Therapeutic Wealth

If I had an angel behind me I would have a good time.  I’d probably take a few more risks knowing that my protector was right there.  I’d probably have already tried skydiving, would have flown an ultralight again, and would have taken interested family and willing friends on the adventures so I could have plenty of people to share the memories. 

For the last few years in the winter we have had and an “Angel” behind us. 

She, Angel Harvey, and her husband Paul  attended our church sitting about 8 rows behind us to the left and rear.   When I greeted him one week  I said,  “Thank-you, Mr. Harvey, for all your GREAT radio broadcasts.”  Still speaking but making sure his wife could hear I continued, “I think my wife is just like yours [an angel]!”  When a state of the art sound and video system was installed in our church it was Angel who had shared very very generously.   Of course we sent a thank-you card.    A several weeks back we got the news that the Harveys were returning to Chicago and probably wouldn’t be back.  Angel’s leukemia was ravaging her frail frame as it had been for a year.  We offered special prayers but she succumbed to the disease at 92 years of age.    Our pastor and his wife flew to Chicago where he delivered the memorial.   It sure was a lot more fun writing the thank-you than the condolence card.  

What about you?  Do you have an “Angel” ?  Make sure you treat your spouse like one.    Though my live in angel can’t protect me from the law of gravity she is the wind beneath my wings.  She encourages me to do what I love even if it means taking a risk.   She has helped me touch the lives of many more than I could have touched on my own.  She put up with my long hours of editing and compiling the cash practice secrets home study course.    Another question she is good at asking is “What do you really want to do”?  What’s your angel saying to you?  What do YOU really want to do? 

At 4:21 p.m. today my cell phone rang the pre-programmed “home” ring.  Instead of my beautiful wife’s voice I heard, “Hi Daddy “.  ”  It was one of my little ones!  “I called you because I knew your number”!  My children are young and of course exceptional in every good way but this was a first for me.  They’ve known my number for a long time but this was a first time for one of them to actually dial and speak to daddy without my wife’s having dialed the number.  Children have such an eagerness to learn to do new things. 

If we physical therapists renew our eagerness to the eagerness we had as PT students or even 10% of the eagerness we had as children we will realize our dreams and goals.   If you know professionally and business-wise what you must do, do it.  Stretch.  If you could need some leaders to follow check out our website .  You can achieve your goals!  Email subscribers at our Cash Practice Secrets course website can get the same phone number my little one called by the way.  I and my team love to be of help. 

By the way my little one wanted me to get home soon (which I did) so we could have a swim (which we all did)- at the timeshare resort.  The water was nice! 

Have you ever wondered how a timeshare company can sell an annual or semi-annual week of ownership of a condo at a resort for tens of thousands of dollars, assess ever-increasing maintenance fees and have customers that actually come back to buy more ownership?  Though many people have bought, repented of, and lost lots of money via timeshare ownership I have a different story of my timeshare ownership that will benefit you and your PT practice should you wish to grow it.

I recently called our timeshare company, Westgate Resorts, to reserve our floating week.  The operator didn’t ask, “Who’s calling please?”, he asked, “With whom do I have the pleasure of speaking?”.  He was very kind over the phone and made sure to ask, “Is there anything else I can do for you”?  After I could think of nothing else he didn’t say, “Thanks for calling, goodbye”.  He said something MUCH nicer that made me feel so good I wanted to call again just to hear his and their phone etiquette!  To make sure I got it right, I just now called Westgate reservations again.  I got a lady operator on the phone and had her go over her ‘good-bye” with me.  She says, “On behalf of Westgate Resorts it was an honor and a pleasure speaking with you.  Have a great day!”

How will you speak to your clients and potential clients? We have very good examples in our course by the way.  Drop me a line anytime.  I frequently speak with subscribers to our email training at www.CashPracticeSecrets.com .  They get my personal phone number.

On behalf of www.CashPracticeSecrets.com it HAS been an honor and a pleasure writing to you.  Have a GREAT day! 

Lance P. Van Arsdell, PT, MSPT   email: lance@cashpracticesecrets.com

One night there was a man groping around 42nd Street.  “What are you doing?”, a passer-by asked him.  “I’m looking for my glasses.  I’m almost blind without them,” he replied.  “Where do you think you might have lost them?” the helpful passer-by asked.  “Back on 38th Street” the now visually impaired man replied.  “Why don’t you go and look there?” the passer-by questioned further.  Squinting beneath the street light the man stated, “The light’s better here”. 

Cash practice physical therapy will work almost everywhere though some locations are better than others.  Follow the piles of cash.  Several years ago I told the son of one of my cash-paying senior customers that his dad was always worried about how much the [extended “maintenance”] therapy was costing.  The son smiled and laughed audibly.   When my client’s wife unfortunately died a bit later my client showed me a full 1/2 page tribute to her life and generosity to the University of Iowa.   In our http://cashpracticesecrets.com home study course I share interviews with PT’s from 13 states running cash practices.  The locations were QUITE varied.  Not included in the course is the fact that one lady PT started her cash practice in her 5th wheel trailer 55 plus trailer court.  By the time I interviewed her she’d moved into her 1.5 car converted garage on horse property and has now expanded it to 1000 sq feet with a going fitness concern and two assistants.   Her town is known for having a rodeo, and two(?) stoplights I believe.   On the other end of the spectrum PT Phil, who also contributed to http://www.cashpracticesecrets.com runs an all-cash PT and multi-specialty practice overlooking the national cathedral.   One of those two locations is an easier place to start a cash PT clinic than the other but having the best instructors will speed your progress.   

There is a foam board on her head, a dumbell in her right hand, a blindfold over her eyes, a ball between her knees, a 1/2 Bosu(TM)-style ball under her right foot, a foam roller under her left foot, and in her hand at the end of her outstretched arm there is a Pekinese dog.   She is wearing a T-Shirt with the (slightly edited) inscription, “Pain Stinks”.

Is this masochistic Chinese Torture?  No, it is an ad I just received today for a personal trainer con-ed. class on “corrective exercises for pain and performance”.  After I write this the ad is going in file 13.  It is a two day course for $299 taught by a non-therapist CSCS.  By the way, in the background of the shiny postcard ad there is a Total Gym(TM), an exercise bench and a rack of dumbells.

You don’t have to go learn how to do PT from personal trainers but there is a marketing lesson in that ad.   We have to go for great results with our clients and must add value at every step of the way to give every patient a “WOW”.  Experience.  Another thing we can learn from this trainer is to expose yourself to the media.  This particular one had been quoted in a major newspaper.  Write, and get local media to cover you.

I have a challenge for you.   This week ask your patients this series of questions at the end of their treatments, “Did that have value”?  Maybe the next visit ask, “For example if for some reason insurance wouldn’t pay quite as much for your therapy would it still have value to you”?  Maybe the visit after that ask, “How much would you be willing to pay for services like my treatments if insurance wouldn’t pay at all”?  Work with those questions a little and get back with me on your results.  Ask them one thing they really liked about your services.  Write it down and get their permission to print it.  The best way to find out how much perceived value we’re providing is to ask.   Lance@cashpracticesecrets.com  

“How much money do you make?”  the lovely lady in the passenger seat of the borrowed old blue Nissan pickup truck questioned.   I’d met this lovely specimen of humanity the a day before and logic, wisdom, and reason had fled my cranium just seconds after that.   Unwilling to let the girl with the golden brown hair get away I admitted, “I probably make 2-3 times what a therapist earns here”.    Clearly that was “the hormones talking” but it indeed was the truth.  Back in 1996 as a home health physical therapist I was easily earning over $100,000/year.   As I’d crossed our northern border to meet this lovely lady this was even more true because the U.S. dollar at that time had more earning power than their dollar.  In those days before 27 page home-health “OASIS” forms it was quite easy to see 8-10 patients per day and collect the equivalent of a contracted $59/visit for each one of them.  My fuel costs were $100/month.  Finances were easy for any PT willing to do home health. 

Four months later on Valentines Day in the rainy mist (as you may recall from a previous post) that pretty young lady said that she would marry me.   Of course I wanted her family to meet mine before the “big day” so down her parents flew from the mist of Victoria, BC to the sun of AZ to meet my family.  Wanting to have an appropriate nest ready before our wedding day I had already started house shopping.  When my beloved’s dad saw the 2 BR + Den newer rancher with a pool and hot tub I was preparing to buy, he was incredulous.  Off to the side he told my dad, “I don’t think they should be buying such a house as newlyweds”!   ”But he’ll be paying cash for it”, my dad explained.  “Then they should have it”, my prospective father in law agreed.    An easy $132,000 check written to Mrs. Johnson and toward the middle of June 1997 I carried my bride over the threshold of our lovely new home that was all ours.  We owed nobody.

In eleven years what has happened to the wealth building ability of PT’s?  I have seen sub-contracted PT’s who get $65/visit.  Their fuel costs are at least $300/month and their paperwork load has gone up dramatically.   The cars they drive cost twice as much to replace.  With the additional paperwork most PT’s are considered full time at 25 visits/week.  Fewer visits are possible so their earning potential is no greater and in most cases considerably less.   That same house I bought my bride has since sold for $300,000.

What is driving the trend in physical therapy?  Third party payers.

With the number of medicare recipients growing and the number of people paying into medicare shrinking, change in the downward direction isn’t debatable.  It’s inevitable.  No amount of legislation will change the fact.   The laws of economics are simple.  Our PT claims to Medicare must become smaller or fewer as the amount of money available to pay the bills becomes smaller.  We have lobbied successfully and not had our part B rates cut and this year have even received a 1/2% rate “increase”.   In the last few years have you noticed your cost of living decreasing?  Though it doesn’t look like it on the books our effective spending power for unit of time billed has decreased. 

In other third party supported clinics it is difficult to find a payer better than Medicare.  Kerry Halcomb, PT who owns two out patient clinics in Phoenix, AZ says, “Medicare is the best payer”.  The infamous United Health Care has a plan that is less than the cost of providing the services.  

What then is the answer?   Increasing the quality (cash paid at the time of service) of our services.

Even if a PT isn’t interested in having a cash practice, his or her patients will progressively be paying more out of pocket for their healthcare.  Rising copays are a thing of the present and the future.  Why not make your facility sensitive to the needs of your client now before the next raise in copays?  Next time I’ll give three ways you can increase your perceived value as a PT or PT practice for less than $1/visit.   If you’d like to get some of that info for free now you can register at www.cashPracticeSecrets.com.

1) Give every one of your patients the option of paying cash from the beginning. You can give many of them incentives them to pay up front because money today is worth more than a partial payment in 90 days. James Ko, PT a contributor to the cash practice secrets course puts the cash option as option #1 on his forms. It has a check box with text behind it that says, “I will take advantage of the $30%discount [This can be a lesser discount or other benefit but I suggest at least discounting the 6-10% that it would cost you to collect that money after the time of service.] offered for paying cash at the time of service.” Remember there are many clients for which cash is the only option. I treat many of them. If you intend to treat Medicare patients you may be “non-participating” and set up your system where the client pays you directly and gets reimbursed by Medicare.

2) Respect your clients’ time and their money. Advise your patients honestly like you’d advise your own family members. You can’t have too much integrity. Those who can afford to pay cash frequently think they have very busy lives even if that “busyness” is going from one social to another. They frequently don’t want to come in for therapy three times per week if they can be taught how to do many of the treatments at home.

3) Learn everything you can about cash practice physical therapy. Take advantage of cash practice teleseminars and internet training. These will help you develop your practice and also to will let you know if you might be interested in further training from that publisher, author or speaker. Don’t spend a $1000 on a course without first checking out the free content from that author. Seek out specialized knowledge on this topic.

A free audio chapter on how to run a cash practice is viewable for those who simply register at http://www.CashPracticeSecrets.com Other absolutely free bonuses include free email /internet training and free teleseminars. These high-value teleseminars are being held at least monthly for a limited time for free for those who have opted in by entering their email address at the above web-site and then confirming by clicking the appropriate link in an automatic email. This information has been compiled by Lance P. Van Arsdell, PT, MSPT who is the president of Cash Practice Secrets. Lance has a house call physical therapy practice in Mesa, AZ http://www.AtHomeMEDrehab.com and this is the BLOG he authors for physical therapists.  Spread the word about this BLOG.  Here’s the link again: http://www.TherapeuticWealth.com .  Thanks! 

Knowledge is power.  If you know how to make your practice visible obviously you will have more customers.   One way to make your practice and career more obvious is on the web.  If a web site is static it will seldom be ranked high by search engines.  Incoming links to one’s site enhance your presence on the web. Having your Technorati Profile  completed can also increase the visibility of your blog.  If you appreciate what you learn here tell your friends and build a link from your site to this blog.  Spread the word!  Happy webbing!

At about 12:15 p.m. today I saw my PT acquaintance Scott’s pickup along with another vehicle parked near the door of one of his clinics.  This didn’t look good.  I’d seen signs of a possible move out previously and stopped to see what I could do to help.  I had already left him messages by phone too.  Today it was too little too late.  Scott was indeed moving out - closing his doors.  His financial partner was going on with one of the other two clinics without him.  I doubt the split was because they were making too much money.  Scott is a very good and conscientious PT.  I’d personally seen him doing muscle tests with objective dynamometers.  I know he tried his best.   They were “in-network” with at least 25 insurance companies with a “multi-plan” agreement.   I asked if I could help him later as I had a cash-paying customer at 12:30 not far from his office.  They were nearly done moving out but my heart goes out to them.  I will be of help however I can.  For now he’s taking a job in a skilled nursing facility. 

I just can’t end on that note.  I promise to be upbeat. 

 Several years ago a large home-health care agency that I worked for closed down and couldn’t pay me for my last few visits for them.   A newspaper reporter called me to interview me on how it had effected me.  I held no malice.  They’d gotten “into bed” with too many HMO’s that didn’t pay their bills.  More of my patients were willing to pay cash to continue.  Adversity can bring opportunity to the prepared mind.  Why wait for adversity? 

What to do:

1) Give every one of your patients the option of paying cash from the beginning. You can give many of them incentives them to pay up front because money today is worth more than a partial payment in 90 days. James Ko, PT a contributor to the cash practice secrets course puts the cash option as option #1 on his forms. It has a check box with text behind it that says, “I will take advantage of the $30%discount [This can be a lesser discount or other benefit but I suggest at least discounting the 6-10% that it would cost you to collect that money after the time of service.] offered for paying cash at the time of service.” Remember there are many clients for which cash is the only option. I treat many of them. If you intend to treat Medicare patients you may be “non-participating” and set up your system where the client pays you directly and gets reimbursed by Medicare.

2) Respect your clients’ time and their money. Advise your patients honestly like you’d advise your own family members. You can’t have too much integrity. Those who can afford to pay cash frequently think they have very busy lives even if that “busyness” is going from one social to another. They frequently don’t want to come in for therapy three times per week if they can be taught how to do many of the treatments at home.

3) Learn everything you can about cash practice physical therapy. Take advantage of cash practice teleseminars and internet training. These will help you develop your practice and also to will let you know if you might be interested in further training from that publisher, author or speaker. Don’t spend a $1000 on a course without first checking out the free content from that author. Seek out specialized knowledge on this topic.

A free audio chapter on how to run a cash practice is viewable for those who simply register at http://www.CashPracticeSecrets.com Other absolutely free bonuses include free email /internet training and free teleseminars. These high-value teleseminars are being held at least monthly for a limited time for free for those who have opted in by entering their email address at the above web-site and then confirming by clicking the appropriate link in an automatic email. This information has been compiled by Lance P. Van Arsdell, PT, MSPT who is the president of Cash Practice Secrets. Lance has a house call physical therapy practice in Mesa, AZ http://www.AtHomeMEDrehab.com and authors a BLOG for physical therapists viewable at

 you’d advise on of your own family members

Ooh It’s getting late and I said I’d share with you the thank-you cards I send out.  Well one has a Roadrunner on it.  I thought that was appropriate for a house-call PT.  The other has a really awesome flowering Saguaro  (say SuhWAHrow) cactus on it.  They cost no more than $.49 each but with a personal note help build relationships.  I certainly hope this post has been helpful and uplifting.  Thank-you for reading.  Spread the word!

Yesterday I had a few minutes to spare and stopped to see my friend Monty at Linowski Physical therapy here in Mesa, AZ.  They were busy so I was in and out in less than 30 seconds.  I always make a point to stop and say hello to Dale and Mark who work there too.  They run a great business that has no employees.   If you talk to someone there it is one of the owners.   As I run a house call practice I make a point of at least saying “hi” to every PT practice owner in the area.  It has been fun getting to know a few practice owners.   

Today I got a call from a lady in Michigan.   I didn’t know her and she didn’t know me.  She needed to arrange therapy for her boss’s 94 y/o father, and avid golfer, who got sick on vacation,  was recovering, but really needed to be gotten up and around.   How did you hear about me?” I questioned.  Apparently a local PT office that doesn’t do out-calls recommended me.  In a little while I got a nice call from the son of the prospective patient.  There are a few details to be taken care of but the $150 price of the 45 minute therapy sessions isn’t one of them.  

I really don’t know which office recommended me but am sure it’s just because I take the time to say hello.   Next time I’ll try (to upload a picture) to share how I “say” “Thank-you” but for now let’s just say that the 49 cent card outlet and I are good friends!

If you enjoyed this post tell your friends about it.  Have a great day!