As consolidation continues to increase, more and more independent PT practices are being swallowed up by national chains and corporations. Now, depending on your business goals, you may be chomping at the bit for an offer (in which case you should check out this post about exit metrics). Conversely, you may be concerned that the opportunities for success as a small, indie practice are running thin. 

Well, the good news is that while the PT landscape is definitely changing, there are still plenty of opportunities to go around—even if you have no intention of handing over the reins to the highest bidder. That said, you may need to change your strategy a bit to maintain a viable level of new patient volume. After all, larger healthcare networks have a vested interest in keeping their referrals in-house. With that in mind, here’s how the so-called “little guys” can stake their claim among corporate behemoths:

1. Identify your speciality.

When defining your ideal client, It can be hard to narrow your focus. After all, it might seem like the wider the audience you serve, the more potential patients you’ll be able to reach. Bigger net, more fish—right? Not exactly—especially when you’re competing against plenty of expert generalists. In that case, it may be worth narrowing your niche—that is, identifying one speciality that you and your team truly excel at and establishing a reputation as the go-to expert for a subset of specialized patients. (Hint: Outcomes data can be an invaluable tool for helping you zero in on your strengths and weaknesses.) 

That way, you’ll stand out to anyone in need of your exact expertise—and the physicians in those larger networks may be more likely to refer to you instead of in-house PTs who may not be able to provide the level of specialized care that you can. This becomes increasingly more likely as we continue moving toward a more value-based care paradigm that prioritizes patient outcomes above all else.

2. Differentiate your practice.

Even if you’re not ready to go niche, it’s still crucial to establish your differentiators: the attributes of your practice that truly make it unique. In other words, what do you provide for your patients that no one else can (beyond exceptional patient care, because let’s just take that as a given)? An unbeatable patient experience? Stellar rapport with one or two key therapists who truly care about them as people—not numbers? A communication channel that allows them to connect with their providers between appointments and modify their HEP in real-time? Excellent educational content tailored to their unique needs? A warm, friendly, welcoming environment and staff?

Once you’ve gotten clear on what sets your practice apart, emphasize it so you stand out from the crowd. After all, a common symptom of consolidation is that big corporations tend to look and feel a lot alike. While they may have access to more resources, they’re often not as nimble, flexible, or personal as smaller-scale practices can be. 

Take a grassroots approach.

Fortunately, if the “shop local” movement is any indication, today’s consumers—including patient-consumers—make a conscious effort to support local businesses. This means there’s a great opportunity for you to truly connect with the people in your community and garner their support and loyalty via a grassroots-style effort (think holding events, sponsoring local community activities, or volunteering to support a charity event—basically anything relevant to your practice that helps establish you as a fixture in the community and creates a warm feeling that connects people with you and your brand). Beyond that, word-of-mouth is also an extremely effective marketing tool. Simply ask your already-pleased patients to share their positive experience with their friends and family (in person and online), paying special attention to what they value most. Curious as to how your current patients truly feel about you? Consider implementing NPSⓇ tracking to gauge current patient loyalty—and to identify potential problems before they become systemic.

3. Build solid relationships.

Many independent providers eschew building relationships with providers who work within larger networks, because receiving referrals from those providers seems like a longshot. But, that’s not always the case—especially if, as we discussed above, you’ve demonstrated that you can provide better care than what their in-house team can deliver. Regardless of the referral reward, though, building a solid network of providers in your community can be especially effective in increasing your overall brand awareness, generating new business opportunities, and enabling you to grow as a thought leader and expert as you encounter new people, approaches, and treatment philosophies. In other words, it’s always a good idea to get to know your peers.

Include other health and wellness service providers. 

Beyond physicians, you’ll also want to build mutually beneficial relationships (perhaps even partnerships) with other health and wellness service providers: think massage therapists, nutritionists, yoga teachers, personal trainers, and even retail store owners. For example, when WebPT Co-founder Heidi Jannenga was a clinic director, she tapped into an entirely new athletic market (wilderness sportspeople) by building relationships with the owners of local sporting goods stores. So, don’t box yourself into replicating the same strategies that have worked before. If there ever was a time to get creative in attracting new business, it’s now. And if you’re not taking advantage of direct access laws to market directly to patient-consumers, you’ll want to start immediately. After all, physicians aren’t the patient gatekeepers they once were.

4. Optimize your operations.

The goal of most businesses is to maximize revenue while minimizing overhead, and in the private practice physical therapy space, that’s never been more important than it is now. In addition to rising consolidation, we’re seeing more and more reimbursement cuts, which means that in order to thrive in this next decade, independent PT practices must maximize efficiency and minimize waste (i.e., anything that cuts into your available resources).

Leverage software automation.

That means taking a long, hard look at every aspect of your business—from your marketing efforts to your billing processes—and recognizing where you can turn to software automation to streamline your operations, reduce errors, and free up your teams to do more mission-critical, business-building work. If software automation won’t cut it, then you may want to consider outsourcing certain tasks completely—especially ones like billing, where problems (i.e., denials, delays, and audits) can be extremely costly, time-consuming, and reputation-damaging. Yes, you’ll have to pay for those services, but if you’re able to improve your collection rates and funnel crucial resources into other business-generating activities, it’s probably worth it. And speaking of improving collection rates, make sure your team is actively collecting copays, deductibles, and outstanding balances at the time of service as opposed to sending bills. This step alone will dramatically improve your cash flow.

Minimize your overhead.

You’ll also want to review your scheduling processes and staffing system to ensure you’re using your PTs and PTAs to the fullest. And consider implementing ancillary cash-based wellness services to expand your reach and revenue. Looking for more ways to cut overhead costs? Partnering with other providers to offer multiple specialties in one facility can be a great way to add value for your patients and share some of the operational costs (e.g., rent, property insurance, and utilities) with another entity. In some cases, you may even be able to share the cost of specialized equipment, which could help you both reach an untapped market. 


There you have it: the independent clinic’s guide to competing with corporate PT giants. There will always be a market for independent physical therapists; you may just have to switch up your strategy until the consolidation pendulum swings back into the center. Have your own strategies to add to this list? Share them in the comment section below.