Horizon has passed 500 five-star reviews. People assume that number is about clinical skill. It is not, or at least not in the way you would think.
I have read most of them. The techniques I spent years and a lot of money learning — manual medicine, spinal manipulation, systemic dry needling, mechanical diagnosis and therapy — barely come up. What comes up, over and over, is time.
He actually listened. She didn’t rush me. They explained what was happening.
That is the review. Five hundred times.
What that taught me about the business
When I opened in 2012, I was competing with hospital systems that had more locations, more referral relationships, more marketing budget and more name recognition. I could not out-spend them. I could not out-advertise them. The one thing I could control was what happened in the room.
So the model became: fewer patients per hour, more minutes per patient, one clinician who stays with you. It is a worse model on a spreadsheet if you only look at throughput. It is a better model on every line that actually compounds — completion of care, referrals, reputation, staff retention.
Volume clinics are optimizing for this quarter. We are optimizing for the patient telling three people.
Three things I would tell another owner
1. Reviews are an operations metric, not a marketing one. You cannot ask your way to five hundred five-star reviews. You can only build a room worth writing about and then make asking a habit. When a review score dips, do not look at your review-request email. Look at your schedule density.
2. Systems are what let you keep the standard. The romantic version of a small practice is the owner who does everything. That version caps out fast and burns out faster. Every promise you make to a patient — you will be seen on time, your therapist will remember your case, your physician will get a report — has to survive you being out of the building. If it lives in your head, it is not a standard. It is a mood.
3. Hire for the room, train for the technique. I can teach a good clinician a new manual technique in a weekend. I cannot teach someone to care what happens to a person from Flint who has been dismissed by healthcare before. Hire the second thing.
The part that is not a business lesson
Horizon is the only Black-owned physical therapy clinic in Flint. That fact does not appear in the reviews either, but it changes who walks in the door and how quickly they trust what I tell them. Representation is not a marketing angle. For a lot of my patients it is the difference between following the plan of care and quietly deciding this is not for them.
Five hundred reviews is not a trophy. It is five hundred people who felt like the forty minutes were theirs. That is the whole product. Everything else — the certifications, the equipment, the letters after my name — is in service of being able to say something true in that room.
Dr. Jerome Adams Jr., DPT, OCS, is a board-certified orthopaedic clinical specialist who founded Horizon Physical Therapy & Rehabilitation in 2012. He speaks to entrepreneurship programs, chambers and clinical schools about building and keeping a practice.
About The Author
