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Setting Up an Effective Management Structure For Your PT Practice

Wondering how to set up the most effective PT management structure? Start here with the essentials every practice owner needs to start or grow their organization.

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Setting Up an Effective Management Structure

Practice management isn’t built overnight; it requires weeks, sometimes months of planning to provide everything your patients and staff need to succeed. Even then, implementation is a challenge due to the ever-changing needs of your practice and the underlying communication required.So, where do you start? What tools and advice can get you ahead on day one?In this article, you’ll learn—step-by-step—how to implement a winning physical therapy management structure that leads to happy employees, more patients, and the longevity of your new (or existing) PT practice.

Consider Historical & Future Needs

Before you start putting a plan into action, it’s worth considering past and future needs for your PT practice.


If you haven’t been in business before, go ahead and skip this step. If you’ve been in business for a while or know other successful practices take a moment to reflect on their organizational structure.

  • How many PTs should you have?
  • How about admin staff?
  • Who answers to who?
  • What worked and what didn’t?

Answering these questions is a lot easier if you speak directly to the department heads, PTs and other members of the organization. Combine their expertise with your own findings before creating an actionable plan.


Planning for expansion, shifting patient expectations (like the current demand for telehealth therapy), and unexpected leaves of absence can keep you on offense as inevitable uncertainty unfolds. Speaking with industry experts and relying on historical data can put your practice on solid footing.

Outline Your Organizational Chart

The first actionable stage of creating an effective physical therapy management structure is outlining your organizational chart. By definition, these tell an organization how decisions are made. It describes “who’s who” in the organization—defining their roles and assigning responsibilities within those roles.The organizational chart can also include important timelines to complete applicable responsibilities, so every role has clear expectations of their expected contributions. These contributions should point directly towards the overarching success of the practice. Snag a page out of your business plan to project expected patient volume and compensation. Without this, your organizational chart is more of a wish list rather than a practical guide. Knowing how many PTs to hire can prevent patient overload or rash hiring decisions. And calculating an approximate salary for each role ensures you can execute.Finally, consider all historical and future data you’ve compiled. Build out multiple iterations and share them with industry experts for valuable feedback.

Put People in the Right Places

If you’re expanding or making changes to an existing practice—start plugging PTs, marketing and administrative staff into your organizational chart. If not, use this fresh start to your advantage by hiring staff who are passionate about the role they’ll be filling and skilled enough to carry out their responsibilities.When making hiring decisions, allocate additional revenue for salary growth by using websites like Glassdoor, Salary, and PayScale, as well as industry professionals, to approximate what similar roles make in your zip code. Then, compare this data with your overall salary budget and the candidate’s skill level. This will allow you to offer higher wages as time moves on, nurture great employees, and drive business growth through expansion.When placing each employee into a defined role, know you’re allowed to be flexible. While establishing your practice, you may have one person filling 2-4 different positions. As your patient count and business efficiency increase, you’ll likely fill in areas where a single employee handles multiple roles.

Distribute and Delegate Responsibilities

Everyone at this point should have a clear understanding of their role and responsibilities within the organization. And if you’ve made radical changes or hired on staff, it may take time for everyone to acclimate to the new structure.As a practice owner, you and the department heads (if applicable) will need to nudge the staff in the right direction. Coaching staff in the moment helps adjust behaviors and clarify expectations. By coaching in private and praising in public you're likely to cultivate better relationships with your employees while improving their quality of work.If you’d like to get everyone on the same page without spending too much time coaching, consider holding quick meetings or weekly stand-ups. Giving the staff important information in person can provide employees with meaningful direction without using time-consuming one-on-one sessions.

Don’t Resist Necessary Changes

One certainty in life is that nothing is certain. As you plan, forecast, teach and brace for difficulties along the way, you’ll never see every problem before it strikes.Relax and be flexible with your PT management structure.Take in the new information as it comes and apply it to your current strategy. If this information doesn’t affect your existing structure, then disregard it. If so, make changes and communicate them well.

Encourage and Empower Communication

The backbone of the PT management structure is maintaining open lines of communication between staff, leadership and patients. This communication should flow through practice owners. However, telling each employee first-hand or sending out an email isn’t always an effective strategy—especially for larger PT practices. Instead, trusting your department heads with informational circulation and scheduling routine “stand-up” meetings will help align your team while prioritizing tasks.Keeping an open-door policy seems cliché, but it’s essential for seamless communication. Empowering employees with internal messaging software can protect practices against HIPAA violations while streamlining processes, especially when expanding your business to multiple locations.

The Bottom Line

Implementing the building blocks of PT management takes time, research, and plenty of trial & error before you find a winning solution. And even then, measuring your results over time and staying flexible can significantly improve your practice’s efficiency.There’s always more to do than time allows, which is why automating tasks and improving operational efficiency should be at the forefront of every practice owner’s mind. An easy-button solution is to get the best software available, which will give you more time to interact with employees and patients. That’s why MWTherapy created their all-in-one PT software—to give busy practice owners more time to tackle the challenges technology can’t. If you want to supercharge billing, communications, EMR and give your patients a review-worthy experience try MWTherapy’s free demo and see for yourself how it can save time and increase revenue.

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