I rarely go a month without hearing the question, “How in the world do you convince patients to pay $150/hour for Physical Therapy?” Another related comment goes something along the lines of, “Cash-pay patients??! But I struggle to get many of my patients just to be okay with paying their co-pay!” The mindset underlying these statements is quite upsetting to me. Why? I feel that the majority of Physical Therapists are guilty of the same thing the majority of the general population is: a significant undervaluation of physical therapy services.

The chronic undervaluation of physical therapy servicesThink about it … those of us who get good-great results for our patients, help them to move, exercise, and LIVE with less/no pain and dysfunction. We help people get back to lifting their grandchildren up for a hug, going for a run when that hadn’t been possible for months, and looking over their shoulder far enough to safely change lanes while driving! Is that not worth more than a $20 copay, 2-3 times per week for a month or two? Really!?

I understand that everything is relative, and there could be valid arguments and complaints about this post depending on individual circumstances, but I’m not trying to propose a payment formula that will work for all individuals, or argue about cash-pay vs insurance-pay; that’s not what this post is about.

I’m simply trying to draw attention to the widespread mindset that I see pervading our profession about the value of what we do. How in the world can we expect the general population to place a high level of value on our services, if we (on average) do not do so ourselves? I know that it makes all the difference in my own cash-based practice that I am fully confident in the difference my services make for my patients.

I really hope that my colleagues from all sides of this topic decide to chime in and voice their opinions below. Of course we have to make sure that our services are available for all. And of course not all people have the disposable income to be able to go out-of-network/cash-pay for PT treatment. Again, that’s outside of the topic I really want us to hone in on here. I want us to look at how we as members of the physical therapy profession view and quantify the value of the services we provide.

Why do we tend to minimize the value of physical therapy?

I trace a big part of this valuation issue back to “habituation.” I think that a great majority of Physical Therapists have simply never known anything different than the model in which someone can come to a nice clinic, spend an hour receiving care, and pay $10-20 as they walk out the door. When this is one’s reality throughout one’s professional life, it’s completely understandable for that person to develop the mindset that an hour of their time is only worth $10-20 to the consumer. So does that make this opinion and valuation correct? I would say “No!” It is simply “the norm” (at least at the time of this writing).

I would like to ask all those who have spent their careers in this type of scenario to really focus on that question. Yes, the insurance/Medicare systems will (hopefully) pay your practice much more than that $10-20, but do you think it’s okay that your patients view your services as “worth about $20 per hour”? I think even mediocre PT care is worth more than that, but maybe I’m just biased. (Okay, to play the devil’s advocate, if you’re seeing 4 patients at a time, counting repetitions all day and delegating most of your actual treatment to techs, then yes, that consumer is probably correct in valuing his time at the PT clinic at $20/hour.)

Everyone is screaming about insurance companies and Medicare paying us less than they should, but I think our fights in these areas are doomed as long as the majority of us mentally undervalue our own services.

Reconsidering our mindset about physical therapy

In my opinion, “mindset is everything” because even if you do everything else in your business correctly, but your mindset about your business and your value is not where it should be, you will still struggle to succeed. That’s why I dedicate an entire chapter to “mindset” in my Cash Practice Guidebook.

I think it is long overdue that we as a profession really evaluate the way we perceive our value, the way our patients value our services, and the value that the general public places on what we offer. How can we improve and increase the value that most people place on physical therapy? I have numerous ideas on this topic, and I’m sure many of you do as well, but I would like to begin with this statement:

It all must start with us. If we don’t view our services as highly valuable, speak about them in this way, and convey that value in everything we do, then our patients, the general public, and insurance companies/Medicare will not highly value us either.

So what do you think about all this? Do you think that PT services are undervalued by Physical Therapists themselves, and/or the general public? Let us know in the comments below, and give your opinion on what can be done about it. Share this post with your colleagues and get others involved in the discussion.

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