Maximizing New Patient Flow: Converting Referrals To New Patients – A PT Owners Club FB Live Event With Nathan Shields And Adam Robin

While PT owners focus on marketing to get new patients in the door there is a crucial step that can be overlooked – the conversion process from referral to the patient actually showing up for the initial eval. It is in this transition that the capability and processes of the front desk personnel can be exposed and decrease the number of new patients you could be seeing. In spite of your best marketing efforts, a weak process here could severely counteract your promotional efforts and leave you wondering why your marketing efforts aren’t paying off. In this episode of the Physical Therapy Owners Club podcast, Nathan Shields and Adam Robin discuss what owners need to do in order to maximize their marketing efforts by getting every referral to show up for that first visit. Their insights bring so much value to maximizing new patient flow. Start driving more patients into your clinic when you tune in!

(This episode is taken from a Facebook Live event in the Physical Therapy Owners Club Facebook Group).

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In this episode, I got a good buddy and partner, Adam Robin , with me again. How are you feeling?

Honestly, I have been working hard but I’m feeling good and charged. I’m excited to be here.

You threw out this topic. It’s one that I have never covered on the show, honestly. I remember mentioning it a little bit in a marketing episode that I did with Joey Allbritton years ago but even then, you probably spent five minutes on it. Converting more referrals to new patients, where’d that come from? What made you decide on that topic?

When I’m thinking about these topics, I usually go back to the last coaching calls that I have had. I ran through my calendar. I had this coaching call with a client and she was like, “Our conversions are down.” I was like, “Tell me more about that.” She was like, “When we get a referral, we call them one time for the week and leave them a voicemail.” I was like, “What? Wait a minute. No. We call them twice a day.” I was like, “I’m wondering if there’s some more work we could do.”

The one thing that I feel in our profession or when we are trying to evaluate performance is there’s a sense of urgency that needs to be there. Even more so when you are talking about conversions or sales, speed and urgency are important. I felt like, “I don’t remember talking about this in detail with you for a while so let’s chat about it.”

I like that you brought up the sense of urgency because it starts with the owner. They set the pace and tone for the clinic. I’m a laid-back type of dude. Instilling urgency in me almost has to come externally. My coaches needed to tell me, “No. You were supposed to do that when I brought it up last week.” I didn’t know that was a homework assignment. “Now is the time to do it. When you go back, you do this blank.” There could be many owners out there like me who don’t want to offend. We are very much a profession that doesn’t want to offend. We need to be nice to everybody.

That’s why we try to get in fights with the AMA or anything like that and stand up for ourselves. We want to placate everybody but that also bleeds into passivity and also unwillingness to be urgent about some things. When it comes to a person in our community who needs help, we need to urgently seek them out and find and bring them into our clinics because we know we are the answer. To think otherwise is a little bit selfish. I would be willing to go that far to say that if we are not being urgent about helping people, then we are being selfish because we are thinking about how we feel. I would look bad if I impressed or pushed myself onto somebody, even though we know they need help.

We're being selfish if we're not being urgent about helping people.
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When someone has a musculoskeletal injury, we know they need physical therapy. If that was my mom who needed physical therapy, I would hope that the physical therapy clinic was calling her 2 and 3 times a day to get her in, because I know that the sooner she gets in, the sooner that she gets better and that’s in her best interest. That urgency needs to start with the owner. Somehow the water needs to get to the end of the row so that the front desk person has that same, if not more, urgency to get that patient in the door to be seen.

Urgency is a big deal and you are right. In our profession, I always tell people that all the stuff that you tell yourself about like, “I don’t want to be bothered. I don’t want it to be weird. I don’t want them to think I’m pushy,” you have to get rid of it or find somebody on your team who doesn’t have that.

Think about the words that you are using. They are the words that people use in their head and this is the talk that they have in their mind. It’s all about, “I don’t want to be seen as.” That’s why I say it comes from a selfish place. “I don’t want to be the person who. I don’t want to be seen as the salesman. I don’t feel comfortable doing blank.” It comes back to selfishness. We limit our impact because we don’t want to be seen in a negative light when we could be withholding.

It’s a little self-confidence, believing in yourself and what you are doing, and having that mindset established like, “We are here to help people.” We are serious about it. That’s it. We have an obligation to do everything that we can to help them. That doesn’t necessarily mean that they are a great fit for this clinic but we are going to find out. If there’s somebody out there in pain, had a torn knee, or some type of ailment, they could benefit from our service. It’s our job to identify we are a solution to that problem and seek that out.

I come back to the physical therapist and providers. Where I am several years down the road was separated from the physical therapist who opened up his clinic and was scared of every new patient that came into the clinic. I’m like, “Someone is going to figure out that I’m a fraud one of these times,” and they never did. Did I have success all the time? Not. I would love to go back to that younger Nathan Shields and say, “You are a musculoskeletal expert.”

We know as much musculoskeletal stuff as much as orthopedic surgeons and more than the general practitioners. We are experts in the musculoskeletal field. You have a responsibility because of your expertise to serve other people. Act from that mindset and stand in that space confidently. You might not feel it but simply because of the training that you have had, that’s who you are.

To live in that space confidently attracts more patients and the belief patients have in you. If they have that belief and confidence in you, then they are willing to show up for the next visit and follow through with a full plan of care. They are less likely to cancel. That confidence bleeds down. Especially as you grow, it’s imperative that confidence bleeds down into your team.

I noticed that when our team, especially the front desk person, were confident that we were doing good in this society and community, and we got great results, it was easy for them to have conversations with patients and tell them, “You don’t cancel. You reschedule.” You need to maintain your plan of care. It’s so imperative that bleeds out into our team members. The urgency and mindset are one thing to talk about. How do we get that urgency? How do we get trained into our team? What are some of the things you do to ensure that these new referrals are converting into new patients?

We are in a world where there are so many distractions like Facebook, Instagram, emails, phone calls, and text messages. It’s unbelievable. There are so many people competing for your attention or that patient’s attention. If you aren’t loud enough, they are not going to recognize you. People are like, “How do you do that? What do you mean like, ‘This is what we do?’” We call all new referrals within one hour of them coming across the fax machine. Our goal is to call a patient as they are walking out of the doctor’s office.

The speed of that first phone call is a huge deal. The longer that you wait, and we haven’t run the statistics, your ability to convert them as time goes on continues to decline. They get distracted and their priorities start to shift. They want to go to Starbucks and go shopping. Christmas is coming up. The speed of that first phone call is one big one.

Whenever someone brings up speed in terms of getting new patients better, more effective treatment, better care, and getting patients in the door, speed is a component of power. As you decrease the amount of speed, that increases your power. If my car runs 1 mile, in 10 seconds, it’s more powerful if I get that mile in 5 or 6 seconds. That’s a powerful call. We are a more powerful company. We can create better results and do better things if we can get those patients in faster. We all know that we are more powerful, we get greater results, and we can have a greater effect the faster we can get things done. When that business moves faster is more powerful.

The one thing that we do is cross-train our providers to schedule new patients. If we get overloaded in the front office, it’s like, “Somebody, pick up the phone and start scheduling these new patients.”

Don’t let that phone ring more than three times before someone picks it up.

What happens is new patients come off the schedule. You take 1, 2, or 3 days off. You don’t get those new patients in. The beginning of the following week is starting to suffer. If you don’t have those new patients continuously coming on the schedule quickly, your pipeline is going to be emptied.

We did the same thing, not the one-hour rule. That’s amazing and people need to leverage that for sure. I love that you put it in a specific timeframe because it’s one thing to say that these people need to get in ASAP. It’s another thing to say, “We need that referral to get called within an hour as soon as it comes off the fax line.”

There’s a deadline. This is the expectation. It came in here and you called here. Make a note of it because we want to see how quickly you are doing it. I’m sure you note this stuff. To go to the next step, it’s funny because the front desk personnel, in my experience, would tend to make those calls at about the same time every day. They’d get into a routine, come in, and do this and that. They then make the calls.

If you are not getting these patients or referrals to pick up the phone at 11:00 AM every day, why do you keep calling at 11:00 AM every day? They might be at work, working out, or at lunch. You don’t know. Maybe they work overnight or are sleeping. Don’t call at the same time every day. Let’s vary the times, please, when we call. I’m sure you are doing that. Why you are doing two calls a day is for exactly that reason, I’m assuming.

We call two times a day for the first week. One is before noon and one is afternoon. We also change up the times. We might call early morning on day 1 and day 2, we might call late morning. We are always playing with those times.

You are opening up your third clinic. Hopefully, this isn’t too big of a tangent but for those who are reading, I don’t know exactly how many owners have multiple clinics like you do or are big enough. When we got to about four clinics, we started having the conversation about a separate call center. Do you envision that being somewhere down the road for you where this call center handles all the phone calls and the faxes and makes those calls so the front desk doesn’t have to? Is that something that you have looked at or is it in the future for you?

That’s a unique skill. There’s a huge difference between somebody effective on that first phone call versus not. It’s hard to train a new person at every single clinic, especially if you have 5 or 6 clinics, how to be good on the phone? I can see how only having 1 or 2 people to do the entire company would be a lot easier.

That little call center would handle all the calls that come into all the clinics, make all the scheduled appointments, do all the follow-ups, and call all the doctors. There’s some benefit in that but you are probably not seeing the benefit of that with three clinics coming on. Is that a point where you’d maybe start considering it?

To be honest, we are going into our third clinic and it’s our second clinic that we are open within a year. We are learning a lot about our operational capacity. The administrative and operations team is being stretched. We are in that place of like, “Maybe we don’t have to continue doing it the way we have been doing it. Maybe we can do something a little different.” I don’t think that’s bad. Even things like authorizations or other types of backend work are a little bit more niche, phone-heavy, or more of the same tasks over and over.

Are you doing some stuff on the front end? You talked about the capacity and capability to work well, talk well on the phone, and handle good phone conversations. What are you doing during your interview process or are you doing anything on your interview process to see if they are good on the phone?

Two things. Number one is we have an in-person interview. Let’s back a little bit further. Stage one is let’s do a phone screen. There’s a resume. Let’s call somebody.

Let’s have a quick 5 to 10-minute call.

We want to have that call unplanned for them because we want to know exactly how they answer the phone when they are not. Getting clear on like, “Are they chipper?” Are they like, “Hello, how can I help you?” Is it more like, “Hello, who’s this?” Are you a jerk?

I remember that experience clearly. You’d call some people and they are like, “Yeah.” That’s exactly the tone I don’t want at the front desk.

It’s like, “This is Nathan calling from RISE Rehab.” “Hi, Nathan, yeah.” They automatically pick up. It’s a little ding.

You faked it unconsciously. I’m glad you brought that up because, in that first phone call, you want to get their natural tone level or an idea of what their natural tone level is. Are they chipper people naturally or are they upset that you called them?

How do they handle themself on that call? Are they exciting or engaging? Are they driving the conversation or are they a little bit more passive? It’s a little bit more of the same whenever you are in the interview. Are they exciting? Are they smiling when they talk to you? What are their relationship skills? What are their communication skills like? Lastly, during that working interview phase, it’s like, “The next time it rings, I want you to pick it up.” “I don’t know what to do.” “That’s okay. Figure out what you should do.” See how they navigate that.

“Thank you for calling Blankety Blank Clinic. How can I help you today?” Start with that and then see where you go from there. See what their tone or voice is like. I’m glad you brought that up because it’s imperative to figure out how they do on the phone. One thing that we don’t talk about a lot in the interview process is how they come across on the phone, especially at the front desk position. They are going to have to be on that phone a lot and you want them to have a nice and comfortable voice that’s chipper.

The values that you represent as a company need to be exuded through the phone. It’s important. Outside of that, what are some of the other things that you are doing to get those new referrals converted rather quickly? You have someone who’s got a good phone voice. They are talking or at least reaching out within the first hour and they are doing that a couple of times a day, for how long?

As long as it takes.

At what point do you throw in the towel? At some point, you got to be like, “You call this people ten times.”

Do you mean for a referral? I don’t know if this is exactly the way it is but it’s twice a day for the first week. I believe it’s once a day for the second week, 3 times a week for the third week, and 2 times for the second week. We taper it down. After a month, we sent a note to the referring physician like, “We weren’t able to get in touch with Nathan Shields.” It’s a non-admin.

You give him a month.

We give him 30 days.

You are much nicer than we were. We have this three-strikes-and-you-are-out rule. We might go a little bit longer if it’s a new patient and a doctor that we admire. We said, “You need to call them at different times of the day on multiple days.” At some point, it was probably within the first week. We’d send that fax and I’m sure you are sending a fax as well to the doctor that says, “FYI, we tried these communication dates at these times. They are not responding to our communications. Just so you know, they are not coming to physical therapy.”

I learned that not necessarily a hard way but in a real-life example. I went to visit a physician who was a great referral source down the street. She said, “Tell me about so-and-so.” I looked him up quickly and I was like, “It never came in.” She said, “I got done seeing him this morning. He said he’d been to 4 or 5 visits of physical therapy and that it wasn’t working.” I’m like, “He never showed up.” She’s like, “You can’t say that.” You can’t trust the patients to tell the truth when they go back to see the doctor. We wanted to make sure we were on the right end of that.

Here’s the other thing. How many times have you reached out to a patient for 1 week or 2? You send that note over to the doctor. The patient calls you back and says, “I got a call from my doctor. I need to come in for physical therapy.”

I have seen that a few times. Especially if they were a workers’ comp case, they are in big trouble.

Get that doctor involved because that’s the doctor. Leverage that relationship.

The doctor’s abilities are on the line when they are sending out that referral. If a patient goes to a physical therapist and gets great results, they might not necessarily look back at the doctor and say, “You referred me to a great place.” If the doctor sent them to a physical therapy clinic that got bad results, that’s going to look bad on the doctor.

The doctor wants to make sure these people get good results, especially if they are post-surgical and they know they need the physical therapy follow-up. They are going to ensure that those patients get in. It’s imperative that you increase that communication. I even considered some of those faxes as marketing material.

Put your logo on the top of it.

A logo and name up there and say, “We are professional. We did these things.” I want to be seen as that type of organization and have my name associated with it. Doctors, if they don’t have to sign something and they can be told something, they appreciate that.

How many times have you gotten a phone call from a number that you didn’t know? You’re like, “Let it go to voicemail.”

All the time.

If it’s a number, they’re thinking, “Who’s this weird phone number calling me? I’m not answering that. It’s a telemarketer.” How many times have the phone stopped ringing and then it starts ringing again with the same number? You pick it up like, “Who is this?” You call, they don’t answer, you hang up, you pick it back up, and you call them right back. We should track this stuff but I bet you over 50% of people will answer on the second call. Don’t leave a voicemail on the first call. You call. If it goes to voicemail, you hang up. Pick it up immediately and call again. Leave a voicemail on the second call. That’s another little trick. We have that little call sequence. That’s helpful for getting more people on the phone.

I experienced that. Alex Hormozi recommended that.

I told him about it.

I don’t remember him giving you credit but I’m sure it’s in the notes somewhere. When he’s making those sales calls for his gym launches and stuff like that, he’s like, “If your salespeople don’t know what the double call is, then make sure they know about the double call. That’s how it goes.”

I thought I made that up.

You are not the only one. Do you track your conversion rates?

We track our conversions. Maybe one day when I have a real call center, we will track it like a call center but it’s just how many referrals we get to schedule.

How many referrals came across the fax machine versus how many were scheduled? Is that what you are saying?

Correct.

Do you know your percentages?

I don’t but we are looking for 90% plus. We need 90% and 90% is always our standard for most metrics.

Are you doing a lot of Facebook ads?

We are.

Would you say your ratios go down with some of those Facebook leads? Some of those Facebook leads from what I’m gathering can be fishy. These are people that are looking for free stuff. “I didn’t know I was signing up for physical therapy. I thought you’d give me something.” As my friend said, he’s getting calls from out of town because they don’t do geotracking as much anymore with the Facebook ads. Have you noticed that at all?

We haven’t. I will plug Chad Madden. We are doing Chad Madden’s Breakthrough stuff. If you haven’t checked out Chad Madden, he helps us with our Facebook ads. What we do there is convert them into a workshop. They are doing pretty good. I wouldn’t know for sure because I’m not a Facebook ads guy but I would have to assume that the quality of the leads has a lot to do with how good your ads are. If you are not getting quality leads, then you are probably pre-qualifying people to schedule a call with you. That’s my experience.

The quality of the leads has a lot to do with how good your ads are.
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What are you seeing then in your workshops? How many workshops have you done? How often do you hold workshops? What are your conversion ratios on those from those? From people who sign up to people who show up to people who send that PT.

Back at the napkin number, I’d say half showed up. If you get twenty people signed up, half will show up. About 80% will convert to a new patient. That’s a whole other topic but we weren’t at 80% in the beginning. We had to figure that out. How we present, how we close the workshop, how we position ourselves as a solution to their problem, and that sense of urgency. We have to train our therapists on how to convert at that workshop.

That leads to something that I thought of and maybe you can talk to it, whether it’s a provider or a front desk person. What are their scripts? What are they saying to convert that person from a referral into scheduling the first initial evaluation? That’s valuable and where a lot of people can get lost. I remember having to stress to my front desk personnel. When people call and say, “Do you take such and such insurance? What are your hours,” you can’t just answer those questions and hang up.

Those people are shopping. If you don’t go the extra mile and ask, “Tell me a little bit about your condition. Are you calling for yourself or someone else that you know needs help,” they need to know at that point they need to switch into sales mode and start talking to the patient, not just to give information that their patients are calling about but to recognize that if they are calling about some of these other things, whether it’s accepting insurance, availability, or hours, they need to switch the conversation back to, “How can I help you? Where do you feel like you need help?” I’m wondering what you are training those people to say to convert them from a referral to a new patient.

The thing that is powerful here is to take your time on the phone call. Slow down. It’s not a race to see who can hang up the quickest. Invest a little bit of energy into building a relationship with whoever’s on the other end of that call. You do that by asking questions like, “What’s going on? How can I help you?” “I’m having shoulder pain.” “How long have you been having shoulder pain? What led you to the call? What have you tried before this?” It’s almost like if you can go back to a few episodes ago, we talked a little bit about the sales process during the initial eval. It’s the same thing.

It’s the presale. It’s the same type of script but it’s scraping the surface of that. When they get on that call, you are reminding them why you are calling and how big is your problem. Once you can get clear on that, then it’s like, “We’d love to help you. What I’m going to do is schedule you with one of our specialists.” Transitioning them to a call is the biggest thing.

That’s a similar script in the workshops, I’m assuming?

Very similar.

Remind them why they are calling. 2) I love that you are bringing up what other things have you tried to fix this problem and how it worked for you in the past. 3) How urgent is this?

How long have you been dealing with this?

“Would you like to get this fixed sooner or later?”

“What activities are you having a hard time with?” Get them to start to peel back the layers of like, “I do have shoulder pain.” Maybe this is a big deal. It’s been bothering me for years. It sucks because I can’t play golf anymore and I want to. Get them focused on what their problem is and that they have a problem that requires them to take action. We are distracted. We have Starbucks in the background. We got the microwave going off in the back and the kids are crying. All of those things are pulling at our attention. Sometimes people get distracted and they forget. They talk themselves out of taking action.

There’s an opportunity there. I remember this from a phone call or an episode that I did with Sturdy McKee where he talked about training the front desk to be more than just information gatherers and providers. Phone calls might start with, “I need to schedule an appointment for physical therapy.” Depending on the EMR, the front desk person might ask, “What’s your date of birth?”

Get all the information. “You are scheduled for Wednesday at 3:00.” Instead of that, how could you live the values of the clinic through that conversation? Someone says, “I need to schedule physical therapy.” Maybe it should instead be more along the lines of, “We would love to help you. What are we signing you up for,” or something like that?

Also, “That has to hurt. My mom went through that but how is it affecting you? Have you tried physical therapy before? What are you expecting? It sounds like we could help you. I need to gather some information before we get started. Do you have any questions or concerns? Have you been through therapy before? Do you know what to expect?” “No. I haven’t been through physical therapy before. I don’t know what to expect.”

“I’m setting you up with so-and-so. They have been here for so many years. I have been in physical therapy myself and I love it.” In those conversations, you could see how that’s a different tone altogether than someone who’s gathering information. What that can do to ingratiate and engage the patient in your clinic, instead of someone who’s like, “I got an appointment at 3:00 PM on Wednesday for my shoulder.”

The initial part of that call, the purpose of it is to get an agreement that they are going to give you the information that you need. You are building the relationship, helping them get clear on what their problem is, and letting them know, “I have heard you and it matters to me. What I would love to do is solve that problem for you. Would you be open to that? That’s Nathan’s specialty. He does X, Y, and Z. He’s the best. Do you want to do it?” “Yeah.” “Great.” Once you get that yes, then it’s like, “Let me get some information from you.” You have to go through the checklist.

It’s got to be done at some point.

You got to be like, “Now that I have invested in you and I have served you, I’m in a position where I can ask.” If you get on there and you are like, “Just shut up and give me your insurance information. Give me the number that I can send the claim to quickly.”

Let me ask you this. Do you do free consults in your clinics?

We do.

This is something that I thought was pretty bold. Joey recommended this as well but for free consults. He doesn’t do free consults. You could but if someone is going to do a free consult, they are going to have to provide credit card information so that if they cancel that free consult, they will be charged $25. Have you ever tried anything like that?

Bold move.

I’m like, “I don’t know if I’d signed up for that. I haven’t signed up for you and I’m not giving you my credit card information before I even show up.”

If you study The Art of Persuasion , I don’t know Joey but I’m sure he has been in business for quite a while. Is that what you said, Joey?

I don’t know if Joey has been in business for a few years.

I’m assuming that he’s probably built up some social proof. He’s got a reputation in the community and some things. People know him and seek him out because his reputation in the community is so big. Once you have that, you can start leveraging that and positioning yourself with a little bit more leverage when you are scheduling.

It could be a filtering mechanism. You could say, “We are going to do free consults but we have had some poor attendance of free consults.” If we want to get a higher arrival rate for our free consults, then they have got to have a little skin in the game. If they show up, we will not charge you anything but if you don’t give us the notice that we need because we are setting aside this time specifically for you in a one-on-one appointment, then we are going to have to charge you for it. I could see that as a potential filtering mechanism that you could use to ensure, maybe even incentivize, and filter out those who aren’t serious.

It’s common. If you are getting a lot of leads or people in your door who are not qualified, that either A) You can’t help or, B) They are not qualified, then the only solution I know of is to increase the barrier to entry. You could do that with your recruiting efforts when you are getting resumes or with free things that you are giving away. I can see how that could be used.

Increase the barrier to entry, and you could do that with your recruiting efforts.
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As far as your conversion process, that’s pretty much it. You get the referral. They call within an hour. Call multiple times a day. You guys do it for a month. Kudos to you.

Don’t forget text messages.

You are leveraging not just phone calls.

Some people don’t like to talk on the phone, especially with digital. If you don’t have a way to text your patients, get one. You got to have that. You could stop this episode. Get something that’s going to allow you to communicate via text message with your people.

It’s not coming from their cell phones. Make sure it’s coming from you.

There are all kinds of programs out there like software that you can download to your computer or maybe they are in the cloud. You get a number that you could communicate with via text message. It’s way worth it. Don’t forget that you can text them.

When you are reaching out to them a couple of times a day, it’s phone and text or phone or text?

We do phone and text. Ideally, they pick up the phone. If they don’t, then they are going to text. That text is very important because if it’s too long, they are not going to read it. You say, “This is Nathan. I’m texting you on behalf of your physician. We have orders that we need to discuss. Please give us a call.”

This is something that they can copy and paste. They are not creating this on the fly for every patient. This is part of the procedure and system.

There’s the outreach piece. It’s always more urgent, quicker, and has more channels like leveraging text or emails. Sometimes an email will come across the facts. Leverage all the communication channels that you can. If there’s not a secondary phone number, call the doctor and see if they have another secondary phone number. Get multiple phone numbers.

Leverage all the communication channels that you can.
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Go after that patient. You want to get them on the phone. Your job is to make them either convert or tell you no. You don’t ever want to have a cold lead. That’s the outreach piece. You are going to serve, invite, and ask them to give you the demographic information. We also have to make sure that they show up. There’s some information that they are going to need. Make sure that they know what time to show up.

If their appointments are at 10:00, they don’t show up at 10:00. They show up at 9:30 or 9:45 because there’s paperwork. It’s like, “Nathan, we got to close the call.” You are going to arrive at 9:30 and there’s going to be five pieces of paper for you to fill out on your first visit. How many times have you gotten new patients that come in there and are like, “Welcome to your first appointment. Here’s your paperwork?” “What? I don’t want to fill this paperwork out. What are you talking about?”

“I did this at the doctor’s office.”

“You guys can get this from my doctor.” You are a jerk. If you make sure that you tell them that there’s going to be five pieces of paper for you to fill out and it’s just for the first appointment, cool. They get there and there are five pieces of paper. They have to make sure that they know where you are located. Not just the address. They can’t spit off the address.

“We are on Rock Ranch Road right across the street from McDonald’s. Do you know where that’s at?” “Yeah.” “Great. What side of town are you coming from?” “I’m coming from this side of town.” “You pass that up. We are going to be right there on the left-hand side.” “I know exactly where that’s at.” “Great.” 9:30. Lastly, they are going to have to make sure they bring their photo ID, driver’s license, script if they have a script, or their insurance card. What we like to do is make sure that they have to be educated on those four things before hanging up.

You have to include a fifth thing I’m sure there as well and that is what is their financial responsibility.

That’s a great topic. We don’t do that.

Tell me about that.

We will if they ask.

Prior to showing in.

Our theory is we are not going to create objections for them. It’s like if you go buy a car. If you call and say, “I want to buy a new Ford pickup truck. How much does it cost,” they say, “Come on in. We will take a look at it and drive it around. We will get clear on what you need. We will then talk price and see if we can work out something financially for you. Does that sound fair?” Not that we want to be used car salesman.

People reading this are like, “You are treating patients like cars.”

Not at all. Not even for a second. However, it’s also that I have a hard time lying out and telling people to show up with $100. If they don’t even know who I am, they don’t know what we do, how we do things, what value, or even if we can help them, I want to try to give them an opportunity to come back, meet with the therapist, get clear what their pain points are, and give us an opportunity to explain what we do and how we can help them. We then can overcome that money objection.

Allow patients to come back, meet with the therapist, get clear with their pain points, and allow therapists to explain what we do and how we can help them. That's how you overcome that money objection.
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You have this conversation after the eval is what I’m hearing.

It’s when they come to the window.

Prior to being seen.

Correct.

I’m assuming you did this because you had some negative experiences of people canceling prior to that first visit because of financial concerns. Do you feel like that issue has been allayed because you have waited to have that conversation until they show up?

One hundred percent. We never had a ton of people not scheduled because of finances in the first place but we have very few. If they ask what their copay is going to be, we are going to tell them but we are not going to throw it out. It’s like one of those things of, “This is Southern Physical Therapy Clinic. Make sure you bring $25 because you are going to owe us $25.”

They can come across poorly.

That’s why we choose to do it that way but I don’t think there’s a right or wrong. Whatever way you choose is fair.

I was going to say that. You could go either direction and make a case for either appropriately. Partly in my head, I’m thinking, “I don’t want them to be surprised that I’m asking.” Especially if a deductible hasn’t been met, I’m going to be asking for $150. I don’t want them to come back and say, “I didn’t know. I didn’t bring my credit card.”

They are like, “We are stuck. Either you go find your credit card, we reschedule, or we see you and hopefully collect it next time.” I’m glad you went into that because I hadn’t heard that side of things that you intentionally don’t provide the insurance information prior to them walking in the door. I can see your thinking behind it. Not that it’s wrong. It’s just different than what we did.

Ideally, if you set all this up right and you have some markers, checkpoints, and things that you want to make sure that you hit on that call, you should see more patients scheduled, more referrals being scheduled, and showing up on time. I wouldn’t say it’s the most important thing but one of the most important things to the success of your practice.

You do have to consider. My entire time being an owner, I never tracked how many of those referrals were converting to new patients. Simply because 80% of that time as an owner, I didn’t know what I was doing. I also wonder if I would have trusted my front desk, which also goes back to my inabilities in the past to train my front desk appropriately and hold them accountable. I don’t know if I would have trusted my front desk to give me the proper metrics. If they are not following up on those referrals, then that makes them look bad so they are not going to report the right numbers.

There’s a little bit of trust. That’s with all metrics though. There’s always an element of trust.

Where do you get those metrics? Are you getting them through your EMR or are you having someone manually track those?

It’s both. Referrals are going to come over the computer electronically. You have to scan them into the system and create a new episode for the patient. In theory, if the front desk person didn’t do any of that, then there would be no way for me to know unless I drove to the clinic and started counting on the fax machine.

Do you still get paper faxes?

No.

I want to make sure that we are on the same page because I don’t get paper faxes anymore. When I was an owner, we were. In my clinic, they are all electronic. It’s easy if there is someone overseeing the front desk and then running things. Even with the tiniest bit, someone else could count the number of referrals that they are getting faxed in and then count how many new patients came in that week.

There are so many touchpoints that we have and we have daily reporting for all the front desk people. It would be hard to get away with it for too long. We are going to look at how many faxes came across the fax machine every day, how many of them were scheduled for evals, what percentage of them were scheduled for evals, and how many of them were unscheduled. We are tracking that every day.

Is that a tracking spreadsheet that they turn in every day?

Yes. They have to report once a day at the end of the day to the director of administration. They have to look at their arrival rate and schedule utilization or collections. Have one person that you trust. That leader or director of the administration who’s over all the front office is the key to that because they have their finger on the pulse. If they see one metric starting to climb like unscheduled referrals, they are on the phone and are like, “What’s going on?”

If you don’t have a director of administration, that’s probably a job that you need to do when you are not seeing patients because you are the director of administration, director of marketing, and director of operations. You don’t have time to be seeing patients and fulfill all those roles.

You’d be amazed that some people are like, “I want to get busy and get more evals in the door.” Their solution is, “I need to market more.” Sometimes, that’s not the case.

That’s exactly what we are talking about.

The number of evals that are scheduled and show up is not only related to your marketing efforts. It’s a secondary marker. The primary marker is the number of referrals that you have. At least track the number of referrals that you have because that’s the number that you need to be looking at and deciding, “Do I have a marketing problem issue? Do I need a better front office person or some more systems in the front office? I could increase my volume by 30% with a little bit of phone training.”

That could be a sieve. People could be bleeding. It happened to us a couple of times, especially with front desk people who had disengaged but were still present physically. More than a couple of times, we let somebody go and went through all our stuff, opened a drawer, and there was a pile of paper referrals. Dropped to your knees and screamed at the skies like, “What is going on?” Now that you can track that electronically, it’s imperative to have your finger on the pulse. You could have all the best marketing efforts and if that front desk person isn’t converting them, it’s all a waste.

They got to be a dog. They got to go get it.

I’m glad we talked about it because we haven’t had it on the episode before.

All of this comes back down to the importance of that front desk person. When you find a good one, pay them well, keep them happy, invest in them, and train them. That’s somebody who can make a difference in your practice.

“Trust but verify,” to quote Ronald Reagan. We trust these people and we will train them up. They have our values and everything but we are going to verify. If people want to reach out to you, how do they do that?

Adam@PTOClub.com for any questions about growing your practice, marketing, or system, you name it. Whatever you have, if I don’t know the answer, I will find somebody who does.

Same here at Nathan@PTOClub.com . Join us on the Facebook group, the Physical Therapy Owners Club , if you don’t know about it already. Check out PTOClub.com where you can set up a time to talk to us about your business and schedule an appointment there. Thanks. It was good. We will talk to you later.

During his spare time, Adam enjoys spending time with his family and friends. He enjoys challenging himself with an eager desire to continuously learn and grow both personally and professionally. Adam enjoys a commitment to recreational exercise, and nutrition, as well as his hobbies of playing golf and guitar.

Adam is inspired by people who set out to accomplish great things and then develop the discipline and lifestyle to achieve them. Adam focuses on empowering and coaching his team with the primary aim of developing “The Dream Team” that provides the absolute best patient experience possible. He believes that when you can establish a strong culture of trust you can create an experience for your patients that will truly impact their lives in a positive way.

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The post Maximizing New Patient Flow: Converting Referrals To New Patients – A PT Owners Club FB Live Event With Nathan Shields And Adam Robin appeared first on Physical Therapy Owners Club.