We’re all for helping physical therapists create and retain loyal customers. After all, improving patient retention is one of the absolute best ways to grow your business. All the hard work you put into branding and marketing your practice won’t go very far unless you’re able to attract your target audience, help them successfully complete their plans of care, and send them out into the world as raving fans. While many practice owners focus heavily on new patient acquisition, few have a strategy in place to keep their patients around once they begin treatment. And if you’re one of those practice owners, it’s going to hinder your ability to grow a loyal customer base—which ultimately translates into lost revenue.

In this post, Scott Hebert—co-founder of Strive Labs—wrote, “Improving patient retention can be of incredible value to your clinic. And having a process and a quality set of tools to help facilitate that improvement is crucial.” What he’s found is that “educating, engaging, and empowering” patients works—and that’s “all about improving the relationships you have with your customers.” In fact, “by providing this level of service to go along with your incredible treatment techniques, you can ensure that every patient you treat gets the most out of every interaction with your clinic.” And those patients will be sure to share their positive experiences with friends and family.

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Churn: The Opposite of Patient Retention

To fully understand patient retention, we first need to understand its opposite. In rehab therapy, patient churn is the opposite of patient retention. Churn rate is simply the percentage of patients who drop out of therapy before they complete their course of care. Unfortunately, churn rates in our industry aren’t pretty. In fact, Strive Labs found that only 30% of patients who receive outpatient physical therapy services attend all the visits their insurance company authorizes. While we certainly advocate for getting patients better faster, the unfortunate truth is that it’s highly unlikely that the majority of patients reach full functional recovery within the first six visits.

Thus, we know something else is afoot. So, what does such a high churn rate tell us, other than that much of the time, patients are leaving care early?

  • Patients are not engaging with their care.
  • PTs are not effectively demonstrating the value of completing a course of care.
  • Clinics are losing a staggering amount of money to patient churn.

It stands to reason, then, that if you can improve the patient relationship management process at your clinic, you will end up with more satisfied, loyal patients and increased revenue for your practice. That is the true power of patient retention.

Patient Relationship Management

The diagram above breaks the patient relationship management process into three main phases: experience, engagement, and empowerment. The circles represent the patient’s path along the way, ultimately ending with a patient evangelist and a walking billboard for your practice. But, because you can’t improve what you can’t measure, you need a way to quantify retention.

Patient Retention Rate

The patient retention rate (PRR) calculation is very simple: it's the difference between the number of visits a patient attends and the number of visits your therapist determines is necessary in that patient’s plan of care. For example:

  • A therapist at your clinic felt that a patient would require 10 visits to reach full functionality.
  • That patient attends seven visits before self discharging—and the patient did not reach his or her goal.
  • If you only treated this one patient, then you would calculate your patient retention rate by dividing seven by 10 and multiplying by 100 to get a percentage.
  • Your PRR would be 70%

PRR is a metric that you should be calculating on a per patient and aggregate basis. Simply using visits per case can be misleading and often hides true patient churn because of the high variance in actual visits per case. The beauty of PRR, though, is that a practice owner can use it to determine the amount of lost revenue occuring as a direct result of patient dropout. Meaning, if your clinic’s PRR is 70%, you are running 30% below maximum revenue. How much of a difference would that 30% mean to your business?

Small Changes, Big Improvements

Even small changes in patient retention can have major financial implications on a clinic’s bottom line. That’s because for every additional visit over the three visit dropout threshold, your patients become increasingly likely to complete their course of care in full. In a Strive Labs case study, we found that improving patient retention from 85% to 88% across a 14-site PT clinic led to $150,000 in new revenue. The clinic’s team accomplished this by diligently monitoring their patients’ experiences and rapidly intervening when they identified a patient at risk of dropping out. Tools such as Net Promoter Score® (NPS®) tracking can prove incredibly valuable in managing this process—as can other engagement insight tools, such as an HEP that tracks patient activity and efficient patient relationship management (PRM) software that tracks messaging effectiveness.

Retention by the Numbers

We already know that customer retention strategies boost engagement and decrease churn, thereby increasing revenue. Here’s what else the data says about the value of retained customers (highlights from an excellent infographic found here):

  • It can be up to five times more cost-effective to retain an existing customer than to acquire a new one; yet, only 18% of companies put their primary marketing focus on customer retention.
  • “The probability of selling to an existing customer is 60-70%, while the probability of selling to a new prospect is 5-20%.”
  • “Existing customers are 50% more likely to try new products and spend 31% more,” when compared to new customers.
  • Email marketing is the most effective marketing tactic for customer retention (yet most practice owners don’t have an automated platform for sending the right information to the right patient at the right time).
  • “Increasing customer retention rates by 5% increases profits by 25% to 95%.”

Tools to Help

The right PRM software can help practice owners improve their retention rate by decreasing patient churn and increasing their percentage of loyal customers. Effective engagement solutions that monitor the patient experience and allow you to intervene before a patient drops out of care are critical to the process. To see how WebPT’s new PRM software can assist you in developing a strong patient retention program, schedule a complimentary demo here.


Do you manage patient retention in your clinic? If so, what strategies have you found to keep your patients engaged throughout the course of their care? We want to know what’s worked—and what hasn’t—in the comment section below.

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