Nitin C: Today, I have the privilege of interviewing Donald Tepper, the editor of PT magazine. Don, today’s talk is about how a physical therapist in private practice can market himself or herself better. There are a lot of techniques out there on how we can get the word out to physicians and patients about our practice. As a private practice owner, going to physicians with the intention of helping them promote their practice either through your network of patients or though your own newsletter for example, or through patient handouts is a great way to initiate a relationship with a physician who doesn’t know you. What are your thoughts on initial physician networking for new private practices?
Donald Pepper: Well, you are absolutely right. The PT should go in more as a colleague, more as one who is able to assist the physician in the physician’s mission and thereby serving the physical therapist as well as opposed to going in simply as a sales person. If a PT is approaching a physician and there hasn’t been contact before, one of the most important things to do would be for the PT to establish his or her credentials to give some reasonable level of confidence that the PT is confident, that the PT can work in coordination with the physician that ultimately what the PT does, will be of benefit to the patient. That is probably the most critical thing, if there hasn’t been some sort of prior contact.
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Nitin C: Don, if a therapist encounters a gatekeeper, I mean the office manager who makes it difficult if not impossible to communicate with the physician, are there any things that the therapists can do to get the message to the right person?
Donald Pepper: Certainly, there are a number of techniques; I mean these apply not only in the health care field but generally as well. What that means is recognize that the gatekeeper is not going to be a 100% effective all the time. For example one might choose to interact with the physician outside of the physician’s office where physical therapists could join or attend as a visitor and make contact with physicians. That is one way of immediate contact. There are other ways too. Physicians very likely browse online. They may participate in different online groups such as yahoo groups or other healthcare related type groups. By raising more visibility as a physical therapist there, it makes you known to the physician about having to worry about the gatekeeper.
Nitin C: If a physical therapist is trying to get in touch with a local physician but doesn’t know people, let us say you are new to the area as a physical therapist. You don’t know the names the phone numbers and the addresses of local physicians. Would you suggest any sources to acquire this information? I have heard of a couple. I wanted to get an opinion from you from what I have shared what I know, unless you prefer that I go first.
Donald Pepper: A few things come into mind. You may have better resources than I do but there are 2 or 3 different ways that one might go about it. One is there are services at the mailing list services where you can specify a person’s occupation, zip codes and developers to name that way, there are variety of services. A second possibility is again doing an online search with keywords such as ‘physicians’ with the town name, or zip code. There are other groups and again I will get back to local medical societies, other groups that physicians would join that a PT might be able to access mailing lists or other contact information and make it that way.
Nitin C : That is a great idea. In fact, what I have found is that there are 3 networks that have worked for me in my practice. One called the local chamber of commerce, there is one called the BNI, there is a 3rd one, it is not very well known but I have found it is much better for me than others. It is called LeTip International (letip.com) and some of these groups have exclusivity – which means let us say you are a physical therapist in the town called Hackensack, you are physical therapist for the Hackensack chapter of the LeTip, they won’t accept any other therapists in that chapter which allows you to literally be the only therapist promoting yourself to other professionals and businesses in that chapter. It might be a great opportunity because it is an underutilized resource.
Donald Pepper: Let me kind of add on to that the segment, you can also be at a slight disadvantage if very limited number of other health care professionals involved. You might have a physician. You might have one or two others but again, often by exclusivity you may find that you can’t reach 10, 15 or 20 physicians through that approach. In fact, you wouldn’t be able to hear any piece of inside information at least in the area that I am in, which is northern Virginia. You can attend the meetings of other BNI clubs and in our particular area, there are probably 35 to 50 different BNI chapters. You can attend frankly one every morning and one at noon everyday lunch for as long as you want circulation among the different ones and continue establishing contacts all of whom are within the same general geographic area. But you are reaching fresh people each time and you are reaching them on a peer to peer level.
Nitin C: Great Idea, Don. The question that I get very often is, if a physical therapist spends a lot of time marketing, any of these things take time because at the end of the day referrals are function of time and to certain extent money spent on advertising. Do you believe that? What advice would give to a physical therapist who is trying to balance time spent on promotions versus actual clinical time?
Donald Pepper: It does become hard to strike that balance especially if you are new and looking to grow your practice. Absolutely one of the things that I would suggest is setting up a schedule and blocking out certain periods of time in order to market yourself as I referenced a moment ago, a lot of BNI chapters meet early morning so do some of the chambers of commerce around the world for exactly that reason because people are busy, they are ready to take on mid morning, mid afternoon to attend a meeting. Block out that 7:30 to 9 AM once or twice a week or whatever is appropriate and that will not likely put a major crib into your available time with patients or do another office work. Similarly, although we haven’t got there, there are other ways to raise your visibilities such as blogs; either one’s own blog or posting on other blogs and that can be done 24 hours a day. One might block out some early morning time slots for face to face networking and blocking up let us say 9-10 PM in order to write a blog or write postings on other blogs. Just set the schedule up. Make it doable and workable or you don’t have to go overboard on it and then stick to it. You will eventually build up a critical mass of contacts, inputs and opinions that other people should access and get to know you that way.
Nitin C: Don, are you of the belief that over a period of time as the practice grows bigger and bigger the owner of the practice, the PT can focus more on the marketing and dedicate more time personally towards marketing and hire other physical therapists to do the clinical work?
Donald Pepper: Because at some point, the owner has to ask himself “am I going to dedicate more time on marketing and growing my business versus treating and maintaining my business?” That is an issue that a lot of businesses, in fact most businesses say and the question is what duties can be assigned to other people, what duties are best handled by the practice owner or more generally, the business owner and a good way to approach it I would generally agree as the practice grows. It may make a lot of sense to have other PTs handle the intervention. The key really is to determine what you are best at and then focus on doing that. If your absolute strength is in manual therapy or some other aspect that is great in that case, instead of hiring another PT and trying to go into marketing, you may want to hire someone to do some of the marketing for you. Now all of that can be outsourced because you know personal relationships with physicians or other people, you don’t want to see who they are actually dealing with but in general consider what you are best at and focus on that. What are you most efficient at and focus on that? Then outsource those things which you are either less comfortable with or is performed more efficiently by others.
Nitin C: I think of it in terms of 3 circles parameter. If your will, interest, desire and need and the exact point where the 3 circles converge say a portion where there is common ground between the 3 circles, is what we as therapists should focus most on. I have found and I have been guilty myself. I tend to waste time sometimes on things that won’t grow my business or won’t help my patients as much as they should and stuff that should be outsourced. I am talking about making enhancements to the website, I’m talking about perhaps, writing out an ad myself when I should hire somebody to do that I think we, as therapists should either focus on clinical which we are trained to do or marketing which is a strong need of a private practice and outsource I believe. That is my take on it.
Donald Tepper : I would agree absolutely. The real challenge is for physical therapists and general business owners to be determined what those intersecting areas are what is best to handle personally and what is best to outsource. Once you have identified that you take a major step to maximizing your time and your effectiveness.
Nitin C: With direct access being available in most states in the United States of America, would you as a physical therapist start focusing more on reaching patients directly, advertising to patients directly or do you think we are still at a stage where a majority of our marketing should be geared towards physician?
Donald Pepper: No, no, no, it is an excellent question. PTs in many states have developed some very interesting technique in order to capture those patients. They’re operating fully within the practice of parent states but they want to go after patients separate ways. For example, when patients call them and the physician referral is needed, the practice is geared up to provide the easiest route for the patients to reach a physician. The physician will then make a referral as opposed to for example, simply saying “I am sorry, we can’t help you. We need talk to a physician first” so it is possible regardless of direct access to maximize the patient’s involvement, the greater question might be “does it work for a particular practice?” Some physical therapists are far more comfortable continuing to operate on referrals.
Some who may perhaps be more entrepreneurial want to target patients directly either way works fine. I would say longer term, 10-15 years maybe less, it will be extremely important for PTs to appeal directly to patients whether they are on a direct access state when more and more of them are or even if they are not. I don’t think that it is necessarily a healthy situation long term for a business owner to depend exclusively on referrals from other business owners in order to have a growing concern.
Nitin C: Don, are there any legislative concerns about direct taxes that may make this less appealing?
Donald Pepper: None really. They are concerns that have been raised which are spurious concerns deal with the issue of differential diagnosis that is like physical therapists may be getting in over their heads as patients directly approach them. A physical therapist may not fully understand all the complications the patient is having. It turns out that one of the new educational programs that are out there, “the DPT”, the training afterwards and the physical therapists who don’t have a DPT. The experience they have gained, it turns out that is a spurious argument but that is a concern that has been raised regarding direct access and regarding perhaps appealing directly to patients. All I would say is that physical therapists must fully understand what their own state practice act provides and must be alert on other conditions or situations that they may not be qualified to treat.
Nitin C: Don, as far as reaching out to patients directly is concerned, one of the strategies I have used is ask my patients to mention my name or spread my newsletter or my handouts to their friends and family in case they should leave for physical therapy. I also have patient appreciation days where I invite patients who have benefited from physical therapy and referred other families and friends who have also benefited from therapy. What I also do is that I have special lunches and once in three months, I organize an event where I take patients out to a movie. The patients that are key referral sources, not all patients. All of this is okay but where is the line between being appreciative of patients and being unethical and for bribing patients (for lack or a better word)? Where is the line drawn?
Donald Pepper: That is a difficult question and I am not fully qualified to speak on this because for example, the American physical therapy association is just at the tail end of revising a whole series of guidelines regarding ethics while I can’t speak directly and specifically to the question. You raised is a valid question which the physical therapists do have to be sensitive to. We run a column in our magazine and while we haven’t addressed that particular topic, one of the many tests that has applied to any ethical situation beyond how it comports with a PT, how does it comport with the state practice guidelines and so on. How does it feel if what you are doing is plastered on the front page of a newspaper? How do you think people will react to that?
Also, look into yourself, are you simply trying to bribe the patient to use the trouble you raised a moment ago? If that is it then don’t do it. It’s firstly fine again within all the guidelines that exist, to provide information, to provide education, to provide services as appropriate to volunteers to support events, to provide any number of other services that may be appreciated and valued by patients. There is a whole wide range of things that can’t be done that are ethical and fall within guidelines. Just be careful especially when at the back of your mind you hear a little voice saying, “Am I pushing this too far?” If that is the case, then really carefully examine what you do.
I define it as if you are taking patient out for dinner. If you are showing them some sort of appreciation, genuine appreciation as opposed to some sort of material or money exchanging hands, it is okay that is the way I see it. But I wasn’t clear about where the line was drawn.
Nitin C: Don, one final question for the day, when a physical therapist tries to reach out to the patient community, how can and should he / she position himself / herself?
We must make it more attractive for patients to come to us, first of all, patients I believe have become more sophisticated with what they need, more educated and more demanding than they were even 5 years ago. Also patients are faced with so many, bombarded with so many marketing messages that its reach is really challenging to get their attention, in fact, a lot of businesses now rely on sensationalism just to get the consumer’ attention.
We can’t be sensational because we are professionals and we have a practice act to follow but how can we as physical therapist get the patients’ attention and help them understand the importance of therapy and get them to make the call or walk in through the door, any tips?
Donald Pepper: Yes, a number of them. You mentioned the technique of word of mouth referral from one patient to another. That is incredibly effective and that carries a lot more weight than an advertisement email something like that that PTs who have treated the patients who have had a favorable outcome, stay in contact with that patient, provide tools for the patient to refer friends and family to you.
That way you are not just spreading the word about who you are and where you are located. You are receiving a built in testimonials from someone who has actually been through the process, appreciates the service and the outcome that you provided. Definitely stay in contact with all patients, stay in contact with past patients in particular because they may have future needs. You may have treated a patient for a particular problem and had a good outcome then another problem and especially in your access spaces. They may come to you first so again do it that way. Also, recognize that consumers are becoming much more technologically savvy so don’t over look the issue of blogs, of online newsletters, of email newsletters and of services such as Facebook, Youtube. There are all sorts of instructional videos that have been posted on Youtube.
It would make sense for a PT to post appropriate things as videos on youtube. And then either people will find that because it is posted and will be picked up by the search engines or promoted to your patients or perspective patients, to let them know if there is free information which you have provided that is available for them 24 hours a day 7 days a week. You will both live off goodwill and will be able to get your message across about your practice.
Those are some of the things that I will look at that are not expensive, there is very little cost involved in those and yet far more effective than simply placing an ad somewhere or even doing piece of very creative direct mail. When you have a built in referral from a foreign patient or would you have already built credibility by providing good useful information. You have overcome many of the barriers you need to overcome in order to acquire new patients.
Nitin C: Don, do you believe that patients actually google physical therapists in their cities? Are patients searching for physical therapists on websites like Google and finding therapists locally in your opinion?
Donald Pepper: I am sure they are. I would suggest in addition though, that any physical therapist who wants to be found that way not only promote themselves as physical therapists which of course they should. Then again, blogs on their website, involvement in other online communities but address the benefit and services that have been provided so may be true and may work if someone is Googling physical therapists. But they are Googling back pain or carpal tunnel syndrome or of the thing that they feel great are they are treating.
Nitin C: Knee pain, back pain, shoulder pain & neck pain.
Donald Pepper: Right. Make sure that your website is optimized with those terms. Make sure when you are posting your own blog or posting on other blogs that you reference the benefits of the service that you provide when someone is searching for a solution to whatever their problem is. When the problem is back pain or neck pain, they search and you pop up. with a clear explanation as to why you are fully qualified to treat the issue and why you should be the first person they come to.
Nitin C: I have found two strategies to be very effective, Don. The term WordPress is nothing but a platform for hosting a blog wordpress blogs rank very quickly in the search engines. Let us say you were to write an article on physical therapy and put in the name of your town. You were to put that in the WordPress blog, Google has an affinity for writing WordPress blogs very highly especially if a blog is updated once a week. WordPress blogs are a fairly quick way to get ranked in the first page or the second page of Google keywords; let us say you’re based in New York City, which would be a more competitive keyword because it is a major city: lower back pain New York City, physical therapy New York City. Another thing that I have found is Youtube videos again Google now owns Youtube so any Youtube videos that have keywords on them as a title rank fairly quickly on the first or the second of Google as opposed to a static website which is never updated. That is my 2 cents worth. Those points are absolutely critical when you say they are ranked quickly.
Donald Pepper: That can be done in a matter of hours absolutely; I mean the results are amazingly quick. Make sure you are refreshing your content whether it is on the website or on your blog since search engines especially like new, constantly updating content.
Nitin C: I want to thank you for your time. I think you have provided a ton of great information. Outstanding. I am so glad you took the time to speak with us today. We have learned a lot, I personally have. I appreciate you taking the time. Do you have any closing comments before we wrap up this interview?
Donald Pepper: To be open to new ways of marketing, talk to people who are in areas other than healthcare. Find out what they are marketing. They still have to reach customers. They still have to reach other peers who they exchange business with. Find what they are doing. Don’t limit yourself to healthcare. Healthcare is unique in many ways but as far as marketing to patients and as far as marketing to peers, there isn’t that much difference in the techniques that can be effectively used.
Nitin C: Thank you so much for your time.
Donald Pepper: Thank you. It has been a pleasure.
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