So, you’ve started a physical therapy clinic—and grown it into a thriving, successful business. Is it time to expand further—to bring in a partner to complement your service offerings, hire additional employees to round out your schedule, or even open up another location (or maybe a few)? While it may be tempting to expand as soon as you start turning a profit, there’s a good reason to make this next decision carefully. After all, overexpansion can cause failure that you may not be able to recover from. With that in mind, here are six signs that you may need to expand your business (adapted from this article and this one):

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1. You’ve got loyal customers (patients) who are asking for you to provide more services—or expand into a new location.

If you’ve got a loyal, growing base of customers who are not only willing to share their positive experiences with their social networks—thereby generating a steady stream of new business—but also expressing interest in using more of your services, then it may be time to expand. For example, if your patients have shown interest in participating in wellness services post-discharge, then you may want to consider renting out a larger space to incorporate a medically oriented gym or Pilates studio—and perhaps even bringing in another non-PT provider to complement your care. On the other hand, if you know that many of your current patients are traveling great distances to access your services—or if you believe there are potential patients in a particular area who are being underserved—then you may want to consider opening up a new clinic in that location. Either way, be sure your current patient base is strong enough to support your new endeavor.

2. You’ve got more patients than you can provide the best care for.

As I discussed here, if patients are having to wait weeks to schedule an initial examination—and your staff members are barely able to manage their current workload—then it’s most definitely time to bring in some reinforcements. The question, then, is whether you should hire temporary staff members or expand and hire more full-time staff members—and the answer will depend on whether or not you believe the rise in customers represents a long-term trend. According to Mike Kappel—the author of this Forbes article—“You should be a little leery of sudden spikes in customers. If you see a sudden surge, don’t take that as your cue to expand your business immediately.” Instead, Kappel recommends business owners “wait a bit to see if your increase in customers is consistent or temporary.”

It’s also worth noting that you can leverage technology—such as patient relationship management (PRM) software—to help automate some of your internal processes and better connect with your patients. That way, your staff will have more time on their hands, and your patients will feel more engaged in their care. Think of it as an interim expansion step.

3. You’ve got a stellar team.

As Rieva Lesonsky—the author of this article—writes, “To handle growth, your staff needs to be ready for additional work, new demands and new challenges. In other words, they need to have their act together.” Even with the best leadership skills on the planet, you’re not going to be able to ensure a successful expansion—whether that be the launch of a new service, the onboarding of new employees, or the opening of a new location—without a strong, capable team of people who are ready to “step up and take charge.” You’ll also need their buy-in, so be sure to communicate your ideas for expansion in a way that clearly identifies the benefits of the decision for your staff and your patients.

4. Your operational processes are on point.

To quote Lesonsky again, “If your business is still operating by the seat of your pants, business expansion is not yet in the cards.” That’s because “you’ll need documented processes to train new employees, replicate your services at other locations, and ensure consistent quality.” In addition to ensuring you have all necessary policy documents for patients and staff members developed and disseminated, you’ll want to take a look at the patient journey in your clinic—from a patient’s first interaction with your organization to the last—and identify any snags. Are patients waiting too long between exercises? Is the billing process smooth—or are claims being returned for missing information? Are patients receiving automated appointment reminders for upcoming appointments? Is there a process for getting lost patients back on the schedule? And don’t forget to review your technology solutions—including your EMR, HEP, billing software, PRM software, outcomes tracking solution, and analytics tools—because they’re going to become even more mission-critical as you grow.

5. You’re profitable.

This one might sound fairly obvious, but you’d be surprised by how many businesses decide to expand without being consistently cash-flow positive. According to Kappel, business owners should look at their “business’s net income,” which is essentially gross income minus expenses such as salaries and overhead. “This will tell you how much money your business is actually earning after you pay your bills,” Kappel said. “If you have regular increasing profits, it might be time to grow your business.” However, he warns business owners to focus on more than “short-term success.” Specifically, he recommends looking for “long-term successes and consistently growing profits,” the keyword being “consistently.”

6. Your industry is growing.

According to Kappel, “if your industry is growing, expanding your business will be easier.” Well, according to this resource, the US outpatient rehabilitation market is most certainly growing. Plus, as WebPT President Heidi Jannenga wrote here, 90% of adults who could benefit from seeing a physical therapist never end up doing so. In addition to being “tragic,” this statistic represents a huge untapped market for physical therapists to reach—if they can figure how to brand their individual practices as well as the PT profession as a whole, that is. There’s no doubt that the physical therapy industry has the potential to grow, but it’s going to take a concerted effort by the entire community to establish physical therapy as a valuable healthcare option.


There you have it: six signs that you’re ready to expand your growing rehab therapy business. What factors are you considering—or did you consider—when deciding whether or not to expand? Tell us in the comment section below.

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