• Rise of The “PT-preneur” – an Inside Look at Todays Innovative Physical Therapists in Private Practice


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    Welcome everyone. This is Dr. Joe Simon from the Private Practice Business Academy. Today we have a special guest on. His name is Dr. Aaron LeBauer. He’s the owner and therapist at LeBauer Physical Therapy, LLC. Aaron has been so kind to jump on board to discuss a few things, because Aaron not only runs his offline clinics, but he also does online consulting as well for physical therapists. Aaron, it’s great to have you on. Please tell the audience a little bit more about yourself.

    Aaron: Thank you, Joe. Thank you for having me this morning. I’m a physical therapist and massage therapist. I own in practice in Greensboro, North Carolina. I see each patient for an hour. I do mostly hands on therapy. I teach my patients to do any exercises at home. I teach everyone how to treat themselves at home so that they can be empowered to take care of their bodies. I’ve recently started a consulting practice about a year ago to help other physical therapists start similar cash based physical therapy practices, and I’m excited to be here. Thank you very much.

    Joe: Excellent, excellent. What made you decide to start a private practice so fast right out of college? Or right out of the PT school. I shouldn’t say right out of college. Right out of PT school.

    Aaron: Right, thank you. I knew going into PT school that I was going to do something different, and I had been a massage therapist for eight years prior to enrolling in PT school. So I had a small solo massage therapy practice specializing in treating chronic pain and injuries that people had not had success with in other therapies including physical therapy and medicine, surgeries.
    During PT school I was on a critical rotation and I saw 43 patients in one day in about 9 hours of treatment. That was the day I decided that I’m not doing that type, I can’t do that type of practice to stay sustainable. From there I knew I would have my own practice and do it right away rather than go to work for someone else. I also didn’t think that anyone else would want to, or that I would fit as an employee in with anyone else knowing myself as well as my practice style, so I just sort of jumped into it as soon as I graduated. Got my license, got my permits and everything and started, hung my shingle out, as they say.

    Joe: Great. There are a lot of, the audience is compromised of all medical healthcare and dental professionals, physical therapists including, and a lot of them are sitting on the fence I would say because the lot that I speak to, they want to know that, what’s the first steps? What would your advice be for the first steps? Kind of guide me through it as you would guide someone else. What would be their first step, say day one? What would you ask them to do to start their own practice? How did you do it?

    Aaron: The number one thing to do is to brand yourself or brand your business. You don’t have to do that with a, you can do that before you have a business license, before you have an actual business, by putting out a blog, whether it’s a personal blog, which is what I really recommend to people, because then you start to build awareness with other people in your area. But also, as your blog or website ages, Google, Yahoo, Bing, they recognize it as being more important.
    But starting to create content in the position one’s self is the expert in your topic, that’s kind of where I would start. Then from there you develop your sort of philosophy on practice, and doing that type of activity while you’re getting the nuts and bolts and administrative chips in a row, which don’t always have a direct A to B transition, you sometimes have to jump around to get everything and all the permits and licenses in the right order.
    If people are transitioning from a current practice to a cash based practice, the main thing to do is to start adding cash based services and services that you’re unable to provide currently or that have a higher value or longer time length to them. That’s kind of where I think people should start, because the Internet is extremely powerful in driving patients to my practice, and so that’s what I think is the number one thing to start with.

    Joe: Absolutely, absolutely. I express that thoroughly to a lot of other practitioners. What platform do you see as a, platform meaning Google, Facebook, Yahoo, the blog, you mentioned the blog, which one do you see as the most powerful tool that you’ve seen that has worked for your practice?

    Aaron: It’s the WordPress, the self-hosted WordPress blog and cross- posting that to Google+.

    Joe: Got it. So Google+ is a powerful platform for you.

    Aaron: Right.

    Joe: Excellent, excellent. Let’s go back to the blog, because a lot of practitioners, they’ve come up and said, “Should I start a blog?” They don’t even know where to start with a blog. Right now you say a WordPress blog for them. For myself and for you, we get that, but for someone that’s fresh out, you’re speaking alien to them right now. So let’s dive a little more deep and kind of explain exactly what that is, and why would you think a blog would help them so much?

    Aaron: Well, a WordPress blog is well recognized by search engines, which is important for allowing people to be able to find you, but the self-hosted blog, which is different than a free blog, though it’s not very expensive, allows you to control your content, which is important if you want to keep your content or change your content or make any changes you want to it as well on going forward.
    The reason that’s important, a blog is a web log. It’s a way to express yourself freely on the Internet to learn from you, to help people. The blog content can be picked up by a lot of different feeds and readers, and you can post it to social networks. It’s a great way to kind of express yourself to create your brand in being, I am this type of practitioner, and these are the things I believe in, and these are the things I believe can help you live a healthier life or can help you live in less pain.
    I guess it’s a platform that you can use to develop yourself into a leader or a thought leader or a expert in your field so that when people and potential patients are looking online for you or for their condition, they will run into and see, “Oh, this person has something to help me, and they’re not trying to gain anything other than help me. Let’s read further and see, oh, their practice is in my town. I trust this person.” They already have a sense of who you are. I think that’s important.
    I think that the other important thing is even if someone is not in private practice and they are an employee somewhere else, a blog can help them drive more business to themselves and to their practice, because you can brand yourself even though you’re an employee. You will still have patients asking and requesting to come see you, and that can only look good to your employer. I think that it’s a great platform and tool that a lot of people use to express their thoughts and opinions as well as teach and educate.

    Joe: Aaron, that is a great point that you just brought up as an employee bringing more value to the practice. A lot of practice owners always discuss with me about their staff and how their staff can bring more value to the practice. Now, I’ll be honest. I don’t know anyone that is doing that right now. I think I know a couple people that are doing that with their employees, asking them to write for their blog, but is it effective? The numbers aren’t out yet. No one’s really tracking it. Myself and you, we’d probably track our blogs and we’ll track certain things to get our numbers and analytics which is very important, but a lot of practitioners out there are just not tracking to see where their referral sources are coming from.
    Those numbers are just not there just yet, but I think that is something very important for the listeners to really know that make sure you track those numbers, and even if you make your employee start doing a blog, which I think brings a lot of value to the practice just like you said, but if they can track that and they see there’s a benefit from that, and obviously each employee that just writes a post, you would get who gets the most hits, who gets the most comments. Very important and powerful stuff.
    With that being said, you’ve touched on a lot of different bases. I’ve stepped out of the physical therapy field myself for a little bit. Not saying that I stepped away from the clinics, but I haven’t attended any of the APTA functions or anything. I know you’re newer to the, the reason why we wanted to bring you on because we saw the fresh face. I said, you’re doing a lot of stuff, and I said, “This is inspiring,” and I wanted more of my listeners to be inspired by you.
    But I want you to discuss, where do you think the field, from what they taught you in university and PT school, where do you think the field is going and do you think there should be a change where it should be going and how it should be directed? What are your thoughts on the practice of physical therapy, where it should be going?

    Aaron: That’s a big question.

    Joe: That’s why I’m asking.

    Aaron: My main thought is I think the younger generation of therapists are starting not only with social media, are able to easily connect with each other, are just starting to get their voices heard. The problem is I see the membership with APTA as they’re not a lot of, I mean, the majority of physical therapists are not members of the APTA. There are very few other voices for physical therapists in politics on a state and national level, and so that’s what makes it difficult.
    But I think that, the best way to say this is I think there’s two types of physical therapists and there’s two different types of people in business. There are the people that are owners and managers and the people that are employees. It’s not to say it’s bad. Some people thrive on working and going home at 5:00 and turning off their brain from work and collecting their steady paycheck.
    Other people, entrepreneurs like yourself and me, we probably, I work all day long. I’m thinking about work at night. I rarely turn off my work brain. I’m a member of the APTA, and I would guarantee that…I can’t say guarantee. I would highly speculate that the majority of APTA members are people that own practices or a majority of practice owners are, there’s a higher percentage of them in the APTA because of our best of interest in where we’re going.
    Now that being said, I think that the direction of the physical therapy progression is not only driven by that, but by people. You have to have a national voice at some point, whether it’s through the APTA or a very, very popular website or blog to help drive the profession forward. I think it’s going more towards higher value.
    Some of the problems with reimbursement are creating sort of these new holes for therapists to come in and say, “Look, I’ve got this way to help treat patients and give them value and help them get better in a way that takes less time or takes them away from their work less days of the week.” At the same time, you’ve got the younger generation of PTs that are all doctors of physical therapy, and whether or not that creates a rift between the younger generation and older generation, it’s there and it’s a fact. That’s going to start changing sort of the focus or the way that we decide or the way that physical therapists look at legislation.
    To be specific, I think and I hope that reimbursement doesn’t continue to decline, but as it does decline and co-pays get larger, the cash based model will become a little more prominent. I think that if a patient’s already paying $50 for a co-pay and they have to come in two times a week, they’re not going to be far stretched to see a therapist one a week and pay $100 for a visit or more. So I think it’s moving in that direction. I don’t know that that’s what’s going to dominate, because I think that insurance is important. I think we need to look at it as more of a catastrophic insurance rather than a maintenance plan of insurance.

    Joe: Excellent. Let’s dive in a little more deep on the cash based, which you’ve discussed. There’s a lot of practices out there right now that are switching to cash based programs like you said. These are all from, you’ll be surprised that it’s just not PTs that are out there that are trying to figure out more cash based programs that they can offer. I think that since you’ve come from a different background, from massage therapy, you already have that kind of built into you where it’s okay to ask for payment for your services, whereas I see a lot of PTs and a lot of physicians are not okay to ask for that. You bring something so valuable to the table that you could teach so many others.
    Let’s just do a little example. Let’s explain to them, like how would you basically approach a patient and say, and you can give us any of the examples of a cash based program, something out there, a program that you see that’s working, but how would you approach a patient and say, “Hey, my services cost x, y, z,” whatever you’re charging. If it’s $100, we can make it just easy and say it’s $100. But let’s just start with that. How would you approach that patient so a PT out there could say how do I tackles this? Because they have a lot of barriers to this.

    Aaron: Right.

    Joe: I’ve heard this many, many times, and they have a lot of barriers to asking for money. I’m trying to give them a lot of examples and show that there are easier ways and it’s not a bad thing to ask for money. How do you do it, Aaron?

    Aaron: Right. Well, the main way that I do it is I position myself so that patients will find me. They will hear about me through word of mouth. I don’t actively go out and try to convince people to come and see me. One of the things that I don’t think I can do is convince someone who wants to use their insurance to pay for their physical therapy. That’s almost not the type of patient that’s in my demographic. It’s the patient mindset as well as a therapist mindset.
    So I use my blog and my website to explain what I can do for people. What I can do for people is on average see them once a week for an hour where I’m the only person they see, and they’re getting 80% of the time is hands on manual therapy, massage, really soft tissue treatment, and then I teach patients to treat themselves. If we do an exercise, I’ll teach it to them and expect them to do it at home. In that way I can explain to people what I can provide.
    Most people who come to see me understand that I can provide something that a lot of the other clinics here cannot. If a therapist is seeing three patients an hour where you’re not spending 50 or 45 minutes with one patient, you’re splitting that time amongst three patients, so the divided attention is not the same quality. You might have the same results after three months, but you might have the person may have to come and see you more often to get the same results.
    But I do specialize in patients who have seen other practitioners, who have had medications and surgeries and haven’t found relief for their symptoms. That’s sort of my niche in where, I don’t really advertise, but when I advertise myself and try to sell myself that’s one of my selling points, is really helping people feel wonderful.

    Joe: Got it.

    Aaron: So how do I approach people with it is that I tell them what I can do. When I talk to a person the first time I ask them about themselves. I ask them about their problem and why are they’re seeking therapy, and then how did they hear about me. Those questions give me a lot of information. What I do is, as I schedule their appointment I let them know what the first session’s fee will be and that I will provide them with a receipt and information and help they need to file it with their insurance.
    However, majority of the people who call already have some understand of that via my website or word of mouth referral from a friend of theirs. When I see them, I tell them what the cost will be, and when I see them I ask for a payment. I think that as physical therapists and healthcare workers and healers one of our drives is to help people, and in helping people we don’t always put a value on what we’re doing to help them. I think that’s the hardest part, is being a business person as well as a healer, because they don’t always go together.
    Lawyers ask tremendous amount of money per hour per 15 minutes or per email from us to help us start our business or set of practices or create legal documents or what have you, and they have no qualms about asking $500 an hour for some of their services, and yet as physical therapists some people are discounting their co- pays, even thought hat may be illegal. They’re like, “Well, a patient doesn’t want to pay the co-pay,” and maybe they can’t pay the co-pay, but I think that we shouldn’t discount our services and we should charge what we’re worth. We’re worth a lot more than people realize or people realize, and what we have to do is bring the value to the patients so that they see and feel and experience the value that we have, and then it’s not a problem asking what we’re worth.

    Joe: That is absolutely an excellent point of bringing the value of what you bring to the table and showing your value. You’re right, a lot of practitioners do discount their services and they don’t present their value, and right away, before the patient even opens their mouth, you’d be surprised at how many have already discounted their services and waiving co-pays and waiving deductibles. It’s amazing how that’s done. They’re just so afraid to ask for money they’d rather just cut the price in half. You also brought up a good point. There are patients out there that legitimately can’t pay for their co-pays and they can’t pay for the health services, but again that brings it back to how much can you help someone without your own practice going under?

    Aaron: Right.

    Joe: That is a problem I see with a lot of practitioners who are more than happy to help somebody because we are healers and you want to help. Great example was the lawyers. You’re absolutely right. The lawyers have no problem for a 15 minute consultation or even an email, they are charging you for that email.

    Aaron: Right.

    Joe: I’m not knocking lawyers, because I have interviewed a few lawyers on this show and they have brought some great advice and great tips to all the practitioners out there, but you’re absolutely right. They have no problem asking for money. That is actually a great comment.
    One thing I heard you talk on was your demographics. The majority of this show does not even think about the demographics. You just kind of glazed over it, but what are your demographics? You said your niche is basically people that have already seen other physical therapists, which is obviously a great niche because if you have five other practices in your area and they are not like you and you’re the one that does the complete opposite of the other five, you’re in a win-win scenario, so that’s great. What’s your demographics besides that niche?

    Aaron: Okay. Well, majority of people still have back pain. But really it’s people that either want to avoid medications and surgery or people who have tried medications, surgery and other therapy and still have pain. They may have their function back. They may have their range of motion, but they still have pain. Majority of them have a soft tissue problem that wasn’t addressed.
    The other part of my demographic was the patient that wants to take control of their health and help themselves and help heal themselves. It’s not just someone who needs me to watch over them while they do their exercises or self treatment. It’s someone who, when I can teach them how to do it, they’ll go home and do it.

    Joe: Got it.

    Aaron: That’s my demographic, the niche, and it really has nothing to do with how much a person earns or how much their personal value is worth or what kind of car they drive.

    Joe: Got it. I just want to add to that as well, because you can also add to demographic, for the listeners out there, if you just look at your patient records, if you have maybe six months or a year worth of patient records, you can see who saw you the most. Was it male? Was it female? What age group that was your basic clientele? Occupations, if it’s maybe a local university close by or if it’s a company close by. These will help you kind of narrow down to see who you should be targeting in your ads, your advertisements, in your marketing pieces, because that is so important instead of just throwing everything on the wall.

    Aaron: Right.

    Joe: If you can just narrow down and just really target that exact audience, you can easily raise your new patient intake by at least 20 percent easily. Great information. That niche I think is an excellent niche to follow, if other PTs that have started cash based practices in other parts of the country and you are working in a place that sees four or five an hour, which I have years ago. I think almost every therapist has at one point has worked that type of practice. Hey, listen. I don’t knock it, because if you look at the owners back then, they were basically monopolizing as much as they can for their market at the time. The change in the industries happen. There is change and times have changed and practices have grown drastically.
    This was a great interview, Aaron. I’ve got to say there’s so much more information we can jump in on, but for today that wraps it up for today. Aaron, I want to thank you again for sharing those nuggets with us and helping those that are just getting of the ground and just starting and showing them that you don’t have to have 5 years of experience or 10 years of experience before you start your own thing. I think that they can learn so much from you.
    Again, Aaron also has a consulting company as well. He consults physical therapists basically on everything. Do you want to talk a little bit about the consulting company, Aaron? I don’t want to put words in your mouth, so fill me in on LeBauer Consulting.

    Aaron: Right. Well, LeBauer Consulting is a website and it’s a business to help physical therapist start cash based practices. A lot of what I talk about on the blog are how to set your mind so that you can think about, how do I advertise, how do I ask patients for money, what kind of mindset does a therapist need to have to have a cash based practice? But also nuts and bolts issues, like how to start a self-hosted WordPress blog. I’ve got some information, like a walk through e-book on how to start a WordPress blog that’s free on the website.
    It’s also about how to market and how to advertise directly to patients, because one of the big things in my practice is that I don’t see patients that are directly referred by physicians. I get maybe three a year who actually come into the office. I get maybe one a month, and the majority of those referrals are not good referrals from a practice because the patient’s not in my demographic. I do a lot of marketing to my patients, marketing to my current patients, and I talk about that in the practice in the LeBauer Consulting blog as well as that’s what I help people do, is how do you do those things and how do you start a practice. I’m available for questions and comments on the blog.
    That’s where it grew from, and I just enjoy seeing other people thrive. I think the type of service that we as physical therapists can offer to patients in the world is super valuable and undervalued, and I want to help people to understand that we have a very valuable service and sometimes you can’t get the most value out of a $20 co-pay.

    Joe: Absolutely. Aaron, again I think you’re a great innovator, especially leading the way for the next generation. I think you’re doing some amazing stuff. Once again I want to thank you for being on the show. Again, if you want to contact Aaron, you can find him on his LinkedIn page. That’s Aaron LeBauer, as well as his consulting company. Aaron, give me that website one more time for the consulting company.

    Aaron: It’s LeBauer Consulting. (lebauerconsulting.com).

    Joe: Awesome stuff. Thank you, Aaron, for being on the show. Once again everyone, this is Dr. Joe Simon from the Private Practice Business Academy. We’ll see you soon.

    Aaron: Thank you.