Goodbyes are never easy, especially when they’re directed at patients who haven’t yet reached their physical therapy goals. Even if you’re dealing with a difficult patient, cutting him or her loose goes against everything you’ve been taught as a healthcare provider. And if you’re a practice owner, losing a patient probably seems contradictory to your business goals. After all, more patients equal more money, right? Not necessarily.

Unfortunately, this belief—no matter how well-intentioned—can result in wasted time, energy, and resources for patients and providers alike. That’s why it’s important to recognize situations in which saying goodbye might actually be a good thing. With that, here are some common scenarios when it’s okay to lose a patient:

The State of Rehab Therapy in 2018 Guide - Regular BannerThe State of Rehab Therapy in 2018 Guide - Small Banner

1. Your schedule is overstuffed.

Today’s physical therapists are operating under a lot of pressure—pressure to do everything from completing documentation in a timely manner to delivering outstanding outcomes. On top of all that, PTs often feel obligated to cram as many patients as they can into their daily schedules in order to help their practices stay financially solvent amid shrinking reimbursements. That’s a tough balancing act. After all, if your schedule is too jam-packed, it could keep you from devoting enough time to each patient to give him or her the proper one-on-one care he or she needs—and that can directly affect therapy outcomes. And with many payers shifting to value-based payment models, poor outcomes could mean poor reimbursements.

Don’t get me wrong, losing patients due to an overstuffed schedule isn’t ideal. Instead, physical therapy practices should focus on matching patients with the right providers—ones who aren’t overworked. Doing so will:

  1. take some pressure off of therapists who are already spread too thin,
  2. ensure that each patient receives the care and attention he or she needs, and
  3. guarantee that the workload is spread evenly across all providers on the team.

2. The patient's diagnosis falls outside of your scope of knowledge.

Let’s say you’re a physical therapist who specializes in sports rehabilitation, but you’ve received a referral for a diabetic patient suffering from peripheral neuropathy. As a sports PT, you could probably help this patient alleviate his or her neuropathy pain, but chances are, there’s a provider out there who’s better suited for the job. In cases like this, it’s good to have a network of providers you can turn to so you can ensure the patient gets to the physical therapist with the right experience and know-how. Plus, identifying these patients—and referring them to the right provider—is crucial because it:

  1. minimizes excess healthcare spending, and
  2. helps the patient return to full health faster.

(As a side note, to prevent these situations from occurring in the first place, make sure your practice website and marketing materials clearly communicate which conditions you specialize in and the types of services you offer.)

3. The patient isn’t responding to therapy treatment.

I’m sure I don’t have to tell you how valuable physical therapy is, but every once in a while, therapy alone just isn’t enough. As Christie Downing, PT, DPT, Cert. MDT, ICLM, discusses in this article, physical therapists can be instrumental in identifying patients who would be better candidates for surgery than physical therapy intervention. By using your own diagnostic methods, paying close attention to the patient’s medical history, and establishing good lines of communication with physicians, you can make sure the patient gets the right care at the right time. As an added bonus, if you’re open and honest with a patients when they’re not the right fit for physical therapy, you’ll earn their trust. And should those patients need PT services in the future, they likely will return to you.

Losing a patient isn’t always a bad thing, but that doesn’t mean you should turn a blind eye to patient dropout. Ready to increase your clinic’s revenue—and produce better patient outcomes in the process? Download our free guide to patient retention.

4. The patient has the wrong mindset for physical therapy.

Let’s face it: physical therapy is hard. You know it, and I know it—but do your new patients know it? When a new patient walks into your practice, he or she won’t always know what to expect. It’s important that patients know their success with therapy hinges on their participation in, and adherence to, their home exercise program. That’s why it’s important for therapists to have an expectation-setting conversation with every patient at the start of care. That said, some patients—no matter how much you want to help them—just won’t be prepared to put in the work. It can be difficult to accept, but when patients have the wrong attitude for therapy and aren’t willing to be your healthcare partner, they’re wasting their money and your time. When that happens, you may need to offer them alternative options until they’re ready for therapy.

5. Your practice is too far away for the patient.

Finding the perfect location for your physical therapy practice requires research—and strategy. Even if you’ve scoped out a beautiful space with ample parking and little-to-no competition in the surrounding area, some patients might consider it too far to be worth the trip. This can be especially true for new patients. While loyal, long-time patients are more likely to go out of their way to see you, new patients—especially those who are new to physical therapy in general—might be more inclined to skip their appointments (or find a provider closer to them). Even when a patient is highly motivated and committed to therapy, if he or she lives too far away, you may start to see a pattern of consistent tardiness and cancellations—both of which hurt your practice’s bottom line. (Pro tip: If you practice in a rural area where most of your patients must travel substantial distances to see you, you might want to invest in telehealth technology or an interactive home exercise program tool like WebPT HEP. That way, you can always stay connected to patients, even when they can’t make their appointments.)


They say that parting is such sweet sorrow. But, when you and a patient go your separate ways, it doesn’t necessarily have to be a sad occasion. Whether you’re passing the torch to the right provider or mitigating financial waste, splitting up might be the best course of action. After all, if you do your best to do right by the patient, it might not be “goodbye”—just “see you later.”

  • 4 Subtle Ways You're Killing the Patient Experience Image

    articleJun 22, 2018 | 6 min. read

    4 Subtle Ways You're Killing the Patient Experience

    A positive patient experience is essential for instilling confidence and security in your patients—and for sustaining a healthy practice. When patients feel rushed, dismissed, or expendable, they’ll often drop out prematurely —and possibly seek care from a different PT (or move on to a whole other discipline). With that in mind, here are some of the common ways you’re subtly sabotaging the patient experience that you work so hard to create in your practice: 1. Providing a …

  • Why I Paid $75 Per PT Visit for Two Months Image

    articleAug 24, 2018 | 9 min. read

    Why I Paid $75 Per PT Visit for Two Months

    When I woke up after a night of boot-scootin’ my way down Lower Broadway—Nashville’s famous honky-tonk alley—my head wasn’t the only thing that hurt. In fact, the moment I stepped out of bed, I knew I was in serious trouble, even if I wasn’t quite ready to admit it to myself. Part of me was in denial that I could actually injure myself from swinging through one too many do-si-dos. But, the shooting pain I felt on …

  • Why Every PT Needs a Physician Bestie Image

    articleJan 28, 2019 | 6 min. read

    Why Every PT Needs a Physician Bestie

    Physical therapists fought long and hard to earn the professional autonomy that they have today. And yet, it’s still not complete, full autonomy; unrestricted direct access isn’t universal , and PTs have to obtain physician recertification of Medicare POCs every 30 days. It sometimes seems like a frustrating Mean Girls type of situation, where physicians are like the cliquey, cool kids, and you (the PTs) are forced to constantly compete for their attention and respect. So, maybe …

  • Patient-Focused Revenue Strategy for Outpatient Rehabilitation Image

    articleMar 23, 2018 | 6 min. read

    Patient-Focused Revenue Strategy for Outpatient Rehabilitation

    If you run an outpatient rehabilitation practice, facility, or department, chances are good that you’ve been looking for ways to help boost your organization’s revenue—especially given the fact that third-party reimbursement rates have been steadily declining (or at least remaining stagnant) for a while now. While you could certainly try to renegotiate your contracts —or haggle for more approved visits per patient—these strategies may require more effort than they’re worth. Instead, there are patient-focused strategies you can …

  • 6 Ways to be the Healthcare Partner Your Patients Want Image

    articleMay 4, 2018 | 7 min. read

    6 Ways to be the Healthcare Partner Your Patients Want

    If you’ve ever been ballroom dancing, then you know how important it is to communicate effectively with your dance partner. Heck, even if your experience with whirling around a dance floor is limited to weddings and high school proms, you surely know that dance partners must move together to avoid stepping on each other’s toes. It may not seem like it, but as a rehab therapist, you share a similar goal to waltzers and fox-trotters everywhere. That’s …

  • Founder Letter: 3 Ways to Become a Better PT, OT, or SLP in 2019 Image

    articleJan 8, 2019 | 11 min. read

    Founder Letter: 3 Ways to Become a Better PT, OT, or SLP in 2019

    It’s official; we’ve closed out 2018 and are stepping into a brand-new year. While I don’t recommend saving up those important intentions and resolutions for the kick-off of a new year, it does represent a potent time to release the things that no longer serve us—and embrace more of what does. In the past, I’ve used this occasion to put out some predictions for the year to come—and I’ve done that again here —but right now, I’d …

  • articleOct 28, 2010 | 3 min. read

    TOP 10 Ways a Web-based EMR System Can Improve Your PT Practice

    More focus on patient care . Less time spent with double-entry of findings and less room for error and confusion that is inevitable in hand-written notes. Simple and consistent SOAP note formatting gives you uniform documentation throughout your clinic. More professional image. Physicians have already started using EMR systems and come to expect the same from other medical professionals. Reduce supply costs . Average cost of paper charts can be anywhere from $3 to $6 in raw …

  • The State of Rehab Therapy in 2018 Image

    downloadJun 28, 2018

    The State of Rehab Therapy in 2018

    To see results from our most recent industry survey, check out the 2019 State of Rehab Therapy Report. To say that the healthcare industry is complex would be an understatement. While the advent of technology has made care more precise, efficient, and collaborative than ever before, it has also put greater pressure on providers to deliver high-value care at scale. After all, big data makes it possible to not only develop the most effective, evidence-based best practices …

  • The Great 8 Elements of the Patient Experience Image

    articleMay 24, 2018 | 10 min. read

    The Great 8 Elements of the Patient Experience

    As I was getting ready to graduate college and begin interviewing for jobs, I was blown away by the experience I had with Ernst & Young. They were engaging, showed interest in me as a person, and paid attention to all the details. When I flew out to visit the office, they picked me up in a limousine, left a gift bag in my hotel room, and took care of just about every other detail. And even …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.