When Should I Hire My First Physical Therapist?

Use net gain to see whether you have enough patients to fill another schedule. Net gain is total new patients minus total discharged patients, measured across the last three months.

For example, 50 evaluations and 15 patients who discontinued gives you a net gain of 35 patients. In Ben's practice, a full caseload is 35 patients per week per physical therapist, so a three-month net gain of 35 or more means he can confidently fill another physical therapist's schedule.

Find your own full-time staff physical therapist number and reverse engineer from there. This is the process Ben used to bring on three full-time physical therapists at the Oakland location.

Post on Indeed, LinkedIn, and your social accounts once you are consistently seeing 8 to 10 visits per week. Do not wait until you are too busy to onboard well, because a new hire needs a 90-day ramp-up.

If you only want to see 15 to 20 visits per week, hire at 15 to 20 visits per week. Building to 30 just to ramp back down wastes time and money and can damage patient relationships.

Hire a physical therapist first if you can still handle the admin work yourself. Ben hired a physical therapist first so he could master patient sales before training an admin on a proven system with measurable KPIs.

The rule is simple: you cannot effectively delegate what you do not understand yourself.

Ben now hires new grads because they are more motivated and more open to the cash-based practice model. His mistake was hiring the physical therapist with the most experience, because veteran clinicians were harder to train on cash rates after years in the traditional model.

Show candidates the full value of the job instead of only competing on salary. A cash-based practice can offer one-on-one treatment, no more than seven patients per day, limited documentation time, and active, motivated patients.

Hire people who value those things. They fit better, and you do not have to overpay to keep them.

Start offloading your caseload so you can work on the practice instead of in it. Plan for a 90-day ramp-up period and document the patient journey before the new physical therapist starts.

Use a tool like Loom to record the process so training is plug and play.