PT Classroom - The Patient Ascension Ladder Principle ׀ by Nitin Chhoda, PT, DPT


Nitin Chhoda PT, DPT, received his Doctorate of Physical Therapy degree from the University of New England. He is a successful private practice owner and private practice consultant based in Denville, NJ. He conducts workshops, online courses and writes books and articles on private practice marketing.     



The Patient Ascension Ladder Principle

Every individual can be considered to fall into one of the following categories, as it pertains to your private practice.

A stranger (unlikely to do seek your services)
A suspect (aware of, but unsure about your services)
A prospect (considering your services)
A patient (actively using your sources)
A referral source (recommends your services)
A human billboard (has used your services and is a raving fan)

These stages form the 'patient ascension ladder'.

With your clinical skills and business systems, your goal is to move an individual through the various stages of this ascension ladder by offering them the best possible experience every step of the way. This can increase awareness and interest about your practice. An understanding of the patient ascension ladder will allow you to build sustainable, long term relationships with patients and referral sources..

Once the foundation of evidence based practice and advanced assessments, interventions and techniques are in place, consider a 'prospect stimulator' to promote your practice. The best way to do this is to have a 'front end' product that gives the patient valuable information and leaves them wanting for more, which is why they seek out your services.

When a patient calls for information or visits your website, offer them a free ‘front end’ DVD or book filled with unique content relevant to them.

Transition the individual up the ascension ladder.

When a stranger or suspect accepts your gift / prospect stimulator, they have already made a small commitment to your practice. A small affirmation can lead to a larger one over a period of time. When a patient requests your prospect stimulator, you should make it mandatory for them to provide their mailing address, phone number and email.

This helps you build a patient and prospect list. The next goal is to provide value to this list through regular phone, email and snail mail communication so that they are responsive to your message. More importantly, the individuals on your list will organically transition up the ascension ladder.

The best way to move patients up the ladder is to get them into the ladder in the first place. In order for a stranger or suspect to enter your 'funnel' and climb up the ladder, you use the 'prospect stimulator'. What you achieve with this tool is:

1. A mechanism for your practice to collect a list of qualified prospects for your practice
2. Instant differentiation - You are now the only practice ‘giving away’ a valuable educational tool
3. The ability to contact your prospects again and inform them about special offers, lead them back to your services and finally bring them into your clinic

Once you established a system to move patients up the ascension ladder, offer them new and improved services to improve their lifestyle and well being.

The ascension ladder does not have to be restricted to patients alone, it can be applied to all kinds of referral sources. There are 3 types of individuals critical to the growth of your practice:

1. People whose lives can be changed by physical therapy (Patients).
2. People whose lives have been changed by physical therapy (Past patients = referral sources).
3. People/ organizations related to physical therapy (Physicians, medical organizations, medical representatives, health clubs, spas, massage parlors, insurance providers, accountants, attorneys, manufacturers and retailers of exercise equipments = referral sources)

Building relationships with local businesses and moving them up the ascension ladder is an important component of business and marketing. Imagine if you joined forces with a local accountant (there are several you can speak with right now) and jointly created a special offer like “Free DVD reveals 21 ways to save money, improving financial and physical health” and allowed the accountant to promote this to your patients. In exchange, the accountant finances the cost of the DVDs and also sends it to his entire list of clients.

Take a moment to think what just happened here. You have managed to:

- Position yourself as an expert for free
- Leverage the time, energy and resources invested by the accountant to cultivate a list of clients – and you just got instant access to them
- Create a new referral source (you can mail to his list again in the future)
- Reach a new category of patients who would never have known you existed

Imagine doing this with local, enterprising physicians with successful, growing practices. Imagine if you created such a partnership each month and advertised this in the local newspaper?

Such marketing collaborations can build your practice from the ground up, in little or no time, as long as you can build the relationships with them and move individuals up the ascension ladder.


To learn more about private practice and marketing you can visit Nitins' websites at where you can download his free 4 step formula on how to attract new patients, increase referrals and grow your referral network with a simple 4 step plan and  where you can download a free book on physical therapy marketing.


Last revised: April 12, 2011
by Nitin Chhoda, PT, DPT

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