Insanity Einstein

When individuals are subject to too much change in too little time, they can experience what Alvin Toffler called future shock. All the change brought about by healthcare reform and increased regulations have left many therapist disoriented and confused on what to do next.Instinctively, we want to hunker down in our clinics and hope that the reform storm will pass us by and we can get back to taking care of patients.

Being self-employed, I’ve experience discomfort as a consumer as my own health insurance deductible and copay have skyrocketed. I’m looking for healthcare providers I can trust and where I can get my money’s worth.

You may struggle to keep up with the changing times and find yourself doing the same thing yet expecting different results. Perhaps this article that originally appeared in LinkedIn’s Pulse Blog will give you a nudge toward adding self pay services to your clinic. The post was written by Survival Strategies‘ CEO Craig Ferreira. He talks about the do’s and don’ts that make the addition of a cash program successful.


Add Self Pay Services to Your Practice That Work

One of the main things that a practice owner has to watch for, when adding any new line to their practice, is the profitability of the new endeavor. While this sounds like something too obvious to mention, it is often overlooked or camouflaged. If it is not tracked closely, the new area can become a vampire to your practice, sucking the life out of it rather than adding to your profitability.

I wanted to share some of the key items that make adding a cash program to your practice a success. First, let’s look at what does not work. These are points that will make your cash program drain your existing practice of resources, and a year after adding it, you will be no closer to attaining your profitability goals that you were before you started.

Key Factors to A Successful Cash Program

  • Unsuccessful practices simply add the cash program as another service their staff are delivering. It is just added to their practice, with the existing staff doing the new functions (as well as their previous functions). So staff who were already busy enough, now have additional duties or additional patients. Question: What does a busy therapist do when overloaded with too many patients?  Answer: Discharge the patient before they have completed their full treatment program. Or other corners get cut, reducing your profitability.
  • The practice did not take advantage of one of the biggest goldmines for new business that they have: their existing and past patient base. This can provide a wealth of new patients for your cash business, provided you know how to handle them properly.  This assumes of course that you have been doing good work all along and you have a large base of satisfied patients. If this is not the case, or if you have just taken over a practice where the existing and former patients are not satisfied, then a different approach is needed. In this situation, a public relations campaign is needed to handle public perceptions–and a quality control program is needed to ensure your patient care is top notch.
  • They had “salesmen” who were not qualified to be on the job in first place, or who were untrainable. Question: Is the person you have who is responsible for signing people up on your cash program shy? Is he or she someone who would rather work new connections on LinkedIn or Facebook than meet with your patients? Then you have someone who will never make it in sales, and who will cost you a fortune in salaries and lost business.
  • They had no one that really knew how to sell. This is actually the make-break point of any cash program you are adding. As unpleasant as this may seem, sales is the backbone of the program. If you have someone who can and will sell it to patients, you will succeed (assuming you have a program that is wanted by your public–another public relations problem that needs to be solved–this one by surveys).

Sales is the Vital Component

Sales is the vital component. Here is the way the cash program flows, step to step: You do whatever you do to get a patient in for your cash program, you do an eval of the patient, and you present him or her with your treatment program. And now the rubber meets the road: the person has to reach into their wallet and pull out the money. Or they tell you something like, “I need to talk this over with my spouse first. I’ll call you on Tuesday.” If so, that is the END of that patient.

However, if you have someone who knows how to sell and specifically how to close, cash changes hands, the patient starts their program and you are well on your way to having a profitable cash program. If anything happens except for payment and patient starting, you blew it on the one vital point: sales.

Cash Programs can be Extremely Profitable

Cash programs can be done. In fact, they can be extremely profitable for your practice. But, just like with any endeavor, there is a right way to do them and a wrong way. Here are the key things that all successful cash programs I have helped create have had. Also, I want to caution you–these following points are not innately part of the make-up of your average physical therapist. They are points that must be learned, and can be if you have a training program that is oriented around results and not fluff.

  • Those practices that made cash programs successful treated them like a new business, meaning it had its own staffing, and its own financing. If it is done with the same staff and financing from your existing practice, it becomes a leech–draining staff resources on one hand, and financial resources on the other.  You can bottle feed an endeavor for a short period while it gets going, but it must be planned out to be rapidly weaned off the practice so that it fends for itself. Meaning it has its own staff and its own finances.
  • Practices that are successful with cash programs fully embrace the public relations & marketing efforts it takes to bring the program to their communities. These steps are utterly vital, as you must know before starting if your proposed cash program is something the public in your area want and will pay money for. (ie: Are you an inner-city practice servicing low-income families, yet you are planning to start a golf program? Be ready for a flop.) You must know what your public is interested in and what they are so interested in they will pay you money to get.
  • Practices that had profitable cash programs had a trained sales person on the job who knew how to close. And to be clear, “closing” is not, “Mr. Jones says he’ll come back Monday to pay and start.” Closing is money in hand, patient with therapist getting treated. Anything less than that is an “excuse,” not a “close.”
  • And finally, those that are successful with cash programs ensure the patient care gets the expected results. There is no surer way to harm your practice than by getting poor results with patients. In fact, ask yourself this: do you ever have a dissatisfied patient leave your practice? Every time you do, it creates bad word of mouth in your area.  With the good-result patients, ensure those results are documented, so they can be used for public relations and marketing efforts. Third party endorsements are a very effective public relations tool–look at Yelp, LinkedIn, Google Plus and all the other places where patient reviews are so vital.

Get Out from under the Yoke of the Insurance Companies

If you are truly action oriented, and you want to get out from under the yoke of the insurance companies, then cash-based programs are for you. With them you have the ability to determine your own income and the size of your practice.

But it does take training. The points noted above must be followed. Lack of surveys of your public, lack of effective sales, or any of the other points above will kill you.

In the 30+ years I have been working as a consultant for private practices, I have been involved with many practices who have added on highly profitable programs for cash-paying patients. My firm, Survival Strategies, has the programs you need to get real results. Our programs are not just fluff. We create real results–and we guarantee you’ll make back every penny you invest with us in terms of practice expansion and increased profits.

Survival Strategies provides a full program to create and successfully operate a profitable cash-based program. Register here for a free consultation to see what it will take in your practice to get one rolling.


Cash Therapy Roadmap image

I’m launching a Cash Practice Pilot Course for therapists interested in starting their own private practice in January 2016.

The course promises to help students build a solid business foundation that will take students from a practice idea to seeing their first patient. I’m limiting the class to 15 students because I will provide one-on-one coaching to help students do whatever it takes to launch their own practice pilot clinic.

The deadline for signing up for the pilot course is midnight December 31st.

If you’re interested please email me at and type Pilot Signup in the subject line. I’ll arrange phone call so I can answer your questions about the pilot course.


Get Your Own Copy of On Fire


As therapists we have tremendous opportunity to use our abilites, education and expertise to enhance client’s lives. What a privilege? If your are in the therapy business to serve people, then my new book On Fire: Ignite Your Passion with a Cash Therapy Practice might help you. The healthcare industry has undergone so many changes lately and many therapists are overwhelmed, overworked and confused on where to turn to for help in the battle.

On Fire takes a close look at innovative therapists who are using alternative ways to deliver high-value care to their patients. Cash therapy services have emerged as a viable alternative to accepting business as usual.

If you are intrigued by the attention that cash-based practices are attracting On Fire is a great primer to help you get up to speed on the key issues and how if might impact your practice. The book is available on Amazon. If you are interested in getting your own copy join my email list and I’ll keep you up to date on the special pre-order bonuses I’m giving away.

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