For most physical therapy clinics, physician referrals have provided a steady trickle of new patients over the years—enough to keep the doors open, at least. But, when you expand your patient acquisition efforts beyond marketing to local physicians—specifically, by turning your focus to the patients themselves—you could exponentially increase the number of new patients walking through your door. Remember, today’s patients are researching their care options before they even talk to their doctors—which means there’s a huge opportunity for you to grab their attention before they set foot in their physicians’ offices. But to do so, you’ll have to not only embrace consumer-facing, direct-to-patient marketing, but also leverage direct access to its fullest extent. Here’s how:

1. Understand the physical therapy direct access laws in your state.

As of 2014, every state allows for some form of direct access to physical therapy, which means every provider has an opportunity to, at minimum, see a patient first—without a physician referral. While some providers may only be able to perform an initial evaluation prior to obtaining a doctor’s note, others can complete an entire course of care without physician involvement. Regardless of where your state falls in the mix, though, you can (and should) still benefit from direct access—and so can your patients. As Dr. Heidi Jannenga, PT, DPT, ATC/L, wrote here, “Direct access to therapy has shifted from being the exception to being the rule.” To learn about the rules in your state, check out this series of posts on the WebPT Blog.

Check with your payers.

In addition to reviewing your state’s current requirements, you should also review the terms of your payer contracts. As Jannenga wrote here, “in some cases, the referral requirement comes from the payer, not the state. If you mistakenly believe it’s a state requirement when it’s not, then you could actually be missing out on direct access patients with PT-friendly insurance carriers or those who are willing to pay cash.”

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2. Get clear about your value; then, communicate it.

We’ve been talking about the physical therapy branding problem for several years now—and while the industry is making progress, we still have a ways to go. Recently, our friends at Strive Labs put together some really interesting analysis based on data from this source and this one: only 9.58% of all patients who could benefit from seeing a PT ever do. As Jannenga wrote here, “That means 90.42% of those patients are missing out on the extremely valuable care that we are uniquely able to provide.” Thus, she continued,“To make the positive impact we want to make on a global scale—and ensure our ability to continue providing care to patients in 2018 and beyond—we must do a better job of communicating our value. To put it simply, more people must understand the benefits we, as rehab therapists, are able to deliver.”

Create a patient-centered marketing strategy.

To accomplish that, physical therapists must develop—and implement—a marketing strategy that communicates their value in a way patients can recognize and appreciate. Here are a few tips to help you do just that (adapted from this article):

For even more great advice on marketing your physical therapy practice, check out this PT-focused modern marketing guide

Now that some form of direct access is available across the entire US, physical therapists have an even greater opportunity to step into their emerging role as care coordinators for patients with neuromusculoskeletal conditions—something Jannenga believes “PTs are are uniquely and exceptionally well-qualified to do.” By seeing patients first—even in states where PTs are only allowed to provide an initial evaluation—you can be the one to assess a patient’s condition and determine whether physical therapy intervention is appropriate. If it is, great—you can then refer that patient out to a PT-friendly physician in your network to obtain a referral before continuing care. And if it isn’t, also great—because you can then refer that patient to a provider who is better suited to help, thereby strengthening your relationship with that patient and the other provider. Just think: if that patient has a positive experience with you, he or she may return if another problem pops up—and/or refer you to a friend or family member.

Partner with other providers.

As we’ve mentioned before, this new era of health care is one of collaboration and cooperation—not competition—and that goes for fellow therapists as well as other providers. According to Jannenga, 2018 “will be the year we step out of the physician shadow and firmly establish ourselves as care coordinators for patients with neuromusculoskeletal conditions.” But that’s going to require a confidence boost—and maybe even some bold moves, like pushing for interoperable technology that enables better care coordination among providers.


While you don’t need to drop the doc completely—nor should you—relying solely on physician referrals isn’t a sound business strategy going forward. Rather, expanding your marketing efforts to include patients—as well as other providers—will ensure more people are aware of the benefits of not only physical therapy in general, but also what you and your practice have to offer.

Are you using direct access to build a more profitable PT practice? Tell us how it’s working for you in the comment section below.