If you’re thinking about starting your own physical therapy practice and want the inside scoop of what it’s really like, then you’ve come to the right place.
There’s a crazy amount of work that goes into building the foundation of a business. Even when you’re driven and enthusiastic to get started, there are plenty of unexpected roadblocks that can crop up…and I say that from experience.
But the silver lining is that I learned the hard way so you don’t have to! Here’s a list of the things that no one told me, and things I didn’t expect when I opened my own cash PT clinic.
1. The most important part of the business plan is the marketing plan.
I spent weeks putting together my business plan in order to get a bank loan. It ended up being 20+ pages long with detailed pro forma calculations that always had revenue and profit going up and to the right.
But the section I spent the least amount of time on…marketing!
My marketing plan literally said, “Develop relationships with doctors to get referrals, and talk to Mario the running coach.”
That was it. Word for word…Clearly, I had a lot to learn!
That awful marketing plan is why I opened my practice without a single client on the books. Nobody told me that switching from a staff PT to a cash practice owner meant that doctors would no longer refer to me, despite having incredible relationships with other medical professionals. MDs wouldn’t have that conversation with their clients, because referring to a cash clinic was too clunky.
I had to learn everything about marketing: I invested in courses, coaches, and programs that taught me “direct response marketing,” and that transformed my business in a month.
If you don’t have a concrete plan in place to get clients, then you aren’t ready to open your business. You need to understand WHO you’re selling to specifically, what they’re looking for, and how to handle potential objections they might have about working with you.
2. Nobody wants to buy physical therapy.
Nobody has ever stayed up late at night with excitement knowing they were going to buy a physical therapy session the next day. You may love physical therapy, but clients don’t.
In fact, most clients have no clue what physical therapy really is or what it can do for them. All they’ve heard is that PT “hurts”…and that isn’t a good place to start when you’re trying to convince a client that they need 10 sessions of care to hit their goals.
Nobody told me that I should sell something other than physical therapy.
I thought that, if I told people what an amazing PT I was and how I had the best PT equipment, they would flock to see me.
I was dreadfully wrong. All clients heard is that I was amazing at something they didn’t understand.
What clients REALLY want is hope: to feel that their goals are possible, and to feel excited about the potential they can achieve… and to have a great experience doing it.
I had to learn to talk about the benefits of physical therapy instead of PT itself. Similarly, with our gait lab technology, I had to describe how it would benefit THEM versus what it was or how cool I thought it was.
If you’re trying to sell physical therapy, your message and service won’t resonate with clients.
3. If you can’t clearly and concisely describe what you do and how you help someone, you’ll lose.
Physical therapy is hard enough to understand — you don’t need to make it any harder.
I didn’t expect how hard it was going to be to describe what I do for people and why they should work with me.
In my clinic I have force plates, 3D motion sensors, specialized pressure treadmills, high speed cameras, and EMG sensors. Although the equipment is amazing and state-of-the-art for a PT practice, describing them in a way that makes sense is tricky.
Nailing down your “elevator pitch” is key. When you’re at a race booth or talking on the phone with a prospective client, you only have a limited time to showcase how you can help.
If you don’t have that pitch nailed down, you’ll confuse the client and give them an easy reason to say no.
You should be able to describe what you do as if you’re talking to your grandmother, and she should be able to tell you exactly what you do and how you can help. Seriously, go and practice it!
4. Trading 40 hours to work 80 hours is exciting for the first year… but then it needs to change.
When I switched from working 40-hour shifts as a staff PT to an 80-hour work week as a business owner, I was PUMPED. It was a tradeoff I would make 100 times out of a 100. I expected the excitement, thrill, and pressure to “make it work.”
What I didn’t expect was having to keep up with 80 hours for over a year.
I naively thought that my business would grow fast enough so that I could work less than 40 hours and “have it all.” I could be making money for myself and working less hours than my previous job.
In reality, that took closer to 3 years.
Knowing what I know now, I’m sure I could have accelerated that substantially… But when you start a business, you’re still going to have to “grind” for a while.
It is very exciting at first. You need that energy to take risks and push yourself outside your comfort zone. Over time, though, it wears on you. It affects your sleep and your personal life.
So, as you set your business plan, anticipate that the workload per week is front-loaded for the first year — then, your plan should be to hire staff as soon as possible so you can shift gears from “grind” to “strategy.”
5. Digital marketing gives you a greater reach, but local in-person marketing gives you greater initial success.
Before I opened my business, I had read all about “digital marketing” and Google ads. I read how businesses were getting customers left and right by marketing to the masses.
I thought that if I ran digital marketing, that’s all I would need to grow my business.
But I learned very quickly that, with a new business, potential clients want to see and get to know ME — and that’s hard to do with an ad.
I learned that I had much greater influence when I could speak to a local running group or sports team and provide upfront education which helped me stand out from other companies.
That’s what made a substantial difference in how quickly I grew at first. I didn’t expect small local events to beat out ads that reached thousands of people, but that’s exactly what happened.
I encourage you to identify 5-10 key local partners and provide them education upfront to start building your practice. Then, once you have the ideal flow of clients, use that money to buy digital ads.
I wish I knew that 7 years ago…I would have saved a lot of money!
6. Being a “solopreneur” is lonely…hire an admin assistant as soon as possible!
When you’re treating 16+ clients per day working for a mill clinic, all you can think about is having your own practice and treating on your terms.
But no one tells you that working for yourself can also be lonely at first.
Yes, working for yourself is invigorating and exciting, but being in a clinic where YOU alone have to provide the energy, passion, and connection (while also doing the billing, calls, documentation, and marketing) can take a lot out of you.
Having just ONE more person there makes a world of difference. Not only do they help offload some of the work you’re doing, but they also help you solve problems, provide a new dimension, and can enjoy lunch with you.
You likely got into PT because you like people, so why not bring in someone as soon as possible to help you and be there with you to help grow your practice?
Looking back, I wish I had hired an administrative assistant 2 years sooner than I did!
7. I thought I wanted to treat clients my whole life…and then I fell in love with the game of business.
As physical therapists, I believe we all want to “be the best.” We attend continuing education conferences, go through residency training, and find mentors we can learn from.
For me, I loved every minute of learning and growing as a physical therapist and thought I would end up teaching at some point.
What I didn’t expect after opening my own business was that I enjoyed “the game of business” just as much, and now even more than being the best physical therapist.
As a business owner, there is always more to learn when it comes to leadership, mentorship, recruitment, finance, marketing, sales, and operations.. and that’s exciting.
Plus, I’ve found so much joy and passion in my life from building a team, creating great relationships, and helping others become the best version of themselves they can be.
For me, the game of business truly is an exciting game to play.
8. A fancy website looks nice and will impress your friends… but it won’t get you clients.
Before I opened my practice, I thought that the BEST website would have stunning images, hip videos, and minimal text. I figured if people saw something cool, they would want to buy it.
When it came time to actually launch my website, I realized that it looked great, but there wasn’t anywhere where people could provide their contact details or interact with the page!
It sounds simple now, but at that time, it was a big revelation for me, because everyone told me to create a fancy website.
The lesson here? If someone isn’t a marketing expert, they probably know as much (or as little) as you, and they aren’t a great resource for business advice…
So, I changed my website, and it didn’t look nearly as cool — but it did get me clients.
I didn’t expect the change to work as well as it did. Just goes to show: the popular opinion is only relevant if it’s coming from the right source.
9. The initial rejections hurt, but they make you stronger.
Another thing I didn’t expect was how much it would hurt when a client told me they didn’t want to pay cash to see me.
Since I thought I had the BEST PT service in the area, I figured everyone would say yes to my offer. Not true.
I wasn’t prepared for how much mental strength and resolve I would need at the beginning to keep calling and reaching out to possible clients, even when I was getting rejected. That was a muscle I had to develop over time.
Physical therapists aren’t trained in sales, and for the most part, they aren’t cut from the sales cloth. Being naturally empathetic and relationship-oriented people, it takes time to be comfortable with uncomfortable conversations.
Over time, I learned that my best chance to help a client in pain was to learn a better way to communicate over the phone — and when I did, it transformed my practice.
Although there have been many lessons and surprises along my journey, these are the ones that stood out and made the most impact on my business’ success.
You’ll never be able to anticipate all the twists and turns in business… but that’s all a part of the journey and the fun.