After a few years and a variety of frustrations in a 100% insurance practice, Mark DeAnda decided that he wanted to start offering some non-covered services and charging his clients directly. First of all, this approach would allow him to optimize plans of care for each individual patient/client by offering novel and effective treatments that were not being reimbursed by insurance companies. Plus it could improve the financial stability of his practice by making him less vulnerable to delayed or denied payments by insurance companies. In making that transition, however, Mark had some fear and limiting beliefs. In this episode he talks about the mindset shifts that allowed him to overcome those fears and successfully turn his practice into a 50-50 hybrid (50% cash and 50% insurance). Then he goes on to share some of the actual strategies and tactics he used along the way, including his approach to presenting cash options to his patients.
Garrett Salpeter: (00:04)
Welcome to the new Fit Undercurrent podcast. I am joined today by Dr. Mark De Anda, a physical therapist and owner of Optimum Physiotherapies in San Antonio, Texas. I had the good fortune of getting to know Mark about six months ago. We met at a physical therapy event, and he has brought on and started using the newbie. I’ve got a chat with him over that time and heard his experience and his perspective, and his passion for how to sell cash-based services inside of a physical therapy clinic setting where there is also some insurance and traditionally more. And I think he has, a wonderful take on that subject, and was really excited to have him come on and share that. So thank you so much, Mark, for joining us.
Dr. Mark De Anda: (00:52)
Hey, thanks for inviting me.
Garrett Salpeter: (00:54)
Heck yes. Just so everyone can get to know you a little bit, can you share with us a bit about your practice and staff and the types of services you’re offering there?
Dr. Mark De Anda: (01:05)
Sure. My wife and I started an outpatient clinic here in San Antonio at beginning of 2015. It was, you know, myself and her and, you know, one other person. We handled, you know, one just about 100% of federal insurance, and we practiced with the old model of marketing to physician offices, you know, begging for patients, you know, just for the scraps, I guess. Because a lot of them were pushing their patients to their own clinics or to clinics that they had some kind of ties with. So very much, you know, it was not a system that was for us, and around 2017, we started to go into more direct marketing to the people and offer more types of services not offered by insurance. And around 2018, we doubled our numbers, and since then, recently, we had our best year ever during Covid. And we have a staff of 10. We offer a variety of cash services, and we still help people with federal insurance and insurance groups. But we are very much a 50-50 cash and insurance reimbursed clinic.
Garrett Salpeter: (02:35)
Awesome. So, of 10 of the 10, how many are other physical therapists, techs, and admin staff? What’s the mix there?
Dr. Mark De Anda: (02:42)
One, we got three therapists working the floor at any given time. We will have, you know, technicians, three. I called a movement specialist because they got a four-year degree. Four-year degree in Knice, and, you know, they’re trained by me, and they’re also certified in other systems that we use. So, you know, I consider that a specialist in movement that we offer, and we have administrators too. We have three working on five administrators. So!
Garrett Salpeter: (03:13)
Good, good for you. That’s awesome. Growth and having gotten to know you a little bit, it’s not surprising. But I know I have a ton of respect for you and what you’ve been able to achieve there and want to acknowledge that. So, excellent, excellent work. In making that transition from, you know, 2015 when you were 100% insurance based to now? What were the challenges in converting and starting to offer some cash-based services?
Dr. Mark De Anda: (03:44)
Well, you know, first off, fear, I think the change in any change, it’s scary and if you go into private practice, I think you have a little bit of an appetite for fear, more than what most people are willing to take on. So that was definitely one of the first challenges. There’s a lot of self-limiting beliefs, you know, that you had to get over, you know, deep within yourself, right? And your psyche, right? And the marketing, you know, the marketing is important. But I would even say just on the conversation level with my clients, you know, that is very important. You have to go about the right way. One that, you know, doesn’t come off like, you know, a sleazy salesman, but one that comes off as what we’re healthcare professionals and we want to help our clients, you know, we generally want them to get better and to hit their goals, but, you know, how do you go about having that kind of conversation, you know, effectively and sincerely without coming off sales. You know, that was a fundamental thing too.
Garrett Salpeter: (05:05)
So, walk everybody through. I think some people will relate to that, but for some, it might still be foreign, so can you just set the stage. Can you walk us through what’s the scenario? So a new patient comes in, you do an evaluation. What are you even trying to have the conversation about in terms of what are you trying to offer them? And then we’ll get into how you have that conversation. But can you just kind of tee it up for us too, so everyone’s on the same page?
Dr. Mark De Anda: (05:32)
Well, you know, when they come in for your evaluation or assessment, whatever it is that. You call the first visit. Because some people call it a free screen. Some people call it a discovery visit, and some people call it an evaluation. I would think most of the people that are still very much insurance based, you know, they’re only doing evaluations. Right? But, you know, it really starts with the tone. You got to come at people with a tone that shows excitement and shows curiosity as to how I can help you. I’m just so excited to understand, you know, how I can help you the best way I can, you know, with what I have to offer. And use that tone throughout the whole assessment, throughout the whole evaluation. That’s crucial as opposed to, you know, having a tone that’s, you know, not so not much was the same conviction. That’s not so enthusiastic, you know, your referral says you need some therapy here, you know. Okay, so we’re going to try this before, you know, that has to go. We had to be, you know, eager to find out how we can help them in the best way and, you know, just really defining what’s their situation. And that’s a kind of evaluation. Right? You want to know, you know, what’s their range of motion? What’s their strength? You know, functionally. What are they doing? But say it, and let them also be a part of it. Let them say it. Let them understand where they’re at. That’s crucial. And then just understand what their goals are. Really talk about their goals, and really understand the drive of those goals and if that means asking how you feel about your situation, how do you feel about your goal and getting there? You know, that’s a very good question. I think it’s a question that’s not asked a lot, Garrett, you know. How do you feel about this situation? How do you feel about your goals? And I think you’ll be surprised when you start asking your clients that. You’d be surprised about the reaction that you get from people. It was surprising to me, but once you have emotion on the table, I think people are much more interested in what you have to offer as opposed to you just kind of, you know, not going through the evaluation the same way you just, you know, confirm you had the script. Don’t get me wrong. That’s powerful coming from a medical doctor or orthopedic, a script to a physical therapy office, you know, that transfers authority to the therapist. That’s great. But it’s not all that we need. We need to do more than that. We need to do more. And doing those things, I think, is crucial. And that’ll really move towards them getting on the same page with you and agreeing to the plan of care that you’re putting together for them, which is the best plan of care, right? We’re doctors of physical therapy, you know. Who better to know? How to rehab them than a doctor of physical therapy? So them agreeing to our planet care is exactly, what they need to do, you know?
Garrett Salpeter: (08:49)
Yes. That’s wonderful and independent of whether you’re billing insurance or charging cash. I think that’s wonderful advice and should be, you know, really everyone’s mindset going into any sort of evaluation or assessment or free screen, asking questions, finding out what somebody wants. And, you know, that’s really an example of leadership. You know, first of all, I think it’s important that we think of that therapist-patient relationship or coach-and-client relationship as an element of leadership. And if we’re going to lead someone, we have to be leading them to some destination. And so we have to figure out what that destination is in the first place, and then, part of leadership is also, like you said, laying out the plan of care, helping to, you know, either the therapist, oftentimes, like you said, therapists the expert, make some recommendations, but working together to figure out their goals and kind of co-create that plan. If they’re involved in co-creating it, they’re going to buy in a lot more. So that’s awesome. You’re tapping into some really,
Dr. Mark De Anda: (09:57)
I mean, it sounds super. It sounds almost textbook. Right? You know, you would be surprised, you know, how far people may come away from that. And not forget, you know, we can’t just assume like these clients are, you know, these patients walking in are just going to, you know, do what we say because we’re the physical therapist. No, we need to get some emotional investment in the conversation. We need to draw that out of them. We need some verbal confirmation. All of that is crucial. And that puts them on your path to complete your path of care, which includes your cash services.
Garrett Salpeter: (10:39)
That’s awesome. Yes. Very, very good. So then you’re having this conversation with them. Asking them questions, identifying their goals, and then you go through an evaluation. And then, when you present your proposed plan of care, is that when you’d mentioned some blend of insurance-based services, and some cash-based services? Right?
Dr. Mark De Anda: (11:01)
Absolutely. Yes, you know, you go through your evaluation after the conversation goes on, and you know, you’re writing your thoughts down for your plan of care, including your cash services. Right? You’re completing all that up and then you just, you know, take the pressure off you. You ask them, “Hey, you ready to go through this plan of care? I think I have something for you.” And then, you know, you present it to them, you show them of course your physical therapy plan of care, which is, you know, your foundation, but also special tools that are very important, which may include some cash services and how this is super crucial and you did to go back. Talk to their emotion, talk to their overall outcomes that they want to achieve. And this is what we need to get to there, this physical therapy foundation. But we have these special therapists, excuse me, special therapies as well, that is crucial, vital. And talking with that conviction, again, that tone, Garrett, has to be throughout the whole conversation as 100% certainty. This is the way we’re going to get there. Being the bridge to those goals that you want to get to, you know, and then show them. I show them the price. Let me tell you, I had so much you could tell. So you could have, so you later, but I fought that. I fought that so much. I didn’t want to show prices. I’m the physical therapist, I’m not going to talk about finances. But who better to talk about finances with when they have so much certainty? Right? And we should be viewed as fiduciaries. Right? Healthcare fiduciaries. That’s what we are. So who better and who more trusted to talk about that than us? So yes, I talk about the prices with my patients, I say, “Hey, this is what the special therapy newbie is, and I 100% believe this is going to help you get to your goal. We can start today,” you know. And with that, I just shut up, honestly. And that’s tough because we can continue to ramble on about our credentials and how we’re so smart. And I mean, we are, you know, and what we do, it’s a very small, you know, little bit of information. Right? This physical therapy knowledge. Right? It’s compared to world knowledge. Right? But we know a little bit about this one category, but, you know, we don’t need to be talking about blabbing on about that. We just need to talk about, like I said, talk about their outcomes that they want to get to talk about. Their motion, verbalizing that and talking to that. Play to that tune. And I think you’ll see the results with, you know, being able to sell more, more cash services for sure.
Garrett Salpeter: (14:09)
So if I can kind of reflect back and try to summarize some of the main points here, would you say that a big part of it is really mindset? And I love that you used the word fiduciary, where fiduciary means that you are beholden to give this client, patient, or customer the best options that are best for them, independent of your own financial interests.
Dr. Mark De Anda: (14:40)
Which it should. I mean, that’s number one. Right? That’s what we are. That’s ethically what we should do. Anything we recommend to our people, our clients should with that intent. Right? That’s nothing else besides that. That’s what I’m trying to say. We have to keep that in mind. We’re not selling, excuse my language, you know, a bunch of stuff, or not saying that word, but just saying stuff that doesn’t work. What we’re trying to sell is their buy-in to our plan of care that we 100% believe that it’s going to help them get to where they want to get to.
Garrett Salpeter: (15:20)
Yes, absolutely. So I think that’s a really good way to frame it up, and I’m so glad that you use that word because then that’s sort of the first domino if you go into that interaction with the mindset, you know, identifying as I am the fiduciary. I’m responsible for making the best recommendation for this person.
Dr. Mark De Anda: (15:36)
Yes.
Garrett Salpeter: (15:37)
I think that’s the first domino that triggers the next ones to happen. Where I am going as part of that, then, I’m going to have to ask them questions to understand really what their desires are, what their targets and goals are, and learn about what their constraints are that may inform this decision-making process about what we offer. So there’s a really good mindset there. So that plays into then asking questions and listening.
Dr. Mark De Anda: (16:07)
Listening more. I would say listening more than asking. But still asking why, having that word a lot. It’s super important, that word. Probably, that’s the one word you should use a lot. Why? You know, and just go deeper and deeper into, you know, those things that we were talking about for sure.
Garrett Salpeter: (16:30)
Yes, absolutely. And then, once we’ve listened and we’ve formulated the plan. Then the next part of being a fiduciary is being able to genuinely and authentically provide our recommendation or for you to be able to provide your recommendation. And if that includes cash-based services, then you want to be able to recommend those.
Dr. Mark De Anda: (16:54)
Without assumptions. Without assumptions is crucial too because, you know, I was guilty of doing that a lot. You know, when we had initially brought on cash, or I would just assume. Right? For whatever reason that this person couldn’t afford what I was recommending. You know, if those assumptions are on your mind when you’re ready to present, I mean, it’s going to go south. No, you got to just keep that out of your mind. You’re not helping anybody with assumptions, and you don’t know how important it is for these clients to get to their goals. You’re not in their head. You are not them. You don’t know their financial situation. You don’t know if they have backing financial. You don’t know any of that. So keep those assumptions out of your mind and just present what you believe will get your clients to their goals. If that includes cash services, say it with that conviction without those assumptions in mind, that’s the best bet.
Garrett Salpeter: (17:59)
Awesome. So that’s another good mindset shift is just to get those assumptions out of our minds there. That’s good. That’s good key points in terms of the mindset and how we show up to these interactions. How, you know, for therapists listening to this, how they show up because that many time is the key indicator or the key determiner of how effective the interaction goes and how effective you are as a therapist. So I think that’s really good. I’m so glad you started there with those key mindset shifts, being a fiduciary, asking questions, identifying goals, and getting rid of assumptions. And then, let’s talk tactically, you know, a little more in terms of when you’re actually having those conversations. Are you just introducing this plan, saying this is the plan of care, or are you ever using a good, better, and best scenario? Or can you talk a little bit about the practicality of how you’re presenting options?
Dr. Mark De Anda: (19:05)
Well, you know, one thing I try not to devalue my services and I try to set up my patients for success. Those are two things I’m trying to keep in mind. So, whatever it is that you’re offering whether it’s, you know, physical therapy and needlework or physical therapy with the newbie, keep in mind like that frequency and that duration it, you know, set them up for success. Set them up that they’re going to get to whatever they need to get to truly, you know, based on who they are, you know, their conditions they got going on. So I’m going to keep that in mind and I’m not going to devalue pricing either. I believe in the newbie. I believe that it does really great work for the nervous system, helps people get rid of pain, and helps them rebuild strength safely. I believe in all that. So I’m not going to devalue that price. I’m not going to say, you know, “well, I know it’s a lot then if we’re going to do this 50% thing,” No, that’s not going to happen. I did that initially, you know, but I started to realize I think that’s, you know, not the way to go about it. If anything I would start high, you know, with your recommendations whether it’s a couple of months or maybe a month of, you know, working with the newbie. And then, if they want to, you can give them maybe an option. I don’t like to give them too many options because, you know, then they start thinking about their time, their schedule, and then all of a sudden they’re going into their more logical mindset and not so much their emotional mindset. So I just want to make it easy. So I’ll, you know, give them my recommendation, whether it’s a few months or months of special therapy into physical therapy, or I’ll make a recommendation that I know they’ll get some relief, but they won’t get to their goals. So maybe a week off, you know, newbie training or physical therapy. And I’ll say it, you know, “look, I get it, you know, this is new for you and you just met me, so try it out” and I’ll give them like a trial run. But I said, you know, really immediately when you start to see results, and I’ll play to that tune as they’re going through their trial, you know, I’m there too. Making sure that they realize what’s going on here and helping them make that transition to that full plan of care that I really think will help them get there. And just being honest with them as well. You’re not going to get to your goals in this time period, but it will help you with pain. It will help you with decreasing this, you know, limping you got going on. But I immediately, when you start to understand what’s happening here, you really need to commit to this goal or to this full plan of care so that you can get back to, you know, going to your hikes or go back to getting ready for your, you know, rock climbing expedition this summer or whatever their goals are. But continuing to play to that tune is crucial. And catching them early on, I think as well on during that treatment is very important because there’s a lot of excitement, you know, there’s a lot going on and they may know a big reduction in pain, and catching them during that excitement say, “Hey, look, you’re doing great. I can see you’re not limping anymore. You have less pain.” Let’s just credit you what you’ve already paid for with this trial to your full plan of care, and let’s just commit to that full plan of care. That’s an easy transition. It’s easy, especially when you can show quick results, which the newbie does. I mean, I’ve seen guys that were totally in a, you know, locked up, you know, inflamed situation with their lower back and then some work with the newbie one day, and, you know, they’re walking with a lot less pain. They’re feeling better, about their situation. You know, don’t lose momentum with that. You know, that’s the time to get people to commit when, you know, we can show those quick results. That’s the time to get them to transfer to the full plan of care that you want for them.
Garrett Salpeter: (23:34)
That’s awesome. Yes. And that is one of the things that we hear a lot. I’m so glad you mentioned that about how when people notice changes quickly, they’re motivated to want to continue to comply with the plan of care. So that’s a big differentiator. Some people might be wondering because of that. Do you ever give free trials or samples of the newbie? Or do you ever do anything like that?
Dr. Mark De Anda: (23:59)
You know, we did initially, Garrett. So sometimes, well, I think that does two things. I think that opens the door to people that just want free stuff. And then, that also devalues, goes back to devaluing what you’re doing. And, yes, you know what I’m talking about. This technology that we have at the clinic. You know, it’s stuff that we really sought after we really did some homework. We went around the nation looking for the best tools. I mean, it’s not cheap. No. So, you know, to devalue say, “Hey, here’s a free trial. I mean, I feel like it was my job to show value initially, and if I’m to the point where I’m sorry, I’m starting, excuse me. I’m starting to say, “Hey, let’s do a free trial.” I didn’t do my job right. I didn’t show value. I didn’t talk about how it’s going to help them to get better faster. I didn’t talk about how it’s not going to hurt. Their pain’s going to be less. I didn’t talk about, you know, enough about whatever their desired outcomes are going to be. I didn’t talk about, you know, how certain I was that this was going to work. But all that, you know, that’s crucial. If you do that right and you do that thoroughly with that initial conversation, then you know that the value shouldn’t be a price. Because it’s just going to dwarf that value. Excuse me. It’s going to dwarf the price, and the value will be up there, excuse me. The value won’t be dwarfed. The price will be dwarf, but the value is going to be super high.
Garrett Salpeter: (25:54)
Yes. And if you give it away, the perception of that value is lower. And I think that that’s good what you said, I mean, as physical therapists contemplating charging cash services at all. I think a lot of people have those same fears and limiting beliefs that you mentioned and I think it’s important to remember that you invested the time and money. Right? To get the PT degree and license, you know. So you should be perceiving yourself and charging as, you know, more than a personal trainer or someone who doesn’t have your credential. Or, I mean, you should know that. Plus if you’ve invested the extra time and money to learn the new fit method, acquire a newbie device. I mean, you are absolute, you’re making an investment there that is legitimately adding significant value to your patients, and you can and should be, you know, able to receive more value as well. So I think that’s a great mindset shift in terms of just trying to think about what might be on the minds of some listeners. And one other question that I think may come up is how you’re actually doing this. So with the newbie, is it only a cash service? I mean, is it ever included in insurance in your practice, or is it always a cash service? And is that just an add-on or is that instead of insurance based or was it an add-on? Can you just talk about kind of how you structure it at your practice? And then with the qualification that, you know, we’re not giving, you know, compliance or legal advice to anyone else.
Dr. Mark De Anda: (27:32)
Right.
Garrett Salpeter: (27:32)
I just want to hear an example of how you do it.
Dr. Mark De Anda: (27:34)
Yes. I’ll know a legally compliant consultant. I’ll leave that for my people here in Texas. Mary do long, she’s great. We use her. We, you know, offer a variety of special therapies that are not covered. Right? The newbie is one of them, and we have it strictly, apart from our physical therapy, covered insurance services. And we make it very clear, you know, this is what’s covered by your insurance. These are things that are not if we put these into practice, there’s going to be a price, and we have our price sheet for whatever those special therapies are. But that’s it in a nutshell.
Garrett Salpeter: (28:18)
So you’ve drawn the line in the sand that the newbie, it’s just like dry needling that we talked about, you know, it’s not covered at your practice. And anyone who wants it is going to have to. That’s going to pay cash for it.
Dr. Mark De Anda: (28:32)
Yes. That’s going to have to be your, I guess for the private practice owners that are listening. That’s going to be your inquiry. You’re going to have to inquire about that with your consultants. You’re going to have to inquire that, you know, with your state board, there whatever state you’re. And you’re going to have to make that decision with the laws that are in place and your legal consultant. I highly recommend, you know, getting a consultant for compliance. That’s very important. You know, you don’t want to be double dippy and things like that.
Garrett Salpeter: (29:10)
Yes. And so you’ve made that distinction. And another part that’s important there is, uh, you know, there are people who will make the case that using the newbie is neuromuscular reeducation. However, there are people, as you described in your practice, that you are making the case that it’s not covered because there is no code exactly for the new fit method and the newbie device. And one of the keys there is that you are, however, you apply it, that it’s consistent so that there’s no discrimination, either that you’re applying it. You’re not including it as an insurance base for some charging cash for others. So that’s then the next piece. So the fact that you’ve, you know, made that distinction and you’re consistent across the board is another important piece of it there. So, practicality, that’s great. I really appreciate your description of the mindset and then kind of drilling down into how you’re actually describing it. Then just to kind of clarify that too, when people are signing up, would they be on the same visit? Would they do new fit treatments and also any insurance-based physical therapy? Or would those be totally separate visits? Can you just tell us a little more about how you actually do it?
Dr. Mark De Anda: (30:26)
Well, I mean, you and your training, you have the initial evaluation, the scanning. That’s crucial. You know, you got to know their points of pain and try to eliminate that. So, if I could start that day, you know, and I can give them that option, you know, we can start today, you know, that would be ideal. Right? But sometimes people don’t have an hour and a half to two hours. So I’ll say, well, we got to schedule it, but before we schedule, we got to have some financial commitment. Right.
Garrett Salpeter: (31:04)
When you say they don’t have an hour and a half, that means it’s not like it’s normally the whole visit that, but that’s if you’ve done your evaluation and then they would stay and then do the new then after that. Okay. Yes. Just to clarify.
Dr. Mark De Anda: (31:14)
Exactly. I’m sorry. Yes. You know, cumulatively, you know, you’re looking at an hour and a half visit, maybe two hours. Right? Because they’re going through, you know, your assessment, your screening, and them do going there at their office doing all that paperwork. Right? So they may not have that time, but if they have to reschedule, you know, it’s vital that they have some financial commitment. If they don’t have anything, any skin in the game, there’s a very good chance they’re not coming back. I would say that’s more probable than them coming back. So getting them on the books requires them to purchase, you know, their recommended newbie treatment plan of care in full. Yes. So that’s, but ideally, I would like to see them at least for the scanning, but if that’s not possible, scheduling them, you know, with the payment of the services. Yes. It’s very important.
Garrett Salpeter: (32:14)
Okay.
Dr. Mark De Anda: (32:16)
As a matter of fact, I just had a meeting with my staff over that because I did notice that. And sometimes you may get some surprises, you know, somebody may come back but not all of that. I would say that majority of the time if they don’t have their special therapies paid for. Yes, they won’t come back for that second visit or that first visit, technically.
Garrett Salpeter: (32:40)
And then, when they come back. Are they only doing that special therapy visit? Are they only doing a new fit treatment, or would they do that, and would they do some other of your, you know, other PT offerings?
Dr. Mark De Anda: (32:53)
Well.
Garrett Salpeter: (32:54)
How does it depend on the plan of care?
Dr. Mark De Anda: (32:55)
No, the plan of care, you know, it’s the first day of their planet care. It’s crucial. So going through their training with the specialist and, you know, all the manual work is very important as well. The newbie, it’s a tool. Right? As well we have to use that. And the scanning is important. So we have time for that. It’s really just contingent upon the schedule, you know, if we have sometimes, you know, with the newbie, it brings a lot of excitement. Right? And there’s a lot of people that are using it. So maybe if there’s, you know, somebody using it, we may want to reserve it for the end, but perhaps if it’s open then we’ll use it from at the beginning and we’ll have time with that training. And then once that training is done, that scanning is done, then we move on to our other, uh, crucial things we got to do, which is, you know, mobilizing joints, stretching muscles, relearning movements, balance work. And then, of course, our manual work therapist. I hope that therapists are watching, you know, they’re still using their hands and they’re not using that’s one gun that looks like,
Garrett Salpeter: (34:09)
The hyper volt or the meth Aragon, like those guns?
Dr. Mark De Anda: (34:12)
Yes. That’s just like, you know, I used that once on my elbow and it really hurt. And ever since then, I totally,
Garrett Salpeter: (34:23)
You’re gun-shy around it now.
Dr. Mark De Anda: (34:25)
Yes, a gun shy.
Garrett Salpeter: (34:28)
Yes.
Dr. Mark De Anda: (34:29)
But, you know, it’s just contingent upon the schedule, you know, it’s just whatever the availability is, you know, but it’s very much separate. You know it’s not going to be the treatment. It’s all itself. It’s the training with the newbie. That’s so special that helps people get to that place with no pain. And then eventually, you know, like what you talk about, how it helps them with their safety. It helps them with their strength ratings as well.
Garrett Salpeter: (35:02)
So, when a patient who’s bought this extra package of new fit sessions with you, when they come in to use that in one visit, they very likely, you know, may vary, but they very likely will do their new fit treatment and then either before or after that they may also do some covered services, other manual therapies or other things that would be covered by insurance. They’d be doing both.
Garrett Salpeter: (35:27)
Absolutely.
Dr. Mark De Anda: (35:27)
The cash payments and the covered services are in the same business. And maybe, they have to do some needling as well, you know. Maybe, they have to do some dig around, some very stiff joints, and they may be doing two special therapies. So it’s contingent upon the plan of care. And I’ve even had three special therapies. So it really depends on the plan of care that you’re trying to do and what you have scheduled. But, you know, schedule out those special therapies the way you would schedule out a plan of care and have in your mind. You know how this patient is going to progress throughout the week and throughout the month. And what you don’t want is for them to buy, you know, a whole, you know, plan of newbie and they do it once or twice, and they never use it again. It’s been a month later, you don’t want that, you want to exhaust that. You want to use that and just make sure that’s crystal clear and you have good planning. And it’s very important.
Garrett Salpeter: (36:27)
Awesome. So that’s good. I think we’ve gone through and done a very thorough discussion of the mindset and then, you know, how to kind of structure the offering. How to have these conversations? Is there anything else, knowing your own process and mindset? Is there anything else you feel we really should add here to complete the conversation or any other elements here?
Dr. Mark De Anda: (36:56)
For the new newbie owners and the private practice owners that are starting to do cash services, I challenge you to speak with a tone of conviction and just have that tone and just really try to get them to verbalize their desired outcomes. I think if you just do those two things. You’ll be surprised at the end of the conversation, you know, what they’re willing to commit. And I challenge you. I’ll try to do those two things, use more tone of conviction and more certainty. And then really define those desired outcomes and continue to speak in that language of their desired outcomes. Right? Because we could talk about ourselves all the time, but they don’t want to hear that. They want to hear about them. They want to hear about their goals, you know, their dream outcome that they want to get to and what do we got to do to get there, you know?
Garrett Salpeter: (38:07)
That’s awesome. Yes. Thank you for that for anybody listening. If they want to check out your practice or look you up and learn more about you. What’s the best way to do that Mark?
Dr. Mark De Anda: (38:18)
You can email me if you all want to schedule a call to talk more about this at www.optimumphysiotherapies.com. You can just holler at me, and I’m open to any of my colleagues if they want to talk more about this. I actually talked to quite a few here in Texas, so I’m pretty passionate about it. I would say.
Garrett Salpeter: (38:43)
Awesome. That’s very gracious of you, and I appreciate, you know, giving out your email to listeners. And so if anyone’s interested, that’s Mark, at www.optimumphysiotherapies.com and that’s also his website URL domain too. If you want to look up his practice. Got a great practice just about an hour away from Austin. In Austin, he is down in San Antonio. And I appreciate you coming on, Mark, and sharing your wisdom and passion with everybody. And it’s a great topic. I think this will really inspire a lot of people to, you know, look at how they’re having intake conversations and also how they’re structuring their offerings and, you know, think business, think about interpersonal, interactions with patients and all these different things here. So I think it’s really wonderful and thanks so much for joining us.
Dr. Mark De Anda: (39:35)
Hey, thanks for giving me the opportunity. Thanks, Garrett.
Garrett Salpeter: (39:38)
Heck yes. I loved having you on this podcast. Have a great day, and thanks, everyone, for tuning in to this episode of the Undercurrent Podcast.
