What’s your clinic’s strategy? How do you come up with service offerings or determine which specialty area to choose? What need are you meeting in your local healthcare market? Believe it or not, many of us don’t get into healthcare with those questions in mind.


Many of us went into healthcare for one reason: we want to help people. Those of us who have started clinics, practices, and rehab agencies have taken the step to make a living from our calling. What do I mean by that? I mean that many clinicians that start their own practice aren’t necessarily “business strategists”. They have a skillset that other people (patients, referral sources, etc.) find valuable, and they’ve decided to make a living by providing those skills as a service.


Now, I talk to a lot of clinic owners and managers about “what to do”, “where to go”, and “how to grow” in their businesses before or after they’ve started them. And, truth be told, a lot of them are lost. Like I said: they went into healthcare and rehabilitation because they wanted to serve patients. They wanted to develop relationships, help patients achieve their goals, and make a real impact in their lives.


Now, they find themselves at the helm of a business venture. Unless they are solo-practitioners doing home visits or working out of a small space, they usually have other people depending on them for income. Office staff and sometimes other clinicians rely on their clinic’s success to feed their families and provide for themselves. That can be a lot of pressure, especially if you didn’t go to “business school”. But, whether you’re comfortable with it or not, part of your role as a clinic owner or director is to develop and mange the strategy your business takes to achieve success.


Strategy: Do I need One?


Let’s start with the basic question you may have: Do I even need to think of a strategy for my clinic? After all, especially if you’re starting out, you can probably build a referral list and start bringing in patients without having a formal “strategy”. And in truth, that’s not a bad way to start. You get some early cash flow, patient base, and “proof of concept” quickly.


The issue arises after the initial “launch” of your clinic or business. Once you start growing and begin considering hiring staff, growing your patient base, and expanding, you begin facing the questions I mentioned at the beginning of this article. You start wondering which service would be most advantageous to add to your clinic. You wonder whether you should expand into another demographic or diagnosis area.


All of these questions can be more easily answered when you’ve landed on a strategy or focus for your practice. Some folks lump this under the term “positioning”. Positioning refers to your “discipline for market” proposition. Put plainly, your positioning connects your services to the clients (or patients) you want to serve.


What Should My Strategy Focus On?


I always tell my clients & students that your ultimate strategy should focus on boosting patient engagement & retention. In this rapidly changing healthcare landscape, patients have more options. They’re not bound to go to a certain provider of their referring doctor’s choosing. Unless your clinic offers some very specialized service, odds are that a quick Google search will show a handful —if not more— local competitors that your patients may choose to see.


So how duo you make sure that you end up being the one they choose? By ensuring that every patient that comes into your clinic has an incredible experience, not only of the treatment itself, but of the entire process of care. This means taking a look at communication, onboarding paperwork, administrative & billing processes, and much more.


And just as important is the patient engagement aspect. Everything from your marketing, messaging, and actual patient interactions in the clinic needs to be focused on developing real rapport and relationships with your patients. This makes them more engaged in treatment, confident in your services, and more likely to have a positive experience. That leads to work of mouth referrals, both to other patients and the referring physicians. And that’s what you want. You want a referring physician to tell their patients “there are a few options out there for X service, but I’ve been hearing a lot of good things from my other patients about ABC clinic.”


Finding Your Strategy: 3 Steps to Service Offerings & Marketing


Part of ensuring patients have a great experience in your clinic involves ensuring that you’re attracting the right patients or clients to your clinic. How you message, market & communicate your service offerings either attracts or repulses a potential or prospective patient or client. The same goes for actually developing your service offerings.


In fact, someone recently asked me a question about developing service offerings. They essentially asked me, “Surely you don’t come up with the kind of offerings that will attract patients off the top of your head — some planning or research must take place first, right?” Here was my response:


That is correct. You don’t just come up with service offerings willy-nilly. Your service offerings must come from the overlap of three things: 1) your clinical expertise/knowledge/scope of practice, 2) market demand, and 3) your clinic or organization’s mission or purpose. 


Now, I’ve written about the importance of using your organization’s purpose or mission statement as the benchmark for business & strategic decisions. This holds true for service offering development. You must also consider your clinical knowledge & scope of practice. Obviously, if you’re a physical therapist, your service offerings won’t include ophthalmology, so I think that’s pretty clear. You need to offer services that you/your clinicians are both competent and knowledgeable about. And Finally, market demand should provide some indications when developing service offerings.


Let’s take a look at each step below:


Step 1: Your Experience, Knowledge, & Scope


The first step in this process requires that you take an honest, evaluative, look at your clinic’s knowledge, skills, & competencies. If you’re a solo practice owner, this includes your own clinical skills, knowledge & expertise. If, like many of the practices and organizations I work with, you have multiple clinicians seeing patients and delivering services, then you’ll need a way to get your collective clinical knowledge & skills “on paper”.


To complete this step, have everyone list the areas of clinical experience & competencies they possess within each area. For example, if you run an outpatient adult physical & occupational therapy clinic, have you may have an area marked “orthopedics” and another marked “neurological”. List all of the clinical areas in which you/your staff have knowledge, skills, and competence. Next, have clinicians describe specific skills or competencies that they possess under each clinical area. These competencies may en up being a sub-area of the clinical area. For example, a clinician may demonstrate competence in rTSA Rehabilitation. These skills may also be specific treatment techniques. For example, a clinician may indicate a specific skills in instrument assisted soft-tissue mobilization (IASTM).


You can use checkmarks, tally marks, or something similar if/when clinicians end up putting down the same clinical skill. For example, multiple clinicians in your clinic may be certified in, or demonstrate great skill with IASTM. Simply tally up the number of clinicians next to that item.


After completing this exercise, you should now possess a comprehensive list of practice areas & specific skills & treatment techniques that your clinical staff posses and in which they could provide competence, skilled services. I’ll refer to this as your clinic’s “clinical expertise”.


Step 2: Market Demand or Need


After taking an inventory of your clinical capacity, move on to the next category: market demand. This can be determined a few different ways. The first, would be to simply brainstorm with your clinicians and staff which clinical areas or specialities comprise your current or historical caseload. For example, perhaps you do run that outpatient adult PT/OT clinic and you see many patients following joint replacement surgery. “Joint Replacement” would then be considered an area where you have identified a need, and where you have been able to service that need in your local community.


Do this for every area or subspecialty that your clinic sees, or has seen in the past. Make a list and then determine which areas possess the largest percentage of your current (or historical) caseload. You can use your EMR (electronic medical records) to sift through past patients —I recommend looking back at least 12 months— to determine any trends or clinical areas that make up, or have made up, a significant portion of your clinical caseload. You can also pole your current & past patients about additional services they think they need, or would be interested in.


If you are just starting a clinic or organization, or you’re just stepping into an administrative or leadership role, this step may require a little more effort. If you’re stepping into a leadership role at your organization, then you can likely sift through the data available through your EMR to determine the areas that have proven to be of greatest demand. If you’re just starting out, you’ll have to rely on the info you gathered in step one, and then do some outreach to local area referral sources and the like to determine which areas may be perceived as more in-demand or useful to those referral sources.


Take a look at the information you gather in this step. Look for patterns. Notice if there are any areas that you may have seen a lot of patient in the past that have waned, or any areas in which caseload has recently picked up. Take a look at the information and try to determine where future demand may come from. Are there any areas that you either aren’t addressing —or only minimally addressing— that fit within your clinical expertise? For example, maybe you’re clinical expertise lies in joint replacement rehabilitation, and a large portion of your caseload involves treating shoulder replacements. Are you treating any knee replacements? Are you providing any pre-replacement services such as educational sessions, “pre-hab”, and the like? You want to begin to use the information from this step to look for new potential opportunities for expansion, growth, etc.


Step 3: Your Organization’s Purpose or Mission


After you’ve both identified your areas of clinical expertise & determined where the greatest potential demand lie, turn your attention to your purpose. Since you’re trying to deliver an amazing patient experience, you need to consider the type of patient or service you wish to provide and how that fits in with your clinic’s mission or purpose. The main reason for this is because you want to remain consistent in all your marketing, messaging, and communication with both referral sources & potential patients. Your purpose should drive your business & strategic decisions.


That being said, in this step, take some time to think about what your mission, vision, values, and purpose for your organization are. If you are the owner of your clinic, this is your responsibility. You may solicit advice & input from staff members and your leadership team, but this decision ultimately lies on your shoulders.


Your mission or purpose —your “Why” as Simon Sinek calls it— should not only drive the decisions that follow, but also be basis for the way you communicate what you have to offer to those clients and or patients that you want to offer it to.


Does it Fit With My Organization’s Purpose?


As mentioned above, settling on a purpose, mission, and/or values is the responsibility of the owner or leadership team, depending on how your clinic or organization is structured. That being said, once the purpose is set in stone, other departments, managers, and even staff members can use it to guide areas of growth, expansion, or development. I encourage you to always use your purpose or mission as a way to evaluate new ideas or developments.


Once the purpose or mission is set, then you can take the information gathered in steps 1-3 to determine potential areas for growth, expansion, or service offering development. You will then select the options that fall at the intersection of all three foundational pieces: 1) your clinic’s expertise, 2) market demand, and 3) your organization’s purpose.


Here are a few questions to help guide your decision:

  • How does this opportunity align with our organization’s purpose or mission?
  • Can we easily communicate how this opportunity or service offering capitalizes on our clinic’s expertise and purpose?
  • Does this opportunity show potential for market demand, or has market demand already been demonstrated within this area of opportunity?
  • How will we communicate this opportunity to external entities (referral sources & prospective clients) in a way that highlights our expertise & purpose/mission?
  • Is this opportunity a logical extension or expansion of our current clinical expertise, market demand, and organizational purpose/mission?
  • Do we possess sufficient clinical expertise to expand into this opportunity without having to spend costly resources and building additional clinical competency?


Honing Your Strategy: An Example


I worked with an outpatient therapy clinic (PT & OT) that was trying to develop some new service offerings and expand the business. The were looking for a strategy to expand their service offerings, while capitalizing on the clinical expertise they already possessed. Being PT/OT practitioners, their scope of practice does allow them to treat adult, adolescent, and even pediatric populations. In fact, their clinic’s caseload did seem spread across all three areas. They even tried to market themselves as “we do it all”.


However, after some digging and talking with the clinicians, it was clear that their core competencies were in adult orthopedic rehabilitation. They possessed specializations, certifications, and regularly attended conferences and continuing education seminars on that specific area of practice. They also had strong referral relationships and a good reputation in that space (with orthopedic surgeons, primary care providers, etc.) In fact, 80% of their caseload consisted on orthopedic cases. We used “adult orthopedics” as the area of clinical expertise for step 1.


That provided some insight into market demand & need as well. There was obviously a need, as they were getting regular referrals from practices in the adult orthopedic area. Then, we took a look at what their current and past patients reported or requested. Many patients finished their formal rehabilitation program and would request “tune-up” visits or “check-ins” That pointed to a more clear market opportunity where demand may exist. On top of that, the clinic’s mission statement & purpose involved helping patients overcome limitations and live their healthiest life.


Now, there were two options on the table for the business to expand into: 1) grow and expand it’s pediatric service offerings or 2) develop a medically-based wellness & maintenance program. Looking at the information above, and walking through the three-step process outlines previously, it was a no-brainer. The intersection of this clinic’s 1) clinical expertise, 2) market demand/opportunity, and 3) mission/purpose all pointed to providing services for patients after they had completed their physical/orthopedic rehabilitation programs. The area they should expand into was the medically-based wellness and maintenance/exercise programs.


Now, this is just one example from the outpatient physiotherapy world, but you can follow the same process whether you work in a large healthcare organization or a small, single-clinician practice.




Whether you’re just starting out, or leading a large healthcare organization, you must be focused on the direction & strategy of your clinic. Whether you’re a single-clinician shop, or a leader within a large healthcare organization or system, you are constantly presented with opportunities for your clinic or department. These opportunities may appear to be great fits for your clinic and clinical expertise & bandwidth, but you should always evaluate each opportunity by comparing them with the 3 areas outlines above: 1) clinical expertise, 2) market demand/opportunity, and 3) mission/purpose of your organization.


By following the simple three-step process outlined above, you can ensure that your organization’s strategy and development aligns with your mission/purpose while also capitalizing on your clinical expertise and market demand/opportunity.


Have you had a strategy meeting with your team? How do you plan to incorporate patient experience and engagement into your clinic’s strategic plan?  Share any additional resources that you found helpful in the comments below!

If you’d like to talk with me about your clinic, department, or practice, and how Rehab U can help you improve patient retention and engagement. Schedule a FREE 15-minute call with me.


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Rafael E. Salazar II, MHS, OTR/L is the president and CEO of Rehab U Practice Solutions. He has experience in a variety of rehab settings, working with patients recovering from a variety of injuries and surgeries. He worked as the lead clinician in an outpatient specialty clinic at his local VA Medical center. He also has experience as an adjunct faculty instructor at Augusta University’s Occupational Therapy Program, as a Licensed Board Member on the GA State OT Board, has served on several committees for the national OT Board (NBCOT), and as a consultant working for the State of Georgia’s DBHDD. He is also on the Board of Directors for NBCOT. He works to help healthcare clinics and organizations deliver uniquely impactful patient experiences by improving service delivery through training & advisement and through courses & training programs.

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