"Deducing" Value | Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews

"Deducing" Value

Deduce-- to derive as a conclusion from something known or assumed, infer. From the Latin: deducere, to lead down, derive, equivalent to
Deductible-- capable of being deduced or deducted. Also from Latin-- deducere

The Apple watch. It's essentially a computer on your wrist. It tells the time, calculates your heart rate, you can send and receive calls/texts, control your music, land planes at LAX, and who knows what else. The lowest retail price I've seen is $350.00 and I've seen as high as $17,000.00. There was a such a buzz when that was coming out, I think Jerry Durham (@Jerry_DurhamPT) tweeted out a daily countdown until its release.

When it comes to technology, I would be what Simon Sinek (Start With Why), would refer to as a "laggard." I don't put a lot of value in new tech because in my mind, things change so quickly and there's a better version coming out later if I just wait a few months. Keep in mind that I just recently upgraded to an Iphone-5 this past December after having my Iphone-4.....since 2011. When Evernote started taking 20 minutes to load on my phone, I figured it was time. Needless to say, when the Apple watch came out, I wasn't moved. 

This is my watch. It's a Casio. I got it off Amazon for about $35. It tells the time. It has an alarm feature, stopwatch, and at least two different timers. It's also solar-powered--booyah.

"Great, Andrew-- thanks for sharing. But is any of this relevant to physical therapy?"


These are the type of decisions that our patients/customers are making every time they step into our office. And for those of us still grinding away in insurance-based health care, you may have noticed that the outcomes of these decisions have been particularly impactful on your practice over the past few years. With the arrival of the new year, many patients are facing the reality of once again first paying down their deductible before the insurance company's financial obligation kicks in. It was great in November and December when physio was only $20, or god forbid, $0. But now they might be having to pay $60-$70 per visit. This is the moment they begin to question whether it's actually worth it. Are they seeing the value in what we do? If we've done our jobs well, hopefully this is a non-issue. But there are still times, regardless of how well we think we demonstrate that value, that some people will not "get it."

"Value is in the eye of the beholder"-- Jerry Durham

It would hard to convince me to purchase an Apple watch--at least not at its current price. $50? Maybe now we can have a conversation. But honestly, even at that price, unless it has a laser cutter and repelling line like James Bond's Omega, I probably won't be interested. This is how some people view physio. Perhaps this is why we have to "sell" things with fancy names like ART, PRI, or DNS (I thought that was a computer thing). Simple sometimes seems too "simple" to have value. But more on that in a future post. (In the meantime, for an interesting discussion on that topic, check out the last few minutes of the latest NAF physio podcast from Adam Meakins (@AdamMeakins) with Greg Lehman (@GregLehman)).

So how do we move people (to borrow a phrase from Daniel Pink's To Sell is Human) to value what we do? When a current patient stops coming after the new year because they suddenly have to start paying down that darn deductible, they may be telling us "you are no longer worth my time and money." Or they could be saying, "I don't value my health or function as much as how my hair and nails look." Like me and the Apple watch, there are just some people who we won't convince. But I'm more concerned with the ones that we could move that we let slip through the cracks.

What has always confused me regarding insurance deductibles, is that if you are ever going to see any health care provider during that year, you are highly likely going to be paying it off at some point. So ultimately, it doesn't matter who it's paid to, right? Ah, but here's where the rubber meets the road, as they say. In the mind of the patient/customer, it seems to. It comes back to the perceived value of said health care provider. Physicians, specialists, etc, are assumed to have more value than physical therapy, so patients don't seem as reluctant to fork over payment. Maybe it's the frequency of PT visits compared to the relative infrequency of visits to a specialist. Or maybe it's because people still just don't know what it is that we do! Either way, our customers too often are deducing that paying down their deductible with physical therapy is somehow not worth the cost of admission.
"Price is what you pay. Value is what you get"--Warren Buffett

It's human nature that people are more willing to spend money on things they WANT rather on things they NEED. Most people have the means to afford physical therapy, they just don't appreciate its value. In his Cash Based Practice Podcast, episode 38, Jarod Carter (@DrJarodCarter) highlights aspects of the book Everything is Marketing, by Fred Joyal, and discusses how to increase the perceived value of physical therapy. Although the book is written for dentists, you can perfectly replace "dentistry" with "physical therapy." Like dentistry, physical therapy is a service that most people would rather avoid. But what if we could present it as a "lifestyle enhancer" rather than an annoying inconvenience?

"If a product or service enhances a person's lifestyle, they want the best (think high-definition television). But for something utilitarian, something that is considered a basic need, they want the cheapest"-- Fred Joyal

This requires a change in mindset. Not the customer's (yet)-- our own! After all, if we don't value what we do and consider it important and vital in improving people's lives, how can we expect someone else to value it?

The thought has been that physical therapists are notoriously terrible at "selling." But if you think about it, we're already doing it all day, every day. We convince people to do movements and exercises they don't want to do. Why? Because we know it will help them, and we (hopefully) are communicating that during each treatment session.

We need to take that same approach with communicating the overall importance and effectiveness of physical therapy  So, I don't think that we're not good at selling, (not that we couldn't be a lot better). but we aren't comfortable with it. Fred Joyal suggests instead calling it "facilitating the acceptance of treatment." I like that.

"If you don't believe that money spent on [physical therapy] is a better investment than almost anything else they (the customer) can spend money on, that's YOUR problem"--Fred Joyal

But to change the customers' mindset, we must change their experience.

  • Who in your practice is involved in selling physical therapy? EVERYONE! This means from the front desk to the office manager to all the physical therapy staff members."What you say online, on the phone, in person, and to those who may be speaking to your prospective patients (i.e. your referral sources) should be skillfully crafted to convert that attention into interest and that interest into the decision to choose your practice over another--Jarod Carter
  • Know what patients/customers care about. The number one thing....empathy. As the saying goes, "people don't care about what you know until they know how much you care." They expect there to be a certain level of training, expertise, experience, etc. Now, we know that when it comes to physical therapy, that's not always the case, but it's what people assume. Being good at what we do is important. But it's secondary to demonstrating to our patients/customers that we care about them as human beings. 
  • Tell people what we do. We know what we do and we naturally assume that everyone else, especially our patients, know as well. But this does not appear to be the case. Communicate repeatedly what we do and how our services benefit them. If we start to look at each patient/customer as a potential referral source, we're not just telling them things that may be beneficial for them, but also for everyone they know! 

  • Quality and value is something that we all claim to deliver. However, we don't get to decide what quality and value are-- our customers/patients do. Even though they may not have the ability to determine the quality of clinical care as we might judge from each other, they can measure the quality of their experience. The experience is what makes them loyal, what makes them come back and what makes them refer their friends and family. 
  • The triple threat- Over 50% of patient surveyed (check with Jerry Durham for the source on this) feel that providers miss the mark on delivering care. The three big things highlighted of importance were 1) providers who take their time during an appointment; 2) providers who are easily accessible; and 3) providers who exhibit good bedside manner and demonstrate knowledge and technical proficiencyIn the January, 2011 issue of  PT Journal, it was found that-Interpersonal attributes and the process of care were the key determinants to patient satisfaction. Satisfied patients were more likely to adhere to treatment, benefit from healthcare, and have a higher quality of life. If "improving the human experience" is the ultimate goal of the profession, this might not be a bad place to start. 

As always, thanks for reading.


opening photo credit courtesy of stokpic
second photo credit courtesy of me

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

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