Blog Post

Designing an 11-Star Experience: How the Chairs in Your Clinic are Impacting Patient Outcomes

Non-clinical factors play an integral role in shaping the patient experience, optimizing outcomes, and fueling clinical success. Read on to see why.

Keaton Ray
5 min read
April 22, 2022
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I’ve been in private practice physical therapy for nearly a decade now. I’ve seen the incredible impact physical therapists have had on our patients’ wellbeing. I’ve also experienced the ongoing struggle for payment, patient retention, practice act battles, and employee engagement. For a profession that contributes to healthcare cost savings, adheres to evidence-based practice, receives doctoral-level education, and contributes to so much societal good, why does it feel like we are in a constant fight for survival?

I’ve heard many arguments in response to this:

  • We’re just not good enough at what we do. 
  • There is a deficit in referral source understanding of PT.
  • We haven’t done enough legislative advocacy to stand up for our rights.
  • We’re no good at marketing.
  • PTs just aren’t very good businesspeople. 

However, I actually think we’re doing pretty good at all of the above! I believe there is an entirely different and often overlooked explanation why PTs don’t yet have the market share we desire in the movement industry: Lack of focus on the patient experience. 

Let’s start with a story. 

The patient experience is shaped by more than just the care provided.

I spent four years right out of school at an incredible outpatient orthopedic clinic. They adhered to high-level practice standards including evidence-based continuing education, one-on-one patient sessions that lasted a full 45 minutes, minimal productivity requirements, measured clinical outcomes, and a generally positive company culture. What more could employees or patients really ask for? 

The following 30-second conversation changed the trajectory of my career and was the moment I realized our profession had a critical problem. I simply asked my clinic owner if we could “please replace the outdated paint in the clinic with something more modern? Or maybe get new chairs that were more inviting and comfortable?” He didn’t think twice about his answer: “Patients don’t care about the chairs or the paint. They care that we get them better.“ 

From that point on, I became acutely aware of the non-clinical patient experience and how it would impact not only patient outcomes, but the viability of the PT profession at large. I realized I wasn’t alone when I heard a prominent leader in the APTA speak about non-clinical factors that impact patient outcomes. What do you think he said is the number one indicator to a patient’s success with PT? Whether the patient believes they are going to get better with PT. 

The physical therapy profession has rightfully—and extensively—focused on excellence in clinical practice. We’ve established ourselves as the experts in the movement system and are now staking claim on wellness and prevention. Yet, I don’t believe that society at large universally believes in us. 

We’ve all heard the statistic time and again that only 9.58% of the US population with neuromuscular disorders ever receive PT services. Of those, only 30% actually finish a plan of care. Why? Because at the end of the day, patients are consumers of a product. In this case, that product is physical therapy. So, if we don’t optimize the experience associated with that product, why would they buy it again when there are so many competitors to choose from (e.g., chiropractors, massage therapists, acupuncturists, personal trainers, naturopaths, stretch therapists, opiates)?

To create an 11-star experience, you must consider the non-clinical factors.

At MovementX, we designed our patient experience after Airbnb's philosophy of the 11-star customer experience. According to this philosophy, business owners must consider the law of averages when trying to impress their customer base. In other words, not everyone is going to be impressed with a five-star experience. So, to ensure you’re exceeding their expectations at every turn, your company must aim to provide an 11-star experience. In turn, this makes delivering an actual five-star experience feel less intimidating (and more achievable). 

To deliver this 11-star experience, PTs must put more of an effort toward the intentional design aspect of the care experience. This means looking at the entire care journey through a patient’s eyes—from the way your chairs look in your office, to your staff’s body language, to the automated communication that happens between appointments. All of these non-clinical factors have a considerable impact on your clinical outcomes and business growth. Specifically, there are four key areas that influence the patient experience. 

When it comes to health care, there’s a lot that we don’t have total control over. However, as practice owners and leaders in the profession, we have full control over each of the factors above. So, it’s high time we use this knowledge to our (and our patients’) advantage.

If nothing else, do it for your business. 

Improving the health of our patients is at the heart of everything we do as a profession. Unfortunately, private practices have been through the ringer these past two years, and investing money and resources into improving the patient experience may not be at the top of your to-dos. However, if you flip your mindset from “trying to survive” to “investing to thrive,” you may just be able to recuperate any funds loss in the process—and then some. 

According to this article by WebPT, “as a result of patients not completing their courses of care, the average outpatient physical therapy practice loses out on approximately $250,000 of revenue per year.” Imagine the ways you could invest this revenue back into yourself, your employees, and your communities. 

To this end, I’m calling on all my fellow PTs to get strategic about building and implementing a mind-blowing patient experience in their clinics. These efforts, combined with the research supporting our practice, will help to future-proof our place in a healthcare environment that continues to grow more competitive by the day!

Catch me at Ascend 2022 in Charlotte, NC, where my co-presenter and I will provide a detailed guide on steps you can take to improve the patient experience in your clinic. We’ll also have participants design real life one-star, five-star, and 11-star experiences (which we’ll also be sharing in a future blog post). Don’t miss it! 


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