4 Challenges Every Owner Faces (and How to Overcome Them)

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No matter what business you are in, there are always challenges to be overcome to be successful. For the physical therapy private practice owner, there are four that are common across the board. These challenges run the gamut from directing marketing, managing personnel, leading as an executive, and having the right CEO mindset in order to effectively communicate your ideal scene with your staff, patients and public.


Marketing versus Prospecting: Knowing the Difference

Marketing is one of the first major challenges that new physical therapy owners are forced to contend with immediately upon opening their doors. In order to overcome this challenge, you will have to master the training necessary to develop the skills of communicating your message to people you have never met before. The goal is for you to be able to communicate your “WHY” for starting your practice, and your “WHAT” as your brand for what you want to be known by. Whether you have been in practice for decades or just started last week, you will need to be confident in “HOW” you plan to get your message out so that it is well received.

Marketing is like farming. You go out and plant the seeds, water them and hope they take root to yield you a good crop. As a metric in private practice, you are always hoping to get 2X what the marketing action cost you but sometimes it doesn’t work for brand awareness alone. An example of this would be radio ads, TV ads, and participation in charity events.

Prospecting is when you are actively going out with the intent of capturing new patients. These actions are more like hunting – they are designed to create an effect and bring in an intended result through your direct efforts.  Some examples might include: visiting a doctor’s office for a lunch and learn, or doing a drop off with a success story or promote your survey results to an Allied Health professional.

Every office is going to be slightly different in terms of how much of one they should be doing over the other in order to dial in the correct balance. Your success will also depend on where you are in the country, your patient demographics and your area of practice specialty.

Understanding Marketing Roles

Internal versus External Marketing: Divide the Work for the Greatest Economy of Scale.

It is vitally important to know the difference between internal marketing and external marketing. Your internal marketing department must have a Patient Care Representative (PCR) who works within your clinic to increase patient visits by building greater rapport with the patient public and current referral sources. This can be done by the proper use of success stories, surveys, “Dear Dr.” letters, fax out campaigns, and social media posts. Each one of these tools is effective when used properly and in the right magnitude with each other.  

External marketing is typically done by the person wearing the hat of the marketing coordinator. This can be the same person as the patient care rep if they have the right personality for it and are properly trained. Look for them to be outgoing by nature, a conversation starter, and someone who can communicate well with other professionals. This requires going out to visit doctor offices, allied health professionals offices, and coordinating community events for educational awareness.


Standardize Your Hiring, Orientation, and Staff Retention Programs.

Personnel challenges are the number one struggle of all business owners. This is even more daunting when you consider that the area of personnel management is one where we as physical therapists have had the least amount of training in. The areas of concern include the following factors and if managed well, your practice will thrive.

How do you do this?

  • Perfect your hiring protocol. You want to bring on the best and brightest team players who share and support your company vision, purpose, and goals.
  • Get your staff appropriately oriented to the company and their position within the company so that they know their product and how they are being measured. Having a shared reality is necessary to be a unified group working towards goal attainment. Without having this shared reality, there will be various degrees of push back and disagreement.
  • Employees need to be made fully aware of what they are getting in terms of their employment package and that it is based on the level of exchange that they agreed upon when accepting their position.  
  • Employee retention should be of the highest importance following one’s training. It has been said that turn over can run ⅓ of the salary of that position you are experiencing turn over in.  It is important to have a company culture that regularly acknowledges and validates each individual with the intent of nurturing both personal and professional growth.


Have confidence in yourself as to why you decided to open your private practice, and faith in your abilities to bring about an agreement with others who will support your cause and follow your lead.

Unfortunately, when we graduate from physical therapy school we get little to no training in this area. Too many physical therapists make the deduction that “since I’m a darn good PT and people like me, I will be a good PT owner.” This is like saying “since I’m a good mechanic, I should be a good race car driver.” To avoid this, you need to invest in your self to get executive and leadership training. 

Here are some steps you can take to develop your leadership skills:

  • Deal with your environment and set it up for optimal function and future growth.
  • Get the training and knowledge by learning from others: what are the best systems of operation? How do you develop them into standard operating procedures?
  • Align your policies and procedures into a manual so that everyone on your team gets the same message and knows the same procedures to follow. This cuts down on miscommunication.
  • Communicate your vision with broad agreement. Invest in yourself to become an expert communicator. Learn to confront those around you and have clear and effective communication


Be a Business Owner First, and a Therapist Second.  

A CEO must assemble the best team, invest in them, and hold them accountable via measurable statistics. The mindset is similar to that of the best coach you had when you played sports in school. He or she was most likely supportive, but yet disciplined all the players equally to demonstrate consistency and dedication to the group winning, not preference towards any one individual.  Set your practice up so each staff member knows what their post is, how they get their products, and how they are contributing to the overall success of the group. The individual members of any group can only win when the group is winning, not the other way around.  So start down the road of adjusting your CEO mindset by doing the following: 

  • Create your own daily schedule and make sure you stick to it every day.
  • Never go back on your promises to yourself and others.
  • Never wear other’s problems.  Teach them to work out solutions to their own problems before coming to you.  Let them know you are aware that they may not even have the right solution but that it’s A SOLUTION.
  • Run your practice based off of your annual business strategic plan by using those numbers to drive your annual marketing program so that your duties are always directed toward achieving the goals you have within these two plans.

Investing in yourself is the key to being a better leader thus a better CEO and a better practice owner. Take the time to develop a well thought out business strategic plan, marketing annual plans, and comprehensive policies and procedures manual will not only keep your group in agreement but also allow you to articulate to them where your practice is going and what your vision for the future is.  


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