5 Essential Steps for a Successful Cash-Based PT Practice

Show Notes

Welcome to the first episode of Dr. JJ Thomas Show with Dr. JJ Thomas! 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 episode (& podcast) was created just for you. Today, we're diving deep into the world of cash-based physical therapy. I'll be explaining the five key steps that shaped my journey, from understanding the true value of your time to knowing when it's best to refer out. Whether you're a PT student, an experienced Physical Therapist, or someone on the brink of transitioning to a cash-based approach I'll explain why you should start your very own Cash-Based PT Business.

Get A Free Copy Of My Book: 5 Things Your MUST do to Build a Successful Cash Based Physical Therapy Practice: https://bit.ly/CashPTebook

Creators and Guests

Host

Dr. JJ Thomas

Master of Movement With over 20 years of experience, Dr. JJ Thomas has established herself as a highly successful clinician and educator. Her unique experiences and training have shaped her into a passionate advocate for movement and patient care. Graduated from the renowned University of Delaware, the #1 ranked physical therapy school in the nation. Holds multiple certifications in advanced specialty techniques, including dry needling, SFMA, FRC, and more. Instructs and trains clinicians nationwide in physical therapy, chiropractic, and sports medicine, both through Evidence in Motion (EIM) and independently. Expertise in movement analysis and dry needling has made her a sought-after professional in the field of sports medicine. Worked with notable organizations and athletes, including the US Field Hockey Team and professional athletes from NFL, MLB, NBA, USATF, PGA, US Squash, USPA (polo), and more. Recognized as an expert and consultant in dry needling, contributing to national legislative advancements and education standards in the field. Lives an active lifestyle, engaging in various activities like running, weight lifting, Jiu Jitsu, hiking, skiing, and more.

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

They think that they need to offer these discounts right off the bat to draw people in. Get a package deal. Do, you know, 10 sessions, and I'll give you 30%. I don't like that model at all. I feel like right away you're saying, I'm not sure that you're gonna believe that I can get you better after 1 visit or 2 visits or 3 visits.

Dr JJ Thomas: 00:18

So I'm gonna make you do 10 visits. Screw that. Welcome to the Cash PT Unplugged podcast with doctor JJ Thomas. Hey. I'm doctor JJ Thomas, and welcome to the Cash PT Unplugged podcast.

Dr JJ Thomas: 00:33

Today, we're gonna talk about the 5 things you must do if you want to build and grow a 6 figure cash based practice. This topic for me came out of years years of getting questions from people I know, people I don't know. I teach have been teaching since 2012. I finish a 2 day teaching course, and at the end of the course, I'm like, I'm teaching dry needling. At the end of the course, people are like, I'm like, any questions?

Dr JJ Thomas: 00:58

I'm thinking they're gonna ask about dry needling. And instead, they're like, yes. I wanna know about your cash based practice. I get DMs. I get emails.

Dr JJ Thomas: 01:05

I get phone calls, and I'm happy to do it because it's the right thing to do. But it's hard to keep up with. So I'm like, hey. Let's put it all in one place. So here we are today.

Dr JJ Thomas: 01:15

That's what's prompted us to be here. And on top of that, I did create a book that you're gonna have access to at the end of the podcast in the description if you like later. But we're gonna talk about all the things that I found when I was building and growing my own cash based practice that I feel like were critical and really helped us get to where we are today, 10 years down the road, a successful growing organically growing cash based practice. So we'll start with this. Let's first get this out of get the elephant in the room out of the way.

Dr JJ Thomas: 01:41

Why would I give you all my secrets? Like, why would I want to encourage competition? The first thing is that I believe we're in a pivotal time in our profession. If you look at PTs right now, there's such a high rate of burnout. Stress is real.

Dr JJ Thomas: 01:57

Struggle is real. People are trying to deal with their student loans. They're not getting paid what they're worth. They're juggling so many patients at once, and they're feeling unfulfilled by that. They're, like, they've got, like, maybe 4 patients there at the same time, and they're, you know, they got most of us, almost all of us, I'd say, got into PT because we want to help people.

Dr JJ Thomas: 02:15

And we go to school, and we're like, I'm gonna learn all this stuff, and you learn all this stuff, and you can't wait to use it. Make it to the clinic, and you're like, oh my god. I don't have time to use this stuff. Or I think this could work, but I don't have time to test it and retest it and really see if it works. So most PTs in that environment are now feeling unfulfilled.

Dr JJ Thomas: 02:35

And then on top of that, then they go home and they have paperwork from the day, or they they can't leave the office if their if their system doesn't allow them to do the paperwork at home. They can't leave the off the work office until their paperwork's done. And now that's taking away from their personal life, their family time, whatever it is. And everybody's just feeling so trapped. So most people look at me and they think, like, or they see my world.

Dr JJ Thomas: 02:57

You know? We've got this beautiful clinic. We've got great staff. We've got great patients who wanna be here, and they value what we do, and we value them. And it's it is great.

Dr JJ Thomas: 03:05

And we've been doing this for 10 years, but I wasn't always there. There was definitely the time, my pivotal time, where I was in your shoes. If you're listening to this and you're in those shoes that we were just talking about, where I was running around like a chicken with my head cut off, and I felt like I couldn't do as well. I wasn't living up to my potential as a therapist. And patients were getting better, but I knew they could get better faster.

Dr JJ Thomas: 03:27

There was this one patient. This was actually probably one of the pivotal points for me where, there was a patient that I saw from walking in and out of the clinic, and she was working with another therapist at the time. She had chronic headaches, and I happened to be walking by to get my next patient, even though it was hustling and bustling. And, and I said, hey, girl. How you doing?

Dr JJ Thomas: 03:48

And she was like, oh, this pain is handling me. And she said that, and I was like, oh, god. Like, that's such a deep that's such a deep thing to say, and it's so true. Like, most of our patients, their pain is handling them. And And I was like, you know what?

Dr JJ Thomas: 04:01

I don't care how busy I am. I'm gonna get this girl on the schedule. I'm gonna spend some alone time. I got her in a room. We spent that time, and we I was able to help her, and I'm like, yes.

Dr JJ Thomas: 04:10

That's that's what this is about. So that's why we're at a pivotal time in our profession. We need to be able to bring back why we all got into the profession in the first place. So cash based practice is a great way to do that, and I want to give you guys the tools to be able to actually capitalize on it and make your lives better. So it's the right thing to do.

Dr JJ Thomas: 04:29

On top of that, the second thing is that it's the right thing to do. On top of being able to help patients on an individual level, I don't know if you guys have noticed, but we're kind of losing our reputation here. I've had so many people where I meet them at a party and I'm like, oh, you know, they say, oh, I got this knee. Oh, you're a PT. I got this knee thing.

Dr JJ Thomas: 04:49

Of course you do. But, once they tell me that, I'm like, oh, well, maybe we can help you. Oh, I tried PT. It didn't work for me. And I hear that, and I'm like, well, let's talk about it.

Dr JJ Thomas: 04:59

You know? It shouldn't be like that. It should be like, I had PT. Man, that was that made all the difference. So So I wanna help you guys do that.

Dr JJ Thomas: 05:07

And the last thing, when we're able to do that, we're gonna get people better faster. Right? So part of that, it's the right thing to do. Let's get everybody better faster. And then the last thing you might be asking yourself is, again, why would she share all her secrets?

Dr JJ Thomas: 05:19

I'm actually inviting competition. Competition drives excellence. And so I'm inviting you guys to go be the best you can be. Go help more people. And then, yeah, that's gonna make you better, which is gonna make me be better.

Dr JJ Thomas: 05:33

Right? If I'm not gonna live up to that challenge, then I don't deserve it. So let's all get better together. So I'm gonna give you the secrets now. Here are the 5 things.

Dr JJ Thomas: 05:42

We're gonna start with the first. The first is keep it simple. You wanna open a cash based practice. One of the biggest things I see people struggle with is they get what I call decision paralysis, And I'm actually probably gonna talk about that in a future podcast because I think it's really important. If you keep it simple, you think about what your goals really are, what you really wanna achieve from opening this practice, then you're going to be able to succeed.

Dr JJ Thomas: 06:08

Right? Don't make it so complicated. Figure out exactly what you need to get the goals that you are desiring for you, your patients, your family, everyone. Lots of times, that means less is more. Less is more in terms of overhead, especially in the beginning.

Dr JJ Thomas: 06:25

Find a space that is low rent, that has flexibility. You're not locked into a lease in case in case you need to make changes, right? In case maybe the market isn't what you thought it would be. Less is more. Also with equipment, less is also more.

Dr JJ Thomas: 06:41

You don't need a lot of equipment. You are a highly skilled individual, and your tools, your most valuable tools, are likely your hands and your brain. You don't need to buy a lot of equipment for that. The equipment you do buy should support whatever your strengths are. Less is more.

Dr JJ Thomas: 06:58

Even in terms of pay structure, when you're thinking about how patients are going to pay you, think about how you can use that in a way that's going to give you exactly what you need to be able to survive and thrive. So the pay structure should pay you for your time. In my clinic, when I first opened, and it's still this way today, we chose to do a cash based model that is essentially by the minute. So patients pay by the minute. It's rated as a 15 minute interval.

Dr JJ Thomas: 07:27

So 15, 30, 45 or an hour. If I don't if I only see them for 40 minutes, I don't make them pay for that extra 5 minutes. I want them to know that I value their time. So pay structure, keep it simple. We did it.

Dr JJ Thomas: 07:39

Pay by the minute, essentially. The second topic, the second thing you must do is recognize that your time is valuable. One of the things I often see other therapists do when they open their cash based practice or when they're actually contemplating cash based practice is they don't value their time enough. They're afraid to make the leap and say that their time is valuable. Your time is valuable.

Dr JJ Thomas: 08:02

You're going to make yourself very accessible to this patient, which is going to allow them to get better faster. And you need to make sure that you're asking for the right amount so that your time is paid for. Do the research. I'm not saying just, like, put a high number up there, but look at the market in your area. Look at comparable therapists or clinicians, might be a Caspes chiropractor.

Dr JJ Thomas: 08:24

Look at comparable clinicians to your to essentially what you deem as your own value and then create a rate based on that. But don't undersell yourself. That's one of the biggest mistakes I see people making. Another mistake I see people making is that they think that they need to offer these discounts right off the bat to draw people in. Get a package deal.

Dr JJ Thomas: 08:44

Do, you know, 10 sessions, and I'll give you 30%. I don't like that model at all. I feel like right away you're saying, I'm not sure that you're gonna believe that I can get you better after 1 visit or 2 visits or 3 visits. So I'm gonna make you do 10 visits. Screw that.

Dr JJ Thomas: 09:01

What I want you to do is make yourself so valuable to them that in the first three sessions, they're gonna know they wanna come back for more. Right? So don't don't draw them in by the money. What's gonna draw them in is you as your you and your tools. Now what I want to say to that though, don't also take this advice and say, oh, you know, JJ's group doesn't offer discounts.

Dr JJ Thomas: 09:23

That's not true. I give discounts more to show patients I value them. If I have a patient that really values what we do and they we call them the o g's, you know, they're gonna get a discount. If I have a colleague that, I think that will be great collaborators and I want to establish a referral relationship, they're gonna get a professional courtesy discount. I give discounts to show I value my patients, not to show not instead, I don't give the discounts to make them think, oh, I don't value myself enough.

Dr JJ Thomas: 09:56

So that's that's rule number 2. Your time is valuable. The 3rd piece we mentioned to you already, and that's accessibility is key. In a cash based practice, accessibility is maybe one of the most appealing things to these patients, because they usually, when they're coming to a cash piece practice, I always say there's 2 types of patients that come to us. There's those that have failed treatment everywhere else, and there are those that want to be better yesterday.

Dr JJ Thomas: 10:25

Both of them need accessibility to their therapist in order to get better faster. So the accessibility is huge, and what it does really is it shows the patients you value them. That rapport, that relationship between you and your patient is so important and the minute you have it, it's undeniable. It's hard to recognize that right now when you're in this practice where you're seeing 4 people at a time and you know the the tech or the PT assistant or someone else has taken them through their exercises, but, if you can just stop and imagine it, you're gonna, go for it, and it'll be obvious as soon as you go for it. The third piece about being accessible to them, and this is also very important from a clinical standpoint, is when you are accessible to them, you're going to get them better faster because you're going to have that test retest immediately.

Dr JJ Thomas: 11:17

Whereas in a in an insurance based practice, what's happening is you see a patient on Monday, you're not going to see them again till maybe Wednesday or Thursday. You're not going to hear from them because it's just not that kind of model. There's no accessibility. Whereas with my patients, I say to them, as soon as I finish, as soon as I finish a treatment with them, you know what? You're gonna be sore.

Dr JJ Thomas: 11:37

If you're sore more than 24 hours, let me know. If anything makes you nervous, let me know. Or I give them an exercise and I say, you know what? I want you to do this exercise. I want you to video yourself and send it to me so that I know you're doing it right.

Dr JJ Thomas: 11:47

We nip those things in the bud right away, and it shows. We're onto the 4th. And this rule is, you are the expert, act like it. So I've seen this with a lot of clinicians that transition from insurance based practice into a cash based model. What happens is, habits are formed.

Dr JJ Thomas: 12:08

Right? You're just treading water in the cash based in the insurance based world. You're treading water. You're trying to basically get people a little bit better. You're trying to just give them anything you can in the limited time that you have.

Dr JJ Thomas: 12:22

In this model, you actually have the opportunity to really get to the root cause of their issue. So what you need to do is drive that. Be a leader for that patient. Now you're gonna have patients that come in, and they're like, ah, I hurt my neck, or I know it's my shoulder. I have this history.

Dr JJ Thomas: 12:37

You know, I saw this doctor over 2 months ago, and he said it was this. I think he's right, but I want you to treat me. They they're not there to drive the treatment. If they're paying for you, they deserve to have you and your expert capabilities. But what that means is you have to have the confidence to actually go to them and say, you know what?

Dr JJ Thomas: 12:55

I really appreciate that feedback. They need to feel heard, but you need also need to have a system where you're evaluating what you actually think is the underlying cause. And then the beauty of that is you can show them. You don't have to tell them. If you're using a movement analysis system, I I tend to start with an SFMA, selective functional movement assess assessment, and then I do breakouts from there.

Dr JJ Thomas: 13:17

But if you have any type of movement assessment where you can create a correlation and show your patient how when you treat their shoulder, their low back gets better or something that they may not have expected. Now, they recognize, oh, this is why I come here and this is why I don't mind paying cash. You need to show them those things, but I'll tell you what, it takes a lot of guts when you're expecting someone to pay cash, and they say to you, I want you to treat my neck. Takes a lot of guts to say to them, you know what? I really respect that.

Dr JJ Thomas: 13:45

Let me evaluate you and see if that's the best place we should go. So that's the 4th really important thing that I want you to take home from this talk. The 5th rule is you are not an expert in all things. So I just went off on a tyrant about how you're an expert. Right?

Dr JJ Thomas: 14:00

And you need to be an expert and you need to be a leader, but you also need to recognize you're not an expert in all things. So you can use that to your advantage and for your patient's advantage by recognizing your strengths and recognizing your weaknesses. The areas that are your weaknesses, go out and find someone that's going to give your patient what they need in that area. It will help everyone. It's a win win win.

Dr JJ Thomas: 14:23

Your patient's going to get better faster. You're going to establish a relationship and a rapport with other clinicians, and you're going to show them, hey, you know what? I value what you do. Now all of a sudden their eyes and ears are open up and they're going to be like, wow, she values what I do. I'm also not afraid to send to her.

Dr JJ Thomas: 14:40

So maybe I can value what she does. And guess what? It happens. And once again, patients are going to get better faster that way. So recognize your strengths, recognize your weaknesses.

Dr JJ Thomas: 14:52

When you recognize the weaknesses, refer the people out to someone who's strong in that area. If it's something you want to pursue, go get it. Go get it yourself. Become an expert in it yourself, but don't act like an expert when you're not an expert. Just go send to an expert.

Dr JJ Thomas: 15:06

Sounds pretty simple. Right? It is simple, not always easy. It definitely takes guts in a lot of ways. But if you draw out a plan for yourself, you listen to these 5 things, and you hold yourself accountable to them, it can create a life for you that's so great.

Dr JJ Thomas: 15:22

It can create fulfillment where your patients get better faster. It creates fulfillment where you have time with your family. Your your stress is way reduced, and you can actually make the money that you deserve. So in summary, keep it simple. Your time is valuable.

Dr JJ Thomas: 15:39

Accessibility is key. You are the expert, act like it. And then the last one is you're not an expert in all things. I hope this helps you guys. I look forward to working with you guys more, and feel free to continue to reach out, DM me, like and follow our channel on YouTube, subscribe to us.

Dr JJ Thomas: 15:57

And, lastly, if you want access to the ebook, please click the link in the description. And, I look forward to working with you guys in the future.