Thursday, March 28, 2013

Consumer Awareness & Access to Physical Therapists (Part 2)

Now honestly, I should probably make this a three part post - I'd just hate to split up the continuity of this content... here's an extra long Part 2.

Continued from Part 1 of Consumer Awareness & Access to Physical Therapists.

The Business Flaw (in short):
Our biggest business flaw is a marketing problem; it is another classic case of content vs. distribution. We obviously have solid clinical content & provide good services - HOWEVER - physical therapists lack a truly effective way of bringing this content to customers.

  • Change the marketing culture of physical therapists (in Part 1)
  • Engage in new business models in proving physical therapy services.
  • Breach new healthcare roles as physical therapists.
  • Create corporate unity in law, politics, and policy.

Engage in New Business Models:
Wellness & Maintenance:
A curious cultural perspective of the physical therapy profession is that once a patient has met rehabilitation goals, they are discharged and services are discontinued. It is almost intrinsically seen as bad form to keep a patient for "too long". From a business point of view, this is insane!

Rehabilitation to wellness is a business model that I think every outpatient physical therapist should be thinking about. Wellness/maintenance is cash based in nearly all financial circumstances. Additionally, these services are valued at competitive market levels, not at predetermined "values" as arbitrated by some third party (more on this later). One physical therapist who I feel has been consistently exemplifying this business model is none other than Ann Wendel at Prana PT. Have more questions about this business model? Ask her! I'm sure Ann also has other PT's she can refer you to as additional resource.

Family Physical Therapy Concept
Here's another idea for an emerging business model: the Family Physical Therapist. Many other professions have already dialed this concept down: family physicians, dentists, optometrists, psychologists, counselors, even lawyers have demonstrated value and economic social welfare by providing services to the family unit. Why not physical therapists?

Imagine with me, now... how about a family physical therapy practice that practices as an outpatient group,  offers home health services, and is also contracted as inpatient independents at hospitals (the same way many surgeons are) should a patient be unfortunate enough to require hospitalization?

Part of the marketing issue for physical therapists is that we need to demonstrate that physical therapy is for all people of all ages of all walks of life - this goes beyond the old, the injured, and/or the athlete. A family practice physical therapist would provide developmental screenings in pediatrics, address osteoporosis concerns in geriatrics, collaborate with patients to avoid the common pitfalls of workplace ergonomics (and maybe secure an ergonomic contract at local business firms???), as well as construct solid pre-op/post-op plans for expectant orthopedic surgeries which are now so common in the baby boomer generation (ie. total knee replacement and/or total hip replacements).

Executive Health/Physical Fitness Screening
After a quick market survey of the southern California area, I found that most executive health screenings run somewhere in the range of $300-500 a pop. WHAT AN OPPORTUNITY FOR PHYSICAL THERAPISTS!

Most health screenings focus on cardiovascular health and diet; there have yet to be wellness programs developed based on physical health (neuromusculoskeletal) screenings and/or assessments. To take this down the rabbit hole further, most of these programs are modeled in such a way where wellness programs will contract with business executives at local, national, international, and even global firms. Screenings are done and spa treatment is complimentary in the form of any luxury you can imagine.

Cash-Based Physical Therapy Practice
Having tested the market with a very exclusive, modified-concierge home health/wellness PT practice, I can tell you that the demand for highly skilled health professionals that are expert in physical health, exercise, manual therapy, and physical rehabilitation is strong and healthy in our current economy. From a philosophical standpoint, I much rather our consumer's determine our market value than some predetermined set point by a 3rd party. Nevertheless, it's not always the best option for every PT practice, therefore, I'll defer further discussion to the true experts. The three that I can point out as having consistently demonstrating their expertise and presence on this topic are (in no particular order):

Dr. Jarod Carter - @DrJarodCarter
Julie Eibensteiner - @laurusrehab 
Ann Wendel - @PranaPT

Again, I'll defer the real discussion to them since they run the business in full time, real deal.

Get into product development & sales!
I've made mention to this in my Mickey Mouse Moment series in that I feel that physical therapists NEED to get into researching and developing technologies as a path to create and produce for sales and services.

I think one of the best examples I've seen do this in the Twitterverse is the OMPT himself, Dr. Erson Religioso. Having created the EDGE tool and the OMPT channel - his product has now manifested itself as the EDGE Mobility System. Along with a host of other blogs and websites, Dr. E is a great example of someone who has mastered social media generated sales for products - not to mention a solid clinical expertise to back it all up!

Physical therapists inherently fix things; there is a constellation of physical health problems which are begging for solutions. Find one. Fix it. Patent it. Sell it! And, make the world better!!!

Creating Demand through Social Media 
So I've been hinting at this through Part 1 of this post as well as the CSM2013 reflections 2 part post; as we all know, social media has become perhaps the most viral of all medias known to man. What once used to rely upon the printing press, then the radio, which morphed into the air waves of television, now is the free market digital code of Facebook, Twitter, YouTube, Yelp, LinkedIn, Pinterest, Tumblr, and much more.

However, I think that for the consumer, the big three remain Facebook, Twitter, and Yelp. Consumers look at Facebook to see how their friends & family regard a business. Consumers will independently look at Twitter to see how proactive, and, perhaps more importantly - how many followers a business has as a measure of reputation. Finally, consumers will take a careful look at Yelp reviews to see if they should even bother with your business. Regardless of which social media outlet(s) is/are favored for your business or persona, the key is consistency - AND - INTERACTION. The general strategy is to create demand, which will create its own awareness, which will develop momentum to legally leverage consumer access to physical therapists in manners of the following:

  • Have patients, families, friends, business allies, clients, and suppliers like your Facebook page.
  • Have the same group of people follow your Twitter handle.
  • Encourage any consumer that receives any service from you leave a review on Yelp.
  • Post a blog or tips of the day or week; it can be done so on Facebook if the post is short enough!
  • Offer social media incentive programs when interactions are done:
    • Raffle a free wellness manual physical therapy session for liking a Facebook page.
    • Offer product giveaways, gift cards (to anywhere!), or special services to your practice for sharing a Facebook post on their home page or adjunct Facebook page.
    • Use a special retweet offer for a 10% discount on a 3 month wellness checkup after patients have met their goals.
    • Have new patients & clients mention (or print out a special Yelp based coupon) that they found you on Yelp for a free/discounted service/product.
    • Use Twitter #FF #FollowFriday mentions as a raffle for a free 6 month check-up.
    • Interact with patients via Facebook and Twitter as a method of checking up on their weekly progress; post on their Facebook wall (should they give you permission!), "How's the shoulder today?" - You can tweet them as well (should they give you permission!), "How are your back exercises going? #MDT"
    • Encourage patients, clients, and other consumers to join #solvePT discussion or thread on your own Facebook page. Offer prizes for doing so.
    • Offer prizes and/or raffles for using social media to log patient Home Exercise Programs (HEP's); imagine if 50 patients a day tweeted your handle about how they did their HEP - some even with a video or picture tweet. What if some of them were social media fiends just like you, and, shared a photo album on their Facebook page and tagged you along with it!?
    • The list can go ON and ON.

Again, physical therapy practice suffers from poor market distribution. We have great things to share and are having a very difficult time sharing it. Social media costs next to nothing - just your free time and passion. Yet, for the larger practices, you can have an office secretary manage some of the online interactions.

Breach New Healthcare Roles:
This area is perhaps more pertinent to physical therapists working in the inpatient settings, however, it can also carry over conceptually to emerging business models. I made some reference to some of these ideas on Therapydia's PT TV Episode 12.

Inpatient physical therapy practice can be quite challenging because of the vast interdependence on the wide range of other healthcare professionals, and, the organizational politics which such dynamics are inherently bonded with. Nevertheless, if we wish to improve consumer awareness AND access, we must also do so by breaching new grounds in healthcare roles. Examples of such include roles in healthcare administration, case management, utilization review, interdisciplinary practice councils, and innovative & collaborative change initiatives.

Our fellow healthcare professionals are actually our best allies. Nurses and physicians being the most influential as well as the best positioned allies we can strengthen our ties to. Imagine if an entire host of nurses throughout a hospital are keenly aware of what physical therapist do, our training, our education, our scope of practice - how much power such awareness will hold to our consumers at large! Additionally, if an entire medical group or health system's affiliated physicians regard physical therapists as the key to solving their chronic pain, weight loss, osteoporosis, and mobility impaired patient populations - how much better would that make consumer access to physical therapists?!

Breaching new healthcare roles is vital in positioning ourselves in areas to influence change, spark new initiatives, and improve policies. Such actions can actuate cross-professional functionality which will make our allies aware, our consumers aware, and eventually - will spark advocacy to fight for access - or - may  provide access through health system policy change as a start/interim (which we've seen already!).

The Big Guns: Law, Politics, and Policy:
A call to PT directors, managers, and owners: bring out the big guns! For far too long the physical therapy profession has played a game of legal defense. It is time to take initiative, get possession of the ball, and move the line of scrimmage in the other direction!

Ultimately, we are locked into what we are legally licensed to do. Therefore, OFFENSIVE movements in legislation to aggressively protect AND expand our LEGAL scope of practice is the next step in safeguarding our consumers and their ability to access our expertise for care. California has tried to get direct access to physical therapists for years; due to a heated battle over turf and policy, we have yet to attain what many other states have decided is best for the public. Nevertheless, our patients - our consumers - are the key to securing direct access. They will never be truly satisfied with our service without direct access, and, they will never get it unless the general public is aware of the scope, depth, and breadth of services which physical therapists provide. In the state of California where I practice, this is a great battle that needs to be won - more information can be found HERE:
However, this legal battle must be accompanied by our bosses and our bosses' bosses becoming impassioned to change current business strategies, to foster forward thinking growth in organizational culture, and, to progress health system business strategies for more a smoother, inter-system-referral-model to expedite care for patients needing care from a neuromusculoskeletal expert. Yet, this goes beyond just business operations. Bring out the big guns may need to include making corporate policies to join the APTA (which is really the most salient advocacy group for our legal/professional rights), to pursue clinical credentially en masse, to write legislators en masse, etc. This is particularly important for large health systems which employ hundreds of physical therapists - all well positioned to influence the politicians, the public, and the private sector at large.

Yet, another vein of thought is for physical therapists not to just get involved in legal and corporate advocacy, I would suggest we should indeed explore politics itself! Perhaps there are other options and better points of leverage should we attain legislative positions. Maybe? I should think so.

What's required along the way? Professional Unity:
It's difficult to present a good argument to the public and to the politicians if our professional unity is anything but sterling. I made mention about this in my Mickey Mouse blog post from the New Year; we are better being more similar than dissimilar. It's better for marketing, it's better for business, and it's better for our patients.

There needs to be reconciled unity in the physical therapy profession at large. The PT culture is broken; we're segmented in grouping of age, time of graduation from school, degree conferred, specialty, setting, those who want direct access & those who don't, and of course, general life goals/desires. These segments should be strong parts of a greater whole, not petty ground to quibble over. What perhaps is the most terrifying is how willing the culture is in tearing each other down - rather than promoting each other's strengths. When is the last time you'e heard another health professional of a different discipline or complimentary-alternative-medicine professional speak ill of their colleagues? Sure. Like any profession - there are good apples, there are bad apples - there always exists a performance curve. But, how about this? Instead of accepting a normal distribution in our performance culture:

Low Performance-Low Passion ó High Performance-High Passion

Why not promote each other, take criticism through constructive accountability, and build a culture through academia, residencies, and fellowship that looks more like this:
Low Performance-Low Passion ó High Performance-High Passion

Such would be a state of professionalism where all physical therapists exhibit high performance and passion in all the aspects of our practice. Sure. It's a long work in progress - I say its worth laboring for - TOGETHER.

Want inspiration?
If you feel you need a little extra "umph" to gather momentum in how you wish to market your services, check out this amazing lecture on selling your ideas the "Steve Jobs Way". I think this is one of the best lectures I've seen regarding presentation styles and marketing content. Enjoy!

  • Physical therapists need to make a cultural change in self-perception and intrinsic willingness to market our services, our abilities, our training/education, and our contributions to both consumers and referral sources alike.
  • Physical therapists need to explore new business models to provide for the demand which is ALREADY present in the consumer marketplace. Not exploring such business options is leaving ready oilfields untapped.
  • Physical therapists must breach new healthcare roles, especially in regards to healthcare administration, case management, and healthcare councils in order to place the profession in a locked-and-ready position to pounce on opportunities of expansion and growth.
  • Physical therapy managers need to create corporate policies encouraging/requiring employees support legal rights of physical therapists, influence organizational culture changes for positive growth and professional unity, and, perhaps seek out opportunities - or - promote their own employees to seek out opportunities in the world of legislation and politics as a method to better position our profession at large.

Regardless of which paths we choose to better our future and the future of public health, I believe there is something that can definitely be agreed upon:

Much work to be done as to inform the public that there exists a healthcare practitioner specializing in pain, mobility, & restoring ability for life.

I hope you've enjoyed this "business side" of this blog and hope to share more business solutions including a Mickey Mouse Moment Follow-Up.

Thank you for reading and sharing in my thoughts.

Very respectfully,

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