As a rehab therapy provider, you’ve undoubtedly encountered the following scenario: a new patient comes to therapy, sets goals, and agrees to the course of treatment. Then, within the first few visits, he or she vanishes into thin air. This disappearing act is beyond disappointing, especially when you know that patients who remain in therapy are more likely to recover—and there’s a lot of research to back that up. But as Heidi Jannenga, PT, DPT, ATC/L, the president and co-founder of WebPT, explains here, "approximately 20% of PT patients drop out of treatment within the first three visits, and 70% fail to complete their full course of care." If that number frustrates you—and it should—know that you’re not alone. In fact, I’m right there with you. So, why do people go to physical therapy only to disappear later on? Here are a few reasons patients flake out, along with fixes for each.

The PT Patient’s Guide to Understanding Insurance - Regular BannerThe PT Patient’s Guide to Understanding Insurance - Small Banner

The Reason: Results aren’t immediate.

According to this white paper from Marquette University, a lack of immediate results is one of the leading causes of high attrition rates. When patients fail to see instant gains, it can leave them feeling discouraged—and convinced that therapy isn’t helpful. As a rehab therapy provider, you know that’s not the case. But how do you prove that to your patients?

The Fix: Set expectations.

Anyone who’s ever started a fitness regimen knows how easy it is to get discouraged if you don’t set goals for yourself. It’s even more discouraging if you set your goals higher than what you can realistically achieve. The same goes for your patients. That’s why, at the initial encounter, it’s crucial to set realistic goals for every patient as well as educate those patients on the kind of results they can expect. Be sure to explain that restoring function takes time and effort. Therapy is effective—and the results tend to last longer than those derived from more instantaneous treatments (e.g., surgery or injections)—but it’s not an overnight process. So, if a patient expects a speedy road to recovery, he or she will likely end up feeling disappointed.

It’s also important to reinforce the patient’s own role in his or her recovery. For example, if the patient consistently adheres to his or her home exercise program, he or she likely will experience faster—and better—results. And don’t be afraid to go a bit Ghost of Christmas Future—that is, let the patient know what he or she can expect in the event that he or she bows out of therapy early (namely, a lot of wasted time and effort with very little improvement).

The same Marquette white paper notes that dropouts experience greater physical pain, more functional limitation, and decreased health-related quality of life compared to those who complete therapy. But patients may not be prepared take your word for it, so consider leveraging your own evidence (e.g., your practice’s outcomes data) to prove the efficacy of your treatment.

The Reason: The cost can be substantial.

Let’s face it: no matter how big or small it is, an unexpected cost can be a significant deterrent to seeking necessary treatment. According to a recent survey conducted by Bankrate, one in four Americans forego health care because of cost. And considering the commoditization problem hanging like a dark cloud over the physical therapy profession, PTs are especially vulnerable to the effects of this trend.

The Fix: Advocate for your patients.

It’s a touchy subject, but understanding how to talk to patients about the cost of treatment is a big step toward setting better financial expectations. Health insurance is complicated, and some folks have the misguided belief that if a service is covered, that equals low—or no—out-of-pocket expense. That’s why it’s important to have your front-office staff go over each patient’s insurance benefits with him or her prior to the initial visit. Some practices also craft a fee schedule discount structure for those patients who pay entirely out-of-pocket, which can help lessen the financial burden. This is especially useful for cash-based practices that strive to assist individuals from all income levels.

The Reason: Patient lifestyle doesn’t jibe with treatment.

These days, about 80% of Americans have sedentary jobs, which means most of us have to put in extra effort to maintain healthy and active lifestyles. This can be a major roadblock for those who are recovering from injury or experiencing chronic pain. If the nature of a patient’s job prevents him or her from improving, the patient might feel pressured to choose between treatment or employment.

The Fix: Seek a compromise.

This can be tricky, but it’s not impossible. It starts with researching different methods to accommodate patients’ daily activities as well as helping them make healthy lifestyle changes. This could involve suggesting that patients take sick leave in order to heal, recommending products that can improve posture and form, or teaching them simple exercises they can do at their desks. Your work as a care provider should go beyond the clinic, and that includes looking for “hacks” to help patients improve without having to derail their daily lives.

The Reason: Chronic pain impacts mental wellness.

Persistent pain is an emotional issue as much as a physical one. According to the US National Library of Medicine, those with chronic pain have elevated levels of stress and commonly suffer from depression,. The Marquette study also found that patients who dropped out of therapy had higher depression scores, which can impact patients’ ability to stay motivated.

The Fix: Focus on mental health.

The fact is, for patients to improve their physical health, they often must make major lifestyle changes. This is especially true for patients with physical conditions that cause chronic pain. The combination of dramatic change and crippling pain can seriously impact a patient’s emotional well-being, so it’s vital that you emphasize the outcomes that patient can achieve by sticking with therapy. But, even if your patients can see the light at the end of the tunnel, they are going to need a guiding hand. And even though individual outcomes rely heavily on a patient’s adherence to his or her HEP and treatment, it’s up to you—the therapist—to lead the way.


Patients drop out of therapy for any number of reasons, but savvy providers know how to address those obstacles proactively—before they turn therapy patients into therapy dropouts.  By acknowledging—and solving for—both environmental and emotional factors, you can keep patients on track to not only achieve their therapy goals, but also live happier, healthier lives.

  • Retention, Please: Why Patient Dropout is Killing Rehab Therapy Practices— and How to Stop It Image

    downloadApr 24, 2018

    Retention, Please: Why Patient Dropout is Killing Rehab Therapy Practices— and How to Stop It

    Patient health is the top priority for most rehab therapists—specifically, getting patients back to a level of health that allows them to do what they love. But, when patients say “sayonara” before they reach their therapy goals, they lose the opportunity to live their fullest lives. To make matters worse, the average rehab therapy practice will lose $150,000 annually due to patient dropout alone. Talk about a one-two punch to the gut. Here at WebPT, we believe …

  • MCIDs: What Are They, and Why Do They Matter? Image

    articleDec 28, 2017 | 3 min. read

    MCIDs: What Are They, and Why Do They Matter?

    Things aren’t always as they appear, and that’s certainly true when it comes to measuring the success of rehab therapy treatment. As any therapist knows, if you make decisions based on observational data alone, determining whether or not your treatment is making a difference can prove difficult. That’s why outcomes exist: they give therapists an objective, concrete way to measure patient improvement. But, a positive outcome score isn’t necessarily enough to tell you that your physical therapy …

  • 6 Icebreakers for New PT, OT, and SLP Patients Image

    articleFeb 16, 2018 | 6 min. read

    6 Icebreakers for New PT, OT, and SLP Patients

    While beginning a new patient’s first appointment by asking why that patient is seeking your services may be the most efficient route to developing his or her treatment plan, such a direct approach can leave your patients feeling brushed off. Now, more than ever, patients want to feel connected to their healthcare providers, and that requires excellent patient communication skills on your part—communication skills that you’ll need to apply before you jump into the clinical stuff. Think …

  • Common Questions from our Cloudy with a Chance of Reform Webinar Image

    articleFeb 13, 2017 | 13 min. read

    Common Questions from our Cloudy with a Chance of Reform Webinar

    In our first webinar of 2017 , WebPT’s co-founder and president, Heidi Jannenga, teamed up with CEO Nancy Ham to discuss the current and future healthcare trends that will impact PTs, OTs, and SLPs. (Missed it? No worries; you can view the complete recording here .) As always, we received quite a few questions during the presentation—way more than we could address live. So, we’ve put them all here, in one handy Q&A doc. Scroll through and …

  • Cloudy with a Chance of Reform: 5 Key Healthcare Forecasts for 2017 Image

    webinarJan 5, 2017

    Cloudy with a Chance of Reform: 5 Key Healthcare Forecasts for 2017

    Predicting the weather is tough—just ask any meteorologist who has called for sun on the day of a major downpour. Well, predicting the fate of the US healthcare system isn’t much easier—there’s a lot up in the air, after all. But, even without a healthcare equivalent of Doppler Radar, there are a few key trends that are sure to have a major impact on PTs, OTs, and SLPs in 2017 and beyond. And to keep your practice …

  • Ditch the Carrots and Sticks: 4 Ways to Motivate Your Patients Image

    articleMay 25, 2018 | 4 min. read

    Ditch the Carrots and Sticks: 4 Ways to Motivate Your Patients

    For most patients, physical therapy takes a long time—much longer than many other types of care. Improvements happen slowly, and progress isn’t always immediately noticeable. So, how do you keep patients engaged enough to continue working hard—inside and outside of the clinic—when they start to question the effectiveness of your treatment? Well, you ditch the carrots and sticks in favor of motivation techniques that really work. Here are four strategies you can implement today to better motivate …

  • More Than a Number: Personalizing Patient Care in Your Growing Therapy Practice Image

    articleMar 28, 2018 | 4 min. read

    More Than a Number: Personalizing Patient Care in Your Growing Therapy Practice

    Many small private practices achieve success because of the stellar one-on-one care they provide—and amazing patient experiences they create. After all, what better way to foster patient loyalty and garner word-of-mouth referrals to ultimately boost revenue as well as your reputation? Unfortunately, though, that level of attention can be difficult to maintain as your practice grows—and patients can end up falling through the proverbial cracks as providers’ calendars become increasingly jam-packed. That is, of course, unless you …

  • The State of Rehab Therapy in 2017 Image

    webinarJun 5, 2017

    The State of Rehab Therapy in 2017

    WebPT recently conducted an industry survey of thousands of rehab therapy professionals across a wide variety of settings, specialties, and geographic regions. Our goal: To capture an accurate snapshot of the demographics, trends, frustrations, and motivations that shape our businesses, our future outlook, and our potential for success in this environment of change. In our July webinar, WebPT president and co-founder Dr. Heidi Jannenga, PT, DPT, ATC/L, and WebPT CEO Nancy Ham will share and analyze the …

  • Knock Out Patient Dropout: 8 Ways to Increase Retention and Revenue Image

    webinarFeb 12, 2018

    Knock Out Patient Dropout: 8 Ways to Increase Retention and Revenue

    In one corner, we have a highly skilled rehab therapy provider known for delivering amazing clinical outcomes through noninvasive, movement-based treatment. And in the other corner, we have a discouraged, disengaged patient whose quality of life has taken a major hit due to musculoskeletal pain and dysfunction. [video://fast.wistia.net/embed/iframe/d11isduky2]   If you’re a rehab therapy provider, you’ve probably seen this battle play out more times than you can count—and we’re betting that more often than not, your therapy …

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