How To 19x Your Cash Based PT Business WITHOUT Traditional Marketing

Show Notes

In this episode, Dr. JJ Thomas discusses the power of genuine patient relationships. And how she used that to skyrocket her business to a 19x increase in revenue. All without relying on traditional physical therapist marketing methods like Facebook Ads, email marketing, or flyers. Learn how you can incorporate these non-traditional methods and skyrocket your Cash Based physical therapy business.

Get A Free Copy Of My Book:

5 Things You MUST Do to Build a Successful Cash-Based PT Practice

This quick, easy-to-read guide is your no-BS steps to what really works in building a Cash-Based Physical Therapy business.

👉 https://bit.ly/CashPTebook

What is The Dr. JJ Thomas Podcast?

Welcome to The Dr. JJ Thomas Podcast! Here I'll be talking all things physical therapy, raw and unplugged, giving you the unfiltered insights you've been searching for in your cash-based physical therapy business. If you're caught in the grind of the traditional model, swamped with paperwork, or feeling like you're not reaching your full potential as a physical therapist, this podcast was created just for you.

Dr. JJ Thomas: 00:00

When you are true to that relationship and you're in this practice for the right reasons and you follow your instincts of, hey. Reach out to them and be like, hey. How'd it go? That bond is irreplaceable. Welcome to the doctor JJ Thomas podcast.

Dr. JJ Thomas: 00:19

Hey, everybody. Welcome to the doctor JJ Thomas podcast. I'm pumped to be here with you today. Coming off a great weekend of teaching with other physical therapists. We just had our dry needling master class.

Dr. JJ Thomas: 00:31

And, you know what? Every time I teach, it brings me back to why I'm doing this. I love helping clinicians help other people get better. So I'm pumped about today's episode because, really, what I'm gonna do is reveal to you the 4 things that I credit for helping me scale my practice so quickly. And, essentially, if you follow these four things, you're going to 10 x your business organically without a a whole lot of, monetary input.

Dr. JJ Thomas: 00:56

Let me back up and tell you a little bit about myself. For those of you that don't know me, I've always been in this, like most of you, for the benefit of helping people. So when I started my Cash AppSheet's practice, my intent was not to make money. My intent was to find a way out of that insurance racket world where I realized that I wasn't able to treat patients the way I wanted to treat. I wasn't able to gift to them the ability to give them a 100% of what I was capable of doing, and I needed a way out.

Dr. JJ Thomas: 01:31

And on top of that, professionally, I felt trapped, and then, personally, I was trapped because I was working my tail off trying to get patients better and coming home to all these notes, and I had enough time for my family. So my original intent for my practice, for my cash based practice, really wasn't to grow at all. It really was to just make ends meet in a way that I could still look at myself in the mirror and know that I was practicing in a way that I started out to do. That was why I got into it. That's still true today.

Dr. JJ Thomas: 02:03

But what's crazy is by following these, by following my value system and by by being true to that in my own marketing, I've been able to increase my revenue, my gross revenue, from in a in a year, it doubled. In 9 years, it's 19 times. It's it's gone 19 times the gross the gross revenue. So almost 20 times my original income just by doing these four things. Now these four things again, I say this on a lot of my episodes, and it is the God's honest truth.

Dr. JJ Thomas: 02:35

These four things are not focusing on how many times you're posting on social media. They're not tracking how many people are following you on social media. They're not following with following up with emails every, you know, every day or every twice a day to get your marketing. What they are is very simple things that you can do with your patients, and what it comes down to is relationships. So I'm gonna give you these 4 things, but keep in mind that these 4 things, the reason they work, the reason my practice grew organically without me even intending it to happen, is because it all comes down to relationships.

Dr. JJ Thomas: 03:13

Relationships with your patients are the difference that is going to really multiply both their outcomes and your success as a business owner. So here's the first one. The first thing you need to do with your patients is from the minute they walk in the door honestly, whether it's a patient or not, whoever walks in your door at the place where you're practicing, you, within the first 7 seconds, need to look up at them, make eye contact with them, and smile. Super simple. Right?

Dr. JJ Thomas: 03:45

It absolutely is simple, but it's one of those things that cumulatively makes a huge difference. Just think about it. When a patient is considering coming to your practice and they and they decide they make that decision to walk into the door, even though they may know already that they're not going to be using their insurance directly to pay for you. But they have this inclination that, you know what? Let me see what this is about.

Dr. JJ Thomas: 04:08

Maybe if I go to this person, they're gonna be able to help me solve a problem. They're gonna help me move better. They're gonna help me feel better. They're gonna help me play with my grandkids. And so they have the guts and the and and the inquisition to say, let's go to this practice and see.

Dr. JJ Thomas: 04:23

They walk in the door. Research actually shows that it takes less than 7 seconds for someone to form an opinion of you. 7 seconds. That's like nothing. If they walk in that door and you're reading something or you're working with a different patient and you you make the decision to not look up and greet them, you're basically you might as well just say I'm not interested in your business.

Dr. JJ Thomas: 04:46

You might as well just say I'm not interested in your problem. I'm not interested in helping you get better. But when you make the decision to make it a point to stop what you're doing within the first 7 seconds and look up at them and take the 3 seconds it takes to look at them, make eye contact, maybe introduce yourself. Hey. I'm JJ.

Dr. JJ Thomas: 05:07

I'll be right with you. I'm with somebody. But just saw like, show them that you are someone that deals with situations as they come, and you're interested in what they're here for. The minute you show that to them, you're establishing a rapport with them that is going to turn into loyalty and trust and success for both you and them. So that's number 1.

Dr. JJ Thomas: 05:28

It sounds like a very simple thing, like I said. It's not complicated. It's not getting your email list to grow. It's not doing a podcast. It's making guy contact, smiling, and introducing yourself.

Dr. JJ Thomas: 05:41

My team knows this is really important too. If you're a therapist that's on your own, it's simple. You you control your own you control your own actions. But if you have a team, you need to make sure that you're letting your team know that this is very important. Teams, they wanna help you.

Dr. JJ Thomas: 05:55

They wanna they wanna serve you. And if they don't know that it's important to you that you make eye contact and say hello and introduce yourself to every single patient, every single person that walks through that door, whether it's the mailman or a patient, then they're not gonna be able to serve you. They're not gonna be able to do that. So this is a topic that we bring up at our meetings regularly because it's important to me. It is by far one of the single most things that has helped me exponentially grow our practice, and it all comes down to the first seven seconds of meeting somebody.

Dr. JJ Thomas: 06:22

The second thing that you need to do to be able to exponentially grow your practice and your revenue is listen. Just listen to your patients. If you're in the insurance world now or it wasn't long you know, even if it was long ago because for me, I haven't been in the insurance based world in over 10 years, and I still remember struggling with this exact thing. Because in order to actually listen to somebody, in order to fully, intentionally listen to somebody, you you have to block out all the other thoughts in your head. You have to focus and hear what they're saying, but actively listen to them.

Dr. JJ Thomas: 06:59

In an insurance based environment, that is almost impossible because on top of that single patient that you're trying to listen to, you have 4, maybe at least 4, 3, 4, 5 people in the midst, and you're thinking, oh god. Is mister Smith gonna fall off the bike because his balance isn't so great? Is missus Jones' blood sugar gonna drop because she has diabetes? Is that tech or that other, not clinician, but accessory staff, are they gonna take them through that exercise right? Are they gonna just waste their time?

Dr. JJ Thomas: 07:32

All of these things are in your head, and you can't actively listen to them. But in the cash based world, they're now paying you for that time. They deserve to have your full attention. And when you are able to give it to them and you truly focus on them and listening to what their problems are and what their situation reveals, you're going to get them better faster, and they're gonna know that you're listening to them. They feel it.

Dr. JJ Thomas: 07:58

I'm gonna tell a story about a time where listening, for me, was, became so evident of how important it is. And it, again, it started with a relationship. There was a patient that, I developed a relationship with, believe it or not, back when I was in the insurance based world. This patient and I connected because she knew that I cared. She was even though I had other patients at the same time, I would consistently take her in a room.

Dr. JJ Thomas: 08:25

We spent time listening, talking, problem solving. She knew that I was an advocate for her. I'll share her story another time because there was a there was an incident that really proved to her that, that I was there advocating for her. But but the real story I wanna tell revolves around her daughter. So this woman and I had a relationship.

Dr. JJ Thomas: 08:47

I went off and opened my own cash based practice, which is about an hour from where I was working at the time when I first met her. So a couple years later, I get a call from her. And I can hear she's upset. And she's like, JJ, I really need your help. Something's wrong with my daughter.

Dr. JJ Thomas: 09:03

I'll leave names out, but something's wrong with my daughter. And I've met her daughter in the past in the past years. Her daughter's an active, healthy athlete. She was a a competitive swimmer. She was about 9 at the time.

Dr. JJ Thomas: 09:14

She said, something's wrong with my daughter. She woke up yesterday morning, could not walk. Couldn't walk. Like, this active, healthy, strong girl woke up and couldn't walk normally. Literally, her mom got her crutches.

Dr. JJ Thomas: 09:29

And I knew this family. Like I said, they weren't a a a hyper stressed family. She had to use crutches to walk because she had pain and she could not coordinate the walking. Her mom got an appointment. She said she said, I I got a last minute appointment with an orthopedist.

Dr. JJ Thomas: 09:44

We went to the orthopedist. And the orthopedist was like, I don't see anything really glaring at me. It doesn't none of my tests are coming through as anything that would cause her to not be able to walk. Go to physical therapy and see. So they went to the local physical therapist, who I knew from when I worked in the area, and she was great.

Dr. JJ Thomas: 10:01

She's a great clinician. But she had all these things in the back. Right? She couldn't fully listen to what was going on and fully ask the right questions. So she went to this therapist, and this therapist, as I said, who I respect a lot, did all her testing.

Dr. JJ Thomas: 10:15

And she's a great therapist. She did lots of great orthopedic tests. Tests. Nothing came positive. So she surmised that the problem was that this girl had invented, sort of, you know, sensitized this issue, and she flat out was like, you gotta just throw the crutches away and walk.

Dr. JJ Thomas: 10:33

And the mom was like, are you kidding me? This, she's not making this up. Like, she can't walk. What do you mean? Just throw like, that's the answer?

Dr. JJ Thomas: 10:39

It's just throw the crutches away and walk? So she called me. She's like, JJ, I'm really looking for some answers. Can you take a look at her? Absolutely.

Dr. JJ Thomas: 10:46

So on my lunch hour, because I had no spots available that day, I said, come on up. Come visit me. They walk in. I watch this girl walk in who I as I said, I've seen in the past. Very athletic, very strong.

Dr. JJ Thomas: 10:57

I walk her walk in with I watch her walk in with 2 crutches, and she has, like, a spastic gait. I mean, like, a central nervous system type gait. It was scary. And I'm trying to maintain composure because I don't wanna freak them out, but I'm thinking, what the heck is going on? So I stay calm.

Dr. JJ Thomas: 11:15

I'm like, alright. Let's take a look at her. We put her on the table. We sit down. And and, of course, honestly, my brain first went to a central nervous system disorder because, as I said, she walked like she had low grade cerebral palsy, and I knew this girl didn't have cerebral palsy.

Dr. JJ Thomas: 11:28

So one of the first tests I did on her is, hyperreflexia and, central nervous system disorder tests. Well, wouldn't you know? My theory was right based on how she was walking. Reflexes through the roof. High very hyper.

Dr. JJ Thomas: 11:42

Boom. I do I do the patellar tendon reflex. Boom. Like, shoots out like crazy. I do clonus.

Dr. JJ Thomas: 11:47

I well, first, I do Babinski, positive. Then I do clonus 3 to 4 beats 3 to 4 beats. And I'm literally, I'm retesting this multiple times praying that I'm making this up in my head because all I can think of is, oh my god. This happened overnight. How could this have happened unless how could this have happened so quickly, a central nervous system disturbance, unless this poor girl has a very rapidly growing tumor?

Dr. JJ Thomas: 12:11

This is what's going through my brain. And then I'm like, okay. Calm down. Listen to what they're saying. Ask the questions.

Dr. JJ Thomas: 12:18

So I go back to their history. Okay. Did she do anything new? No. She had a normal practice.

Dr. JJ Thomas: 12:23

They might have increased volume for swimming a little bit, the mom says, but nothing huge. Okay. So it's not that. Did she have any trauma? Did she fall downstairs?

Dr. JJ Thomas: 12:33

Did she fall? Because I'm thinking, well, maybe she's got a central cord disturbance from, like, an like, a fall at her low back. Maybe she has a spondylolisthesis, something like that. Mom says, no. Nothing traumatic has happened.

Dr. JJ Thomas: 12:44

And then all of a sudden, I thought, okay. So I've ruled out change in activity. I've ruled out trauma. And then I'm thinking, you know what? I need to I need to ask about medication.

Dr. JJ Thomas: 12:56

So I say to the mom, have you guys had any recent changes in medication? And I'm not an expert on medication. Right? I don't know all the side effects of different medications, but I do know that medications can change someone's, presentation relatively quickly. And the mom says, you know what?

Dr. JJ Thomas: 13:12

2 days ago, we started a new, ADHD medicine. And all of a sudden, I'm thinking, please let this be the answer. So I said, you know what? I'm not familiar with all the side effects of ADHD medicine, but let's take a look. So I pull out my laptop.

Dr. JJ Thomas: 13:26

I search the I what medication is she on? I search it up. Wouldn't you know, one of the side effects is hyperreflexia and, basically, increased central nervous system activation, heightened central nervous system activation. So I'm like, oh my god. Thank god.

Dr. JJ Thomas: 13:41

Thank god I didn't have to tell this patient that, you know, potentially her daughter had a a fast growing spinal tumor. But it made more sense that it was medication. Right? But the only reason I was able to get there is because I I had the capacity, 1 on 1 with my patients, to sit there and analyze the situation effectively. My friend, the girl that was in the insurance based practice, she just didn't have the time to process that.

Dr. JJ Thomas: 14:06

She was still drowning with all the other patients around her. She's a capable therapist. I believe if she had more time and more proximity with her patients, she would have been able to get there. Just as a follow-up for you guys so you know, I talked to the mom about this. She went back to the doc.

Dr. JJ Thomas: 14:20

They switched back to her previous medication, and all her symptoms stopped. So moral of the story is listen to your patients. It's gonna make their outcomes better. It's gonna make you have the gratification that you're craving for being a good therapist anyway, and that now they are a lifetime patient because I had the time and capacity and willingness to slow down and listen to them and problem solve a solution. Those are the incidents that are gonna 10 x your practice.

Dr. JJ Thomas: 14:48

Those are the incidents that are going to increase your gross revenue by 19 times organically. Literally, I still don't have an email list that's very big because it's never been it's never been a priority for me. The priority has always been the value system of let's help more patients. So they co they walk in, eye contact, listen. Those first two things.

Dr. JJ Thomas: 15:11

Now the next one that I'm gonna say you need to do is you need to advocate for your patients. The example I gave with the young girl, the young swimmer, that that's that's one explanation. Right? Like, I advocated. I said, look.

Dr. JJ Thomas: 15:23

Let's talk with the doctor about this. If if he needs me to explain what I saw clinically, happy to do that. But it does get tricky sometimes when you have to advocate for your patients in a way that might put some tension on a referral source relationship. But when you stay true to advocating for your patients, you're going to, again, build that loyalty, and those patients are gonna trust you so immensely that they're gonna come to you. Their Their parents are gonna come to you.

Dr. JJ Thomas: 15:51

Their children are gonna come to you. Their friends are gonna come to you. That's how you 10 x your practice. I'm gonna give another example of where advocacy it can be tricky, but it'll it'll it'll pay out for you, both emotionally and financially. There was a wrestler that I knew from my boys all wrestle.

Dr. JJ Thomas: 16:10

And there was a wrestler that a local wrestler, amazing athlete, that I knew from, actually, from the years of my kids' youth wrestling. And this athlete had some problems with, like, shoulder dysfunction like a lot of wrestlers do, and he had to diagnose slapped hair. He was able to wrestle through this, and he was still doing really well. His his his win loss record was excellent. He was he was competing very, successfully.

Dr. JJ Thomas: 16:38

And then in the middle I think it was his junior year, he tore his UCL, a traumatic tear fully tore his UCL of his elbow. When he went to the doctor that was recommended to him by the, the staff that were present at the time, that doc was like, yes. You tore your UCL. But this doc did more s more labral surgeries than he did UCL surgeries, to be quite honest. And this doc was like, you know what?

Dr. JJ Thomas: 17:05

Let's do your shoulder surgery first. You're gonna you're out for wrestling anyway. Let's do your shoulder surgery first, and then we'll do the UCL following that. So I'm talking with his family because I know them personally. And I'm like, that listen.

Dr. JJ Thomas: 17:18

I need to talk to you. Like, we need to look at you because if your shoulder was functioning with conservative treatment without surgery if you do the shoulder surgery first, you can't wrestle with the u without a UCL. Like, you're not gonna be able to compete at the level you're competing at until you get that UCL fixed. So if you go in that pattern, if you go shoulder surgery then UCL surgery, you're you're not gonna have a season at all. You're not gonna have a season junior or senior year.

Dr. JJ Thomas: 17:46

And his goal was to wrestle in college. So I said, look. I know it's a lot to handle, but let me look at you. Let me see if I think your shoulder can consay conservatively treat. So I brought him into the clinic.

Dr. JJ Thomas: 17:57

We looked at his shoulder. I'm like, look. This has real potential. You've already been practicing and training and and competing high at a high level with it. Why don't we do this?

Dr. JJ Thomas: 18:05

Let's meet with my doc that I know and love that does shoulder surgery and UCL surgery and is one of the best there is at UCL, at both of them, really. And let's consider doing the UCL surgery first. And while the UCL surgery is recovering, because it was it was left UCL right slap, while the left UCL is recovering from surgery, we can make sure we're rehabbing the right shoulder. Then when you're done, you try to compete with the right shoulder as is, just as many athletes compete with with labral tears and and and are able to do it successfully. So we totally had to flip it.

Dr. JJ Thomas: 18:39

I had I mean, in doing that, I essentially took a patient from this doc who I also respect. So that was tough. Right? Like, it was a little bit of a tough situation, but I had to advocate for that friend who is a patient, and in doing that, I gained their trust and loyalty, and I also gained the trust and loyalty of all of their friends and family around them because I did the hard thing. Like, the hard thing was to say, look.

Dr. JJ Thomas: 19:06

I disagree with this doc. I respect him, but I think it should be done this way. Many therapists, I find, are so afraid of being, confrontational to a referral source that they won't stand up for what they believe. And if you're not willing to stand up for what you believe for your patients, you're really not worth much anyway. Honestly, because they're paying to they're paying you cash so that you'll advocate for them, so that you'll champion the hard decisions.

Dr. JJ Thomas: 19:36

They don't know what he had no idea that if he did his shoulder surgery first, he wouldn't have an he wouldn't have a wrestling career at all. Now he went to my my colleague who well, I call him my colleague. We don't have a financial relationship, but I trust him immensely. He got his UCL repaired, reconstructed. We rehabbed his shoulder.

Dr. JJ Thomas: 19:55

He went back. He qualified, and now he's wrestling in college. I feel good about that. He feels good about that, and I have forever patience because of it. So it's not always easy.

Dr. JJ Thomas: 20:05

Like I said, sometimes you're gonna rub people the wrong way. But as long as you're being true to your own values and honoring your patients' needs, it's gonna come back tenfold. The 4th thing that you need to know, that if you do this, your revenue, your outcomes will increase exponentially, is follow-up with your patients. You now have this ability to foster a relationship with your patients that is beyond what you ever could do in the insurance based world. In the insurance based world, as we know, you're treating literally up to 4 to 5 times the volume that you're seeing in a cash based practice.

Dr. JJ Thomas: 20:43

So take advantage of the fact that you have this one on one time to develop relationships with patients and use it to benefit them so that they get better faster and you build that trust and rapport that they that they now trust you immensely to tell you more and to ask you for advice more. And what I mean by this is when I have a patient who I know is about to do something, like actually, just yesterday, I have a high school football athlete. He's a double he's actually just, just committed to, Notre Dame as a double sport athlete. So he's a total stud, and he had an incident where he had, like, a costochondritis, and we treated him. He went to the dock next day as well.

Dr. JJ Thomas: 21:29

So we did a real fast, like, let's get this under. It's more under the gun. He had a game. I knew he had a game yesterday. So I treated him on Friday.

Dr. JJ Thomas: 21:36

I followed up Friday night. Hey. How is how's it feeling? He's feeling pretty good. He's gonna go try to go play.

Dr. JJ Thomas: 21:41

Saturday, I knew his game was 1 o'clock. 3:30, I text mom. Hey. How'd he do? I mean, literally, it's just being true to what my feelings are for my patients.

Dr. JJ Thomas: 21:53

I love my patients. I want them to succeed. When I feel that, I reach out to them. That's what I'm saying. When you are true to that relationship and you're in this practice for the right reasons and you follow your instincts of, hey.

Dr. JJ Thomas: 22:06

Reach out to them and be like, hey. How'd it go? That bond is irreplaceable. Really? There is nothing there is no email marketing system.

Dr. JJ Thomas: 22:15

There is no podcast. There is no Instagram post that is going to give you a greater outcome than being true to your value system and connecting with your patients on another level. So that 4th thing is follow-up with them. Like I said, whether it's the high school athlete or whether it's my patient that I knew was going to New York with their family for the for the weekend, and their symptoms tend to get aggravated with walking a lot. I'm I'm reaching out to them as well.

Dr. JJ Thomas: 22:45

Hey. How was the weekend? How was walking through the city? Did you make out alright? They're so relieved that they know that I'm thinking about them on on time that's not on their dime.

Dr. JJ Thomas: 22:56

Right? Like, it is not easy for everyone to pay cash for our treatments. But when you when they know that you're willing to take time that's not, on the clock and not necessarily directly billable time because you're thinking about them and you genuinely wanna know how they're doing, it's gonna enhance that relationship so much more in a way that is effectively going to organically grow your business. Like I said, I didn't get into this for the, exponential growth that my business has taken on. It's just morphed into that by be by honoring my patients and honoring these relationships.

Dr. JJ Thomas: 23:36

It all comes down to relationships. So in summary, to build these relationships and, as a byproduct of that, build your practice, do these four things. Make eye contact. Say hello and introduce yourself and smile when somebody walks in the room. Listen to your patients.

Dr. JJ Thomas: 23:53

Truly listen to them. Advocate for them even when it's not easy. And follow-up with them. Let them know you care outside of your billable time. So if you wanna know more about how to exponentially increase your revenue and your profit in your business, feel free to click the link in the description and get a free copy of my book that talks about the 5 things you must do, the nitty gritties of how you're going to grow your practice to a 6 figure practice.

Dr. JJ Thomas: 24:19

Thanks so much for joining us. Looking forward to hearing you more. Hit that like and sus subscribe button so that you don't miss any of the future episodes. I'm having a blast sharing all my secrets with you and looking forward to more.