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Practice Management Challenges in 2024: Caseload, Relationships and Time

Over the past year, Canada’s physical therapy, chiropractic and occupational therapy landscapes changed dramatically.

Practitioners rallied to address and conquer some of the top issues of the past, like the need for more self-care and patient access to modern care solutions.

In this article, we look to the year ahead and explore three significant practice management issues facing practitioners in 2024.

1. Caseload Management

It’s no secret that retaining your patients is good business, but why is this one of the most significant issues facing clinicians in 2024? According to a 2020 survey of  Chiropractor, PT, and OT clinicians, managers, directors, and owners, the three leading causes (outside of insurance concerns) of patient retention are time, cost, and practitioner expectations.

  • 53.3% of patients have time commitments and scheduling difficulties.
  • 40% of patients believe clinicians have unrealistic expectations for treatment.
  • 73.3% of patients don’t agree with the cost of treatment.

All three stem from one major problem: value. Time commitments would no longer be a problem if patients understood why their proposed care plan was necessary in the first place. Expectations would seem easy if the value to them were apparent. And cost wouldn’t concern patients who knew treatment was essential to living their best lives.

A major root cause of poor patient retention lies in low clinician self efficacy. Many new graduate practitioners suffer from low levels of confidence in their practice ability and hold beliefs that they lack the skills and abilities to effectively practice evidence-based care.

Treat every patient with sterling professionalism, continually underline the benefits of physical therapy, and praise people for their efforts along the way and you’ll keep the patients you have and fuel future visits from their friends and family. Success boils down to building a culture of value around your craft and never letting your enthusiasm waiver in exchange for impressive results.

Other steps you can take to improve the likelihood that patients will return the next time they need therapy include:

  • Set appropriate expectations around treatment outcomes and the patient’s role in their own recovery. Unrealistic expectations are a crucial driver of dissatisfaction; early, honest conversations can help prevent that.
  • Invest in a patient portal software, allowing your patients to register and schedule appointments online for convenience. Patients gravitate toward practices that offer convenience and that leverage technology.
  • Partner with a home exercise program provider so patients leave with a visual, printed home exercise program that illustrates what they need to do, when they need to do it, and how many reps they need to do. Printed HEPs eliminate confusion and improve compliance – ultimately improving outcomes and patient satisfaction.
  • Ensure a patient-to-provider ratio that allows for timely care. If patients cannot get scheduled promptly or as their doctor has recommended, they will move on to another practice, even if they had a positive experience with you in the past.

2. Relationship Management

Managing a healthcare practice is challenging, even for the most skilled entrepreneur. There are many moving parts in the allied healthcare industry. It’s nearly impossible to stay on top of everything simultaneously. However, with the proper time allotted to relationship building, and optimal marketing spend on your personal brand, practitioners can attain an average of 1-2 new patients/day across an entire year.

Building a solid patient base must begin and end with friend and family referrals; also called word of mouth referrals. These referrals should make up 60-70% of your overall caseload on any given day. Asking your current patients to refer you to other friends and provide a Google review are important to building your caseload.

Relationship management with physicians, case managers, employers and community members are where you should expect to cultivate the remaining 30% of your caseload. It’s critical to understand where a GP places value when they send a patient to you. And it’s imperative to understand the outcome a Worker’s Compensation/Employer wants at the end of a treatment plan. It’s a brave new world out there, meaning you might have to pick up the phone and call them.

  •  Being active, current, and relevant on your social media accounts will go a long way to gaining credibility as a clinician.

3. Time Management

Productivity metrics are important when measuring both an individual PT’s and the clinic’s success. But understand that they are precious tools for assessing your employees too. Schedule efficiency and no show/cancelation rates are two great time management metrics.

Use these metrics to identify the strengths and weaknesses of your staff. Ask questions about why specific PTs have better metrics, such as net promoter scores or Google reviews, to figure out how to build up the entire team. The best clinicians prepare their cares plans, are careful not to over treat, and have clearly laid out care expectations with each client. They’re mindful of the 3T’s:

  • Tip: Educate (i.e. reinforce a directional movement that reduces pain_
  • Technique: Manipulation or IMS
  • Take-away: Exercise progression to do at home

Individual metrics for each physical therapist can also provide valuable insight. One therapist with significantly higher volumes or another with significantly lower volumes might trigger additional research and learning. Consider investigating how clinicians manage their drop-off list/recall lists/inactivity lists or what % of a clinician’s EHB case load has clients with three visits of less.

Need additional help? At ELEVATE, we work directly with clinicians seeking how to improve their caseload management, gain more referrals from GP’s and B2B sources, and manage their time so charts are being completed outside of work hours. In 2023, our average time spent providing 1:1 coaching for clinicians was 3 hours over a 6 week period. To learn more or get started, book a free consultation today.

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