If you browse all the different private practice forums out there (or receive all the emails I do from practice owners), it is clear there is a great deal of uncertainty and fear about how Obamacare, ACOs, and other changing components of the healthcare system will affect private physical therapy practices. In many areas of healthcare (often moreso than in the PT realm) we are seeing progressively more corporate conglomeration of private practices and the “pushing out” of small private practices. Physicians are finding it much harder to keep their practices profitable, and hospitals/corporations are buying up them up left and right.  What does all this mean for physical therapy private practice owners?

My referring physicians are being forced to keep their physical therapy referrals “in house”

The above statement is a complaint I’ve heard a number of times in the past few years. With the aforementioned hospital/corporate purchasing of medical practices, those physicians become employees of a system that usually has a “physical therapy department,” and the doctors are being told that they must keep all therapy referrals within their hospital/corporate system. Is this legal? I doubt it, but it’s happening anyway and in greater amounts every year. So what can you do to protect your current or future PT practice against this damaging trend?

Stop relying on physicians for all your referrals!!

This situation, and the fear surrounding it, loses a great deal of intensity if your practice does not rely solely on physicians for new patient referrals. In no way am I saying that cooperation and collaboration with physicians is not important. I’m looking specifically at the topic of patient/income generation (not patient care and/or the health care team).

Some of you may think, “But I’m not in a Direct Access State, so I’m forced to rely on physicians for referrals.” I practice in Texas where we do not currently have true Direct Access, so all my patients must acquire a referral before I can start treatment. However, less than 10% of my patients are directly referred to me by physicians. Most of my new patients come from word of mouth (other patients), complementary health/wellness/fitness practitioners (ex: personal trainers, acupuncturists, massage therapists, etc.), and online sources (Google, YouTube, etc.). The majority of my prospective patients call without having a physician referral and then have to go through the extremely frustrating process of getting one, but that’s another topic altogether. See this post for more information on cash-practices and the direct access issue.

Building non-physician referral sources for your physical therapy practice

So how do you decrease your dependence on physician referrals? Well, I could write a book about marketing PT services directly to the public; and that is in fact a huge component of my Cash Practice Guidebook. I’ve also written a number of blog posts on this topic, so I’ll direct you to these sources rather than re-typing everything:

When you live off word-of-mouth, make every patient a walking advertisement

Break into Niche Markets, and Create New Streams of Cash-Paying Patients

A Free Marketing Technique That Helped Get My Cash Practice Going Strong

Networking – A Key Component of Filling your Cash Practice – Part 1

Marketing Advice for a New Cash PT Practice Owner

Take Advantage of Trends and Squeeze Every Drop From Your Marketing Efforts

How to use Blogging to Grow a Cash-Based Physical Therapy Practice

Discharge Marketing – Are You Capitalizing on this Precious Opportunity?

The landscape of healthcare is changing, and diversification of our referral sources is becoming ever more important for survival. In my next post, we’ll look at a related topic and address a statement I recently heard that “when the Affordable Care Act (aka Obamacare) is implemented, and everyone has insurance, cash-based practices will become extinct.

If you’ve had experience with the conglomeration and referral issues discussed above, or have any advice on how you have marketed your services directly to the public, please let us know in the comments below.

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