Optimal Digital Marketing Strategies Post-COVID With Neil Trickett, PT Of Practice Promotions

T he COVID -19 pandemic has pushed e very one of us  to adapt  to this new normal  and  marketing strategies  are no exception.  In this episode , Nathan Shields interview s   his long-time  friend,  Neil  Trickett , who  talks about  how  marketing strategies  can be optimized in the post-COVID world .  T he CEO of  Practice Promotion s , Neil  is a marketing expert who  has worked for over 900 PT clinics a cross the US and Canada.  Neil and Nathan take some time to discuss online visibility, SEO, web content, and other elements   that PT owners should pay attention to in order to keep their funnels busy.  Stick around to  the end as he  shares his  personal new normal strategies  and what should  owners  be  really  focused on.  

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Our  guest is a long-time friend,  Neil Trick e tt ,  CEO of  Practice  P romotions . Thanks for coming on again. I appreciate it.  

Thanks, Nathan.  It ’ s always a pleasure.  

I t ’ s been a couple of years since we last spoke and a lot has changed , but  I ’ m glad  to  bring you back. I ’ m excited . If  people are interested in learning more about Ne i l ’ s  h istory. He is a prior PT  owner  that has transitioned into marketing with  Practice Promotions .   They  do a wide range of things, especially digital marketing ,  newsletters ,  websites,  you name it .   T hey cover the basi c s.   Now, especially where Neil sits, a  lot has changed with marketing compared to pre – COVID-19 .  I decided to bring you on because you have a real pulse on the industry. You work with hundreds of clinics across the country. You ’ ve seen how people have had to pivot and change ,  firsthand  and  what is working now compared to what was working back then .  I ’ m   excited to get your insight.  Let ’ s  get into it a little bit right off the bat . What’ s it like for PT practices out there now?  

M uch has changed here  and w e ’ re  working with over 900 PT clinics across the US and Canada.  I t’s  i nterest ing to have  a pulse on what ’ s happening in different  s tates, in different parts of Canada  with  lockdowns,   partial openings  and  all this stuff that   has been a challenge for many practice owners out there.  It ’ s  interesting to see what is working now for practices and how people have   evolved and changed their marketing and practice . What ’ s  interesting is a lot of the things that we were doing before that   were helping   clinic owners to focus on, which is going more direct to the consumer ,  that has become more of the way of life now.  We  see  practices across the board . They ’ re  getting busier now . A s  vaccinations are becoming more   used,   things are starting to relax a little bit.  

When you open up your clinic, you're no longer a PT, you're an entrepreneur.
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People are starting to reach back for services. We   see  practices overall get bus ier , especially in March   2021 .  Some  clients were at max capacity  with space  restrictions, less staff, things like that ,  or maybe they had done some layoffs  in 2020. They   have  leaned down their staff . N ow ,  they got t his  ramping back up and   they ’ re busy ,   which  is a great thing.  By  survey ,  we are  seeing that more physicians are referring it to clinics, which is great . M ore pas t patients  are coming back in for care.  That ’ s  a great thing that ’ s working out for practices. Things are starting to get busier and busier.  

I know you ’ re pushing it ,  so it ’ s not the case, but do you see some owners who were reliant on physician referrals leaning back towards that and pulling back their marketing away from other aspects because you wouldn ’ t recommend that ?   I s that a tendency, whether it ’ s because that ’ s what they like to do or because they ’ re going into a slower season ?  

I can ’ t speak for practice owners that are not our clients  or  not working with us .   The  ones that are working with us  are  see ing  going that route of going more direct to the consumer and working with their customer list  and  how valuable that has been.  What ’ s  fascinating is that   quite a lot of our clients  and  practice owners that we work with from  2020  had their best year ever, which is shocking to say this was the worst business disaster that we  probably  ha ve   gone through in modern times.  What  we looked at, what we saw was that the practices were   very heavy on physician referrals.  Maybe  more than 60% of new patients that were coming in were from doctor referrals.  

They  were very busy ,  happy and complacent  that  referrals dried up  w hen  that crisis happened . I f they didn ’ t pivot fast enough to go out into their online community, working with their past patients and customer lists,   they ’ ve struggled . There ’ s  a lot of people in our community that need our hel p  and t hey  focused on that online marketing aspect   and then also leveraging their customer lists. They had some of their best months ever.  We ’ ve  seen them continue on that trend and wanting to do even more and more. They realized that there ’ s a lot of potential s  there .  I ’ ve seen in conversations with prospective clients that they are saying,  “We ’ re  busy now. We don ’ t need to do anything because our physician referrals are taking back up. ”   They were  waiting, but they don ’ t realize  that   it  put s  all your eggs in one basket and that ’ s not what you want to do from a business perspective.   

I  had an  interview  w here we talked about the four different bu c kets of marketing .  There  are  your physician referrals,  c urrent patients who could refer family and friends, past patients who can return and / or refer family and friends . T hen there ’ s direct – to – consumer , the  community around you.  What  COVID forced us to do is pull away from that main bucket ,  which was physician referrals.  Ninety percent o f the owners out there were focused on those physician referrals. That was their bread butter to the point where they weren ’ t even looking at the other three buckets, unfortunately . It  forced them to look at the other buckets .  

I even have a client who, through the pandemic ,  survived because of Facebook  A ds . All  his referrals came from Facebook  A d s. He  grew during the course of the pandemic because of Facebook  A ds .   Now  that he ’ s sprinkling back in physician referrals , i f  his Facebook  A ds  wane  for a week or two, he ’ s   getting some physician referrals that are coming back on .   If  owners can leverage those things, if they can   put  appropriate money, time, energy into each bucket, they ’ re going to see the maximum capacity of their clinics.  

Physician  marketing is an important aspect of your practice, but where many people fall into a trap as they   didn ’ t  w ork as hard on those other buckets .   Sometimes  it ’ s outside of your comfort zone .  For a lot of practice owners, it ’ s comfortable .   You k now how to work  in  physician relationships and that you need to get referrals from physicians . Even  if in your direct access state, it ’ s pseudo direct access where you still need to get a physician ’s  referral for  an  insurance   contract. It ’ s still much better to have that person come in   from finding you on Google,   coming to the clinic,  “We  can do a free screen for you.  This  is going on. Let me coordinate with your doctor .   Let  me have my front desk reach out and recommend this. You may have to go in for a visit .”  You ’ ve already created that great experience for them . They ’ re  more likely to go ahead with their care at your clinic  r ather than purely waiting on the doc tor.  

I did a Facebook  Live  event in our Facebook group ,  The  Physical   Therapy   Ow n ers   Club ,  with  Vin o d Somareddy .   He  shared the successful actions  he ’ s  had with Google  Ads  and brought on his Google  Ad  agency to the   Facebook  Live  event .   What  came to my mind was how a new PT owner approaches   a billing meeting.  We  don ’ t know the first thing about billing ,  and we don ’ t know how to hold them accountable ,  and we don ’ t know what the metrics are .  

You  take an owner like that ,  then similarly go into a Google  Ad  meeting ,  Facebook  Ad, or  whatever agency is doing those ads for you . It ’ s  the same questions  like ,  “ I don ’ t know what I ’ m looking at.  What  are the questions I should ask? How should I hold them accountable? What should I be looking for? Is this successful or not? ” They  could tell you all kinds of numbers and throw stuff at you . If it  doesn ’ t get to more new patients, then you ’ re like,  “ I ’ m not sure if I ’ m spending my money correctly. ”   I l ike  what you said there  that  they  know they need to do it, but they don ’ t quite  know- how  and to  assess the ROI.  

One  of the most important hats for a business owner ,  and let ’ s face  it , when you open up your clinic, you ’ re no longer a PT . Y ou ’ re an entrepreneur.  Sometimes  people don ’ t realize how much of an  entrepreneur they should be.  They  get comfortable treating patients  going,  “ I have a couple of therapists working with me. ”  T he minute you open that door, you ’ re   a business owner . You  have to think that way.  For  a business owner, especially a CEO, one of your main functions is promotion and marketing, but you ’ re not   doing it all .  

You ’ re  making sure it ’ s coordinating ,  happening ,  and you ’ re getting RO I . A s you get bigger, you might have a marketing director or even a marketing team that ’ s helping you out in the clinic ,  and you need to have a good pulse for them . What ’ s  the rhythm going on with your marketing.  If  you  do not own  that hat as a CEO, as an owner of your practice, that ’ s when you get into trouble.  It ’ s  a n   important aspect of being a business owner to focus on  what  is your marketing strategy  and  actions .  

What  are some of those tips that you could share?  What  are some of the new normal marketing strategies? What does that look like? What should owners be focused on?  

We ’ ve  put the strategy together called  T he  Ultimate  PT  M a rketing Funnel . We ’ ve  been doing this for years . It’s  based  o n  research .   This  is what was working well before COVID . If  you were starting to transition  from  that model of more reliant on physician roles to more direct – to – consumer and working with your customers, you ’ re going to be much more successful.  In  th is  strategy, the first most important layer is building a large online presence. You have to be discoverable online in your local community.  You  need to be everywhere t here,  especially from a Google perspective ,  from local search,   through Facebook  and   social media.   One  of the key things there is to make sure that you ’ re focusing on search engine optimization. There  are  a lot of things that can be done there   and you can work with different groups to help you with that.  That  makes sure that your clinic is going to get in front of more people when they ’ re doing searches for help.  

You want to have a nice clean website. You want to have one that might not focus so much on how amazing your clinic is but what you provide the patients .  It ’ s not so much about you and the letters behind your name, but more about the patients . That ’ s  what we learned from past marketing interviews  we ’ ve  done here on the  show .  I also remember   an interview I did with  Angi e  McGilvrey . She ’ s  been strong with her social media presence .  

They ’ re posting 3 or 4 times  a day.  They ’ ve  got a video person that comes in a couple of times a week  which  takes video s  and posts all over Instagram . She  quoted Gary Vaynerchuk. He said,  “If  you ’ re not on Facebook, you simply don ’ t exist as a business nowadays. ” That  works for certain demographics . She  highlighted that . If  you ’ re talking  to  anyone above 35 years old, a lot of them are going to be on Facebook .   A  lot of the decision – makers are on Facebook .   If  you want to have more connection with the younger crowd ,  th e n you ’ re going to be on Instagram, possibly.  

We ’ ve definitely seen that. We   work ed  with all kinds of clinics ,  from pediatric to geriatric to  s uper sports athletes   and  recovery   clinics . You  got to know your audience .   Where  does your audience mostly reside?  For  some of our clients , we’ve got some  phenomenal clinics that are amazing at promoting themselves . They  do a ton of video work . They ’ re  all over Instagram . They ’ re  able to build that up.  One  thing to realize is that there ’ s no one media that is  king  over everything else .  You have to realize that there  are  behaviors of patients when they are   g oing   to  come to you.  F irst off, you ’ re mostly an unknown . P eople  don’t  k now what you ’ re going to do to help them.  If  you went to someone on the street and you said,  “If  you ’ ve got a back problem, who are you going to go see? ”  

Are they going to say PT ? Most  likely going to say chiropractic  or  maybe their doctor.  First  off ,  you got   t o  be able to get in front of them . They ’ re  usually out there searching, not just for,  “Physical  therapy near me. ”  Those are people who are   looking for that service.  You  want to be in front of those people, but the majority of people searching for,  “How  can I help my back pain? I think I tore my knee. ” Can  you get   found in those searches?  That  can get you in a much wider audience in front of people who are never even thinking of PT as the solution to that problem that they ’ re having.  Now ,   you have that opportunity .   That  comes down to   the SEO Trini ty. S EO is  Search Engine Optimization. That  means you can get ranked higher  better in  Google .   Also, Bing and  Yahoo ,  still out there.  Don ’ t  forget those. A lot of seniors are   on  Bing because   of  Microsoft  Edge  and  Explore . T hat ’ s the default browser.  

They  don ’ t know how to change it .  

You have to be discoverable online in your local community. You need to be everywhere, especially on Google.
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While Google is still the  k ing of the  hill, we can ’ t  forget  Bing  in  all those guys over there.   With  the SEO Trinity, what that   comes down to is to rank better and get your clinic more found . Y ou need to work within your website,  and t he content and the copy in there that works with the different keywords like physical therapy .   B ack pain ,  sciatica  and  all th ese  things are keywords . T he   important part  t here is ,   “What ’ s  going on with your website ?  How optimized is that? ”  The other part of that Trinity is  Googl e   My Business .  You  are a local business .  Google  My Business  is the key to   getting your information out there. That ’ s where Google reviews reside ,  question s  and answers reside ,  your hours and operation. You can do appointment requests through there .  

A lot of people miss the part of putting a lot of great photos in Google  My Business . Think about when you look at a restaurant ,  and you ’ re looking on Google  My Business , you look at the  menu and  the food . D oes the place look nice ?   That ’ s  a great thing to use for Google  My Business . Do you have the same thing happening with your clinic? Have you put a lot of great visuals in Google  My Business  to get people to go,  “T hat looks  like a  nice place. They look professional  and h ands-on with people ? ” That ’ s  the second aspect .  

The  third aspect is called listings.  L istings  are  how your business information address, phone number, what you specialize in all these data points. How is that on hundreds of different directories?  When  you go on Apple  Maps , how do es  Apple  Maps  know your business information ?   When  you go on  Waze , how does it know your business information? How does your car navigation know your business information ?   All  that comes from these online directories .   The  more your business information is out there on the internet, on these different directories, Google   crawls those and find s  your information and then ranks you higher.  That  makes the third aspect of that SEO   Trinity.  

Do you  find that a lot of   clinics   aren ’ t doing this ?  

It takes  constant  work.  

For  those owners who say they have an SEO company that ’ s doing this for them  w hen you look at that, are they covering all three bases?  

Usually ,  not. They might be focusing on one aspect.  The  thing to realize is that it ’ s never done. It ’ s a constant battle for the top .   You  always have to be working on it. You always have to be tweaking ,  changing ,  and optimizing things and looking at what ’ s working  or  what ’ s not working.  W e ’ re  doing   it constantly  for our clients ’   online  work there.  

Case  in point on that Facebook  Live  event with  Vin od , his agency showed that in February  2021 , they made 1 , 100 changes surrounding  Vinod’s   website and Google  Ads  to optimize them.  That ’ s  not just one time .   That ’ s  ongoing. They said the y   average 900 changes a month for most companies, which blew my mind . It ’ s  not like a tweak here and there once a week. It ’ s ongoing.  

There are   thousan ds and  thousands of directories online . It ’ s  about getting all kinds of information from your clinic on those different directories that link back to your website .   That  helps build relevance for sure with the way Google looks at your  business.  

M aking sure that  your  online presence is there ,  Google  A ds and Facebook  A ds , w hat  do you see  with those?  

What  I always recommend for  people  is that   what we see statistically is that the person that will take the most action,   meaning they ’ re going to call your clinic or are they going to fill out a request appointment form on your website comes from an organic search .   Meaning  that you rank naturally in what ’ s called the  3 – Pack , which is that part right under the maps   then also the top  ten. It  comes down to the more spots that you can control on Google and page one ,  the more authority people think you have .  

If  you see a business and it has  2  or  3  spots on Google, you think,  “That  must be the best one. Let me click on that .   Let  me call that one. ” It ’ s  critical that you get your  SEO S earch  E ngine  O ptimizatio n  cooking first and then start to spend money on Google  A ds because then you can command even more of page one of Google with Google  Ads . What ’ s   interesting with Google  A ds is that   it drives those other behaviors. I know you probably realize this when you do it next time, but when you search for something ,  and you see their ad pop up, you ’ re not so likely to click on the ad. You ’ re more likely to click on the organic underneath.  

Scroll past the ads, find the first organic one.  

If  you see  RISE  PT on  an  ad, but you see  RISE  PT below it   organic ,  the tendenc y is  you will click on the organic.  It  is good to do Google  A ds because it drives better SEO behavior  of p eopl e  coming to your website.  The  bottom line is  to  make sure you get a good website going, get your SEO in place first ,  and then start to invest in Google  Ads .  

Many  people focused on that moving to direct – to – consumer during the course of the pandemic. I think a lot of people had a lot of success going back to their past patient lists, which they probably hadn ’ t cultivated much in the past .   Those  who are successful are  and t hat ’ s  why  W ebPT came out with reach  and stuff .   They  focused on getting back to those patients that already know , like and  trust them.  

It ’ s your lowest hanging fruit.   The  most successful businesses in the world cultivate their customer lists.  If y ou  think of Starbucks , h ow many times do you go back to Starbucks in a week?  Think  about  it  with yourself . It ’ s  been  a  fascinating journey of these last  many  years of building  Practice Promotions  and talking to thousands of practice owners .  I always ask,  “What  are you doing to market to your past patients ?”   They  giggle because they know they should be doing more like,  “I  know it should be doing more, but we do some emails. We do an email newsletter  or  maybe a birthday card .” That ’ s  typically the extent of it  but w hat  they don ’ t realize is that it costs you  4  to 10 times more to get a new patient in the door  than just to get  a returning patient.  Y our ROI is the cheapest thing you can do to get a returning  patient . They  know you and love you . What  most patients don ’ t   want to do is come back to PT.  You  only go back to PT if you need to .  

You don ’ t want to go to PT if you don ’ t have to .  

When  I was treating patients, it was , “ Mrs. Jones,  it’s  good to see you again.   Your  knee pain  ha s flared up. How long has that been going on ? ”   “ Six  months. ”   “ Why didn ’ t you come back in sooner? ” “ I thought it would go away, ”   or  whatever the usual is with that.   I f you don ’ t  frequently communicate  across many media channels to get in front of as many eyeballs as possible, then you can ’ t capitalize on your list.  W hen you do, you can build your practice up . Where  I love to see clinics get to is 50% or more of their current caseload is returning or referred  patients .  That’s unconditional power.  

That  was something that we frequently did especially as we went into our  “ slow seasons ”  and we were actively working against that mindset and being reasonable with a slow season altogether .   One  of our successful actions was to callback   past  patients . G etting providers on the phone ,   “ If a patient canceled, you ’ ve got a free hour .  Let ’ s look back  at  patients that came in six months ago or  were  discharged six months ago .   G ive them a call  and  see how they ’ re doing. Not only see how they ’ re doing, how are their family and friends doing as well ? ”   Because t hey  could refer family and friends in as well . Surprisingly , a lot of patients would call back ,  and they ’ re like,  “I ’ m  doing fine. I appreciate that you guys took the time to call me ,  and I hope you guys are doing well .” They ’ ll  leave notes like that.  It  was good  to   build that relationship further  more than just a cold email . It  was very persona l  and t hat  was a successful action of ours.  

We did that in our practice.  What  we did is we had our patient list of a few thousand plus people and every quarter we would call them.  W e broke that down into ,  “ W e ’ ve  got to get to a third of that list  this  month .”   We b reak that down. We ’ re going to have the techs reach out  and t hey  got many calls  they  need to do a day . It ’ s  like,  “Just  checking in. How are you doing? Are you doing your home exercise program? Do you need me to resend that to you? How ’ s your knee feeling? ” It’s like, “It ’ s  bothering me again. ” “Do you want to  have your therapist con connect with you on that? ”  

“ I do a free consult on the phone  or come in  for  fifteen  minutes. ”  

There are  many ways to reconnect.  One  of the things that you need to go into it is that ,   “ I need to cultivate my customer list as best as I can. How can I develop raving fans that send their friends and family  who  want to come back know that I ’ m the expert to turn to when something ’ s  happening? ”  I ’ d rather have them call me like,  “ I think I might ’ ve tweaked my knee. Do you think I should come  to   and  see you again? ”   I’m like, “Absolutely. Let’s check  it out  really  quick. ”   That ’ s  the kind of conversation you want to have . To  get in front of those people ,   you  have to realize that people are across all kinds of media.  Back  in the old days , we  used to be able to put a TV ad up because you get in front of about 30% of the people . Now,  you might get in front of   2% of the people on that channel .  

You  need to be leveraging newsletter s   and  personalized emails going out. You need to be  in  social media engaging with that customer list, text messaging, phone call s , callbacks programs and direct mail works well  nowadays.   Even  more   so now  than it was  many  years ago . Do  you ever see that meme ?   It ’ s  from AOL . It  was back when you,  “ I ’ ve got an email .” You  get so excited  and  you ’ ve gone through your mailbox. You ’ re like,  “ I got all this junk mail .” Nowadays,   it ’ s like,  “ I got a letter .  I ’ m so sick of my email inbox. ” Direct  mail works much better  now t han it ever did.   The  bottom line is with your customer list ,   y ou ’ re trying to get in front of as many people as you can.  If  you rely on emails, you might get in front of 30 % , 40 % , maybe 50% of your list consistently.  You ’ re  missing over half of the people that you ’ re trying to reach.  How  can you reach more people? You ’ ve got to be on different media to do that.  

I talked about the four buckets and making sure you have time, money ,  and energy ,  and all four . It  takes so much more energy now for owners . It  was so much easier to drop something off of the physician and expect th e re ferrals to come in .  T o stay afloat and survive in the way things are  with  economies ,  and competition around you ,   if  you ’ re not doing it, the large corporate brands are, and the  physician- owned PT practices are.  If  you ’ re going to stay above water, you need to focus on spreading yourself out across these different buckets and make sure you have the money and energy to do so .  

I always have a stat on this, but  from  up until 2012,   there w ere  about 25% of physicians  who  worked for a hospital network  and t hat ,  in 2018 ,  skyrocketed to 45% of physicians  who  worked for networks .  I can ’ t even imagine what that is now.  Here ’ s  the deal moving forward. It is a different ball game . If  you ’ ve been in PT for   as many years as I have, it ’ s different than when you first started.   You  have to be in that mentality of a business owner .   You  cannot treat full-time if you ’ re beyond   yourself in the clinic .   If  you have additional therapists that are working for you, you have to have time in your day to be a business owner and function that way.  

Marketing  is one of those critical components that you need to be on every single week looking at because acquisitions have skyrocketed .   There ’ s  a lot of buying out of clinics. There  are  bigger groups coming into your area where they will be coming into your area.   Hospital  networks are gobbling up places around them too.  There are  lot more challenges   coming up . There are  also a lot more opportunities .   If  you know what you need to do and you know that you need to learn about that a little bit more, you can take those opportunities and   grow your business with your goal is to be as profitable as you can with the clinic that you have, or if you have aspirations of additional locations,   knowing how to market is  going to  help me get there.  

I’d like to say that y our business ’  love language is quality time . Your  business needs quality time . That ’ s  not like in between patients ,  after hours  or  on weekends .   It  needs quality, consistent blocks of your energy and time to be successful and achieve the goals that you want to achieve. Otherwise ,  it ’ s going to lead to your burnout and lack of fulfillment.   I ’ m sure you probably still stumped a lot of owners when you say,  “What ’ s  your budget for this? ”   Is  that like ,   “ Deer   in the headlights ,  I don ’ t kno w,” still?  

I  like   the  S tate of PT that  WebPT  do es  every year  be cause they survey quite a few thousand practices.  You  get some good information out  of  that .  I t ’ s always fascinating to me when they ask ,   “What ’ s  your marketing budget ?   What  are you spending on  a  marketing budget ?” Across  the board ,  up until probably a multimillion – dollar  or a  $5  million  practice , t he  average was less than 1.5% of what you made that you spend out on marketing.  T he small business association   average across all industries is 11%.  In  total healthcare ,  it ’ s about 8%.  When  you say ,   “What ’ s  my budget going to be for this? ”  You have to look at ,   “What ’ s  my gross income ?  What  are my  goals?  Where  do I need to be in my clinic to   maximize the space? If I hired more therapists, could I maximize and be as profitable as you can be? ”  

You work backward from that . “What  is the number of patient visits I need to be doing ?   How  many new patients do I need to generate on a weekly basis or monthly basis  for making  that all happen ? What ’ s  my revenue going to be ?” If  you ’ ve been spending 1% or 2%, try to go to 5%,  what  happens?  If  you ’ re  spending it right, if you have a good strategy,   you ’ re going to get tenfold on your money.  It ’ s  fascinating that in PT, we spent very little in terms of marketing   compared to many other industries.  

Especially  if you don ’ t have the time and also if you don ’ t have the know-how , y ou ’ re  going to spend that money and not know how to track it .  I ’ m sure you would recommend if someone ’ s going to have a marketing strategy or alter a marketing strategy or  want  to assess their current marketing strategy, they need to ,  know what track, what statistics they ’ re tracking and then see what that impact is when they spend extra dollars in different buckets .  

Sometimes  you go into it thinking,  “This  is going to be so complicated. ”   You  can go down that rabbit hole if you want to.  The  reality is you need to be   tracking,  “ What ’ s my general marketing expenditure here. What ’ s my number of new  patients?  What ’ s my number of returning patients coming in  here?   Let  me look at when my marketing is arriving, doing things ,  and try to correlate that with your increase in new patients ?”   You  can see what ’ s working  and  what ’ s not . It  doesn ’ t have to be super complicate d .   As  you grow, you will need to get more complex in your marketing   statistics, but to start off with, or if you ’ ve been not putting a pedal to the metal with that, you don ’ t have to go crazy with trying to analyze a whole bunch of stats.  

What I ’ ve seen is owners get a little bit gun shy with Google  and  Facebook  Ads  because the expense is greater than what they ’ re used to  or  extraordinary is what they think. That ’ s because they ’ ve spent  $100  to $200 for a doctor ’ s lunch here and there . That ’ s  about the extent of it.   Now ,   they ’ re looking at spending  $ 1 , 000, $2,000, $3,000 a month on digital ads .   Talk  us through that because a lot of owners  aren’t  see ing  immediate results from that .   The  general idea is tha t i t ’ s going to take  2  to  3  months to gain some traction.  

It  comes back to this whole strategy.   There ’ s  a lot of shiny objects out there.  “We ’ ll  do your Facebook  A ds and you ’ ll be getting guaranteed 30 new patients a month. ”  That ’ s  f or some .   For  most ,  what happens is if you don ’ t have a very good website  or a  good organic SEO , it  comes back to people ’ s behaviors .   They  might see you on Facebook. They might see the ad  and  be interested, but they ’ re going to go check out your online reviews  first.   They ’ re  going to look at your website ,  second . T hey ’ re going to might call. They  then  might fill out a form. They might see that ad again on Facebook and then do something with it.  F irst and foremost, before you go spending a boatload of money on Facebook  Ads  or Google  Ads,  you have to have other core things in place.  

That ’ s  the best place to start with your money is .  “ W hat are you doing to your customer list ?  What is your SEO presence? What is your online brand presence? Can you make improvements there? ”   Y ou will  then  start to see results from that  and  then, “ I ’ ve got to get a good solid foundation , l et me tack on some of the more technical things like Google  Ads or  Facebook ads .” Those  things will work even better than if you went at it without looking at those fundamental things in place.  

I love that recommendation as a step -by- step program becaus e  that is  the trend or the shiny object   is to jump in on Google  Ads  and Facebook  Ads .  Whether  you ’ re struggling or whether you ’ re feeling rather comfortable and want to make more progress than you are right now, let ’ s maximize what you ’ re doing with current patients, past patients and physician referrals.  I f you ’ re getting 60 % , 70% are returning patients and friends and family referrals, and then the last few are physician referrals ,   that ’ s  great .   Maybe  that ’ s when you can start capitalizing on   a Google  Ad.  

Look  at that customer list first ,   see  what you ’ re doing there  and  invest  your time there first . For the  current patients , you can  ask for referrals  and   free  screening offers workshops that might invite friends and family to the ir  online reviews  l ike,  “H ere ’ s a statistic for you ,  89% of people consider a review  that ’ s  three months or older  irrelevant . ”   If  you haven ’ t a Google  review  in  3  or  6  months,  that ’ s  hurting how people perceive you online.  The  most important thing to be doing with your online reviews is not necessarily leaving it to an automated system to do .   That ’ s  important to have as a backup, but you should be training your team internally ,   your  therapist ,  and  the  front desk to be asking for online reviews   because that is the best time.  

It ’ s all about timing. You want that person  who ’ s  having an amazing transformation. Their pain is almost gone  and   they  were happy. That ’ s the time to ask for  a  review , and then  you have the mechanisms for them to be able to leave that review.  Ultimately,  it comes back to ask that patient,  “What  can you do before  and  what can you do now ?”   They ’ re  going to leave this amazing transformational review that will convince others.  It ’ s  a simple action but often overlooked and a great place to start.  

I like that  you  said that it has to be recent as well.  People  are going to disregard those .   Especially  a year old. I didn ’ t kno w  three months was too old, but   if you ’ re looking at past reviews that aren ’ t recent, you ’ re like,  “Maybe  they were back in the day. Maybe they ’ re not so good now . ”   That ’ s  my first  thought .  

If you went to a restaurant and the last review was  6  or  9  months ago, you ’ d be like,  “Are  they still in business ? Did  something  happen ? Are they not good anymore? ”  

“ Is the chef still there? I don ’ t know. ”  Those are good questions to ask.  Asking  that routinely  and   I love that you share those things because those are all bang for your buck.  You  get so much return.  To  make a phone call costs time.  Whereas  the Google  A d s   and  Facebook  A d s  spend is going to be money out of your pocket.  Why  don ’ t you maximize what ’ s cheapest first ?  Once  you know that you ’ ve maximized that ,  then move on.  

Our most successful clients are the ones that have a good pulse on their marketing internally because they will be tak ing  a lot of video s,  pictures  and  asking for those reviews .   T he y  know that they need to market to their past patients  and   then we ’ re coming in with the technical aspects.  We  know how to craft the website, SEO, digital marketing, digital newsletters, email campaigns  and  all that to support that.  We  can  then  work closely with them and get the absolute best results because you have to customize it to your brand ,   “ What was your clinic all about? What are you portraying out there? ”  

It ’ s  almost like plugging a few holes in your bucket before you start adding more water into it.  

The worst thing that we get sometimes is a practice that comes on board and it ’ s like,  “ I ’ m paying you .   You  guys do everything .”   That  is the wrong mentality. It ’ s like,  “H ow can you leverage   consultants and professionals around you to enhance what you ’ re doing ? ”   That ’ s  a better mentality to have.  

Do  you see that as you ’ re taking off the items, going to your   current and past patient list ,  doing Google reviews ,  better SEO on your websites and direct – to – consumers ? T hat ’ s what people are doing now to be successful . It ’ s  going to get more and more so going forward, I assume .  

It ’ s  going to accelerate more and more as we go forward into the future.  People  expect it now.  If  you ’ re not everywhere online, if you ’ re not super active in social media, if you ’ re not pumping out tons of video and pictures, then they ’ re going to look at the practice  that is.  

Even  if the doctor says,  “ I want you to go to so-and-so physical therapy practice . ”   W hat ’ s the first thing you ’ re going to do  when  you sit in the car ?   You ’ re  going to look them up. You ’ re going to see what their website looks like  and  what  their  presence is like.  

The  practice  now in  physicians is,  “ I want you to go to PT. Here ’ s a list.  You  do your own research on who you want to choose. ”  There  are  doctors that say ,   “You  have to go to my clinic ,”  and we know that . For  the ones that do refer out, they are giving them a list  because  they don ’ t want to be like,  “ I do recommend these places. They get amazing results, but I have to give you this list. ”  The patient ’ s going to do their due diligence.  

Anything else you want to share?  You  shared a ton already. I love what you ’ ve talked about so far and sho wing  up what ’ s happening within your practices and then moving on to the digital space.  What  more can you add ?  

We  covered so much here. My purpose is to hel p  practices succeed in improving more people ’ s lives. That ’ s what we ’ re about at  Practice Promotion s .  We  have   great advocates there at the  A PT A  level, the government level.  It  comes down   as individual practices. If we work better to educate the public in how we can help them solve musculoskeletal   neurological problems and empower each one of those clinics to be more successful at reaching the community, that ’ s go ing to  raise the ship . That ’ s  a huge focus for us.  

I would come back again. The thing that we try to  p ortray to our clients and help practice owners understand is that   you can definitely be   in charge of your marketing. You can b e  empowered in your marketing, learn more about marketing. It ’ s  a  critical hat as a practice owner . You  have to look when you ’ re working with different consultants out there ,   “ Are  they going to help you build the right strategy? Do they have the right systems processes to help you get there ? Do  they have the specialists that are going to be able to advise you and help you get the results that you nee d? ”   That ’ s  a critical focus for us.  

It ’ s  cool that you systematize things so well and you ’ re not  just  some guy working on his own,  “Let ’ s  try this, that ,  and the other thing ,  and see what works for you guys. ”   You are  coming from a physical therapy background yourself, knowing and talk to hundreds of thousands of owners over the years . You  know what can work best for physical therapists.  

It ’ s  been a fun journey for me   being a PT, working in lots of different types of facilities and outpatient. I ha d  a real passion for manual therapy. I went for a while to the Canadian  College  of  Osteopathy  that wa s  a passion of mine there . I   did  teach  CE U s and did some teaching at a university for PTAs . I  got into my practicing  and  learning how to then be a business owner.  Lots  of training around that ,  getting better practice   and  then going through the process of selling  your   clinic .  

Focus on SEO but just make sure that your clinic is going to be in front of people when they're doing searches for help.
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That  was quite an experience ,  then starting  P ractice  P romotions  many  years ago ,   which is  m y wife, Amy and I . Now ,   we ’ ve been able to build that up to 75 employees and   learning about being a business leader at that level . We  always continue to grow and marketing at this level, marketing  P ractice  P romotions to clients  and  learning a lot as we do that too.  You  can never stop learning. That ’ s a n  important part of your skillset as being a practice owner.  

It ’ s cool to  know  your story and where you come from, but it ’ s equally cool to see how you ,  over the past  many  years ,  have changed your marketing company . You  have gone into the digital. You ’ ve had to learn so much yourself to be in charge of that but to hire people that are even smarter than you to do some of those things.  It ’ s  not just the newsletter here or there anymor e. It ’ s  a lot more than that.  Y o u have it all.  

Many  years ago, we started off with print and direct mail and newsletters. Now ,  we send out over  five  million newsletters for practices over the year.  We have  a big impact there in their communities.   Many  years ago ,  we started to do websites.  We  wanted to do them a particular w ay.   One  thing that ’ s always been a guiding light for us is focusing on the results.  It’s  not just putting something together that looks fancy. It ’ s  always  looking at what’s  converting better. Now we have lots of great data to look through and continue to focus and improve with that .   The  digital marketing that helps you rank better in Google , Google Ads,  and all these things comes back to like a full   all in one marketing solution for clinics.  

If  people  wanted to  reach you, how would they do that?  

W e’ ve got tons of resources and free information for you , and  video training .   Go  to  PracticePromotions .net .  You  can learn a lot there, tips and strategies to help your practice . You  can also get in touch with us there to scheduling a consult ,  a great way to get introduced to our strategy and our systems and talk about our specialists . We  have different plans to help all kinds of clinics.   We  help everybody from small start-up clinics all the way through 80 – plus location  clinics.  

If  they have some questions, then  you schedule a consult?  

Yes.  Get  right on a consult   c all  with  one of our specialists .  

Thank  you so much for taking the time.  

It  was great to be on ,  Nathan.  It’s a  pleasure as always.  

Have a great day.  

You too.  

Neil and his wife, Amy co-owned their successful physical therapy practice in Boynton Beach, FL for 8 years, developing marketing strategies and systems along the way. He has dedicated his career to helping elevate the profession of physical therapy in the public, by empowering rehabilitation practices to successfully market themselves to their local communities.

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