only one who’s impacted by your daily schedule. Whether or not they realize it, your patients can tell when you’re seeing too many patients—and when you’ve struck a happy medium. The fact is, patients don’t want to feel like products on an assembly line. They want to build rapport with you, and when you deliver that rapport, it has a positive impact on patient satisfaction. In fact, multiple studies—such as this one from the Journal of the American Medical Association—have found a positive correlation between patient satisfaction levels and the amount of time a patient spends with his or her provider. However, if you’re cramming too many patient appointments into your day and not providing each patient with the one-on-one care he or she expects, then patient satisfaction levels will likely suffer. So, make sure you’re tracking patient satisfaction—or even better, patient loyalty—at regular intervals throughout each patient’s plan of care. (Pro tip: We recommend using the Net Promoter Score® (NPS®) to really get at the heart of patient loyalty.)
Here’s the truth: there’s no ideal number of patients that applies to all physical therapists. To be successful, you need to see enough patients to pay the bills, but not so many that you fall out of love with your profession—and that volume will vary from person to person. So, instead of focusing solely on a set number of patients, make sure you track more holistic—yet measurable—data such as patient outcomes, NPS®, and satisfaction scores. That way, you’ll have a better idea of when you’ve struck a perfect balance.