10 Min read

10 Simple Mistakes I Made When I Started My PT Clinic

Running a physical therapy clinic is not easy. There are so many moving parts, from the day-to-day tasks such as patient scheduling, rescheduling, diagnosing, prescribing, referral letters, clinical notes, billing, and payments, to exercise prescription, all of which can consume a significant amount of time.

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And that's not all; before you even get to recruitment, onboarding, and training, you'll need to deal with issues that your own staff and team bring, including concerns about pay, holidays, family problems, illness, and other personal matters. Many people never expand beyond being solo practitioners because of these challenges. It can be draining and overwhelming, and some may prefer the balance between life and work that they've found.
However, when you first embark on this journey, it's exciting. You're eager to learn, willing to try anything, ready to fail and try again. You're creating something that impacts other people, and it's incredibly rewarding to see your ideas and ambitions come to life.
When I left full-time employment as a physical therapist to start my own journey, I made a lot of mistakes. So, I'd like to share them with you to help you avoid repeating the same errors and enable your practice to grow faster as a result. 

I thought I could do it all 

Having served as a senior physical therapist, I ventured into starting my own clinic with confidence in my clinical abilities. I believed I could learn the business aspects on the job and make it work. Observing other successful businesses, I thought, "Why can't I do the same?" My business naivety, while initially motivating, also proved to be limiting. I hadn't considered anything beyond filling my own appointment book. My goals were unclear, and I was simply trying everything without a structured approach. In contrast, I was far more organized in providing patient care. My belief was that if I treated patients correctly, word-of-mouth referrals would keep me busy.

It's no wonder that 96% of businesses fail. I was on the verge of becoming one of them because I assumed I could handle everything without a concrete plan. If you don't know where you want to go, how can you be sure you're heading in the right direction? I was definitely in motion, but I lacked a clear destination. It was akin to cycling down a country road rather than driving directly to the airport. Once I determined my destination, I quickly realized I couldn't do it all alone. This realization led me to prepare for recruitment. I had to build a business attractive enough to convince someone to take a chance and join me on this journey.


Making my services cheaper was a colossal mistake. I was eager to establish myself as the new physical therapist in town, so I looked at others in my area and decided to undercut them on price to attract more patients. It worked like a charm—I had a flood of new clients and a fully booked schedule. However, they were the wrong kind of clients. They chose me solely based on price, not because of my skills or treatment philosophy. They were seeking a quick, inexpensive fix, rather than a long-term solution. This didn't align with my values. In the marketplace, you have to decide whether you want to compete based on price, quality, or speed. If you aim to be the cheapest, you can't also be the best in terms of quality or speed. If you prioritize delivering high-quality, long-term results, you must charge more to sustain that level of service.

I initially priced my services low because I undervalued my time and skills. I had minimal overhead costs and believed I could get away with lower prices. I was afraid of being perceived as expensive and worried that people would reject my business idea. I even gave discounts to friends and family, which was a total disaster. Raising prices is a challenging decision, but once you make it, implementing it is straightforward. Starting with low prices forced me to raise them multiple times to reach the level I desired. I lost some clients along the way. However, we eventually became the most expensive option in the area with the best reputation, the ability to pay competitive wages, and an outstanding clinic experience—all while remaining profitable.

If you can't afford to invest in recruitment or marketing, there's a high chance you're not charging enough for the value you provide. You must offer value to the marketplace, and in return, the marketplace will reward you. Higher prices come with higher expectations, which ultimately reflect your confidence levels. Your prices are a reflection of your beliefs about money, value, and self-worth. To become comfortable with higher prices, you need to work on developing your own mindset


"Location, location, location" – this mantra holds the key to success. When we relocated our clinic from a small, rural setting within a golf club to a more prominent high street location, we witnessed a remarkable surge in patient numbers. Our move translated into a steady influx of 10 to 15 new patients each month, solely due to our location. Essentially, our rent became an integral part of our marketing budget. The significance of your location cannot be overstated, especially concerning your ideal patient. If you haven't identified your ideal patient yet, it's crucial to do so promptly. Once you have a clear understanding of your ideal patient and confirm their presence in your target market, you'll know exactly where to position yourself. A bustling road, proximity to a train station, a location near a supermarket, or a spot on the main street of your town will consistently outperform a clinic hidden away inside another business. Visibility is paramount. If people are unaware of your existence, how can you offer them the help they need?

Not asking for help 

I am fiercely independent. I've never liked relying on anyone else. When I embarked on this journey, I was determined to succeed, and I wanted to prove wrong all those who thought or expected me to fail and return to my old job. I was resolute, but I also stubbornly refused to acknowledge that I might need help. It wasn't until I realized that people are often willing to help if you ask that I started to make significant progress.
Take a look at your own network. Who are the contacts you have, and how could they assist you? Equally, consider how you might be able to help them. Seek opportunities to create win-win relationships; it will serve you exceptionally well in your journey to success

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Not understanding the functions of a physical therapy website 

I used to believe that a website was nothing more than a one-page online advertisement for your business. After creating it and putting it on the internet, I mistakenly thought my job was done, and that Google or the web would naturally lead people to it. After all, isn't it true that once you're on the internet, everyone will find you?

Unfortunately, that's far from reality. In healthcare, building trust is paramount. You need to share information, educate, reassure, and demonstrate empathy toward your clients. But for your website to serve its purpose, it needs traffic. How will you attract visitors? What actions do you want them to take on your website? Do you require online booking functionality? What is the core message you want to convey? Fortunately, websites have evolved since 2010, but they've also become more competitive. Therefore, having a website that functions effectively is far more critical than its visual appearance. Trust me on this!

Obsessing over small details 

When I first started, I found myself obsessing over color schemes and choosing the perfect name for my clinic. I spent a lot of time focused on how everything looked, striving to create the ideal brand. However, I've come to realize that these details are not as crucial as you might think, especially in the initial stages of your journey. You're not Coca-Cola or Amazon; you're a local business, and your most valuable asset is you. It's time to shift your focus away from obsessing over minor details and start producing more content. Stop waiting for everything to be flawless and commit to taking action, even if things aren't perfect. The pursuit of perfection can hold you back.
Remember, the person who takes the most action will always outshine the one who endlessly refines something but never shares it with the world.

Not recruiting early enough 

Recruitment was a significant leap for me, and it felt daunting to realize that the success of the business would now depend on paying someone's salary and supporting their family and lifestyle. I was uncertain and wondered if I was truly ready for this responsibility. The truth is, you're never entirely ready.

It's crucial to remember that recruitment is a mutual contract. It's as much the candidate's decision as it is yours. People may leave, they may disappoint you, and it's unlikely they'll stay with you throughout their entire career. So, it becomes a matter of whether you can help them grow and whether they can contribute to the business's development. Can you afford to pay them, and does the business truly need that role?
My initial hire was another physical therapist because I needed more capacity; my schedule was fully booked, and I was confident in what the role entailed and in my ability to support them clinically. However, I soon realized that I needed someone to answer the phones. Hiring a front desk staff member was a pivotal decision. While I didn't consider it an income-generating role since they didn't provide core physical therapy services, I was missing out on numerous opportunities. A mindset shift was in order, understanding that this role was essential for the clinic's success. I also came to appreciate the value of a probationary period of 3-6 months in employment contracts. It allows both parties to assess if they are a good fit. While you may make some hiring mistakes, getting the majority right can lead to significant business growth.

As a personal rule, I always keep three months' worth of salary set aside before making a hire. This provides peace of mind, knowing that I can cover their salary even if we don't treat another patient. I make sure the job makes sense on paper before implementing the plan. For example, if I hire a physical therapist, I know they need to see four patients every day to cover their salary. I also acknowledge they have the capacity to see up to 12 patients and still keep the clinic financially stable, even if they initially see none. Zero patient days have never occurred, and within six months, I've consistently seen them progress to seeing eight clients a day with the right support and coaching.
As the business grows, your role will inevitably change. The earlier you invest in recruitment, the faster your clinic will expand and thrive.

Not implementing a CRM and Clinic management software 

Now that you have a team, it's crucial to implement efficient systems. When capable people work with effective systems, that's when real progress happens. Consider investing in a comprehensive CRM and clinic management solution that enhances patient communication and overall clinic productivity. It's essential to remember that you get what you pay for in this regard. While opting for a simple or inexpensive solution may seem tempting initially, you'll likely outgrow it as your clinic expands. My advice is to invest in a system that can grow with your needs.

A robust clinic management solution should allow you to streamline all aspects of your clinic, from billing to insurance verification and record-keeping, all in one place. This not only improves efficiency but also saves you a significant amount of time and money in the long run.

If you don't have a handle on your numbers or you cut corners, you'll end up paying the price elsewhere. An effective clinic management system should make your clinic run smoother and create a more attractive and modern work environment for your team. It enables you to monitor their performance and gain clear insights into their efforts and outcomes. If your current system is causing frustration or isn't meeting your needs, it's time to upgrade and modernize your clinic immediately. This decision could be the one that significantly increases your profitability. When you know where the leaks are, you can fix them. If your current system can't provide this insight, it's time to upgrade. If you're using an EMR (Electronic Medical Records) system that lacks the reporting capabilities you require, receives frequent complaints from your staff, doesn't offer the necessary business insights, and doesn't respond to your requests for improvements, it's time for a change. You could be missing out on substantial revenue.

If you don't know which of your staff members are not completing their SOAP notes, what they're generating for your clinic, or what their utilization rate is, it's a sign that your EMR and billing systems are working against you. If you're unaware of how many insurance billing submissions are being rejected or sitting incomplete in your system, or if you don't have a clear picture of your cash flow cycle and accounts receivable in days, your current systems are not serving your best interests.

If you find yourself manually handling patient onboarding and insurance eligibility checks, wasting time on the phone with billing providers and insurance companies instead of focusing on providing an exceptional clinic experience, building stronger patient relationships, and delivering top-notch customer service that leads to long-term clients and referrals, then it's time to evaluate your EMR. Imagine the difference it would make if you could perform insurance eligibility checks with a single tap and receive confirmation and co-pay details within seconds, all without making a single phone call. Well, that day has arrived, and the real cost of having an EMR that doesn't work for you is the missed opportunities and lost revenue. It's time to take control and invest in systems that support your clinic's growth and success.

“There is nothing more expensive in your clinic than your EMR and billing solution that doesn’t communicate properly throughout the patient life cycle”

The issue often encountered is that these two systems are typically bolted together, but they remain separate products that fail to communicate effectively at every stage of the patient journey. The burden of accountability in this situation falls heavily on the clinic owner, who must train their team and manage their performance rigorously to ensure proper billing, which is essential to receiving timely and complete payments. What you truly need is a system that comprehensively understands the rules and requirements of various healthcare providers. This system should guide users through the process, ensuring that progress reports are completed at the right junctures and that all relevant fees and documentation are correctly applied to each submission. The goal is to prevent rejections due to human error, incomplete training, or staff turnover.
Unfortunately, in our experience, many clinics do not have such a system in place. This results in significant gaps, leading to substantial financial losses. We're talking about thousands of dollars lost because claims haven't even been submitted, let alone rejected. The time and payroll resources required to address these issues can be painfully expensive.
So, it begs the question: How is your business performing in this regard? Are you equipped with the right systems and processes to handle the complexities of billing and clinic management seamlessly?

Not getting a mentor 

You're not the only one who has walked this path. Don't go it alone. The key to growing a successful business is making a series of good decisions. One wrong choice can set you back significantly. By avoiding common pitfalls, you can accelerate your progress. Be open to learning and channel your energy into the right areas. Making better decisions not only helps your business grow but also promotes personal growth as a clinic owner.

Consider this: The top athletes in the world all have coaches to help them excel in their respective sports. Why should business be any different? Whether it's deciding who to hire next, how to market your clinic effectively, pricing your services, selecting the right premises, recruiting the right talent, implementing the necessary systems, or staying informed about industry developments, having a coach can make all the difference. Having a coach provides you with the ability to anticipate and prepare for what's coming next. This alone is worth the coaching fee. I can guarantee that you'll make faster progress with a good coach than you would on your own. Doubt and hesitation in decision-making can slow down your growth. You'll still reach your destination eventually, but with a coach, you'll get there much faster.

Not understanding importance of marketing 

Many clinic owners underestimate the significance of marketing. Once they have a sufficient number of clients on their schedule, marketing often takes a back seat. They either believe they don't have the time or fail to allocate the necessary time. This is a significant oversight. Marketing should never stop, even when your client roster is full because marketing plays a pivotal role in business growth. Marketing generates leads, and those leads convert into patients who ultimately pay the bills and support the salaries in your business. If your business model is functioning effectively, you should be able to allocate around 10% of your turnover to marketing efforts.

Marketing strategies can take various forms, such as partnerships, hosting free events, utilizing postcards, running Google Ads, engaging in social media, creating blogs, sending out emails, or even using direct mail postcards. If you maintain consistency and invest in marketing, your clinic will consistently experience high demand. I can guarantee you that. On the flip side, if you neglect marketing, you're leaving money on the treatment table.

Consider this: If every patient you acquire is worth $2,000, why wouldn't it make sense to invest $200 to acquire that patient? It's one of the best returns on investment you can achieve with your money. So, think about it and ask yourself why marketing wouldn't make sense when it's a powerful tool for boosting your clinic's success.

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