Founder Letter: Keeping Pace With Patient Expectations in 2022

Our goal as rehab therapists is to provide patients with the best care and the best experience possible in the pursuit of helping them achieve their therapy goals. In turn, we hope our efforts turn first-time patients into lifelong patrons and advocates. Reaching that point, however, isn’t simply about putting into practice the sum of our clinical training; it requires a dialogue between caregivers and patients to understand how patients are feeling about their therapy experience in the moment, and what we as rehab therapists can do to meet their expectations.  

Making the patient experience a central part of your clinic’s focus is something we’ve always preached at WebPT, and it’s advice we’ve followed ourselves. Which is why it was genuinely exciting to see the results of WebPT’s and Clinicient’s PT Patient Experience Report. We surveyed more than 550 PT patients, with 46% identifying as male and 54% as female. Of these respondents, 85% reported themselves to either be an athlete or a participant in regular or light exercise. The goal of the report, of course, was to discern patients’ expectations specifically with PT, and whether those expectations were met, with an eye towards identifying key drivers of perceived success and satisfaction. Although this study was specific to PTs, these results are definitely transferrable and relevant to OT and SLP practices as well.

Any business wants to know what’s working for its customers, but what they really need is insight on where expectations aren’t being met; after all, how can you improve if you don’t know where to start? That’s why I’m breaking down some of the biggest takeaways from the report below, and why the rest of the WebPT content team will be diving into more detail on each point in the weeks to come. (If you missed it last month, Erin Crum and I hosted a webinar on improving the patient experience, as well.)

What is the patient experience? 

Before we delve into the specifics, it’s worth taking a moment to explain what we define as the patient experience for this report. Some rehab therapists may view it solely as the time they spend working with a patient, while others may view it as every moment a patient spends within the walls of your clinic. The report’s definition of patient experience—and it’s one I wholly agree with—is more holistic: patient experience is every interaction and touchpoint between a rehab therapy professional (clerical staff included) and a patient, from initial referral and scheduling to follow-ups and home exercise programs. 

Most importantly, patient experience is the cornerstone of patient success. Patient success is the summation of a patient’s satisfaction based on their experience, care, and outcomes. And in this report, it’s also the likelihood that the patient will either recommend or return to your care after they’ve completed their treatment. 

Now that we’re on the same page, let’s get to the top insights.

PTs can do more to attract patients. 

One area where PTs can make strides in bringing more lifelong patients into the fold is to better market themselves and their services. Of the 83% of patients who were referred to a PT by a physician, 64% stated they would return to a PT without a referral in the future. This suggests that there's a tremendous opportunity to not only attract new patients, but also bring back former patients by educating them on self-referrals and the direct access laws in your state. This can easily be done in-person or through your website, email, and text communications.  

Boost your online profile.

Speaking of your website, bringing in new patients requires a focused effort on your online presence. An overwhelming majority of patients are using factors like social proof and schedule flexibility when choosing a provider, meaning that having a strong website with easy online scheduling tools, paired with positive reviews on Google, can set you apart from the competition.

(If you’re really looking to amp up your search rankings, we’ve got a couple of great resources to help your clinic show up on the first page of results when folks search for PTs in your neighborhood.)

Expand the services you offer. 

This also means understanding the people within your community and expanding your offerings to fit their needs. It doesn’t make sense to offer services that no one wants, but rather to offer services that potential patients are looking for.

Based upon our survey, PT patients are seeking care from doctors and surgeons most frequently, as well as chiropractors, massage therapists, personal trainers and nutritionists. It stands to reason that patients looking for those caregivers first may benefit from physical therapy—provided someone can point them in the right direction. While this information can be a good jumping off point to know what services to consider adding to the fold or to specifically target on your website for search engine optimization, I would still recommend doing a bit of market research in your community to gain an even better understanding of what prospective patients are seeking in your area. What’s more, networking with other medical providers in your area can also help to get a sense of needed services so that you can set up a referral network. Your findings may be more specific to specialty offerings, but that’s to be expected!   

Simplifying the path to care makes a big difference.

On the point of your online presence: digital tools for things like appointment reminders or paying bills are remarkably popular with patients of all ages. Of the respondents: 

• 81% preferred digital appointment reminders, notably text reminders; 
• 79% preferred to fill out intake paperwork from home; 
• 70% prefer to pay their bill online, and 
• 61% prefer scheduling online if they’re not making their next appointment while they’re in the clinic. 

And those numbers aren’t skewed by younger respondents; among those 60 and over, 84% preferred digital reminders, 75% prefer digital patient intake, 65% prefer to pay online, and 52% prefer online scheduling tools when they’re not making appointments in-office. Much of that may have been driven by the necessities and newly learned skills caused by the pandemic, but older patients will continue on using these  more convenient methods; that genie is not going back into the bottle. 

Every PT should be opening the digital front door to all patients who want to make use of it, particularly since we know that the lack of convenient options is a big turn-off for patients— sometimes immediately. Administrators and staff must balance on the amount of patient information collected up front digitally, but the patient experience can be greatly enhanced by  collecting basic information before they come in to simplify what has to be collected on the day of an appointment. Knowing exactly what to expect, how many visits are approved, and the out-of-pocket costs ahead of time can relieve a lot of the reservations patients feel prior to the first visit. Moreover, shorter time spent in a waiting room creates a better first impression and more positive experience for new patients.  

Retaining and motivating patients requires communication. 

Getting patients in the door is a challenge in and of itself, but keeping those patients for a full plan of care? That can be even harder. The report’s findings put the average duration of a patient’s care journey to be 7.4 visits, which coincides with the seven to 10 visit average for outpatient care. However, of those who didn’t complete their course of care (typically 40% of patients), four themes emerged as reasons for them dropping out:

• PT was too difficult
• PT was too expensive
• PT demanded too much time
• They didn’t like their therapist

The upside is that all of these deterrents can be avoided if providers are prioritizing patient communication.

Work with patients to set expectations.

The key to keeping patients in the fold is to set expectations early on in the treatment process. We know that physical therapy can be difficult, and that improvement can take time, but we can’t expect patients to invest in the process unless we include them in the journey. Like anything else in life, managing expectations is key to satisfaction—patients who reported receiving clear and reasonable expectations from their therapist were overwhelmingly likely to return to PT and to recommend it to others.  

On this note, communicating the anticipated number of appointments at the start of care helps to get ahead of any logistical or scheduling challenges. Taking this one step further, we found that scheduling appointments in a series resulted in the completion of 1.5 more visits on average. Not only is this a win for your clinic, but it’s a strategy 56% of our survey respondents stated they preferred! That’s a lot of potential visits for the taking.

Don’t be afraid of feedback. 

Managing expectations also means that PTs must make the effort to solicit feedback from patients if it isn’t readily offered. Nearly a quarter of patients who reported themselves as athletes tended to find the treatment they were given too strenuous, whereas many patients who said they weren’t active found their treatments not strenuous enough. Rather than having a conversation about what patients are comfortable with and meticulously reviewing their exercise programs, some PTs may be falling back on an unconscious bias to push athletic patients too hard and less active patients not hard enough. Both are situations that can be easily fixed with more comprehensive conversations between therapists and patients regarding progress, prescribed programs, or any other concerns they may have.   

Check in with patients between appointments.

Keeping patients throughout an entire plan of care also involves giving them every reason to keep coming back. Perhaps the biggest takeaway from the survey was that the number one driver of patient-perceived success was communication between appointments. Engaging with patients outside of the office with automated patient outreach will let patients give you feedback on their experience thus far and will also keep upcoming appointments and home exercise programs top of mind.  

Make telehealth a part of your practice.

Offering telehealth services in addition to in-person visits can help keep patients who might drop out otherwise. Of patients who dropped out, 27% cited time and scheduling constraints as their primary reason, and 45% of all the patients surveyed indicated they would use telehealth to avoid the hassle of in-person visits. With the effective use of telehealth, we can remove those obstacles, with the added benefit of reducing costs.  

Driving patient-perceived success requires a digital touch.

This is a critical finding that flies in the face of what we perceive as our differentiator as rehab therapists. Self-efficacy can be a tremendous boost to a patient’s outcomes, and an effective digital home exercise program (HEP) is a huge driver for that. The report finds a strong correlation between an effective HEP delivery (one that’s accessible on a patient’s phone or mobile device) and the likelihood of a patient to recommend and/or repeat PT. Overall, 77% of patients attribute an effective HEP to their outcomes. Given both its efficacy and popularity with patients, you might assume that most PTs would have made it their mission to optimize their HEP, but there are still those lagging behind the curve. 

The biggest differentiator between optimal and less-than-optimal HEPs is again (you guessed it) communication with patients between appointments. Patients who received regular communication from therapists reported success with their HEP at a rate of 94%, compared with 67% for patients that received infrequent communication. Worse yet, only 33% of patients reported receiving the HEP in a digital format—a remarkable statistic in 2022.

Unconscious age bias may be hampering digital HEP adoption.

Some of the lag in digital HEP adoption may be the result of assumptions made by PTs about their older patients. Only 22% of patients aged 45 and older received HEP digitally, and yet 50% of that same group reported that they would prefer to receive a digital HEP. That’s in comparison to those between the ages of 18-44, who were given paper HEPs at a far lesser rate.     

The data is irrefutable: PTs must transition their HEP to a digital (and mobile) format to help their patients achieve better outcomes. Not only is digital HEP easier to deliver and manage, but 83% of patients who received HEP digitally reported success with the program. Moreover, digital HEP allows for how-to videos and references for frequently asked questions, as well as goal tracking, which can be an effective tool in helping patients visualize their relative progress. And with 92% of American adults now owning a smartphone, it’s a fair assumption that most patients will want to use theirs to access their HEP. 

Moving your clinic into the digital health realm also presents a tremendous opportunity to add remote therapeutic monitoring (RTM) to your offered services (if you haven’t already). RTM can bridge the gap between in-person treatment and at-home exercises, and has a positive effect on both adherence and treatment efficacy with the additional data collected. And with the newly adopted CPT codes, RTM can be a value-add for PTs looking to offset lost revenue from declining reimbursements.          

Surveys like this one can be invaluable. Not every patient feels comfortable bringing their concerns directly to a therapist, and many might choose to simply stop with a course of care without an avenue for feedback. By getting insight on what patients are really feeling, we’re hoping that rehab therapists can enhance their clinic’s patient experience as needed, with the aim of better outcomes and more satisfied patients. It's so important that we’re offering our free patient experience audit to help you in that journey. Just think: this time next week you could have the inside track on some easy-to-implement and inexpensive options to help you keep pace with evolving patient expectations and achieve longstanding success.