E802 | Three Drop Off Points That Are Killing Your Clinic

If you run a cash-based or hybrid physical therapy clinic, chances are you’re focused on one main metric: converting new patients into a plan of care.

That’s important—but it’s just the beginning.

There are three major drop-off points in most clinics that hurt revenue, limit patient outcomes, and kill long-term growth. Most business owners only focus on the front-end (conversion), but the real opportunity lies in what happens after that.

Here’s how to tighten up your system and dramatically increase patient retention, referrals, and recurring revenue—without needing more new leads.

Drop-Off Point #1: Conversion to a Plan of Care

Let’s start with the obvious: when a new patient walks in for an eval, you need to help them understand why they’re there. Not just for the knee pain or back issue—but the real reason.

• “Why is this important to you?”

• “What is this stopping you from doing in life?”

• “How is this affecting your ability to be present, productive, or fulfilled?”

When you can connect their physical problem to their personal why, they’re much more likely to commit to a full plan of care.

Most clinicians convert between 50–90% depending on their skill and setup. If you're on the lower end, this is your first lever to pull.

Drop-Off Point #2: Completion of the Plan

This one is sneaky.

Even if you’re great at selling packages or getting people to commit to 10 visits… they often drop off around visit 4 or 5.

Why?

Because they feel better. Symptom relief kicks in, and they assume the job is done.

Your job is to explain why it’s not.

This is where most clinicians fail. You’ve got to reframe the work they still need to do—not just for short-term relief but for long-term transformation. Otherwise, they leave, regress, and think you didn’t do your job.

Tip: Schedule all visits on Day 1. “My schedule fills up quickly, so let’s go ahead and get your next 6 visits on the books—we can always adjust if needed.”

Drop-Off Point #3: No Continuity Offer

This is where most clinics leave thousands on the table.

After a plan of care ends, what’s next? Do you have something to offer?

Most don’t. And that’s a problem.

Here are just a few continuity options that work:

• Monthly manual therapy (yes, “maintenance” is a bad word, but patients love it)

• Remote programming with check-ins

• In-person small group training

• Hybrid models that combine hands-on care + training

• Performance coaching tailored to their long-term goals

If you don’t offer anything, you’re missing the easiest sale you’ll ever make: someone who already knows, likes, and trusts you.

The Compounding Effect: Real Numbers, Real Growth

Let’s compare two clinics with the same number of new patients (10/month).

Clinic 1:

• Converts 50% to a plan of care = 5 people

• Gets 50% to complete = 2.5 people

• Converts 50% to continuity = 1.25 clients/month

After 12 months = 15 continuity clients
At $200/month = $3,000 in recurring revenue

Clinic 2:

• Converts 80% to a plan of care = 8 people

• Gets 80% to complete = 6.4 people

• Converts 50% to continuity = 3.2 clients/month

After 12 months = 38 continuity clients
At $200/month = $7,600 in recurring revenue

More than double the revenue—with the same number of leads.

Track It. Improve It. Grow.

If you’re only looking at plan of care conversions, you’re flying blind.

Start tracking:

• Conversion %

• Plan of care completion %

• Continuity enrollment %

Benchmarks:
✔️ 70–80% Plan of Care Conversion
✔️ 80% Completion
✔️ 50% Continuity Enrollment

Don’t be an amateur who only focuses on the front end. Be the pro who builds systems that turn new patients into lifelong clients.

Want Help Building This Out?

If you’re ready to level up your clinic and turn one-time patients into loyal, long-term clients—we can help.

Book a free strategy call at physicaltherapybiz.com and see what’s possible for your practice.

P.S. – Your patients want more than pain relief. They want to move better, live stronger, and stay active long after the injury is gone. Are you giving them that opportunity?

 Do you enjoy the podcast?  If so, leave us a 5-star review on iTunes and tell a friend to do the same!

Ready to elevate your practice? Book a call at the link below with one of our expert consultants today and start your journey to delivering unparalleled physical therapy.

Podcast Transcript

 Danny:  Four to eight hours a week. That's what we have found that we can help clinicians save just by using our AI documentation tool. Claire, head to meet claire.ai. Get signed up for 10 free notes that you can use to test this out and see how it can help save you time. Not only does it listen to your note and document the soap note effectively, but also creates a visit summary that you can send your patients after the fact to help with compliance and help them have clarity.

With what the plan is going forward so that you can help them get the result that they want. Now, if you're tired of having to write notes and you want your virtual assistance tool, Claire, to help do that on your behalf and save four to eight hours a week. Head to meet claire.ai. Get signed up for 10 free notes and test it for yourself.

Hey, are you a physical therapist looking to leverage your skillset in a way that helps you create time and financial freedom for yourself and your family? If so, you're in the right spot. My name's Danny Matta, and over the last 15 years, I've done pretty much everything you can in the profession. I've been a staff duty, I've been an active duty military officer, physical therapist.

I've started my own cash practice, I've sold that cash practice and to date my company, physical therapy has helped over a thousand clinicians start, grow, and scale their own cash practices. So if this sounds like something you wanna do, listen up. 'cause I'm here to help you. Hey, Danny Matta here, founder of Physical Therapy Biz.

And today we're gonna get kind of tactical. I know we get this a lot. Uh, a lot of people listening to the podcast watch YouTube channel, they wanna know, Hey, let's get into the weeds, let's get tactical. Let's talk about the things that are actually working in the clinic. They're gonna help you really succeed.

And this is something I wanna do today, uh, where I wanna talk about three drop off points that we see in clinics that you can start focusing on right now that are gonna help. With throughput through the entire sort of business system that you have to help you improve, uh, both referrals as well as recurring revenue.

Okay? So the, just these three areas, if you just focus on these alone, should dramatically improve your practice if you're not tracking these already. Okay. So let's talk about, you know, kind of where we see these drop off points and what you can do about it. So, number one, let's talk about these three areas.

So the first one. Is in your conversion to a plan of care. Okay? So this is when somebody comes in your office and they have an initial evaluation with you and they decide whether they want to solve a problem, uh, for the long term, or if they want to, or they don't wanna do that, right? Or if they, they maybe the, maybe they, um.

They decide that it's not, uh, you know, the, the right fit for them or they don't see enough value in it, whatever it might be. This is your, in some cases considered package conversion rate, right? So a package of business is what many people are, are using as far as setting up a plan of care. There's, there's multiple ways to do this, but this is just a variation that's very common.

So you might say, alright, cool, you are a, you know, 40-year-old man, uh, who has knee pain and back pain. Like, you know, I would fall into this category. Uh, you, you got some work to do. This isn't gonna happen overnight. Um, my recommendation is 10 visit package that we can spread out over about the next three months.

Here's what that looks like. And, um, you know, then we can get to the point where we resolve symptoms. We really start to make progress in terms of you being able to resolve this long term and we teach you how to keep it that way. So I say, okay, cool. Like, I'm either in or I'm out. And, uh, this is something that, you know, we'll see people convert anywhere between 50 and on the high end, maybe even 90%, uh, based on the population they have come in and, and their staff.

Now you're gonna have people that have acute injuries and things that's, it's a youth soccer player that's spraining their ankle, you know, something like that. They may see a couple times. There's no reason for them to commit to a big plan of care if they have something really simple. Um, this is a portion of what we see that comes in the clinic, but more often than not, a lot of the people that we work with.

They're dealing with either chronic or, you know, uh, acute issues that are typically chronic in nature as well. They've just been exacerbated with something that they've done recently. So these are, these are usually gonna be longer periods of time that we need to work with somebody to make these habitual lifestyle changes, to improve mechanics, uh, to build strength, to improve mobility, uh, control all the things that we help people with outside of just symptomatic change, which typically happens pretty fast.

So getting somebody to commit to a plan of care is, is a big deal in these clinics because. It eliminates drop off. It helps hold them account accountable to the changes that they need to make. Because most people are gonna drop off around visit, kind of two to three. Uh, if they don't do this, this is where they see symptomatic change.

They, they don't realize that the job isn't done yet. They still have work to do. Uh, there's not a long-term change in place. And, uh, so they're like, cool, I'm, I'm good to go. But then their symptoms come back and they think you're not very good at your job when in actuality we know we have a lot of additional work we need to do in order to, uh, save that change.

If you were to think about it that way, really to create a long-term change. So this is the very first part. So this is. Conversion. Okay. So conversion to a plan of care where they decide to do that or not. The, the, the second, uh, portion of this is actually just as important and it's completion, right? So, so it's actually the plan of care you set out, let's say, you know, in this example, 4-year-old male knee and back pain, I.

Three months, 10 visits is what I tell 'em. Basically gonna be this, we'll probably see it once a week for the first, uh, you know, four weeks. And then we'll start to spread it out every other week for the next, uh, you know, two months as we really start to build strength and, and build a program out for you that, that's gonna require you doing a lot of, you know, exercises and, and, uh, mobility work that's specific to the problem that you have.

But like, we can't, I can't do your squats for you, right? Like, I can't do those reps for you. You have to do them. We have to build that and progress that. For you specific to the problems that we find, right? So, so we may see you, let's call it, uh, you know, 10 times over that, that, uh, that, that three months, right?

So four the first month, and then let's just say three and three. 'cause my math was off. So four month one, and then three month, two, three, month, three, right? Um, so we start to spread it out a little bit more. What we want them to use their visits. This is really important. So one of the big mistakes that people make is they.

Are great at selling a plan of care, and then they're really bad at getting people to complete the work. And this usually happens when somebody gets about halfway through a plan of care. They're five or six visits into a 10 visit, uh, program and. They're like, I'm good. You know, I don't need to come back in.

And what has typically happened is the clinician has done a bad job of educating them on why they need to finish this plan of care. So we know symptoms will result, especially for a clinician that is a pretty good manual therapist. Like if you're doing dry needling, you're doing some hands-on work, you're, you know, you're a good manual therapist, you can create a symptom change relatively fast.

The, the structural changes that need to happen take time and they take effort and it takes, you know, the right uh, exercises, the right, uh, amount of dosage, all the things that we have to be able to help people with, and compliance and accountability. I. So when someone drops off halfway through, what happens is those visits just sit there and they sit on your, your books as what would be considered, you know, uh, visits that you haven't earned yet.

So, so that's revenue that you haven't actually earned, and that is not something that you want, as well as you don't want that for the outcome for the patient. So we wanna get them to. Finish their plan of care. Come in, come to your visits, finish your plan of care. This is, this is what you need. This is what we have to get you to do in order to get the outcome that we want.

'cause that's essentially the biggest part of this, is getting them that big outcome, that long-term outcome where they can get back to things that they like doing with the people that they like doing them with. Right. And if they only do half of it. They're not gonna get the full benefit from the actual program.

But the other big thing is you have these that just sit there and then eventually maybe they come back in for other things or whatever it might be, but, but you just didn't do as good of a job as we would like to see of you actually implementing the plan you're telling them they need to do from day one when they commit to it, right?

So this is actually completion of the plan. And then the third big drop off point is from completion of plan to some variation of a continuity offer that you may have, you know, to offer them. And there's a lot of different variations that people have with this. I'll say the, the sort of most common ones that we see, um, are, it might just be, uh, an ongoing visitor, two a month maybe.

They really enjoy, uh, manual therapy, right? Maybe they really like to get, uh, hands-on work done by you. You're really good at it makes them feel better, you know? They can, they can, uh. Train harder, they can be more active and, and this helps them stay that way. Right? There's definitely a place for what's considered like maintenance, which I think is historically a terrible word in the, the physical therapy world.

But people like it, you know, it, people go to chiropractors, massage therapists, acupuncturists. They, they, they go and see people stretch labs, uh, for things like this on a, on a weekly, monthly basis. And they see a lot of value in it. And if you don't think that people see value in it, then you're just wrong and you're, you're drop, you're, you're really losing a lot of money.

Uh, and leaving a lot of money on the table that you could be making in your business for something that they see a lot of value in anyway. So there's gonna be a percentage of people that want to do hands-on work with you if that's your skillset, right? Some people might want to do remote coaching with you.

Maybe they like the way that you build their, their programs out, especially as you build them back up towards the tail end of their plan of care. Because it starts to look more like training and they say, man, my body feels really good whenever I train this way. Um, I don't feel as beat up. I feel like I'm making really good progress.

My joints feel better. I feel like I'm getting stronger without having any setbacks that I was having when I was training a different way. That's awesome. Cool. We can definitely keep doing that. And maybe it's a variation of, uh, just the, just a program. It could be just straight that, right. It could be that with communication, it could be that.

Plus an in-office visit. So you could set that up to where it's a combination of an in-office visit and programming. Um, it could be any, any variation of, of this, but a lot of people do really well with the style of actual programming that we do as clinicians that understand strength and conditioning variables, and we can build that for them.

Right. So that is a, a very, very. Uh, successful continuity, uh, uh, option for a lot of people. The the third thing would be some variation of in-person, um, training and conditioning, right? So maybe you have, uh, in-person small group work. Maybe you have personal training that you offer, um, you know, something in-house that's gonna be in-person that's not necessarily digital or just solely focused on, uh, you know, manual therapy or getting somebody to feel better symptomatically.

Uh, and, and for a lot of people moving them over to something like a small group training. Uh, you know, group is a great continuity offer and something that they really like. I mean, imagine if you keep getting hurt at a gym. And you don't know what to do for training, but you don't wanna do it on your own with a program.

What a great way to, to continue to get healthy and stronger and bridge, you know, from going from physical therapy back to activities that you want to do with a, a small group led by a physical therapist. Like what a great place to do that. Misery loves Company is a great way to train. You can have the program by somebody that understands the injuries that you've gone through.

Great continuity offer, right? Um, but having something in place. Hey, sorry to interrupt the podcast, but I have a huge favor to ask of you. If you are a longtime listener or a new listener and you're finding value in this podcast, please head over to iTunes or Spotify or wherever you listen to the podcast and please leave a rating and review.

This is actually very helpful for us to get this podcast in front of more clinicians and really help them develop time and financial freedom. So if you would do that, I would greatly appreciate it. Now, back to the podcast. For people to then ascend to is really important. Right. And if we look at the numbers on this, like this is, this is, this is where it makes a meaningful difference in your business over the course of, you know, 12 months.

So let's say you have 10 people, uh, that come into your, your office. And let's say, let's say there's two different clinics, right? Clinic one, they have 10 people that come in, 10 new, new patients that come in and they convert to a plan of care at 50%. Okay, so their first drop off point, they go from 10 people, five, decide that they wanna solve a long-term problem, commit to a plan of care.

Okay? So five outta 10. Now let's say that they have a 50% drop off in people that actually commit, the people that finish a plan of care. So now they went from five people that committed to now two and a half people. That have actually finished the plan of care. That means two and a half other people have dropped off and they haven't actually finished their plan of care.

Now, let's say you have 50% of those people that move to a continuity offer. Now you have 1.25 people that have moved to something ongoing from what you've, you know, what you've offered them that have finished a plan of care. That that, which is, by the way, the highest group of people that's gonna move over to continuity.

Is people that have actually finished their plan of care because A, they put the work in they're, they like what you're doing. They have got the outcome that they're looking for. That's the most important thing, and they're ready to see what else you can help them with because you're obviously awesome.

So this is clinic one. So clinic one starts with 10 and at the end they end with one person doing continuity work on a monthly basis. Some sort of offer for them, right? Clinic two, let's say they get the same people, same 10 people, but they're better at converting on the front end. They understand how to have conversations better.

They understand how to actually help people achieve long-term goals and, and have conversations with them about why they're actually there when it's not just their knee pain. So they convert 80%, so eight outta 10 people move over to a plan of care with them. Now, let's say of those eight outta 10 people, 80% of those people.

Finish their plan of care, which this should be really hot. They've already committed to it. You just gotta get them to come in. This should actually be the easiest thing for you to continue to do. Getting somebody to commit to a plan of care should be harder than getting them to finish a plan of care.

So let's say 80% of those people actually finish it. Now we've got basically six and a half people. That are going to finish a plan of care. Right? Now, let's say we just have 50% of these people decide that they wanna move over to a continuity offer, same conversion percentage as clinic one. Well, that's gonna leave you with a little over three people versus one, uh, person in clinic one.

Now, if we take those numbers and we say, what does this look like? If this happens every single month for a year, not even looking at the front end revenue from the, from the actual plan of care. Let's just look at the actual continuity revenue that's coming in by the end of the year. Clinic one is gonna have 12 people.

If that, if that one person each month sticks forever, they're gonna have 12 people at the end of the year that are coming in for some variation of a continuity offer. And let's just say that that's $200 a month, right? That it is just to put a number on it. Well, they're gonna generate $2,400 in revenue off of that one person in continuity, uh, revenue off that one person each month.

It's gonna snowball to 12 people. Clinic two has three people. Three people that come in each month for continuity offer and that snowballs by the end, they have 36 people. That's $7,200 in continuity revenue. If it's $200 per person times 36 people by the end of the year, would you rather have $1,200 or $7,200 at the end of a year for literally the same number of new patients that are coming in?

This is what we're talking about in regards to tracking the right things because most clinics, the number one thing that they focus on. Plan of care conversion, which is fine because that's actually where a lot of people suck. And if you can just get better at plan of care conversion, that can have a very meaningful difference for your clinic it alone, right?

Just by that alone, if you go from converting 25 people to a plan of care, to 60% of people to a plan of care, your revenue's gonna improve dramatically. But you're missing all the rest of this. And there's this, uh, phrase, amateurs focus on the front end. So amateurs focus on just that initial. Uh, plan of care.

That's it. And they forget about all the rest of it. And if you want to become a better business owner, if you wanna become a more advanced business owner, you have to look at these other drop off points. 'cause they're just as important if not more important. Especially when we start to look at continuity.

I. So completion of a plan of care. You gotta get people back in. Schedule people out for visits, get get them set up for four to six visits, day one, build it out. Say, Hey, my schedule books up really quickly. Let's go ahead and get you scheduled for the first six visits of this, you know, first six weeks in a row, or whatever you want to do.

Let's get it on the books. If we need to reschedule something, we can do that, but I'd rather save a spot for you while we can do so. Awesome. Book out the business as much as you can get them in to finish a plan of care, finish to completion. Because if you can't finish to to completion, you have no chance of a secondary sale.

You have no chance to actually move them into something that's gonna, uh, help with whatever their goals are long term. That's, that's just as important, if not more important then where they're at right now trying to solve an injury. Right. So you gotta focus on getting them in. You have to, you have to.

Communicate with them the importance of doing the work, right? You, you can't just do half the work and expect that, that it's going to, it's gonna all turn out as well as it would if you did all of it right? You have to finish the drill. The the third part, and this is where a lot of people. Don't track it at all is how many of these people are sticking around.

This could be buying another package of visits they just wanna chip away at, because they like coming in to do manual therapy work, right? This could be doing some sort of structured membership with you in person, ongoing. This could be remote program, this could be small group work, this could be any number of things that you have.

They're gonna help them achieve their long-term goals. Of being healthy, of being active, and being able to live a high performance pain-free life. That's what so many people want these days. They don't know where to find it. And now they're in your office and you have a chance to legitimately change their life by getting them into a small group where they can train and they can get stronger and they can move better, and they can be around other like-minded people.

And if you don't finish their plan of care, you got no shot at actually getting them into this continuity offer. So you gotta finish the plan of care, and then you have to give them an opportunity to do something ongoing that's gonna help them achieve their goals. And when we see people do this. It not only allows them to work with people in a much more meaningful way, but it will change your business.

So remember, these are the three big drop off points you can focus on. So number one, conversion. This is what a lot of people focus on. Make sure you're having conversations about why they're in the office, not necessarily because their knee hurts, but like why? Why is it important, you know, for you to be healthy and active.

Oh, because you, you coach your kids sports teams and for you to run around on a basketball court, you know, with your middle school kids, uh, is, is causing you a lot of pain and you can't do that. Awesome. Now we know why you're there. Now we have, uh, something we can hold you accountable to. Now we have something we can talk about that is a driver of you doing this uncomfortable stuff we're gonna have you do between manual therapy that probably didn't feel so good.

And weird little exercises that are uncomfortable, uh, and tedious. Now we can tie it to that, right? Then we get you in the office. We gotta make sure that you're finishing it and then we're gonna make sure we have something that we offer you. Maybe it's appropriate for you, maybe it's not. Maybe you're the kind of person that wants to go back to the gym that they came from.

Awesome. That's why we leave our continuity percentage at 50%, because for a lot of people it may not make sense, but for, for a significant amount, it does. And if you don't have something to offer them, then. You got, you got no continuity. You have no recurring revenue, and that is a terrible place to be as a business owner.

So conversion on the front end, completion of the program in the middle, and then continuity on the on, on the back end of the plan of care to give them an option to work with you in an ongoing way. As long as you provide value, right? That is the key. So focus on these three areas. Remember the scenarios that I talked about with these two clinics.

Which one do you want to be Clinic one that's ending with, you know, 12 continuity sessions at the end of the year, or clinic two. It's ending with 36 3 times the amount just by focusing on, uh, improving these three areas. So hope that you like this one. Hope that was tactical enough for you. These are three very important areas to focus on.

Go check 'em out in your business. See if you're even tracking these. You can at least look at your benchmarks for what, what you wanna see. Our benchmarks, we typically wanna see people be somewhere around 70 to 80% plan of care completion, especially if it's an individual clinician. Like if you're just the only clinician and you're the owner, you should be completing.

Uh, plans of care are, are converting people to plans of care. 80 plus percent, right? You should be really good at this if you have staff. 70% is, is, is good. Like that is definitely very, very, very good. Uh, completion of plan of care, we wanna see 80%, 80% of people that are coming in should finish a plan of care.

Like there's no reason why they're, they're already, they're paying you for this. Like they're, they're paying upfront for a plan of care. In order for you to help them achieve a problem, uh, or, or, or, or, or resolve a problem. All you gotta do is get 'em back in the office like 80% it, it should be the, should be the benchmark, and then 50% should move over, uh, to, to continuity.

That's where you can benchmark yourself. If you're not there and you want help on these things, head to physical therapy biz.com. Take a look at what we're doing. We help people improve their cash and higher based clinics all across the country. It's not rocket science. You just aren't a great business owner just yet, but you can be if you wanna learn that, and we can help you with that.

So head to physical therapy biz.com. I think we can help you if this makes sense to you. As always, thanks so much for watching. Catch on the next one.

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