Physical Therapists are Playing On An Uneven Field. Are You Ready For A New Game?

When the keynote speaker, Gary Vaynerchuk, at the 2015 APTA Private Practice Section Conference asked an audience of hundreds of PT practice owners if they were happy about the financial health of their business, less than 50 people raised their hands.

Gary V. was obviously taken back by this lackluster response. So, he repeated the question to make sure everyone was paying attention. Yet again, those same hands went up.

While this marketing genius, public speaker and venture capitalist was totally shocked to learn that most physical therapy practices are struggling just to survive, it really didn’t come to any surprise to me. Over the past decade, I’ve watched our profession get knocked around by insurance companies and big box chains. Physical therapists have to beg and plead for every reimbursement dollar, and for every doctor referral.

There are countless "factory style" corporate chains monopolizing our space. As a result, we’re seeing some private practice owners dusting off their resumes and going to work for the companies that essentially put them out of business. Others are literally getting out of the field altogether.


As a profession, we're playing a losing game against much bigger, stronger and faster players. This is a game dictated by insurance companies that clearly undervalue our work. And this is a field dominated by larger players who have unlimited resources to capture so many patient referrals.

In New Jersey, we’ve been contending with these field conditions for more than two decades. Insurance reimbursements have dwindled away. The only thriving practices remaining are part of hospital systems that have negotiated higher contracted insurance rates, or corporate PT chains that treat people in ultra high volume.

Some of our colleagues are attempting to level the playing field by pleading with insurance companies for more reimbursement. After all, not all physical therapy is the same. Shouldn’t insurance payers reimburse more to a physical therapist who spends quality time with each patient, as compared to a physical therapy “ringmaster” who juggles 4 patients at the same time?

Unfortunately the answer is no. The current reimbursement model rewards those who are most productive in terms of billable procedure codes, not in terms of clinical outcomes.

Simply put, the best jugglers will always win.


Many physical therapists are searching for a new, more sustainable game to play. They no longer want to rely on insurance reimbursement, or to fight for the same customers that the “big boys” can so easily swallow up.

In this new game, the cash value of PT is based on your undivided time, skills, and results. And the target consumer is one who appreciates having you by their side throughout the recovery process. This is someone who knows the difference between being treated like a person versus like cattle.

On a new playing field, you can earn extra points (i.e., more money) by separating yourself with a niche area of study, like pelvic health or a specific sport. You can also gain home field advantage (i.e., more referrals) by passing the ball around to other like-minded players, such as an OBGYN, sports medicine physician, acupuncturist, fitness trainer, or nutritionist. By spending quality one-on-one time with each person individually to achieve the best outcomes possible, you will score the ultimate game winning goal!

Check out my next blog post explaining the value of a good story for your cash PT business.

Or, if you missed it, check out my previous blog post comparing the true cost of in-network versus out-of-network PT.

Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Ian Kornbluth, Co-Founder

CEO | President
Ian's entrepreneurial spirit stems from growing up in Arizona around the family business — a small chain of "New York Style" pizzerias. Early on in life, Ian learned how to treat the customer like a person, rather than a number. He observed how the community came together to support an establishment that offered both quality food and an exceptional customer service experience. He also learned to appreciate how much sacrifice, perseverance and integrity that it took to make a positive change in the world around him.
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