The #1 Reason Start-Up Physical Therapy Clinics Flatline or Fail

Feb 7, 2023

In the physical therapy profession, there has been a growing interest for clinicians to start their own private practices. Specifically, aspiring PT entrepreneurs are looking for alternative models to the high-volume, “mill” insurance practices of the previous generation.

We’ve all “put in our dues” during graduate school, working long hours and seeing 16 or more clients per day in mill practices — and many of us firmly decided that that wasn’t going to be our future.

The issue is that when you look outside the “standard” outpatient model, you’re really only left with two viable options…

Option one is to work for an outpatient hospital system that will provide stability and decent pay; but, you will ultimately be burdened by bureaucracy and a lack of innovation. Option two is to start your own practice, but that choice comes with a big risk and many more unknowns.

Still, even with the uncertainty of success, more clinicians are choosing to start independent practices.  Being able to control your own destiny and use all of your creativity, passion, and energy to bring a new business into the world is exciting and filled with hope and possibility. 

If you’re just starting out on that journey or have recently “taken the leap” and have started your own practice, chances are you’re riding an emotional high of possibility. You need that energy as a driving force for working long hours, wearing all the hats of the business, and getting the business off the ground.

When starting a new business, it’s natural to think about the upside and benefits of being a business owner… However, what most aspiring new business owners fail to contemplate are the downsides, or the factors that could derail the venture.

Although it’s much less fun to think about, understanding where your business could fail will ultimately help you take steps to prevent it from happening. 

There are many downsides and pitfalls to consider in private practice ownership, but there is ONE that stands out above the rest…

The #1 reason why start-up private physical therapy businesses will fail is a lack of understanding and execution of a marketing plan. 

What does that mean, you ask?

Well, physical therapists do not go to school for business education or marketing training. (Similarly, business graduates don’t go to school for physical therapy training.) It would be naive and absurdly negligent for a business major to come out of school thinking they can differentially diagnose a hamstring injury.

If you flip the scenario though, many physical therapists start private practices without any knowledge of marketing. You might be thinking that clients will find you because of your credentials, fancy pictures on your website, cool Instagram videos, or through the few clients you have relationships with from working at other clinics…

But realistically, that’s not enough. Although those aspects might bring in a few clients here and there, it is by no means a “marketing plan.”  

This is where new practice owners run into trouble: they start their practice with high hopes and dreams, only to have an empty clinic and a dwindling bank account. 

To be successful in ANY business, the most important aspect initially is your marketing plan.  Every business needs to acquire new clients on a consistent basis to grow.  

So, what is a marketing plan?

A marketing plan is a strategic roadmap of the specific actions and processes a business will use to acquire new clients.

A marketing plan will include decisions involving: 

  • Which channels will be the primary focus of paid advertising
  • What the spending budget is on paid advertising 
  • Which client relationship management (CRM) system to use to nurture incoming leads
  • Your “ideal” client avatar or demographic 
  • Specific keywords to target in digital marketing and on your website 
  • Website SEO strategy 
  • Public relations to increase clinic awareness

This is only a fraction of the pieces that make up the strategy of a marketing plan.

When most new business owners write out their marketing plan, they only think about it tactically (and sometimes, they don’t write out a plan at all!). Most marketing plans will unfortunately end up looking something like this:

  • Post videos on Instagram 
  • Talk to sports coaches 
  • Create business cards
  • Make a flyer and pin it up at the local coffee shop
  • Save money by making my own website on WordPress 
  • Talk with doctors about sending referrals

It’s a decent effort, but none of these action items have a specific focus or guiding strategy to ensure that they actually move the needle to get clients to interact with your business. 

The lack of a strategic marketing plan is why most new business owners get stuck or fail. 

How You Can Establish Strategic Marketing

Now that you understand that your marketing plan is the most important part of your start-up business plan, the question is: how do you create a strategic marketing plan?

New owners will have to invest in their marketing education in one of two ways:

  1. Hiring a marketing agency, taking marketing courses, or hiring a consultant.
  2. Investing in a franchise system that’s already figured out the best way to market a practice.

In either option, you’re going to have to invest capital in bringing to life a high-performing marketing plan.

Going it alone means that you have to build your own team of experts to create a well-performing marketing process. You’ll need a website designer, an SEO expert, a copywriter, a digital advertising specialist, a graphic designer to make print materials, a PR specialist to get the word out, and a marketing consultant/agency to create your strategic plan.

There’s a lot of grunt work to get your business up and running — and this team is just to get you started. You’ll also need to keep most of these specialists on staff, that way you can assess the process and adjust your strategy accordingly.

In marketing, there is a “learning period” where, once you put a plan in place, you need to track its performance and adapt on the fly. This often takes businesses around 1-3 years to figure out what works best for their business model. 

On the other hand, investing in a franchise will shortcut that entire process. A franchise brand will already have a flushed out marketing strategy that works well for their business, AND they can provide you with optimal benchmarks, budgets, expectations, and support.

A franchise brand will already have an established website, well-performing digital ads, target keywords and phrases that get clicks, educational materials that resonate with clients, awareness and online presence, a social media following, and a treasure trove of 5-star reviews and testimonials that you’ll get to piggyback off of. 

In option one, you’ll need to “pay the tuition of learning” by investing in and building out your marketing system — whereas in option two, you’ll pay a franchise fee to get access to a system that you already know performs well. 

But! Regardless of which option you go for, the key is to really dial into that marketing plan. Without a strategic “go-to” marketing plan, you run the risk of having to forfeit your dream before it even has the chance to flourish.