2026 Rehab Report: Burnout, Cash Flow, and Clinic Survival

0:00 You're listening to the PT Pinecast, where smart people in healthcare come to make noise. Here's your host, Jimmy McKay. Welcome to a breaking news. Something just hit my inbox. Important enough for me to put on a tie for the first time in, checks notes, three and a half years. I'm physical therapist, Jimmy McKay. And let's dive into some statistics just dropped in the state of physical therapy or the state of rehab report by Prompt. Health in twenty twenty six. Eighty percent. That's how many PTs, according to this brand new report, that just should have hit your inbox if you follow prompt.

0:42 Now, eighty percent. That's how many PTs, according to this brand new industry report, are either considering leaving the profession or retiring. have already got one foot out the door. And that's not a vibe shift. That's a system failure. Let's dive deep into the twenty twenty six rehab therapy industry report, which just came off. It's hot off the inbox for what's really happening inside your clinic walls. You think you can figure out what's going on by reading anonymous survey reports from your clinicians? You can't. You think you can figure it out by being in Reddit threads or Facebook groups? You can't. You need hard data where all the data people Oh, good. There you are.

1:22 Prompt got the data. This way you can figure out what's really happening inside your clinic walls, what people won't say to your face or in anonymous surveys. Why are some practices growing like crazy while others are bleeding out behind the front desk stick around we're going to dive into this it's not just for therapists this is for clinic owners directors and educators anybody who gives a damn about where this profession is headed i i wish this report dropped before this weekend so we could have talked about it a lot at the on-site graham sessions that we were at at apc headquarters but here we are on a random tuesday in january and we're going to dig into this now for the people watching the live stream on any platform you can comment live and eventually i'll be able to get to the comments I am a one-man show.

2:08 I know, Tony Meritato, I'm dumbfounded too, but I dug into the closet deep to break out the tie. So let's get into this. We know we'll be talking about this in depth with Tony and Dave Kittle on our PT Breakfast Club live stream on Thursday morning, eight-thirty Eastern. Now, the report comes from Prompt Credit, where credit is due, surveying over five hundred and fifty outpatient practices. That's PTs, OTs, SLPs all over the country. The goal Figure out why some clinics are thriving in this economy while others are stuck in survival mode. We talked about some of these things on the show and on the podcast a lot. I read the whole thing. I didn't. I skimmed it just like you would. I then threw it into AI and I got some notes and then I bring them to you. So on this live stream, I'm going to give you the real take.

2:50 What's driving growth? What's breaking people and what you can actually do about it starting now. Let's start where the fire is the hottest. I mean, come on. This is all over the place. Burnout is not a personal problem. It's an operational failure. We talk about this ad nauseum. I don't have any tattoos, but if I did, burnout might be the thing I tattoo on my ass. Nearly half of clinic leaders say burnout is a moderate or major concern, not a shock. Here's the plot twist. It's twelve points higher in clinics. still using disconnected or manual systems. I just said, it's not a personal problem. It's an operational failure. Can you solve everything by getting connected or automating?

3:30 No. Can you reduce things by twelve points? Yes. Clinicians aren't melting down because they're fragile. They're melting down because they're doing three hours of stuff outside clinic hours while using an EHR or other systems that feel like they're stuck in the mud. They're managing sixty percent productivity quotas with zero tools to protect their time. And don't get us started on student loans and flat salaries. We already talked about that this morning. Here's a quote from the report. Burnout rises when admin friction rises. Those two things are, according to this report, in lockstep. You want to fix burnout?

4:11 You don't need yoga mats. You don't need pizza parties. I do love pizza, but that ain't going to do it. You do need your damn systems to talk to each other and to act like they were born and live in twenty twenty six. That is the first pause. I do want to thank our friends at Sarah Health for being a new sponsor of the show. Talk to Stephen Cohen live from Graham Sessions this weekend. Sarah Health, the remote care platform that's turning patient engagement into real clinic revenue. Wouldn't we like that? Sarah helps PT clinics streamline communication with patients outside extra staff time in lockstep with this report. Patients get daily automated text messages tailored to their care plan.

4:53 No app. No login, just better outcomes with an average sixty five percent response rate. Sarah makes it easy to meet remote therapeutic monitoring requirements and still get paid by Medicare and commercial insurers. It's simple to set up, easy to integrate with your EMR and patients actually use it. Sarah Health is where you want to go. Look, I paid the bills. Now we can go back to the report. They're not paying me to do this. Sarah Health is. Now, step two, cash flow. is more important than visit volume that's what the data in this prompt health report is saying here's what everyone gets wrong they think more visits is more money it's not all the clinics say they're busier than ever but revenue is still a mess so what separates the high performers and the high growth clinics to the ones who aren't the ones who might not be in business in january twenty twenty seven here's what it is the big three They submit clean claims within twenty four hours.

5:52 They get their homework done and they do it quickly. What does that mean? They get paid in on average, according to this report, under seventeen days. And the third big takeaway from this, they use automation to catch denials before they happen. The big three submit clean claims within twenty four hours, get paid under seventeen days. There's cash flow and they use automation to catch denials before they happen. You know what drives all this? If you've been paying attention, you heard the beginning of the episode. Faster, accurate documentation during clinic hours. Two birds, one very powerful stone. Clinics using AI scribing are literally closing notes a full day sooner.

6:35 What does that mean? Closed notes a full day sooner equals a faster claim. Faster claim? equals a faster check. Faster check, a clinic that actually pays their bills on time. I'll go one step further. Pay your bills on time. Understand cash flow, which was not on the syllabus in PT school, but should have been. When you know what money you're going to have a week, a month, a quarter ahead, you can start thinking in the future, which is where the owner should be thinking. Robbie Walkers said it best in this report. If you want predictability in your business, you can't just hope people call to book.

7:16 Revenue should run like clockwork, not bingo night, kids. We're getting some more comments about the tie, and I'm starting to think maybe I need to dress better on the live streams. Let's keep going in the report. I do want to thank US Physical Therapy. This live stream brought to you by USPH, a national network of clinics focused on developing clinicians. Who would have thought? That's also in the report. Leadership tracks available. We'll get into that, why that's important in the report. But yeah, leadership tracks at USPH, mentorship, career growth, and the stability to build your future in PT. If you want a place that supports how you want to practice, that's US Physical Therapy. Hit them at USPH.com.

7:56 That's USPH.com. Next segment of the report, we teased it in the intro, the automation gap. Everybody thinks they've gone digital. But there's a difference between having digital tools and running an honestly, truly connected and automated operation. Fast forward to page thirteen, the visual, if you have this report in your inbox. And here's the big three takeaways. Ninety-six percent of practices use reminders. That's fantastic. I mean, kudos. Ninety-six percent of the five hundred plus clinics surveyed for this use reminders.

8:38 You know there's going to be a plot twist, though. Here it comes. Here it comes. Plot twist. Only a fraction actually automate intake, wait lists, and billing accuracy. listen that's like running a really great first six miles of the marathon and then putting on lead boots i'll say it again ninety six percent of practices using reminders kudos but that's two thousand and six only a fraction automate intake weightless and billing accuracy and that is where the big hairy scary problem begins to start drop offs What happens? No shows. What happens? Underscheduled plans of care. What happens?

9:18 Missed revenue. That's what this data from Prompt says right here. The Rehab Therapy Industry Report. Get it now. Maybe at Prompt website. I don't even know what it is. I don't have the notes in front of me. I do have this report though. High growth practices. What are they doing well to separate themselves from low or no growth practices? They fill canceled slots automatically. You have inventory. You didn't go into this profession to think that you had inventory, but you do. You have whatever time slot matrix you decided. The difference between high growth Low growth and no growth or circling the drain clinics.

9:58 The big one here, according to data, because everybody loves the data, high growth practices fill canceled slots automatically. I would love to hear your take. You can do it in the comments now or you can DM me. This is just what the data says. You can't yell at me. It's just not going to help. High growth practices run reactivation campaigns on autopilot. You put a lot of effort into a reactivation campaign once and Make it feel, look, smell, taste like you and your clinic, but then automate it. Let it run on its own. That will fill canceled slots automatically. And patients come back because the process is smooth. It's twenty twenty six.

10:39 I could right now faster than we've been talking on this live stream and we've been talking for ten minutes. I could book a haircut at my boy Rod, his barbershop down the street. How can I do that? And ask yourself, can I do that reliably at your clinic? If the answer is no, I do not have any empathy for you. Patients come back because the process is smooth. This is not nice to have anymore. According to the data in this report, it is need to have. You don't need more patients. You need less friction. We've been saying this. Look, Tony, Dave, look, look, my live stream co-partners. But now it's proved. We didn't just feel this. Now it's proved.

11:21 Okay, next segment. Let's dig into this. Five hundred and fifty plus clinics surveyed and they broke this down to something that I love, which is like personality types, clinician archetypes. I had a video just a couple of weeks ago, semi-viral, where I compared if physical therapists were Avengers and I matched personality type to types of PT. Captain America, outpatient ortho. uh iron man sports pt uh acute care hulk you get the idea they broke them down into behavior types based on how they document and bill this i like expect more short form videos for this and here is what they came up with is this the right graphic there it is okay so here's the four types and this is cute we all love cute little things like this, where we, this is why astrology is so popular.

12:21 Let's figure out what it means. So here's what the report says. The four types, a traditionalist, an over coder, autopilot, and treadmill. Those are the four types. I want you keeping track at home. What type are you what type of therapist are you in terms of documentation and billing again traditionalist overcoater autopilot and treadmill so a traditionalist their risk is they slow revenue they're negative hours as fast that shouldn't be written like that that's a bad report they're hours slower than other types of billers.

13:11 The risk is they slow revenue. What to do to improve the traditionalist so you're not seventeen hours behind everybody else? Remove friction. That means if you've been listening along, you're already shouting at the speaker. Automate. So the traditionalist needs to be shown a frictionless or as close to frictionless tool. So they change their behavior and this is what happens in your business. They don't slow revenue. That's step one. The second type of behavior in terms of document and billing for a therapist is the over coder. Just too many codes. So I guess an advantage there would be, hey, safer code mix.

13:53 They're safer. ironically, according to the data, they are an audit risk. Ooh, your stomach just dropped out. Because you're thinking, you know who your clinicians are, business owners. You are already assigning these archetypes to your clinicians. You know you're doing that already. But you have to autopilot this. So the overcoders are an audit risk. How do you improve this? According to the report, CPT alignment. You do it with tools. Of course you do. next up the type of therapist the archetype in terms of document and billing this is not treating this is not personality type this is document billing is the autopilot now the risk here is they might under document okay so how do you prevent this Guided templates, according to the report.

14:48 Guided templates. You give them, gosh, you give them guardrails. I'm not good at bowling, but bowling with those little bumpers, man, I could be in the Hall of Fame. Guided templates. And finally, the treadmill. That's burnout city, baby. That is burnout city. You need to reduce late-night charting for this person, or they will have already left or have... Two feet almost out the door. They are minus twenty-eight hours. I thought the traditionalist was bad. Seventeen hours slower. The treadmill person is twenty-eight hours slower. For here, you need to lift the note burden, and as Tony Meritato is chiming in right there, documentation shouldn't take thought.

15:36 That doesn't mean it doesn't take skill, but you should be having the skill during the session. That's where the skill comes in. I don't want, you didn't sign up. I've seen so many people. I didn't sign up to be good at documentation. Good. Gosh, if only there was a tool. There are. You not using them, you not using them as an owner. I'm talking to the owners here because you're the one. You have a decision makers. You not using them in twenty twenty six is a decision. You have decided not to solve this problem. Oh, great quote from Megan Brown. Megan says an excuse is it is a. The excuse is a problem you have decided not to solve.

16:19 Ooh, that hits hard. Thank you, Megan. So here's the thing. This is the kind of data you can use to coach your team, not punish them, but it also needs, you have to ask yourself as a business owner, do you have the tools to do these things? And if you don't, it's on you. I know I'm putting a lot of pressure on the owners, but you guys wanted, you wanted the ball. Now you've got it. Bottom line, in this section of Prompt's report, it says AI doesn't replace therapists. It supports them based on their work style. And it should be doing that. It should be doing that. And here's their archetypes one more time. Take a screenshot of that. I do want to thank Empower EMR. If your clinic is stuck in an EMR that slows you down, should you be?

17:02 Empower EMR gives you speed, clean workflows, and features PTs actually ask for. For better notes, faster documentation, and smooth operations. All wrapped up in customer support that doesn't ghost you. Upgrade your clinic's brain with Empower EMR. You're nodding along. EmpowerEMR.com, EmpowerEMR.com. Sharif just came on the show to talk about many of these things just the other day. Fantastic. Again, bottom line, AI doesn't replace therapists. AI is not the thing. It's the thing that helps you get to the thing. It supports or should be supporting them based on their work style. let's wrap this thing up. Parting shots from this report.

17:42 It's big. If you need it and you don't have it, go to Prompt's website. Download it. This is going to be everywhere. We're going to dive deep into it on Thursday. It's going to be a lot of, oh, we said that. Oh, yeah, we said that. We said that. If the information in Prompt's report shocks you, Shame on you, I feel. But some people need to be told fifty times in fifty different ways. Here it is in writing in a PDF. Parting shot. Let's do that. Let's do the parting shot. This is the parting shot. One last mic drop moment. No pressure. Just your legacy on the line. I'll give another thank you to our new sponsor, Sarah Health, a remote care platform that's turning patient engagement into real clinic revenue.

18:29 Again, this report is, I mean, I'm sure Stephen Cohen is screaming at this report and saying, yes, this is exactly what RTM helps you do. Do it right. Sarah Health helps PT clinics streamline communication with patients without extra time. Patients get daily automated messages tailored to their care plan. No app, no login. It's done via text. Stephen was explaining that this weekend. You just get better outcomes. With an average sixty-five percent response rate, Sarah makes it easy to meet RTM requirements and get reimbursed by Medicare and commercial insurance faster. It's simple to set up, easy to integrate with whatever EMR you're using, and patients actually use it. That's the bottom line, so I'll say it twice. Patients actually use it. Learn more at SarahHealth.io.

19:11 That's SarahHealth.io. All right. Parting shot. Growth isn't about seeing more patients. It's about reducing burnout, but that's operational, not emotional. So maybe we need a new word for burnout. Operational friction. Bad setup in twenty twenty six is not excuse. Automating the right stuff. Fixing cash flow. It's funny how all these things sort of touch each other, isn't it? Run your practice like a system. not a fire drill. That's what I took out of this. It's not an accident. The high performing clinics in this report didn't get there by accident. They didn't get there because they had an inside scoop.

19:53 You don't have to guess what's working. And now it shows you in data what high growth clinics are doing and what clinics who are about to crash and burn and not exist are not doing. So if you're a clinic owner, a director, or just somebody who's trying to make PT better, if you're not the owner, send this video or that report to your boss. send it to them and let's be realistic fix one thing fix one thing this week one workflow one system one unnecessary friction point that we just talked about one let's be realistic Now, don't forget to subscribe and share this with someone who runs a clinic. I'll see you guys in the next episode. I already know we're going to be talking about this on PT Breakfast Club on Thursday, eight thirty Eastern.

20:36 This has been PT Pinecast. I'm Jimmy, your tour guide through the chaos. I'm just yelling into a microphone because I want you to exist in twenty twenty seven. I'll see you guys in the next episode. Until then, stop treating your staff like robots and start building a system that support humans so you can be a great physical therapist and great PT clinic and help people which is why we started this big damn thing in the first place.