12 souls in an 8 seat waiting room. That’s what I was dealing with this morning.


It’s summer and school is out. As a result, our clients’ brothers and sisters tag along to therapy. On top of that, we have an influx of kids that are receiving summer therapy. And on top of that, we have an increase in overall referrals. All of this is good, except for our lack of space.


One of my clinics, Therapy4Kids is located in my home town in the state Arkansas which is between Toad Suck and Possum Grape (both real towns).  Our booming metropolis boasts a population of 5,000 people. That’s not really enough people to make a go of it with a brick and mortar clinic, but when my wife and I did our market analysis we knew we could draw from at least 3 counties.
People who live in the sticks are used to driving to get services and shop at the nearest business district. One reason we knew a therapy clinic had a chance was that we would be saving people from driving an additional 20 miles to get to the next closest therapy provider. We also knew that if went didn’t deliver a high quality experience that people who drive right by us to the clinic right up the street.

Now back to my waiting room…

As these 12 souls (most of them kids) were in my waiting room this morning, a new referral walked in. (Sounds like the beginning of a joke, ‘This unsuspecting mom walks into a loud and full waiting room…”) But it was no laughing matter to me, I wanted to cry. What’s a clinic owner to do?


There were no seats for this new mom with her toddler. She had to stand at the check-in window to fill out the paperwork while her 2-year-old fluctuated between wanting down to play and needing mommy to hold her. Mom was obviously not pleased with the situation.


As a practice owner, you are going to have times where it just doesn’t go right. No matter how well organized, you’re going to need to step in and get involved.  I’ll tell you how I handled this situation, but first, let’s cover how to keep your onboarding from being a total ‘Toad Suck’. By the way, this 4-step approach is also a good formula for your marketing efforts too.


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4 Steps For  Remarkable Onboarding For First-Time Clients


1. Plan

2. Get Feedback

3. Measure Results

4. Revise & Repeat

Make A Plan


Do you have a plan for your onboarding? Have you given this process any thought? Are you just doing onboarding like your previous employers did? Guess what. Your previous employers were in the medical business not the customer experience business. On top of that, they may have been government run. Maybe they were a big institution or a hospital. You are none of those nor should you aspire to be. Those types of places can have mediocre onboarding experiences at best.


Think of other businesses near your location that are not medical businesses. Think about the last place you went where you had a great first-time experience as a customer. Maybe it was a coffee shop or a clothing store or a bank.


 Break down your experience while wearing the shoes of a consumer.


What was going on in that business? What was the first thing that happened that made you say “That’s special!” I promise you it wasn’t the nice pictures on the wall or the soft lighting or even the lavender smell from the essential oil diffuser. It was the people you interacted with.


You have it in your power to make an onboarding experience stellar with the words you use, how you say them and your attention to detail. A great first-time experience for your patient doesn’t happen by accident.


To make it great, start writing down how you want your new patients and their families to feel, whatever comes to mind. Think about when you were last in a strange medical facility and you didn’t know how it was going to go.


 Mine was when I had my appendix out about 12 years ago.


Emergency Room


My Visit To An Emergency Room

An emergency room can be an intimidating place even for a medical person. Your patients may have the same feelings I did. “Will this hurt? Will I have to take off my shirt? Will I have to sit on that elevated mat table with the paper roll covering it? Will they see the holes in my socks?” Those and about a hundred other questions go through peoples’ minds. They feel uncomfortable, vulnerable, stupid and anxious about the unknown.


To help alleviate the anxiety of your patients, you need a plan to address these very real feelings. What are some practical ways you are going to address their feelings?


The next most important thing you must do is communicate. Let them know what is going to happen before it happens. Let them know they are calling the shots and that they have total control of what’s going to happen. The first most important thing you must do is listen.


[clickToTweet tweet=”Let clients know what’s going to happen before it happens. Scott Harmon” quote=”Let clients know what’s going to happen before it happens. Let them know they’re calling the shots – Scott Harmon”]


Many of us have the what I call “go-on-and-on-itis”. We practice owners are a smart bunch of folks. We have been doing this for a while. We have seen a lot, and we want to tell the world how we can help them. Guess what. Your clients want you to listen to them more than hear you talk.


Your plan should include the very practical steps of how you are going to address their very real feelings. Write your steps down. I can’t give them all to you. Your situation is different than mine. Your setup and type of therapy may be different. I do recommend that you have, in writing, what your patient can expect on their first visit. If you can get that explained to them before they meet you, that is best.


On my website, I have a short video that gives potential clients a tour of my clinic and a walk through of how their first session will go down.


A Pediatric Practice Owners Waiting Room Survial Guide


A video goes a long way in helping potential clients get to know you and eventually choose you. If you don’t have a video, write a brief explanation of how a typical first session goes and put that on the front page of your website. Make the information about them, not about you. After you schedule the initial appointment with the new client, mail them a one-page letter welcoming them and include a written explanation of what to expect.


Communication is the key, and honestly, it is not my strong point. I’m a man, and my lack of good communication is a natural part of this. That’s why I need a plan. Over the years, I have written that plan down so that I can train my office workers to do the same thing.


After each initial evaluation at my clinic, the client receives a letter the next day or two that explains what in the world happened during their session. My therapists do a great job of explaining what they are seeing from their observations and what will happen next. But clients and families can suffer from information overload. They may nod their head and seem to understand, but they may need to see it in writing. You can download forms I use in my clinic for free, including my follow-up letter by clicking this link: FREE FORMS


Think about that time you went to the doctor and left saying “now what did they say about my condition?” It’s the same for your clients. You absolutely should take the time to explain what you are seeing and what will happen next while you have them in person. A follow-up letter is a great tool to remind them of what happened during their visit, and it needs to get to them within a couple of days after their visit.


Your “after the initial visit letter” can be a form letter. Keep this process simple, otherwise, it won’t happen. Below are some items that we cover in our generic letter:


  • Thank them for choosing us.
  • Asks them to call or email us if they have any questions.
  • Lets them know they will soon receive a written report of the evaluation.
  • Explains what happens if we recommend their child receive therapy.
  • Covers which insurance we are in network with.
  • Provides a page on our website with insurance and cost of therapy details.
  • Gives a link to take a survey of their experience.

To help you get started download forms I use in my clinic for free, including my follow-up letter by clicking this link: FREE FORMS

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Get Feedback

Get Feedback

The best-laid plans are not nearly as powerful if you don’t get some feedback on how your plan is doing in real life.


After the first session, I put the client’s email address into my email software. If you haven’t checked out Paul’s information about client email management, it’s a must. In my email sequence, the first email goes out the same day or the following day of the first session. It is very short. I thank them and tell them to feel free to ask any questions. I also have the link to the survey so they can let us know about their experience.


I am dabbling with the idea of using a text message with one simple question “Rate your experience at our clinic today from 1-10 with 10 being the best.” Of course, anything 6 or below I want to know about specifically. Anything 9 or 10 I also want to know about so we can duplicate it.


Many clinics use the Net Promoter Score to measure client satisfaction by seeing how likely clients would recommend your services to a friend.


Surveys are a good way to get feedback from your clients. Keep surveys short and simple. SurveyMonkey and Google Forms are free apps to create simple forms to use in your clinic. 


Another way you should be getting feedback is by paying attention to the details of the session. Your clients are giving you feedback as the session unfolds. Do they mention that it’s cold in the treatment room or do they ask for a drink in the middle of the session? Do they complain about anything? Maybe they just wrinkle their nose at the clutter in the corner. Pay attention to the details and then write them down. You simply won’t remember all of the feedback you are picking up from your clients. Write it down.


Another follow-up suggestion is to call them a day or two after the session. Say something like “I’m just checking in to see if you have any questions about your therapy session the other day.” Keep it short. Listen more than you talk. Thank them for choosing you and let them know they can reach out to you anytime if they have questions or issues.


It’s best if the therapist makes this phone call. An office worker simply can not answer therapy related questions. If your therapist does not have great people skills you will need to train them on how to conduct this phone call. Role playing can help.


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 Measure Results

That which gets measured gets improved on. Surveys are a great way to measure your results. Any question you can assign a number to gives you data that you can track. This is why I like to ask the 1-10 question. A good question is “from a scale of 1-10 how likely are you to recommend our therapy to your friends and family with 10 being very likely” I have this question in my email sequence.


Think of other ways to track your onboarding process. How many clients come back for the next session? The next 5 sessions? Break those numbers down by therapist and by the office worker. Who have the best numbers?


Revise and Repeat

After you have received some feedback, you need to revisit your plan. What are you doing right? How can you systemize that? What are you doing wrong? How can you ensure that it never happens again? Plans without revisions will ensure that you continue to be mediocre. Put a date on your calendar, once a quarter, to look at the numbers and the feedback in order to revise your plan. Then teach that plan to everyone involved with new client onboarding.

To help you get started download forms I use in my clinic for free, including my follow-up letter by clicking this link: FREE FORMS


About that new client in our overcrowded waiting room. I simply addressed the situation. I didn’t ignore it. I apologized for the lack of space. As soon as a chair was available I pointed it out to her. We quickly got her to an evaluation room that was quiet and calm.

 Communication is key in the 4 step onboarding process. Ask the right questions and listen to your clients, and they will tell you what you need to know.

Scott Harmon

 Scott Harmon is an occupational therapist and the owner of Therapy 4 Kids pediatric private practice in Conway, Arkansas. You can find Scott at, a website devoted to helping therapists start, run, grow and automate a therapy practice. He hosts a podcast of the same name where you’ll find everything you need to know about starting and scaling a private practice. You can connect with Scott via LinkedIn or Twitter




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