As a rehab therapist, you already expend a lot of energy on optimization—optimization of your patients’ physical, occupational, or speech capabilities, that is. You help your patients be their most perfect, most functional, and most effective selves. But what about your business? Are you working to ensure your practice is as perfect, functional, and effective as it could be? In other words, are you optimizing your clinic—or are there gaps that are frustrating patients and staff and impacting your bottom line?

If you’re leaning toward the latter, you’re not alone. But there are several things you can do to change that—and you can start right now by taking a page from the Toyota Production System playbook. See, we here at WebPT want you to embrace your inner car manufacturer. Just kidding. But we do want you to start trying out some lean principles that Toyota pioneered in the 1930s in order to optimize its production line. In the book Lean Thinking, authors James P. Womack and Daniel T. Jones distilled the principles of lean manufacturing into five points (which we’ve adapted from this source and this one):

  • Value: Pinpoint the value your customers want to receive from you.
  • Value Stream: Map out the entire flow for each product—all steps from start to finish. Then, pinpoint wasteful steps (i.e., those that do not provide value).
  • Flow: Ensure the service or offering flows from start to finish without being interrupted by waste.
  • Pull: Change the focus from pushing a service or offering to pulling, which means performing work based on customer need, thus avoiding unnecessary effort.
  • Perfection: Aim for perfection to inform a culture of continuous improvement.

Mapping the Value Stream

The Profitable Practice, a blog from Software Advice, has a great article about how to apply lean principles to a physician’s office. We’re going to adapt those how-tos here so they apply to rehab therapists. First, though, a few clarification points:

  • As a physical, occupational, or speech therapist, your product is the treatment you provide to your patients, and the value patients receive is functional improvement (or maintenance, as the case may be).
  • If you provide entirely different services (e.g., aquatic therapy, therapeutic massage, or gait analysis), you can map the value stream for each offering individually.
  • To identify value in any stream, look for anything that a patient would be willing to pay for; steps that do not create value are waste.
  • Get your whole team involved—two heads (or thirty) are definitely better than one when it comes to optimization.

Now that we have the basics covered, let’s dive in.

Current State

The very first step in mapping a value stream is to identify a process as it stands right now. To begin, create a very high-level flowchart that describes a typical patient’s experience interacting with your clinic. (We drew up a super simple one below using Excel; you also could use software like LucidChart or sticky notes on a wall.)

From there, you’ll want to fill in all of the missing steps—and we do mean all of them. Your Current State Map should account for every second of a patient’s experience as well as all of the steps you and your staff must take to create that experience. Even steps that might seem like one step—such as a patient scheduling an appointment—can be broken down into smaller ones, such as calling the clinic, being placed on hold, and/or receiving an email appointment confirmation. You also should include steps that aren’t meant to be part of the process but regularly are, such as leaving the treatment room to find a hot or cold pack or calling patients who are running late.

After you’ve completed your first pass at the Current State Map, start collecting data to confirm it actually matches a real life patient’s experience. To do so, shadow your patients. In addition to taking notes on every step that occurs from the moment a patient calls to schedule an appointment to the moment he or she is discharged, you also may want to time each step using a stopwatch. That way, you can begin to calculate averages and spot lag times. Some experts recommend adding a symbol to the chart for any time a patient is waiting.

You’ll also notice junctures in the process where patients take different routes based on specific criteria (e.g., whether or not the patient has insurance). You can represent these forks on your map with a decision tree, like this one:


Once you have a complete Current State Map, it’s time to go looking for waste, which, if you remember, is any step that does not provide direct value to your patients (i.e., it’s not something a patient would pay for). According to this definition, documentation, billing, continuing education, and insurance verification are all waste. However, these things are necessary for you to run your practice and get paid; thus, they provide value elsewhere, which means they stay. Steps like patients waiting to receive treatment or your staff performing double data-entry because your EMR doesn’t talk to your billing software are waste with a capital W, which means they’re ripe for elimination—or at least change. Think about what a drain these things are on time, energy, and money, especially when repeated again and again and again.


At this stage, you and your team get to let your imaginations run wild, drop all constraints, and put together your perfect map. In an ideal world, what would the process look like? Go crazy. After you know what perfect is, take a step back and create a plan that you believe is attainable within the next year or so. This is your new goal. Now, it’s time to brainstorm ways you can transform the current process into the future one. Often, small, incremental changes have the most positive, lasting long-term effects. While perfection isn’t actually achievable, aiming for it will keep you motivated to track your progress and continue to identify new ways to improve the delivery of your services.

For some great examples of how real life healthcare professionals have benefited from implementing lean principles, check out the Profitable Practice article in full here. (Hint: benefits include reducing patient wait times, saving money, leaving work at a reasonable hour, minimizing stress, and improving teamwork and camaraderie.)

Sounds pretty good, huh? Have you experimented with lean principles in your clinic? Tell us your experience in the comment section below.

Speech-Language Pathologist Salary Guide - Regular BannerSpeech-Language Pathologist Salary Guide - Small Banner
  • 4 Keys to Keeping a Steady Cash Flow Image

    articleMay 18, 2016 | 5 min. read

    4 Keys to Keeping a Steady Cash Flow

    As a private practice clinic owner, you’re probably familiar with the cold sweat-inducing struggle to keep a steady cash flow. Claims management muck-ups, inefficient processes, staff issues, and lack of insight into your clinic’s financial health can leave you feeling like you’re riding a revenue rollercoaster. So, whether you’re trying to maximize reimbursements , combat employee theft , or optimize patient payments , these four keys to maintaining a steady cash flow will help you even out …

  • Therapy Practice Scheduling Hacks Image

    articleJun 26, 2017 | 6 min. read

    Therapy Practice Scheduling Hacks

    As the old saying goes, “Organization is a virtue.” Okay, maybe that’s not how it goes, but that doesn’t mean it’s not true. It’s impossible to overstate the value of being organized, especially if you’re a busy clinic owner or office manager. And you probably know that the ability to keep yourself—and your schedule—well-organized is crucial. But for some folks, the constant ebb and flow of cancellations, no-shows, last-minute appointments, and documentation demands is enough to make …

  • FAQ: The Data-Driven Practice: 10 Stats to Track in Your Therapy Organization Image

    articleFeb 8, 2019 | 18 min. read

    FAQ: The Data-Driven Practice: 10 Stats to Track in Your Therapy Organization

    Earlier this week, WebPT President and Co-Founder Dr. Heidi Jannenga, PT, DT, ATC, teamed up with WebPT Vice President of Innovation and Product Management, Russell Olsen, to discuss the ten trackable metrics that can help you turbo-boost your practice past the competition. They tackled as many audience questions as they could during the post-webinar Q&A, but there just wasn’t enough time to get to all of them. So, we’ve compiled—and answered—the most frequently asked ones and posted …

  • Common Questions from Our Stalled Patient Progress Webinar Image

    articleFeb 7, 2018 | 9 min. read

    Common Questions from Our Stalled Patient Progress Webinar

    Earlier this week, Dr. Heidi Jannenga, PT, DPT, ATC/L, the president and co-founder of WebPT, teamed up with Charlotte Bohnett, WebPT’s director of demand generation, to host a webinar on common barriers to patient progress —and strategies for overcoming them. During the question-and-answer portion of the presentation, we received quite a few audience questions on the nuances of fostering patient engagement and moving patients toward their therapy goals as efficiently as possible. We’ve compiled the most frequently …

  • PT Billing Tips from the Trenches Image

    articleMay 22, 2017 | 6 min. read

    PT Billing Tips from the Trenches

    It’s hard out here for a biller—between dodging denials, hunting past-due balances, and navigating the ever-changing compliance climate, keeping a rehab therapy practice’s billing processes in tip-top shape is no simple feat. The heat is definitely on when a good portion of your company’s cash flow falls squarely on your shoulders—but you don’t have to go it alone. In fact, we’ve rounded up several therapy billing gurus who were happy to lend their expertise and spill some …

  • Up and Leave: What to Do When a Therapist Quits Image

    articleJun 26, 2018 | 5 min. read

    Up and Leave: What to Do When a Therapist Quits

    Breakups are never easy. Even if it’s an amicable split, it’s hard not to look back on your time together and wonder what could’ve been. But here’s the good news: if you approach a breakup from a place of maturity and wisdom, you can learn some valuable lessons and apply them to your next relationship. Of course, the relationship I’m referring to in this post is the one between a rehab therapy practice manager and his or …

  • Golden Drops from the Greats: Advice from the Most Successful Private Practice Leaders Image

    articleAug 29, 2016 | 10 min. read

    Golden Drops from the Greats: Advice from the Most Successful Private Practice Leaders

    There’s a lot of advice going around about how to be a successful physical therapist. And while you can always trust everything you read on the internet (just kidding), we thought we’d make it easier for you to find the tips and strategies that you’re looking for—all in one place and all from bonafide leaders in their respective fields within the physical therapy profession. That’s why we set out to collect some golden drops—three (or in one …

  • Calling for Backup: How to Leverage Therapist Assistants to Maximize Practice Efficiency Image

    articleJun 21, 2017 | 6 min. read

    Calling for Backup: How to Leverage Therapist Assistants to Maximize Practice Efficiency

    I love a good procedural cop show. There’s a whole lot to glean from a Law & Order marathon—including valuable lessons like, “Don’t let your emotions overrule critical thinking,” and “Most New York district attorneys are former super models.” (I’m not sure I can confirm the latter.) But the advice that’s perhaps most relevant to my life is, “Recognize when you’re in over your head, and don’t be afraid to call in backup.” It’s something that many …

  • Ascend 2018: Our Biggest Speaker Lineup Yet Image

    articleJun 20, 2018 | 3 min. read

    Ascend 2018: Our Biggest Speaker Lineup Yet

    This year marks WebPT’s 10th anniversary of education, dedication, and innovation in the rehab therapy space—and what better way to celebrate than to put together our biggest Ascend agenda and speaker lineup yet? Rehab therapy’s best and brightest will come together this fall at Ascend—but this conference isn’t just about gleaning tons of actionable business wisdom from our superstar speakers. You’ll also have plenty of opportunities to take the floor yourself as you participate in meaningful discussions …

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