Brad Cote on Patient Retention and Marketing

Brad Cote on Patient Retention and Marketing

{Ray Berardinelli} I hope everybody's having a great day.

For those of you who are in the clinic, I hope everything's going well. For those of you who are outside the clinic, I hope you're laying some foundation for when you're back to your practice. 

Everyone, welcome to the PT Business Builders show where we believe EMRs suck; that systems and software should improve your practice and your life, not consume it; and here, our only measure of success are systems that give you the time to enjoy your life and the financial freedom to do that.

Today, we're having Brad Cote on. We met about two weeks ago. I didn’t even exist.

He's got so much awesome stuff. I must have been living in a bubble; I didn't even know the guy existed. He has got some great systems, he is really helping a lot of PTs. 

I wanted to have him on. We're all PTs or in physical therapy in general. I wanted to have him on so he could help all the therapists in the group, grow their practice.

Brad, go ahead, introduce yourself, brother, and let people know what you do.

{Brad Cote} Hey everyone. So I am a dual licensed practitioner and clinic owner myself. 

For the past 12-13 years, I've been in the industry in various capacities from starting a single base practice, doing personal training and therapy together, to having a clinic with having 15 staff and so on. 

Lately, what I’ve found is my passion has really been about being able to make a big impact in the industry and I want to be able to impact as many lives as possible. 

And what I started to realize, as time went on, was other colleagues of mine who had health practices weren't doing quite so well. And what I was doing is sharing some of the concepts, marketing, sales, retention, and some of the stuff we'll talk about today -- with them. 

And what I realized is, if I was able to help other health practices, and practitioners improve their business, they actually can reach more people. And together, we can grow a big community. 

I've been working a lot more in the consulting space for health practices to market and scale and really grow their businesses to get more freedom and more income. I've really kind of worked in different capacities in terms of therapy from post rehab, all the way up to NFL, NHL baseball players. 

And during my process, or I guess my time treading, I started to develop strategies and what I found was being able to create individualized strategies for help businesses to give them what they need right now. 

I find that it's really contextual with treating, with training, with consulting is that there's a lot of people giving information but there's not too many people are giving contextual information right now. 

What we want to do today is give you guys some strategies that you can implement in order to get your health practices and business in the best position possible.

{Ray Berardinelli} Great. Yeah. 

(Hey, Brent, what's going on? Hey, Andrea, how's it going, Jacob, what's going on?)

That's really awesome stuff. 

That’s kind of anybody who's looking to serve within this industry. That's kind of that driving force, the things that you see people struggling and that you want to help people get through their current situation, get to that point that they want to be.

That's what my whole, our whole lead in and this thing is about this. Basically, the same message that we're working on. Well, that's awesome. 

Why don't you tell us a little bit about, you have your method, like the thing that it is that you do, Brad? That thing that -- your method of reaching people.

Would you mind kind of telling us about that? What it is and the premise behind it?

{Brad Cote} Sure. We've chatted a little bit, both here and Jerry on his podcast. 

My method, really there's three components to the business that you really need to understand.

If you want to grow your health practice and not have it kind of overwhelm you. Everyone always strives to be working on the business instead of in the business at one point.

Because you obviously want to avoid burnout and make more money, have more freedom.

So there's three things that you really got to hone in on. And they're specific to where you are in your actual business later. 

The first thing is you need to have the right structure, which is basically how your business setup -- is it cash base, is it continuity base, are you selling points of care, is it one off treatments, that type of thing. You got to have the right structure to dictate the end goal. That's one consideration. 

The next thing is you need to have the right systems in place. And the right systems allow you to leverage your time, your expertise, create some pre-eminence, basically meaning like authority, credibility, expertise in your specific niche or market that you're choosing and really they allow you to be able to grow your business exponentially and their systems. 

For example, I cover a lot with marketing based systems which are attracting patients to you conversion based systems, which are converting those patients, those prospects into paying patients. And then there's delivery systems, which are, how you actually deliver your service. And we'll talk a little bit about retention based strategies as well. 

And then the last thing is you've got to have the right strategies at the right time. Utilizing different strategies to accommodate the specific times of year the problems you're solving.

Right now, if you're trying to run ads, we talked a little bit about it last night. If your strategy is selling telehealth based ads, you're more than likely going to set yourself up for failure because you're running a strategy based on telehealth and a lot of people don't really even understand what that is and we can chat a little bit about that as we go through.

What's being shown here on the screen is the Omnipresence method. 

I came over Omnipresence method marketing strategy for health practice owners, over the years of having my solo practice, the clinic, and developing a strategy for health practice owners that they can really just take and dominate their specific market. 

I kind of say it's like Dean Jackson, who's a marketer, refers to it as I think it's three mile famous or something along those lines. Where you're basically dominating your entire area. 

People are gonna see you offline, online, at the grocery store, everywhere they go. You're really indoctrinated into the community so that way you're able to leverage all of those different types of platforms and so on. 

We can talk a little bit about that as well.

{Ray Berardinelli} Yeah. I like that. I really love the idea of the whole ecosystem. 

And, guys, just real quick, one of the things that he said that I thought was so important is like the different places that you are within your practice, some of the things that you struggle with. 

If you guys would like to share with us what you're struggling with, like what your particular problem is right now. And potentially, we can get some information for Brad about how we can help like how we can help you get through this particular thing that you're trying to get over. 

These are very unique times. This is a very unique circumstance that we're in right now. Hopefully, it'll be over soon. 

But there's a lot of things that we really have to dial in and work on because the struggle is real guys. And if you're suffering from this problem, just let us know below and hopefully we can try and help something here or share something here that's going to help you through that situation. 

In this omnipresence method, with all of these umbrellas, what's the overall takeaway from that graphic, that whole thing? 

(And I would like to share it but this It's not working now. I keep trying to share it out there and it's bouncing back on me.)

What's the overall idea of the Omnipresence, of the three circles? And how you leverage them to grow your business?

{Brad Cote} Sure, yeah. So what I'll do is I'll just post the link so you guys can see the model there. And I've also got a video that kind of walks through each section. 

The overall strategy with Omnipresence, Omnipresence essentially means like being seen everywhere, everywhere someone goes, so the overall strategy here is it consists of three general sections, and then each general section has three subsections. 

It makes more sense if you look at the picture. 

Essentially, what you want to be able to do is have all the three main sections you have online strategies which are like Facebook, your website and so on. 

You've got offline strategies, which are things like running workshops, which technically are more online now. Workshops that you can have in your clinic, as well as direct mail or newspaper sp offline based strategies. 

And the last one is really, really overlooked but it's extremely crucial component that a lot of solo practitioners should be using when they first start out in order to grow their business exponentially, and their partnerships or joint ventures, so not a partnership in terms of like an equity partner in your business, but partnerships in terms of like, hey, we're partnering up or we're, it's a joint venture. 

And that might be something like setting up synergistic partnerships with companies. So for example, you're doing physical therapy, you're looking at the chain of physical therapy, it's here. 

We've also got what comes before and after. Someone might go to a doctor before so I might have a partnership that's synergistic within a medical doctor. And afterwards, I might have someone who needs to get in shape so I might have a personal trainer or a nutritionist. 

Those are things that you can utilize and essentially omnipresence, what we really want to do is install these campaigns and get them running so that you have a system and a strategy that you can use all the time to help generate new patients. 

What’s really an important part is having, not just relying on Facebook or word of mouth or anything, but if you've got three or four new patients from each one of these sections, you end up getting 20,30 new patients per month. 

And part of the key to it, if you look in the middle, is we talk a lot about retention. And we talked about getting referrals and reactivation.

In the center component, it's not just about getting new patients all the time but we want them completing their full plans of care. We want to help generate referrals because that helps keep our ad costs down and grow our business with like minded people.

The overall Omnipresence method generally for us is able to exponentially grow our clinics as well as the clients that we work with by doing it.

If you are looking at this, you don't implement all of them at once, what we really do is take a look at what your business is now. So if you're a solo practice owner, and you only get by word of mouth, then we might start doing something like workshops and joint ventures to start getting you going. 

If you're a bigger clinic, and you've got Facebook ads and all this other stuff running. We've looked at optimizing those and maybe saying, ‘Okay, well, you got Facebook, it's doing really good. But can we do an AdWords campaign? Or can we do a partnership or something like that?”

And a lot of the time people get that shiny object syndrome, and they're gonna say, “Well, I'm going to do Facebook ads…” 

And they do a really bad job at it and they say, “Well, Facebook ads don't work for me…”

Can you say that you actually spent the time to invest in actually getting them working. And I mean, for me, it took me a lot of time and money. I kind of like to expedite my process by investing in courses and people who can help me get to the next level. 

I spent a lot of money and time on marketing and sales systems and all this other stuff throughout my career. It kind of helped me, but it still took me a while to get ads that would be repeatable and helping me get the right people coming in -- which is a huge thing.

{Ray Berardinelli} Yeah. So the one thing that I really wanted to talk about was the retention piece. 

This is something you and I briefly talked about before we hopped on, the retention about how retention is the best marketing and how right now it's like the vital piece because we're shedding patients right now. 

Like it's our job. We're struggling to bring new ones in. And a lot of the ones that we have are either just sitting on the shelf or have kind of gone away because of the circumstance we find ourselves in. 

Would you kind of mention a little bit about your retention piece and how you see that being leveraged right now in the current circumstance to sustain your practice or grow your practice.

{Brad Cote} For sure. And I mean, retention, like outside of even just  these trying times now is absolutely crucial. 

People always focus on trying to get new patients coming in. But if they've got people coming out, and they're losing them out the back door, then you've got a huge attrition of patients coming in or they're not completing full plans of care. You've got to fix that problem first. 

And when we first do strategy calls with people and onboard them to kind of get them sorted out. A lot of what we talked about getting people started is we need a retention strategy first. 

Because if you don't have a way to retain people, get them to complete full plans of care, they're not going to get as good of results. They're not going to give you reviews and advocate for your business and aren't going to give you referrals.

The whole Omnipresence method and what we, what I really do in my business and help people is getting that retention is crucial. 

A lot of it we talked about now for retention really comes back to being able to over communicate with your patients about their health and what's going on and making it about them and not you. 

And I said, one crucial, crucial error that a lot of people messed up, not just physical therapists, but gym owners and massage therapists --- is soon as things got shut down a lot of people kind of took it personally. 

And we're like, “Well, that's it. I'll talk to you guys later…” 

And they cancel people off their schedule, they would cancel patients who might have seen them for years, who depend on them for back pain, knee pain, whatever it is. And they haven't met, I've had a lot of prospects who are new on the schedule, or prospects who should have been, you know, been getting phone calls and follow ups. 

And really like when you're a couple weeks ago or a month or whatever we are in this vacuum of time now, originally, like if you took action to contact people and say, “Hey, you know what, I can't shoot you for these reasons we're closed and whatnot. But I want to know how I can best support you?”

That's one thing that we did right away is over communicate on to the patients and say, “How can we support you?” 

And from that, we ended up having the simple translation of getting someone who had back pain or knee pain and just saying...

“Listen, here's some ways we can help you.” 

“Well, I want you to help me with my back pain.” 

“Okay, well, here's some ways that we can help…”

And then we didn't have a conversation about saying, “Hey, do you want to do a telehealth appointment?”

It was more like, “Do you still want help? Here's one way we can help you. We'll set it up online. And we'll give you some exercises to do. And we'll do our best for where we're going.” 

That's the first way is having a conversation. And I think a lot of people, practitioners just mess that up right off the bat.

{Ray Berardinelli} Right. I had Steven Dunn on earlier. And he was saying that that was sort of the method that he used.

He would just call people to see how they were doing. And then he would remember the things that they were having difficulty with and ask them.

“Oh, hey! How you doing? I remember you said that you had a hard time when you were washing dishes. Would you mind right now, if I just took a look like we can do a little video thing, and I can watch you do it, I might be able to help you out.“

And he snuck in, into telehealth by using it as a context to get a look at the thing that they were having a problem with because he did want to see it, but it really allowed him to switch on the patient and show them…

“Hey, this is the value that I can offer you right now. Is it okay if we do that?”

And then the pay if the patient says, “Yes!”

Now you're doing a telehealth visit and you help them. 

“Try this does. Does that hurt as much?”

And they will know that that's a little bit better. Well, now guess what you just told them until now. 

Now you say, “Hey, would you be opposed us doing this again? If there's other things that I can help you with, if I can just watch you in your home doing certain things. Maybe I can help you along in this process further, so we're not losing everything that we gain.”

Now he's been able to successfully switch people to telehealth by offering it not as telehealth, but as a way that I can take a look at you, a way that I can see the problem that you're having that I haven't been able to see in the clinic.

{Brad Cote} Yeah, for sure. That's great. 

And it's a big thing is communication. And literally asking people, what do you need help with and just genuinely caring for them.

Some people are not going to answer their phone or they're not going to want to do anything, but that's fine. Who cares? 

We'll just follow up with them. No one's going to get mad at you for saying, “I'm really mad that you call to check in on seeing how my back pain was. Knowing that I'm probably sitting at home doing nothing and it might get worse and giving me some exercises or tips that help me.”

That's really big... this is communication.

{Ray Berardinelli} Yeah, hold on here. I'm going to share, Andrea said this…

“We found the majority of the people that dropped off at the beginning of this pandemic was strictly in fear of what the media was saying and the fear of the unknown. With the information that has been publicized recently and our internal/external marketing efforts. We are seeing our numbers trending up for the last three weeks from the lowest numbers in week three of March.”

But I mean that that's awesome that things are starting to trend out for you, Andrea. There is a lot of fear and this is going to be something that even when this thing's over, we've got to overcome that. 

Like, that fear is still going to be there especially for some of our older patients that might have comorbidities, be immunocompromised. 

There's a big uphill battle. And I'm glad to hear that it's starting to loosen up for you. Hopefully that's the story for everybody here soon. 

The marketing efforts they will pay off. At the very least, you're laying the foundation for that reopen, whenever you're getting back. 

So say you aren't seeing anybody right now. You're at least laying that foundation for that next step in the processing, getting back to basically recapture and retain the people that you had before and that's kind of what Brad's talked about.

Brad, would you mind giving some people some ideas, some of things that they can do right now, to try to help with that retention, to try to help with the people that they've already lost?

And even to hopefully, maybe even get some referrals out of that from other people by showing them value between now and that date?

{Brad Cote} For sure and it goes back to kind of saying the same thing again.

A lot of the retention goes back to communicating. We'll do phone calls or following up with people. 

We'll ask them, “How are you doing? How can we help support you?”

And in one instance, a couple weeks ago, what happened was people are saying, “I need some accountability, I need to move. I'm feeling stiff, like my body's starting to rust.”

So what we did is just put together a zoom call, basically, where people could go on and we would instruct them through, “Okay, here's some basic stretches and exercises that you can do.” 

And what we ended up having is saying, “Hey, is there anyone else who would benefit from this gentleman?” 

We ended up getting patients joining us and actually paying for private sessions. To get more insights specifically for them.

Simple as asking people what they want and then giving them or creating something specific.

{Ray Berardinelli} How do you retain those leads right now?

{Brad Cote} Well, a lot of it is building around that community. If you're asking people what they want, giving them offers of saying, “Hey, we've got a free mobility based thing come join us.”

That's a huge proponent of making sure we handwrite cards, which is tedious for like 500 people. But hand write cards, “Hey, hope you're well. Let us know how you can, how we help you…”

We're over communicating and utilizing our Omnipresence to be able to get as much contact with them as possible. 

And they have the ability to opt in or do whatever but at the end of the day, is that when they need to come back for back pain, they're going to be thinking of us just because we've kind of used inception in their mind of, “Hey, we're providing all these types of value…”

And we're and we talked a little bit last night about leveraging joint partnerships. Having others business stuff to work with saying, “Hey guys, we've got a group of people who are not moving around. Here's a workshop...:”

It's we're literally doing the same thing we would do before except we're changing the delivery of the service to utilizing online instead of offline. So workshops, we do workshops. 

If you're low back, we generally would target like runners, hockey players, and so on. We kind of change our target, depending on who we're trying to reach. 

But we really just take that and just do the same thing online. And you don't really need a lot of technical skills to kind of do that. 

We facilitate the workshop the same, promoted the same way, we're still running Facebook ads. All of that stuff is really the same, the retention is still the same. 

We're following up and doing service calls and the best we can. 

Letting people know, “Hey, I don't know when we're able to get back. But here's some things we can help you with right now. If you want help, let us know.”

You can get a workout, you can do a one on one calls. 

We're constantly doing lots of communicating with them during this process of uncertainty because the more uncertain your patients are, and the more that they're freaked out, like it was the one person (Facebook user, so I don't know who posted it), but one person said, “We have a bunch of people who are freaking out..”

Well, that will only be for a period of time until people realize, my back's killing me or my neck killing me, I need to get some help. 

The problems are still there. And all you've really got to do is just communicate and be in front of those patients so that ultimately you can know when they're ready, you can help them.

And you're not retaining them by forcing it down their throats like you have to do this. But you're being there for them and they'll make the decision.

{Ray Berardinelli} Yeah. And Andrea just actually, she private messaged me. 

But she said that what they've been doing, she said over the last couple of weeks, over the last three weeks or so, they've called it everybody that walked through the door their practice, they've made over 100 and some phone calls, re engaging people. 

And over the last, they're getting three to five new patients a week right now, even during this crisis, because they're reactivating the old people that are calling them and having a conversation with them. 

Something that you and I talked about previously was slide out and you want to kind of introduce everybody to that. 

Like how you can instead of making 100 plus phone calls, or 200 phone calls, or 300 phone calls, how you can reach out to everybody and create that without committing that enormous amount of time.

Naturally, personal interaction is better. And if you have the time, that's what I would recommend. 

If you don't, or you don't want to commit to that time, how you can start to re-engage people, start to warm those past patients back up to you.

{Brad Cote} Yeah, I mean, I agree.

My perception is like -- just do it. 

We call probably, like 500 plus people a week just to kind of, like, get in touch with them. And you know, you're paying the admin and stuff. 

But if you don't have that ability there's a slide down. We can record a message and send it like a blast or a bulk sentence.

It'd be like hitting send or broadcast like it's called. So you hit send and it literally records your message and everyone gets this pre-recorded voicemail for the phone. 

Let's say you could record say, “Hey, Brian here… Just give me a quick call to follow up and see how everything's going and how we ask for you in the times.”

Hit send and next thing you know, it's every single person on the list that you want it to go to. (Maybe not the people on that do not call list.)

{Ray Berardinelli} It segments those people out of the do not call list. We're not going to call them with ads. 

It’s a great tool to get through that armor. So we've been emailing people, we email everybody. 

We emailed them. 

Everybody's getting a little bit of  emails. How many emails in your inbox are sitting there right now that you haven't opened? 

Or you will never open? Or that you have just trashed? Or that you have put into the spam folder. 

It's still an effective media but it's losing its effectiveness every day. When you have leads or past patients that’s an incredible way to reach out to them with this blast. 

And then you'll start to get some of these people calling back. I always like to close with the “Sorry I missed you…” thing, “Hey, just give me a call whenever you get a minute…” 

Because I'm asking them to re-engage with me. I want them to call me. I want to get on the phone with them. 

And that's a great way to convert a lot of your people. Past patients lead into customers again or patients again, by reaching out and engaging with them. 

Everybody has a problem right now. Everybody's got a big problem. 

If you're at home and you're in pain, that problem is even bigger because now you don't think that there's anything that you can do. 

If you can address that issue for people and reduce some of their fear and their doubts about your ability to help them. That's how you're going to convert people. 

You're not really gonna convert a lot of people by campaigns to bring new patients in right now because there's a lot of people that are afraid to leave their homes. You're going to have to really work this retention.

This retention method right now is at well retention and reactivation is going to be your best method right now because you've already knocked down a lot of the barriers with these people. 

The new leads right now, that barrier is very difficult to knock down.

Brad, you want to share anything on that front?

{Brad Cote} The big thing to think about is -- retention and reactivation is not synonymous.

You should always have these systems in. And if you don't, your business is never going to work quite as well. You're not going to get as good of results with your patients and prospects. 

We've talked a little bit about mapping that journey out. And I know that your software does that, it's really important to map the journey out and have these reactivation and engagement based campaigns for current patients, for past patients, for prospects. 

And all these sections here, having an optimized system and strategy for those, allows you to, help more people, make more money, grow your business and have more of an impact and more freedom and everything else. 

It's important to note that, what we're talking about here, we're just adapting a little bit towards what is going on. 

But ultimately, these are strategies and things that you should be doing all the time and if you're not, you're missing out huge and you really got to consider starting to implement these things into your business. 

{Ray Berardinelli} Not to derail it, but the numbers are just staggering. 


WebPT, the biggest EMR in the game, did research that showed over 75% of people do not complete their plan of care. 

Three quarters of the people that walk into your practice, never finish their plan of care. That's like, but just that number is just staggering. 

The amount of money that is left on the table because you're not retaining your people is absolutely incredible. And then if you look at the next step, of those 25% that you retain, they are responsible for 80% of your future business. 

80% of your future business comes from actually, 20% of that 20 5% that remain, so it's a very, very small portion of your practice. 

That's why what Brad's talking about work so big, because if you make 20% of 25%, and at what 3%. If you move that 3%, 4% that's a 33% increase in business by moving those happy customers by 1%. 

You can have a 30% growth in business. The amount of money that we just leave and let go on the table is absolutely mind boggling. 

And everybody worries about getting a new patient, while the person that's really controlling the future health of their business and the future growth of their business -- not that they're ignoring, but they're not creating systems and strategies to leverage that point when they only have to make an incremental gain, to make huge growth in their business. 

It's staggering to me the amount of money. 

What are your thoughts on that? Why do we focus on the shiny new, when the thing that's right in front of us can do 100 times more than the lead gen ever could, by and large kind of gets pushed to the side?

{Brad Cote} I think it's just that what is really taught in business is like to get new people. And it's almost a dopamine response when you're like, you know, when it's going to be a personal score. 

I worked in corporate based environments for therapy and training and that's what was really driven. And there's a saying that you'll hear and it says there's three ways to grow your business. 

I actually will say it’s four. I'll give you the fourth one as a bonus. 

Some people probably know this, but the first one is -- get more patients. Well, the problem with that is, that is the most expensive and takes the most skill set to be able to do. 

But you obviously got to do that at one point. You need a system and strategy for that. You can get your current patients to buy more frequently. 

If they're doing one session a week, they go to two sessions a week. And you can get your patients to spend more money.

Can they and this is kind of a bit of ascension. So if you're a physical therapist, can you partner with a personal trainer, can you sell supplements or like is there other things that you can help not just to sell it just for the hell of it? 

But to sell something that someone is probably going to need and probably is going to go to a nutrition shop and mess up and buy the complete wrong product. 

For us we'd say, magnesium is probably a beneficial supplement. And we're not going into such a debate. 

We'd say magnesium is good stuff. What most people do is they go to Walmart or whatever and buy magnesium oxide, which is basically useless. 

We'd say, you know, magnesium, malaise, and glycinate is a blend that we use. This product is better plus you can buy from us and you get a bit of a discount. 

So we're actually enhancing the patient experience, which leads to retention because they don't need to go out and try to find all these things. I'm making it easier for them and they can make more money. 

And then the fourth thing is retain your clients and you'll see it in marketing works like those are the three ways to grow your business. Technically, the fourth one, to grow your business is -- retain. 

If you got 100 patients, maybe a lot or less to some of you, but you got 100 and every month I lose  20 patients, it's exponentially harder for me to get new people to replace them, then the person who just loses five. 

If you work on retention, think of how much money that is, each patient pays you 100 bucks a month, and you got 100 patients, like you're losing so much money with the 20 that are falling off. 

Why not have a system to fix that? And it's really not that difficult. A lot of the stuff that we implement is really basic, small things to engage the community to get these people working. 

Example that I can give you is there's a physical therapist, and he's in Canada, and what we were working with him on is always getting new patients. And so his whole thing was about getting, I need tons of leads, and I need 100 leads from Facebook. 

And that's the first problem is that leads don't mean anything because it's the quality of the leads. Anyone can go out and get a ton of leads, just give a good offer to whoever but whether those people are going to convert that's kind of another story. 

So his whole thing was I need to get tons of leads. I need to get new patients. 

When we sat down and looked at the amount of people that were falling off from his business and the amount of people he needed. I'm like, “Well, why do you need to get so many leads?”

“Well, I need to make more money.” 

“Yeah, but why are you not making money? You're selling like 20 new patients a month? How are you not making any money?”

The reason why is because he's spending so much money on the front end trying to get new people in. And in the meantime, he's not getting results. He's not getting in referrals. 

What we really did was say, “Okay, let's pump the brakes on finding new people. We're going to start emphasize as much. We're going to fix the back end.”

And over the course of six weeks, we are focusing on implementing strategies to retain patients. And what happened was he was able to retain (I can't remember the exact numbers specific to how many it was) but he ended up retaining a lot more patients. 

And with that, what we're able to do is get referrals from those people who are getting better results. 

So without having to spend as much ad costs. I think we probably went from about 2500 bucks a month, maybe 500 or 600 just on Facebook ads. 

Cut off a lot of his ads expenses and all of that extra money is now cash that we can use in the business. I like to actually put money towards retention. 

And in my marketing budget, I put money from a marketing budget to a retention budget, because retention is marketing, in my opinion.

Some of that money that we take, we put into the retention aspect and we use it to stimulate referrals and so on. So he ended up getting more money, more new patients and more money from cutting his adspend costs, just by keeping his patients and getting referrals from them. 

He ends up having 5000 or 6000 around there, I believe per month, more just from that simple switch, or in the course of about six weeks. So it's not like something needs to be, you know, going to take you two or three years to be able to do it. 

You can implement these small systems and strategies right away. And in  four or five, six weeks, you end up having something that is able to generate you referrals, stop drop offs, and you end up having maybe a couple thousand more per month depending on setup of your business.

If you're a massive clinic, I've seen people make $20,000 more a month from that. And this speaking from experience of me consulting going into clinics that just like completely going out the door as fast as they're coming in the door -- maybe even a negative ratio on that. 

{Ray Berardinelli} I can't agree enough, man. 

If people would hear what you're saying, it would mean everything to their business. We as physical therapists in general, I'm generalizing here, this isn't everybody, a lot of people in this group already get it. 

But there's two things that we think about, we need new patients, and we need better skills to bring in and retain new patients. 

I keep coming back to this story. It's one of my favorite stories.

Read the book, great book. He's talking about a hotel experience he had. He tells everything about the hotel, he talks about how I went into the hotel, how nice it was. 

He was talking to the woman and she was really attentive. And he was noticing that a ribbon matched the ribbon on her hair. Within two to three minutes, the bellhops there, she's making small talk the whole time. 

He's not really noticing. She asks him if he's hungry. He says “Yes.”

She says, “Well, we reserve some reservations at our restaurant connected to us. Just for people staying at the hotel. Would you like me to get you a table?”

He says, “Yeah, I'm actually kind of hungry.”

He goes, he has a nice meal all by himself. He thinks the waiter’s just making small talk with him. 

He's drinking bourbon and having a nice evening. He walks back over to his hotel and there's a fireplace in there. And he's at the fireplace’s sled. 

And he was thinking, Man, I would really like another bourbon to sit here and watch in front of the fire.

He looks over and there, sips a glass of bourbon -- not just any bourbon. It's his bourbon exactly the way he likes it. And there's a note that says that this is your bourbon exactly the way you like it.

If you want, you can dump it out. If all you can drink it, if not, just leave it here and I'll take care of it for you in the morning. 

If you need anything. I'll be up all night waiting for your call, Karen, which was the girl who met at the front desk. 

He sits there and drinks his bourbon and enjoys the fire that they started for him. And he goes to bed and he wakes up in the morning to the smell of coffee. 

And there he goes over, he had two coffee pots set. Not just any coffee, it was his coffee. 

There was a note there from Karen saying, “Hey, this is your coffee. We know this is a cream you like it's in the refrigerator. If you need anything, I'm down at the front desk waiting for your call.”


And he's sitting there drinking his coffee. He's like how the hell didn't know this was my coffee and they remember the way he made small talk with him and got this information from him. As he's sitting there enjoying it, and he's like, how did they know? 

And then I remember talking to her up front, she asked me to wake up, I was like, I wake up every day like 7am. So she set the coffee pot for 20 minutes before he got up, so it was ready for him. 

Then there's a knock on the door, and there's a newspaper and he's in San Francisco. And it's his newspaper -- it's in New York Times. 

And he picks up the paper and he's like, how do you think they know? 

And then she remembered when he came in, she was talking about the newspaper. She was reading an article in this newspaper, and she loves this newspaper. 

And he just mentioned that he's a New York Times guy. 

Okay, this whole story, the whole thing that happened to him and he said him and his wife go there at least once or twice a year now for this specific hotel that he just went to by, just to stop. 

He was looking for somewhere to rest one night. None of it had to do with how clean or nice the hotel was. None of it had to do with a thread count, or how soft the pillow was, or any of that, or how nice the room was.

The whole thing was about the way it made him feel -- that they heard him, that they listened to him and that they did something about it. 

In your practice, that's what Brad's talking about this retention and spending money on this retention in your practice. That is the mindset that you need. 

You need to look at this thing, as how can I create this experience for them? 

That is not just going to be like, “Oh, that was great.” It was gonna make them go, “Wow. That was incredible. How did they do that? How did they know exactl know…”

You have to make them think.

This is everything in your business. If you want to grow your business, do it. 

Spend that money, at least some of that money, on creating this experience for your people. 

If you can do that, you can pretty much stop the upfront ads because you'll be full -- you'll be absolutely full. 

Brad, any thoughts on how you could do little things within your practice to implement stuff like that to make the person go -- “Wow, this was a little bit different.”

{Brad Cote} I call that curating the experience. I got the idea off a book, there is one called Predictably Irrational. It's probably one of my favorite books.

And what it does, it talks about people, how they make decisions. A lot of how they make decisions is based on past experiences.

Just an idea is that a lot of people, especially people who are getting physical therapy in like the medical bay setting, the hospital-based setting, the reality is those people generally do not have a good of an experience.

If you can create a great culture and a great curated experience, those patients are always going to come back to you. And if for some reason those patients will go somewhere else, Predictably Irrational talks about people always compare.  

I'm not going back to this place ever again because they didn't give me my coffee and all that stuff. Things that we do, if you got the front desk or if you don't have the front desk, you just do it yourself, it’s knowing everybody's name and everything that they do.

For us, what we use is a CRM and enter everyone’s information so the front desk person, their focus is a lot on retention. 

That's why the front desk person is there, they're there to retain people. We also have an acquisition person, primarily they do stuff in the back and not interact with people as much. 

You have got someone at the front -- retention based. And what their goal is to make every person that walks in feel like a celebrity.  And if you can have them, know their name, what's going on with life, have good conversations and just like what you said have coffee set up for them.

It doesn't cost much. I think we spent $300 a month on little extras especially for those big spenders. 

We have these people who spend 25k a year for their family. And if they want a lemongrass tea, sure, do you want it in a cup or mug. 

Especially for the higher-end people, you would want to curate and make sure they feel really good and you give them a little bit of extras.

But everyone gets a towel, whether they ask for it or not, they've got coffee ready. Do you want to read a specific magazine, sure, you want to take this one, go ahead. 

We do whatever we can to make that experience.  And what we do is I create a thing called a patient's success journey. And we give it to them right off the bat.

Basically what it is, it outlines what the plan of care looks like. Typically when they are going to see results, when we are going to follow up with them, we are going to ask them for referrals, we explain and basically indoctrinate them into the culture.  

I really think that this is an important aspect because a lot of the time people feel, especially in healthcare, feel uncertain when they come and see you. They may have had a bad experience with someone else before and they're thinking…

“Do i need to get medicated?” 

“Is it going to hurt me?” 

“They did acupuncture, I was bruised last time.” 

“I can't do these exercises and it’s a lot of money.”

All of these things are going on in their head. The more that you can help them feel relaxed, the more that they are going to be able to connect with you.  

And at the very least, with had this before where we really had a good experience, even if it's a prospect coming, we give them a book that is specific for them.

Basically just make an ebook and print them out. But we have a care pack. You come in and you’re a walk-in, you want to learn a little bit more of what we’re doing.

What we end up doing is create a care package and give it to them no matter what. And a lot of the time people who are shopping around, they’re going to go to your place. 

Everyone is welcoming, you’ve got like a shock and awe box they have got a good set up. And then go to a place across the road, where they have chairs that are uncomfortable to sit in, the person is texting behind the front desk. 

I have even seen high-end places where the front desk person is hiding, playing a video game. I don't know what they're doing behind the desk and they never greeted me one time. And these are places I went in to go consulting with. 

I would just go in randomly, ahead of time, and just observe. A lot of times, I sat there for 20 minutes and they didn’t see me.

If you can curate that experience,  it is really important to be able to retain those people. And how you can do that now, is hand write cards, like what you've said.  

Everyone is competing for email inboxes.  Pick up the phone and call someone. Write a card.  

If I could write 100 cards, if you have 100 patients and you wrote 100 cards, just with your handwriting and you wrote a personalized message and it took you three hours to do it, that is a really good investment of your time.  

It just helps you stay top of the line. 

I’m not saying you can get 10,000 sales from doing this.

{Ray Berardinelli} A little secret. Your patient does not know the difference between your handwriting and somebody else's handwriting. You don’t have to necessarily write them.

Just in case somebody does not know shock and awe.  Shock and awe is a form of marketing, so we said the mini shock and awe packages for the patients.  

Shock and awe is something that you give to somebody -- it is the shock and makes them go awe. It is based off a desert storm shock and awe.

It is to meet them with an overwhelming force, that they can’t just ignore. You're giving them this thing and they say wait a minute I just walked in and they gave me a little gift -- what is this?

That is going to create a little something different for the patient.  

Than when they walk in and absolutely get nothing.  

If you hand them stuff in their journey, hey try this, see if this works for you, here some therapy.   It doesn't even matter what it is; it is more of the fact that you are going out of your way to create something for them, that you thought of them and you are giving them something.

It creates a total different experience than not being there. 

I just want to give a little bit of a context just in case somebody didn't know what shock and awe was. 

{Ray Berardinelli}  Brad, let’s talk a little about your group. I assume you are teaching people this stuff within your group.

I have been scrolling along the bottom below there. If you want to talk a little bit more about your group, tell them about your group and how you are helping people there.

{Brad Cote} The group that we got on Facebook here -- is Marketing and Growth Strategies for your Health Practice.

And really what I am doing is taking the different components of what I am using right now with my businesses and with clients in sharing condensed versions. 

It is meant to be a community of people so that you can ask questions and I'll be posting different content in kind of helping you guys along.  If you are looking at implementing some of these strategies -- retention or marketing based strategies, learning more about Omnipresence; you can join the group and go to some of the contents there.  

And ultimately, get help on directing yourself in the right path.

{Ray Berardinelli} That is great. Everybody, I recommend, right now, as soon as you are done,  check out Brad’s group -- the Marketing and Growth Strategies for  your Healthcare Practice. 

There is a lot of great stuff there. It is going to fit and well and it's going to help grow your practice. I couldn’t tell you enough.

You really should join that group, if you're not already in it. 

Leverage  the tools. Brad has been giving away stuff for free,  what does he have to lose?

There is so much value in the stuff that we are talking about and he is teaching over there that you can't afford not to take advantage of it.

Brad, anything else you want to share with people in parting?

{Brad Cote} I always like to say this in podcasts and videos -- just remember this, the client/patient/customer doesn't need you, you need them.  

And when you think of the relationship in that context, it allows you to make better decisions.


If you are thinking, how can I constantly improve my patient’s experience  and result? 

And you're driven and passionate towards that; it will allow you to make better decisions on your systems or structure, your strategy and everything else. 

Another thing to follow up is you've got to take action. Taking an imperfect action is the best step. You cannot let fear drive you.

If you're scared of picking up the phone and calling someone, or you are scared of doing a marketing campaign or sales or whatever, you just got to do it and taking action is the first step.  

If you do nothing, I can guarantee you that the result will happen is you're probably going to be worse off than not doing anything else.

Take action. Try stuff out. And you will find overtime what works and what doesn't.

Those who try stuff  and fail faster and do with a growth mindset  are the ones that would want to progress.

They will be able to help.  Why did we even get into this health profession; if it wasn't to make a ton of money because if that is the goal you can go to another industry.

If you want to help people improve their lives, the better business that you can build, the more support you can give to those patients in your practice.

{Ray Berardinelli}  A great thing that you were talking about right before we went live was something that you were saying of being afraid. 

And I was telling him the story that the first thing that when I did this first “live” and I was just scared out of my mind. I was just sitting there and I'm sweating, physically sweating. I'm so nervous my hands are clammy. 

And now I enjoy this. I like coming on here and talking to people and sharing things with people.

Guys do it.  Take the first step.  Know that it is going to bother you.

You are not going to be comfortable with it. It is not going to be something that you enjoy the first time, the first couple of times, you are going to suck. 

Each time that you practice getting better, reaching out to your patients, picking up the phone and calling them, the less uncomfortable it gets. 

Each and every time until it becomes something that you are very comfortable at. The success is going to happen when the comfort finally reaches.

When you start to really get comfortable  talking to them and you are comfortable conveying to them, they are going to know it and they will become more comfortable with you and take your offers up more  and re-engage more or whatever the goal of your plan is.

Take that imperfect action. Get a little bit sweaty, get a little bit clammy, push through it. Keep going until you get there.

Brad, thank you so much and I appreciate you coming on here and sharing all of your experiences with everybody.

If anybody has some questions for Brad, please just put them down below. 

The patient experience stuff that he is talking about  and  the way you can grow your business through Omnipresence and retention and reactivation is absolutely huge.

 He is a great resource, so any questions you got below would be great.

 Brad thanks for coming on and sharing with the group. I really appreciate it.

Everyone, thank you for joining another episode of the PT Business Builders show where we believe EMRS suck; that systems and software should improve your life and your practice, not consume it. 

And here the only measure of success are systems that give you the time to enjoy your life and the financial freedom to do that.

Brad, anything you want to say in closing?

{Brad Cote} Thanks everyone for coming here. If you have questions for me, just give me a shoutout. 

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