Paul Gough

Free Marketing Plan Road Map for Physical Therapy Clinic Owners
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Is Now The Right Time To Start Marketing To Affluent Patients?

I found some UNRELEASED content from when I went to Dan’s house in Cleveland, Ohio…

In this blog post, Dan Kennedy talks about the consolidation of big healthcare systems and how important it is to have multiple sources of patients. Read why Dan says “the worst number in business is one.”

Dan will be joining us in Cleveland on July 8th and 9th, and we’d love to see you there too. Book your seat at ⁠⁠

P.S – Watch the FULL video interview on my YouTube channel here: ⁠


Here in this area, we have the Cleveland Clinic, and we have university hospitals – the two big systems.

And we had in and around Cleveland, the first ring of suburbs and the second ring of semi-rural suburbs.

We had a lot of small regional hospitals.

We had a ton of independent health care practices of every kind.

Eye, back, PT, you know, whatever. And over the last handful of years, Cleveland Clinic primarily, universities secondarily, have bought everything.

I mean the consolidation is stunning. They can’t make signs that say Cleveland Clinic fast enough, right, and that is not an accident, it is part of a trend.

And PT is very vulnerable because they have already depended on doctors to hand them their patient and as those doctors get consolidated and owned by a few big entities, those entities are not going to want to leave the next level of care to a bunch of independent providers running around loose.

No, naturally, you’ll want to consolidate them too.

In the meantime, if you’ve been getting referrals from Dr. Smith and Dr. Jones, and Dr. Smith retires and Dr. Jones become serfs of the Cleveland Clinic system, guess what?

You’re not getting any referrals from those guys anymore.

They can’t, even if they wanted to. You should not sleep well at night if you are the worst number in business anyways is 1, period, out of anything.

And so, if predominantly you have one source of customers, clients or in this case patients, it doesn’t matter what their one source is, by the way.

But if that source is referrals from these five doctors who we drop candy off for and we take to a golf tournament once a year, etc., you ought not sleep well at night because you could have zero sources – like, on Monday.

Now what happens when a lot of independent competing deliverers get crushed into a few, is there’s a big percentage of the population who goes along…

They say well okay, that’s the way it is.

If I got to stand in line, if I got to be on the phone for 6 hours before I can get to a human being, I’ll just be on the phone for 6 hours until I can get to a human being.

But! There’s also a significant, not as big, but a significant and typically more affluent percentage of the population who resists.

Says no, I do not want to be part of that monolithic, bureaucratic, uncaring, non-marketing thing where people snarl at me and hit me in the head with a clipboard until we fill out a form.

Go sit in the corner.

I don’t want to be part of that.

And I have the means to buy other and I will buy other.

So private aviation has thrived, as commercial aviation has become five companies and they’re all shitty, right?

I started flying commercially in 1974, first class, and when you flew first class in 1974, they held everybody else back. They brought you on board. Everybody was happy.

They helped stuff your luggage into the overhead bins. And by God, it was going to fit. And they got you a drink and a snack before they even let the coach passengers on and on long flights, there was one flight attendant for every row they sat down, they played cards with you. There were magazines, etc., etc., etc…

Well, we all know.


How was your flight now, your last flight you took?

It was horrible, right?

So, people with the financial ability to do it, who still feel like maybe they’re paying obscene prices and would rather, if they could fly first class and be treated well, have moved to private aviation and organized companies.

There’s this segment of society that says to itself, “Wait a minute, I can afford to be treated better and I will find a way to be treated better.”

And you have this incredible separation that happens, and it is happening, and it is going to happen here.

There will be independence, truly independent private practices, PT practices that not only survive this, but prosper from it.

And there will be a bigger number who will be eaten by it. They will just disappear into it and there will be another number who will be out if they’re of the age to retire early – which is something that’s happened in dentistry – they’ll retire early.

Or they’re just going to get squeezed to the point they can’t make a living because part of this scheme, the insurers keep reducing reimbursements, but costs keep going up.

Right now, because of the labor shortage, your labor costs have gone up because you either got to pay more to retain them or you got to pay more to get them.

We know, with PT, there’s big signing bonuses in certain areas.

This here’s $5,000. Just come to work.

Your supply costs are going – every cost is going up. Right?

But your reimbursements are going down.

They will literally squeeze some right out of the business.

So, you get to decide which of these three groups you want to be in.

You actually have the choice, that choice is available, and that choice is yours.