Showdown: Physician Referrals vs. Google for New Patients

showdown doctors vs google marketing cash based physical therapy practice

When I started my Cash Based Practice, I thought, like everyone else, that the key to a busy practice and finding new patients would be through physician referrals, though I knew I needed a variety of referral sources.  I thought that physicians understood what physical therapy can do to help patients.  One of the reasons I went back to grad school to become a PT was that as a massage therapist I was seeing so many patients with chronic pain and conditions and who had no relief of their pain and symptoms from medications, injections, surgery, physical therapy, chiropractic, etc.  I figured as a physical therapist the therapy and service I can provide would be understood and I would see patients at the beginning of their problem.  I didn’t realize the full extent of “physician as a gatekeeper” until a few months after graduation while I was trying to market my own practice.

Marketing to “Doctors”

I had the idea during PT school that I did not want a majority of my patients from 1 or 2 referral sources, and started off with a website and working hard to get it recognized by the search engines.  I also spent lots of my time visiting physicians or even attempting to visit with physicians.  I had a few who would meet with me one on one, but others who insisted that I bring lunch for their whole office.  I had decided that I wasn’t going to do that, #1 because I wanted to keep a low overhead and didn’t have $300 to spend on lunch for 5 minutes of their time.  #2 because I consider myself their colleague and I feel that it’s a conflict of interest to pay for lunch so that I can have the brief opportunity to speak with a physician to get to know them.  I am not selling them anything, unlike pharmaceutical and medical supply companies, nor do I have the same budget or annual gross income.  I don’t think many PT practices do.

Is a "Doctor" controlling your new patient referrals?

Is a “Doctor” controlling your new patient referrals?

I started hand delivering evaluation notes to my patient’s physicians as a way to get a foot in the door, then as I became busier I mailed in an evaluation note, personal note and a copy of my newsletter to each physician.  After about 2 years I stopped doing that as well.  The cost vs. benefit was not there.  I spent a lot of my extra time preparing all of those documents and hand addressing each envelope.  However, I did have 1 Chiropractor who received a patient note and subsequently referred 8 patients to my practice in my 1st year!!!

Remember, physical therapists are “Doctors” too! To this day, referrals from physicians are not good referrals for me and my practice.  They are generally based on the referral nurse’s search of Google for a practice close to the patient and not based on the physicians recommendation of my service and therapeutic needs of the patient. Patients typically have a prescription for 3 times a week for 4-6 weeks and expect to use their insurance benefits.

Two things I learned early on.

1) Referrals

There are no referral sources but “referral avenues” or “referral partners.”  It is not a one way street.  When approaching another professional for referrals, whether a physician or yoga teacher, it’s not the best strategy to call and just ask for referrals.  This seems desperate and unattractive, I’ve had people do it to me.   The best way to approach another person is to call ask them about themselves and find out who they like to work with.  Tell them you would like to meet or set up a time to talk so you can learn more about their practice and with the intention that “my patients want to know about you.”  This approach is disarming and shows you are contacting them to give them something.  Typically when something nice is done with out asking for anything in return, the other person usually feels compelled to return the favor.  Just like in a networking meeting, there are people trying to get me to spend money with them, and others who just want to find out what I do or help me make a connection with someone else.  I prefer the second type.

2) Brand Advertising Doesn’t Work

Paying large amounts of money to say, “Hi, we are physical therapy, we are good, we are here”, doesn’t work either.  This is called brand marketing, and is only effective if you have a huge business with large amounts of money to spend like Coca Cola or McDonalds.  I even tried direct response marketing, which is placing an add that directs the consumer to contact you or visit your website.  This was better, but still not something that brought in more than I paid. After 2 years of monthly ads and an article in about every other issue of a local health magazine, I had spent just a few more dollars than I received from patients whom I could track directly to this publication.

Direct Access Marketing

Direct Access Marketing PatientsOver 50% of my new patients find out about me online and my practice is 100% Direct Access. Google for the Win! In general I focus my marketing on Direct to Patient methods such as the internet and word of mouth referrals.  I ask all of my patients to tell their friends, family and co-workers about our practice.  I do this in person, as well as in an automatic sequence of emails sent to each patient via the Aweber auto-responder.  I also spend my time, not my money, on writing online articles, blog posts, making videos, and optimizing my website and business listing so that when people are searching online for a physical therapist or information about their condition, they will find my website, blog, article or video.

In this way, I am positioned as the expert on physical therapy or their condition and they are more likely to contact me about their condition than the therapy practice down the street that doesn’t  even have a website.  I outline all of my online marketing strategies in the eBook that I’m writing and already have some of the most efficient strategies for getting your website on the first page of google within a few hours in my eBook, Dominate the 1st page of Google in 30 minutes.

What are your most effective direct to patient marketing strategies?  Who are your best referral partners?  Let us know your successes and failures in the comments section below.


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About The Author

Aaron LeBauer

Aaron LeBauer PT, DPT, LMBT started a 100% cash based physical therapy practice right after graduation. He's on a mission to save 100 million people from unnecessary surgery & enjoys helping passionate therapists build successful businesses without relying on insurance.


  • Aaron,
    This is chock full of usable and valuable ideas.
    Thank you!

  • Ken Klosterman

    Reply Reply September 21, 2013

    I have taken John Barnes MFR1, MFR 2, Pelvis-Fascial,Unwinding1…
    Will be taking Rebounding and Thoracic-Cervical in November in Chicago. Also hoping to take Skill enhancement in PA in December w John.

    I am a LMT in Columbus, Ohio. I work in a large PT clinic with about 20 other PT’s. Moving to Wilmington area within the next 6 months to be near grandchildren.

    Plan to begin MFR along with massage work in the area. Enjoyed your website!

    Ken Klosterman, LMT and MFR Therapist

    • Aaron LeBauer

      Reply Reply September 21, 2013

      Thanks for your comment and visiting my blog.
      Good luck with your move.

  • Eunice Coughlin

    Reply Reply September 21, 2013

    Hi Aaron,
    Loved the article. I think you are slightly ahead of your time in the PT space and marketing online. I work for a client who is a Practice Manager consultant (in fact, I found your twitter account while doing research for her). At any rate, the “old-school” docs who want you to buy their staff lunch to get the privilege of speaking with them are not going to be in the business 5 years from now. Instead, the next generation of doctors who know the power of the Internet and acknowledge that patients are going to be taking more control of their healthcare are going to have to step up their game to using online marketing to get more patients. You’ve positioned yourself well! Keep at it.

    • Aaron LeBauer

      Reply Reply September 21, 2013

      Thanks for your kind words.
      I have plenty of patients who are unsatisfied with their care under physicians, mainly due to the lack of time and communication with them and their office. Patients are becoming better consumers of their own health care expenses, specially as deductibles and co-pays are increasing. One of the first places they turn is to the internet.

  • Anthony Hoang

    Reply Reply November 26, 2013

    Thanks Aaron!!

    Very useful. I completely agree, especially with the ‘buying referrals from doctors’ part.

    • Aaron LeBauer

      Reply Reply November 26, 2013

      thanks for your comment and for visiting my blog.

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