If you’re in the physical therapy business, I don’t have to tell you that profit margins are slim. As a former clinic director, I know how tight PT practice budgets are. In fact, that’s what led me to create WebPT in the first place: I was spending way too much money on documentation and dictation, and I desperately needed a way to trim that expense. At that time, though, electronic documentation was a fairly novel concept in the PT world. Now, ten years later, more than 80% of PT clinics are using some type of EMR. But even though the last decade has seen massive tech adoption among physical therapy practices, it also has seen massive regulatory change. So, while we’re documenting in a more cost-efficient manner, we’ve simultaneously experienced reform-driven cuts to our payment rates. And budget-wise, that’s put many of us right back where we started. It almost seems as if there’s some kind of vendetta against us—like we just can’t catch a break.

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We’re losing tons of patient visits—and tons of revenue.

The real budget-killer, though, is something many PT practice leaders probably haven’t considered—or, if they have, they assumed there wasn’t much they could do about it. Consider this: approximately 20% of PT patients drop out of treatment within the first three visits, and 70% fail to complete their full course of care. As my friend and colleague Scott Hebert, DPT, explains here, “Over the course of a year, this can cost the average PT practice upwards of $150,000.” Now, to take that a step further, given that—based on our own market research—there’s somewhere in the neighborhood of 30,000 to 40,000 physical therapy practices nationwide, that means that overall, this problem is costing this country’s PT industry around $6 billion a year.

We are jeopardizing our patients’ quality of life.

Now, I don’t know about you, but if I were responsible for P&L in a physical therapy organization—as I was during my tenure as a clinic director—I’d be horrified to discover a $150,000 budget leak. And that’s especially true in this case, considering that the price of patient dropout isn’t only measured in dollars and cents; it also represents a multitude of lost opportunities to bring patients to their full functional potential—to ensure they go on to experience the highest quality of life possible. It is truly heartbreaking to think about.

But, if there’s one thing I know about PTs, it’s that we’re not ones to wallow. We are problem-solvers by nature—which is why, no matter how many curveballs the universe tosses us, we always figure out a way to press on, to overcome. Remember back when everyone was sweating bullets over functional limitation reporting? What about ICD-10? We barely even hear about those things anymore—because we’ve adjusted, adapted, and moved on.

We can’t continue blaming the tumultuous US healthcare environment for our financial woes.

Well, I’d posit that the $6 billion patient dropout problem is even more sweat-worthy than ICD-10 or FLR—or any other challenge we’ve faced as a profession. And really, it’s the culmination of a variety of contributing factors:

  • the overprescription and widespread demand for invasive treatment options like surgery and pharmaceuticals;
  • the proliferation of high-deductible health plans that have placed more out-of-pocket financial burden on patients than ever before; and
  • the ubiquitous, yet enigmatic physical therapy “branding problem.”

Those are some decidedly large-scope issues—ones that require large-scale resolution efforts. But, that doesn’t mean individual practices have to sit back and continue losing business—and bleeding revenue. In fact, there are simple changes you can make within your own organization to not only immediately improve your patient retention and average visit per patient rates, but also generate more new patients than you ever thought possible. And it all starts with asking your patients one simple question: “On a scale of zero to 10, how likely are you to recommend us to a friend or colleague?”

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We must create a culture of patient loyalty.

If you haven’t heard this question—or some variation of this question—before, it is the foundation of the Net Promoter Score® (NPS®), which, as I explained here, is “a simple customer loyalty metric that packs a meaningful punch.” And while I’ve talked at length about the importance of NPS tracking in the past, I’ve never really approached it from the angle of revenue preservation and growth. I’ve always believed in its unique ability to generate the honest, relevant feedback necessary to spark real, positive change in your practice—change that ultimately leads to better patient engagement, experience, and ultimately, outcomes.

What I have come to realize, though, is that the power of NPS doesn’t end with fostering better health outcomes for your patients; it’s also the perfect tool to support a healthier bottom line for your practice. After all, when you know which patients are happy—and which aren’t—you can take swift action to either:

  • prevent dissatisfied patients from dropping out of therapy early, or
  • leverage satisfied patients for the online reviews and testimonials you need to generate new business in an increasingly competitive healthcare marketplace.

And when you have not only more patients, but also more satisfied patients who continue attending therapy for the duration of their care plans, your clinic’s top-line revenue gets a double turbo boost. Plus, you leave yourself less vulnerable to revenue drainers like cancellations, no-shows, and empty appointment slots.

We now have patient-facing technology in our corner.

Now, I know there’s a “yes, but” protest coming from at least a few of you who are reading this; after all, with everything you’re already responsible for, throwing NPS tracking into the mix doesn’t seem all that feasible. That’s a problem—but as I’ve learned after spending a decade in the tech sector, where there is a problem, there is an innovative solution. And after realizing the massive depth and scope of the physical therapy patient retention problem, I—and everyone here at WebPT—knew we couldn’t sit back and allow this colossal, yet largely unrecognized revenue suck to drag down the PT industry any longer.

So, on behalf of our entire team, I’m proud to introduce the newest addition to the WebPT product lineup: WebPT Reach. It’s a first-of-its kind patient engagement tool that allows PT practices to:

  • create a consistent cadence of automated patient outreach,
  • streamline the NPS tracking process, and
  • easily identify—and request reviews from—their most satisfied patients.

This sort of technology—known as patient relationship management (PRM) software—used to only be available to the largest therapy organizations in the market. But now, it’s accessible to virtually any practice, regardless of size. And that’s huge, because if we want to make a difference at scale—if we want to flip the script on the traditional neuromusculoskeletal patient care journey—then we have to do it together.


As history has taught us time and time again, revolutions don’t happen in siloes. And if you’re in the business of physical therapy, this is one revolution you can’t afford not to join. It’s high time we took back not only our bottom lines, but also our position as the most-trusted, most-sought-out care providers for patients with neuromusculoskeletal conditions. It’s time for us to rise—to expand. Are you with me? Are you #readytoreach?       

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