2024 Cash Practice Trends: Insights from The DPT to CEO Team
Thinking about ditching the corporate grind and starting your own cash-based practice? Or maybe you’ve already taken the leap and want to level up in 2024?
In our latest interview, the DPT to CEO team shares real stories, lessons, and strategies that have helped us (and a lot of others) build successful practices. We’re diving into the tough parts of getting started, what it really takes to succeed as an entrepreneur, and how to market your practice authentically.
We’ll also talk about the best ways to attract patients, why fewer people are asking “Do you take insurance?”, and what we’re focusing on for 2025 to grow even more. Whether you’re just starting out or ready to scale, this is packed with actionable advice to help you take your practice to the next level.
What we're covering:
Let's go around the room and have everyone introduce themselves.
Tricia: Hi everyone, I'm Trish, and I am a virtual assistant as well as a licensed physical therapist. I handle the administrative portion of the DPT to CEO program. Currently, I've scaled back to primarily focus on just you [Morgan] as my client. As a virtual assistant, my main goal—my "why"—has always been to help therapists and healthcare professionals pursue what they love.
Essentially, I take care of the less enjoyable aspects of running a business, which is my niche, though it’s quite a broad one. My role involves doing whatever tasks you might not enjoy or prefer to avoid.
Taylor: My name is Taylor, and I work within the DPT to CEO team as a marketing assistant/specialist. Essentially, I assist Morgan with all of her content and handle her digital marketing clients. I create their content and, most recently, have transitioned into building websites for all the DPT to CEO students. When someone opts for the one-on-one coaching service, I'm the one who builds their website or conducts audits if they already have an existing site.
In addition to this, I run my own business called The Pelvic Marketer. I've been in business for just over a year now, which feels wild. Like Tricia mentioned, I've also had to pull back a bit recently because I had a baby in July, and he now takes up a lot of my mental capacity. So currently, most of my work is with Morgan. Before this, I was helping other healthcare practices with their digital marketing, specifically content marketing. That's kind of my niche, particularly in pelvic health, which I really enjoy. But I love working with all therapists and healthcare providers.
Sam: I am probably the newest member of this team, having joined after going through the program myself about a year ago. It's crazy to think about, but I just celebrated my one-year anniversary of leaving outpatient physical therapy in September. It's been a whirlwind of a year! I now run my own cash-based practice focused on tennis and pickleball functional physical therapy, and I absolutely love it. I'm based in the Dallas area, so if you're in Dallas or Texas, feel free to leave a comment, and I'll get back to you.
I've recently joined the team as an assistant coach, helping Morgan with some of the coaching within the program. I've honestly grown to love this role so much. Meeting new people, seeing what others are doing, and helping them build their own practices is incredibly rewarding. I know my life is so much better today than it was a year or even two years ago.
Morgan: And if this is your first time listening, I'm Morgan. I'm the CEO of DPT to CEO, and I also run my own cash-based practice. All of us are here to improve healthcare for our patients and improve careers for healthcare providers. I firmly believe that you don't have to be miserable in your career; you can actually enjoy it. That's the vibe we're going for here, and I appreciate all of you sharing your experiences.
We have an incredible team spread across the country. Sam is in Texas, Tricia is in New Jersey, Taylor is in Kansas, and I'm in Nevada. We've had the privilege to work with clients and practice owners nationwide, from Florida to California and New Hampshire to Wyoming. Our goal is to help practice owners everywhere build the cash based practice of their dreams.
*Thinking about starting your own cash based practice? Learn how to know if you're ready at the blog post here.
What has been the hardest part about starting your own business?
Tricia: Just doing it—that sounds so simple, but for me, the hardest part was taking the leap and deciding, "I'm going to do this." Coming from a virtual assistant (VA) perspective, it wasn't like I had to figure out if I was going to start a brick-and-mortar business or anything like that. I literally just needed to commit to my decision. Some of my coworkers and family members thought I was insane for wanting to leave my job as a physical therapist. The funny part is, when I told people I became a virtual assistant, they often misunderstood and thought I was working for the VA (Veterans Affairs). So, I was frequently asked if I was still a therapist, to which I replied, "Yes, but I'm also a VA." It's all about making that jump and standing by your decision.
Taylor: I think the hardest part was having to wait out my contract so that I could leave. It required a lot of mental fortitude. But, I had to really commit to the decision of leaving and bet on myself.
Sam: I agree with Tricia—it's hard. For me, the biggest challenge was making the mindset shift. I was so excited to finally work and be my own boss, but suddenly having the boss mindset meant I was the one making all the decisions. There was no one else to blame but myself when things didn't go right or when people weren't coming in the door.
I remember having a conversation with Morgan about this. I questioned whether I really wanted clients if I wasn't acting like I wanted them or if I wasn't taking the necessary actions. It was so important to take action because, especially in the beginning, you can't really take a step back. Later on, when you have a team and can delegate more, it's different. But at the start, making that shift from being a physical therapist in a system where there was always someone else to blame was tough. I didn't want to do the things they were telling me to do, but when it's your own business, it's all on you. Making that mindset shift was challenging at first, but now I love it.
*You can learn more about the "entrepreneur mindset" at the blog post here.
What would you say makes someone successful as an entrepreneur?
Taylor: First, the mindset shift is huge. Have confidence in yourself and understand that it's okay if something doesn't work out because you're going to learn from it and move forward. The mindset shift is step one; you have to get out of your comfort zone and be okay with being uncomfortable while seeking change. It will make you better, both as an entrepreneur and as a person.
Self-motivation is also key. You're the only one who can push yourself to get things done. As Sam mentioned, everything falls on you. If you're not getting clients or seeing the number of people you want, or making the money you want, then you're the problem. It's up to you to figure out how to stop being the problem and really dive into self-reflection. You need to ask yourself if this is truly what you want. Do you want to risk having to go back to work because you're making no money, like working in a clinic? As scary as that is, it's also pretty cool because you aren't being told what to do.
Sam: I would say my thing would be, can you commit? Do you have commitment issues? It sounds like a relationship thing, but I think it applies to life in general, especially when you're starting something new, like business ventures. You can't say if something is a success or failure in less than a year. I think it has to be at least a year, really two, before you can truly say if you failed or succeeded. So, it's almost like being able to ask yourself if you have commitment issues. I think it would be really difficult to start a business if you do because you're going to want to do something new every two weeks. You'll have all these great ideas, which is awesome, but it also takes time to build something. Very rarely does it happen in two weeks or six months; it does take time.
Tricia: I definitely agree that you have to be the one to step up, especially when it comes to things you don't know about. You need to take the initiative to find out what you need to do. That's where we come along as a team to help you figure things out. You're not going to know everything, and you're not expected to. For those who are just starting out, especially newer grads, it's important to start and try things out. Give it six months to a year, and as you're working on it, you'll see how things evolve.
Take Morgan for example. I feel like Morgan can really speak to this. Over five years, her business has transformed. We often meet students who feel like something isn't working, and they worry they've made a mistake. It's important to help them refocus and remind them that it's okay if things change. It doesn't have to be exactly what you started with. Change doesn't mean failure.
Morgan: Absolutely, you know, like, I feel like it's kind of like when you're treating a patient. I've had this happen to me where they come in presenting with one thing, and I think it's one diagnosis, but then stuff happens, and it turns out to be another diagnosis, or they come in with one injury and end up with five. Stuff is going to happen, and you can't always predict what's going to come down the path.
I was just going to say I think it's funny because I’m pretty sure there have been like 15 iterations of what I'm doing. God bless every single person on this call right now because, you know, as I'm navigating and driving the ship around icebergs and launching it off of cliffs and stuff, you guys, I just really appreciate you trusting me and being along for the ride.
I think that's something too, like kind of going off of what Tricia was saying, you know, once you make a decision to start the practice or the business, you're gonna have an idea, try it out, and like Sam was saying, you have to commit to it for a certain length of time to really figure out whether it's going to work, whether it has legs and you can build off of it. If you're switching things every two weeks, you're not going to get anywhere. It's like rowing a rowboat with one oar, just going in circles and not really getting anywhere. You have to be willing to commit to things but also give yourself grace, knowing that things are probably going to change. Rather than worrying about the change, look at it as leveling up, evolving as a business. That's normal and expected.
Taylor, what are your thoughts on faceless marketing?
Taylor: Yeah, I think it is possible. I mean, I think you can do it. But, especially when you're selling a service like therapy or a solution to a problem, you have to be able to invoke an emotional response in somebody. Without them being able to see your face and know that you're a real person who can help them get back to exercising without peeing their pants or playing with their grandkids without, you know, whatever—back pain, something random—they have to be able to see and know that you're the person who's going to give them that outcome.
So, I think you can do faceless marketing, but I'm like 98% sure it won't be successful in terms of getting clients. And that's just kind of the long and short of it. People don't care what you look like. People don't care if you are done up or not. Heck, all of Morgan's content shows her chilling in her tank tops, and that works because people see her for the authenticity and the genuine person that she is. They're like, "Oh yeah, I can relate to her. I don't have to be fancy and look cool." I think that's maybe one of the things about the DPT to CEO program that stands out. We're not in your face.
Morgan: We're like mostly "normal."
Taylor: Exactly. And that's what people want to see—they want to see normal people dealing with normal or common problems. So yeah, Sam, just tell whoever asks you that—don't do it.
Sam: No, that's a good answer, and that's kind of what I was thinking too. It's just funny because there's this trend of faceless marketing, where it's all about extremely passive income. I know people get into that space wanting to be a CEO, and of course, they want the easy way out. It's like we said earlier, wanting to put in the minimum amount of work or working just one hour a week. Maybe if you've been in the business for 20 years and you've offloaded everything, that's possible. But starting now, I just don't think that's reasonable.
Taylor: I was just going to say, like, I know myself, if I'm looking for a service provider for anything, and I don't know what the person looks like, I'm going to have a really hard time trusting them. So, they need to be able to see your face. Even if you're only doing an online practice, if people don't see who you are, why would they trust some person from the internet?
Morgan: Yeah, absolutely. In my opinion, the only way to really make that work is through a ton of word-of-mouth referrals. You know, people calling you because someone gave them your phone number. But for most folks starting their own practice, you're basically starting from scratch. Sure, you might have some connections in the community, which is great, but to handle the volume of customers you need, you'll have to figure out how to get more inbound leads. So, exactly, having a website, a Google Business profile, and an Instagram is essential. Without those, you practically don't exist in the business world.
What are the best ways to marketing PT and find patients?
Taylor: To start with, if you want to get patients fast, you really have to put yourself out there and talk to as many people as possible every day. This means going to any facility or place where your target population hangs out. It's the fastest way to gain patients, but as you mentioned, it requires a lot of effort. On the other hand, digital marketing is also a lot of work, but it offers longevity. Once you create content, it's there forever.
I think social media marketing is extremely important. You should definitely have a presence on YouTube and Instagram—those are the top two platforms you need to focus on. If you're wondering where to start, those are the ones. You need to be on them consistently, sharing information about your practice, the services you offer, and how you help people. However, this approach takes longer. So, you either do the hard work of talking to people directly, or you commit to these two platforms for the long term. Honestly, both approaches are challenging and neither is easy.
Morgan: Yeah, and none of it really is, but I guess that's part of, you know, like what you're signing up for. What's easy is staying in a job that you hate because it's theoretically secure, you know? But I don't think any of us got into healthcare to have an easy career, so you guys can probably do hard stuff.
What do you think Sam?
Sam: Honestly, I'm really into community building, and it's a big part of what I coach. I believe it's super important, especially for my practice, and it has really helped it grow. Like Taylor said, it's probably the most uncomfortable thing to do because you have to get out there in person, leave your house, and talk with others. For me, I do this by playing tennis and pickleball, which I enjoy. But when people ask what I do, I have to talk about myself, be confident, and make a sale if it's appropriate. Despite the discomfort, this approach has been the most effective for me, and it's something I strongly advocate for.
I still use social media, of course—my Instagram is probably my number one platform. Like Taylor mentioned, Instagram and YouTube make the most sense, and I agree. I get cold leads from my Instagram, which is great. I've even had people approach me at my car when I'm leaving someone's home, curious about what I do, so things like car decals can be effective too. However, community building stands out for me. In our program, we have something called The 100 Challenge, which is all about telling 100 people what you're doing. It sounds simple, but it works, and I've seen it work repeatedly, especially for me when I did it a year ago.
Morgan: I love introducing this other idea to people, especially those interested in the fitness realm, whether it's CrossFit, bodybuilding, powerlifting, or just regular gym-goers. It's like a niche you want to develop with your practice, kind of like level two of The 100 Challenge. The whole vibe is about acting like a successful business, which to me means being assertive and aggressive in pursuing what you want—kind of like a shark.
One fun challenge you could try is what I call "Gym Shark Month." The idea is to spend an entire month scheduling and attending workouts at different gyms. The initial intention is just to check out the vibe, the community, and the people there. It's about exploring potential business opportunities but without the pressure to pitch anything. You just go in incognito, participate in the classes, or use the gym facilities to see if you enjoy it.
I'm talking about scheduling three to five classes a week. This way, you're really putting yourself out there in the community, especially if you don't already have a foothold somewhere. It helps you figure out where you feel comfortable, where you can make friends and new connections. This strategy builds momentum and builds on what you've accomplished with The 100 Challenge. At the very least, you'll have the fittest month of your life, which is a win for both your body and your company transformation.
*If you're hoping to see clients out of a gym setting, check out the blog post here.
I haven't had a patient ask if I take insurance in a really long time. What are your guys' thoughts on this?
Sam: I 100% agree that the cash-based health model is way more common these days. Especially, I don't know if it's just the population that I treat, but, you know, tennis women usually have money, country clubs and so on, and they're more likely to see cash-based practitioners like me. They still carry insurance, but I think this trend reflects a broader shift in health care in America. People are more willing to go cash-based because it often means better care, and in the end, it can actually save them money. A lot of my patients have PT deductibles that are insanely high, and it's cheaper for them to see me once a week than to pay for three sessions a week at an outpatient clinic.
I do think there's a shift in America towards people wanting concierge care. I have someone who refers to me; she's a functional medicine doctor who only operates on a cash basis. She charges a monthly membership fee, which isn't cheap, but she does very well because people want to live longer and healthier lives. Health is becoming a priority, whereas maybe in the past, it wasn't as much. So, I think there's a bit of a mindset shift happening both with clients and with practitioners.
Tricia: I definitely agree with that. Even my primary care doctor, it’s the same thing—we have a monthly fee, but I can literally text him whenever I want, and I get answers. I feel like I have his attention whenever I absolutely need it. And that’s where the concierge model is so different compared to what people experience in the clinic. Especially in outpatient settings, it’s not uncommon to have multiple people assigned to you in that half-hour or hour session. Even in subacute care, the groups kept getting bigger, and concurrent sessions became more frequent. I had really sick patients who just wanted me with them, but they were getting a new PT every other day. If you can have just one therapist who’s focused solely on you, they’ll get better faster. Who doesn’t want that?
Taylor: Yeah, I think it just kind of goes without saying that the quality of care is going to be better when you’re not sharing your time with multiple people. But I absolutely agree. For example, my parents have been to therapy recently, and their co-pay is like 50 bucks a visit. I’d say the average cash visit is probably around $150 to $200, depending on where you live. But, like you said, they’re kind of being bounced around. If we can get people better faster by providing better quality care, they’re either going to spend less money, or they’re going to spend the same amount and actually get results. That’s a huge incentive.
Tricia: Not to mention, for that, they’re probably on an insane waitlist. Sometimes, especially as you get into more specialized care, it’s like, “Oh, I can see you in three months.” No—find somebody who is solo and can see you tomorrow.
Morgan: Yeah—so I started seeing a pelvic floor patient earlier this year, I think. She came to me because the pelvic floor PT she was referred to had a 14-month wait. Like, how do you even have a wait that long? I mean, she could have another baby in that time! Wow. So I was like, “Okay, cool, I can see you next week.”
What are you going to be working on in 2025?
Sam: So, I’m looking to scale next year. This was my first year in business, and I still consider it September to September. I spent this year really working on getting solid systems in place, making sure people know who I am, and basically doing all the roles myself.
Next year, I’m planning to scale my caseload a bit and maybe outsource some things I’m not great at. I’m finally at a point in my business where I can start doing that, which feels huge. It’s exciting to think about stepping more into the CEO role instead of just treating all the time.
Tricia: So, I’d say for 2025, my goal and vision are really about laying the groundwork for future plans. Right now, I have one kid in school and one still home with me, which is part of the reason why I’ve narrowed things down to just Morgan and me. As we’re getting closer to both kids being in school, I’m starting to think about and prepare for what I want this to evolve into. I’ve talked to Morgan a few times about some ideas and visions for what I’d like to do when there’s more time—when I’m not being interrupted by a three-year-old in the middle of work! So yeah, I think 2025 is going to be about vision boarding, figuring out what’s next, and laying the foundation for it all.
Taylor: Yeah, so I feel like more than anything, going into working for myself, my whole goal was to have more flexibility—to raise my family and really prioritize that. So for 2025, instead of focusing on growing my business, I want to work on molding it to better fit the lifestyle I want for me and my kids. And I know that’s probably not super motivating for students who are just starting their own practice, but it’s the season of life I’m in right now. That’s one of the great things about being an entrepreneur—you can adjust to make things work for whatever stage of life you’re in.
Personally, I feel like I’ve been more disorganized now than ever before. In the beginning, that was super anxiety-inducing, but now I’m just like, “It is what it is; I’m doing my best, and it’s going to be fine.” So, for me, 2025 is going to be about doing things that make me happy. I want to work, but I also want to prioritize my family.
Tricia: I still think that’s super motivating, honestly. For you, I don’t know—I felt excited for you just hearing it. But Morgan, you can probably speak to this. Our students aren’t always just, “Hey, I just graduated from PT school or healthcare school, and I’m ready to start my own business.” They’re people with families, real-life responsibilities, and experiences.
You talk about wanting real-life experience? We’re out here trying to survive—balancing jobs, kids, and everything else. And, eventually, these two [Morgan & Sam] will join the mom club and have to juggle it all too. But for so many of our students, that’s their dream: to be home with their kids, not working until 8, 9, or 10 o’clock at night or spending weekends in the clinic. They want to actually see and spend time with their kids.
I think that’s incredibly motivating. It’s not just about building a business—it’s about creating a life that works for you and your family.
Sam: I do want to add something, and I don’t know if this is going to sound silly or not, but yesterday was one of those moments that really hit me. I had a full day of things to do, and at 1:27 p.m., I just stopped for a second and thought, I’m not working in an outpatient clinic. It was a random Wednesday, and I felt so lucky to have created this life. I couldn’t imagine my days looking like they used to in the past.
There is truly nothing more rewarding than having the freedom to control your own time and decide what you want to do with every hour of your life. It’s like your days feel longer, and you actually feel like you get all seven days of the week. That’s something I never thought I’d experience. So, if there’s one thing to take away, it’s that—having the freedom of your time is everything.
Morgan: Yeah, I think that’s all really great stuff to bring up because—and this might sound like a pitch for this program—but there are so many coaching programs out there that promise you the world. They’ll tell you that you can have multilocation clinics with tons of clinicians, make $3 million in your first year, and blah, blah, blah. And sure, if that’s what you want, that’s an option—you can absolutely go for that.
But a lot of our students really value their time. They want to take their lives back and build a business that fits into their lives, instead of just trying to squeeze in life around the clinic. And I feel the same way. Even when I get stressed because there’s so much to do, I remind myself, This is what it’s like to really live. I’m in control. I’m doing what I want to do.
There’s so much value in that. These are amazing goals, and I’m so excited about what’s ahead. I also really want us to keep reaching more practitioners and working with more clinicians next year—to help more people build a life like this, where they’re doing their best and truly living.
*If you're interested in building a practice that fits your life, check our DPT to CEO program here.
How to contact our team:
Morgan
*Website: https://www.morganmeese.com/
*Instagram: @dpttoceo
Sam
*Website: https://www.functionphysicaltherapy.org/
*Instagram: @drsam_thefunction_pt
Taylor
*Website: https://www.thepelvicmarketer.com/
*Instagram: @thepelvicmarketer
Tricia
*Instagram: @patriciaminer_va
Listen to this episode on my podcast!
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