PT & Psychotherapy Under One Roof: Building an Integrated Physical Therapy and Mental Health Clinic (w/ Chloe Tudor, RMT)

[01:17] Chloe Tudor: Thanks for the intro — it’s great to be here.

[01:26] Neil: Let’s dive right in. What made you decide to bring physiotherapy and mental health together in the same practice?

[01:34] Chloe: We always talk about the mind–body connection, yet most clinics keep the physical on one side and mental health on the other. I saw a huge gap, especially here in Toronto, and I recognized a big benefit for clients — especially those with chronic and more complicated pain — in integrating the two. I do want to be clear that we didn’t start with psychotherapy; we added it about a year after opening. As business owners, you have to stay curious and ask questions. Talking to my client base, I kept hearing mental health come up, and I realized most people have psychotherapy benefits. It was a huge additive value we were missing, so we added it.

[02:29] Neil: I used to joke with patients that physical therapy was 60% psychology and 40% actual care. Your mind controls your body. When someone has chronic, long-term pain, they’re going through all kinds of doctors — I call it the medical merry-go-round — they don’t get answers, and they start to have mental-health issues because of the pain, which creates more pain.

[03:16] Chloe: Exactly. When you have chronic pain your brain starts creating new patterns, so sometimes you need the mental-health side to help break the patterns and road maps that have been created — and trauma especially. A lot of clients have that, and they’re missing such an important piece. What’s been really cool about the integrative approach is that clients who’d been struggling for a long time are seeing the biggest changes, and now we attract a whole other group of clients — the complicated, interesting injuries.

[03:57] Neil: Do people reach out because of your treatment programs and then discover you also offer psychotherapy, or do they come for the psychotherapy first?

[04:12] Chloe: It’s a bit of both. A lot of people read our Google reviews — you’ll see “I dealt with this for 10 years and it was controlling my life.” And our SEO has embedded that chronic-pain and trauma work, so people find that we’re a different kind of space here in Toronto.

[04:45] Neil: I worked in inpatient rehab — for a while at a brain injury center in Orlando — and it was very integrated: PT, OT, speech, mental health, a physiatrist. We bring mental health into the whole treatment at that level, but it doesn’t carry over into the outpatient setting. You’ve essentially taken that inpatient model and made it outpatient.

[05:31] Chloe: That’s a good point — I hadn’t thought about it that way.

[05:39] Neil: Did you have any initial struggles marketing or explaining the practice to the public?

[05:48] Chloe: Marketing has been interesting, and it’s forever changing — you have to be adaptive and creative. Physiotherapy and chiropractic versus psychotherapy vary quite a bit. For mental-health clients, people look for someone who walked a similar path; they’re interested in commonalities around what they’ve been through — their ethnicity, their sexuality, their religion. So our psychotherapy marketing draws on keywords you’d never use for a physiotherapist. We’d get calls asking for a therapist who’s a single mother, or a Black therapist, or a Muslim therapist, so we had to adjust our advertising to reflect our team and who we can help.

[07:06] Neil: You can feel like you’re on an island with chronic pain and all the mental anguish that goes with it. Having reviews and case studies is critical — people can see someone like them who’s been helped.

[07:29] Chloe: Absolutely. On explaining yourself — I always ask business owners if they’ve read Building a StoryBrand by Donald Miller. We’re a multidisciplinary practice, but what are we beyond that? It’s changed over the years, and now it’s simply “we improve your health and happiness.” It takes something complex and makes it simple, so people can hold it in their head and want to learn more.

[08:26] Neil: From the mental-health side — with so many disciplines, is there a step-by-step process a new patient goes through?

[08:57] Chloe: A bit of both. We have a high internal-referral rate, so sometimes a client is directed to a specific therapist. For new clients, we try to bring them to our care coordinator, who asks about their goals and concerns and puts them on the treatment plan that makes for the most efficient recovery. Having someone at the top to direct clients matters, because it can be overwhelming — there’s so much information out there, and if we simplify it and put them on a guided plan, that’s brought us a lot of success.

[09:39] Neil: I think you’re leading the pack with this model. The Canadian model of holistic, integrated services is a bit different from the U.S., which tends to be more segmented — PT clinics on their own, mental health on its own, chiropractic on its own. The public wants the integrated approach, and North America needs to move that direction.

[11:05] Chloe: I think that’s where health is moving — a holistic approach. Beyond psychotherapy, it’s knowing when to lean into Eastern medicine and when to lean into Western, and how they work better together. A lot of people would be surprised which one actually benefits them more.

[11:39] Neil: And it’s what the public wants. In the States especially, care is increasingly out of pocket, with high deductibles, so there’s a growing market seeking wellness services to supplement traditional care. The clinics that thrive will be the ones that integrate and bring more services in — better treatment for patients, and multiple profitable lines of service for the business, sometimes at premium cash-based pricing.

[12:52] Neil: When you started out, how did you market the practice, and what’s changed?

[12:59] Chloe: We did something different. We actually started as a corporate health company — my business partner Katie and I are both RMTs — going into Toronto offices to provide on-site massage. We were in 30-plus companies: tech firms like Uber and Facebook, banks, law firms, all around our downtown clinic. People would experience us in their office, hear about For Health’s Sake, and then follow us for regular care. It was effective and cost-effective — then COVID hit and that stopped. Many employees don’t even go into the office anymore.

[14:03] Chloe: During COVID we realized we didn’t have a professional website, we didn’t have SEO, we didn’t have that foundation, because we’d been thriving off the corporate wave. That’s when we found Practice Promotions. As far as I could tell, Canada didn’t have anything similar, and I wouldn’t go back — it’s given me confidence that the foundation is working so I can be creative with marketing on top of it.

[14:56] Neil: There are a million digital agencies, but very few in the rehab space. The mistake I see is picking a local company because they know your area. What’s more useful is a company that knows your industry and what patients are searching for.

[15:35] Neil: Now that you’ve incorporated so many disciplines, what else have you done to market them?

[15:52] Chloe: We work with you for our Google Ads — with Justin at Practice Promotions, and he’s been great. It’s a learning curve for everyone because you don’t have many mental-health clients, so we experiment and talk through the keywords that are popular right now. Originally I ran the Google Ads myself and honestly had no idea what I was doing. What gives me confidence now is the monthly results email showing where our leads come from — I love seeing those numbers.

[16:47] Neil: Google Ads is complicated, and Google makes money when you spend, so it’s easy to burn budget. The key is dialing into what people are searching for and staying off networks you don’t need — you don’t need your ad showing up while a kid plays a game on a tablet.

[17:29] Neil: With these different lines of business, what have you found most profitable?

[17:37] Chloe: Psychotherapy is one of our most profitable, for a couple of reasons. It’s virtual, so we can keep growing without being limited by space, and there’s no rent, so the ROI is already higher. The price points are higher too: individual therapy starts around $160 for a 50-minute session, where a massage is about $116 for the hour. Relationship therapy is around $230, and family therapy higher still. So psychotherapy has by far the highest ROI at our clinic.

[18:41] Neil: Did you have to overcome compliance or regulatory issues in your province?

[18:49] Chloe: There weren’t significant issues adding psychotherapy, but we hadn’t offered it before, so we learned a lot. Confidentiality on the booking system and chart notes matters — only the therapist can read the charts. Privacy in the space matters — we insulated the walls and put sound machines everywhere so clients feel safe. And the big one is training your admin, because they handle sensitive topics and someone may call in a mental-health crisis. We have a whole document of resources for what to provide depending on the situation.

[19:44] Neil: [A quick note from our sponsor — grab the free Practice Promotions marketing sample kit at practicepromotions.net/kit — and now back to the show.]

[20:25] Neil: Some real nuances there — training the support staff and making confidentiality a higher priority. This is a big thing I’m pushing with U.S. clinics: start thinking outside the box, because Canadian clinics are ahead on the integrated approach and we need to mimic that here. It’s better for the client and better for the business.

[21:31] Neil: You have three locations now and around 40 employees. In business we often hit an inflection point — you grind along and then suddenly, boom, expansion. Where did growth really take off for For Health’s Sake?

[21:55] Chloe: Opening the second location. Going from one clinic — where we knew we were busy — to a second is a big step; you have to optimize everything: procedures, policies, leading a whole other team. It gave us confidence, and once that was successful we opened the third, which was our first franchise location and the biggest inflection point yet.

[23:18] Neil: Do you still treat patients?

[23:25] Chloe: I do — this year I’m cutting down from three half-days a week one-on-one with clients to two, and the goal is to fully step out, because I love business. I’m constantly reading and learning, and I want to keep growing the brand, especially now that we’ve franchised.

[23:57] Neil: Any mindset shift for managing your time between business owner and massage therapist?

[24:12] Chloe: My brain is always going — I like to move fast, figure out what’s important, and get it done efficiently. Funny enough, massage is physically demanding but I treat it as my break from being a business owner — a chance to get curious again and hear what clients are looking for, which can help the business side too.

[24:50] Neil: That’s interesting, because a lot of physios do what they know well — treating patients — and avoid the business side or the HR headaches. We call it “hobby-horsing,” going to what you love. But if you’re wearing both hats, one of them suffers, and staying fully in the practice can stall the growth of everyone else — you become the bottleneck. It depends on your goals, but beyond a certain point you have to pull back and let your team shine.

[26:56] Neil: As you work on the business and the franchising, what’s your main source of new patients?

[27:03] Chloe: From my monthly Practice Promotions reports, I love the pie chart of where clients come from. Our biggest slice is organic search — the SEO is working, about 70%. Then Google Ads is a smaller piece, plus internal referrals, and direct searches, which are our second biggest.

[27:31] Neil: That’s a healthy mix. If most of your business has to come from paid ads, you haven’t built up enough organic and direct traffic yet. Organic should be the biggest, direct next — email lists and referrals — and ads a smaller percentage.

[28:14] Neil: Before you worked with us, what challenges did you hit with ads?

[28:30] Chloe: So many. You’re not confident; I was throwing money out there thinking I was saving by doing it myself, but you’re just wasting more. I wasn’t sure which clients were coming in or whether they were quality. I knew we needed to hire someone. My advice: if you’re going to do Google Ads, hire someone — you’ll save more in the end, and knowing your numbers month over month is so important.

[29:42] Neil: What problems were you facing before working with us?

[29:49] Chloe: Not knowing our numbers — how can you be a business owner if you don’t know your numbers? We have a strong community in Toronto and strong internal referrals, which gave us breathing room, but not knowing the numbers and lacking that confidence was the biggest struggle. Now the foundation is built, and everything else is a bonus we work on.

[30:28] Neil: I hear that constantly — owners don’t know what’s working. It’s easy to get clinic numbers like visits and cancellations, but marketing tracking is often missing, so people hope something works, get busy, then panic when new patients dry up.

[31:16] Chloe: And there are so many marketing companies pitching every day. They sound too good to be true — “guaranteed 30 clients or your money back.” Katie and I wasted money being optimistic about different initiatives. I call it wasted, but they were learning lessons. Now we don’t play with other companies; we stick with you and with Google Ads, because we can see the numbers and feel confident.

[32:04] Neil: The traditional model is “throw money at it and see.” You need a structured approach. A lot of agencies are one or two people; they overpromise to win the business but don’t have the bandwidth or expertise to deliver. So — how has Practice Promotions helped you?

[32:35] Chloe: For one, a professional website that looks far better than before. The SEO is huge — we’re found organically now, whereas before it was all word of mouth. I’ll ask clients how they found us and they say “a Google search,” which was never the case before. We’re only six years in, but we’re competing with — and sometimes outperforming — clinics that have been around far longer.

[33:39] Neil: Something I learned long ago: promote and brand yourself higher than you actually are, then bring your services up to that level — rather than the reverse. Create the demand and you’ve got the fuel to build the business.

[34:11] Neil: You’ve opened a third clinic and you’re moving into a franchise model. What does the future hold for For Health’s Sake?

[34:19] Chloe: I hope to keep growing the brand into different communities through franchising. It started organically — therapists asking to open or own a clinic with us. We said no at first, partly because adding partners is a lot and we didn’t want quality to slip as we scaled. We looked at licensing, but after talking to lawyers it doesn’t make sense if you want any say in your business, so franchising is the route. What I love is that we’re giving like-minded, trusted people the chance to grow our brand into communities — including rural Canada — that don’t have Eastern-and-Western, mental-and-physical care under one roof.

[35:28] Neil: I’m seeing more of that franchising model. Plenty of physios want their own business — that’s why I started mine, and probably why you started yours — but it takes a lot to figure out alone. Buying into a ready model is appealing.

[36:15] Chloe: At first we asked ourselves why someone would join us instead of opening their own, and we did the research — because if it didn’t make sense we wouldn’t do it. It was obvious: money and time saved, leveraging what we’ve built, growing quicker, having a mastermind of clinic owners for support, and, if you ever plan to sell, selling something with multiple locations versus an independent. It was a no-brainer. Franchising isn’t very common in Canada.

[37:09] Neil: You see franchising across industries, and I think we’ll keep seeing more of it in rehab. You’re pioneering the model — I know you’ll do really well. Any final words of advice for business owners?

[38:06] Chloe: Don’t forget the small stuff. People forget to create a positive work environment and celebrate wins. When a physio gets a great Google review, we send it to them — “look what you got!” — and celebrate it. Those little things make people feel important, and that leads to overall clinic success. It sounds basic, but so many of our therapists came from very different clinic settings and are grateful for it, so it’s worth the reminder — create that space and the rest follows.

[38:47] Neil: Wonderful advice, and you’re right — acknowledgement is the number-one thing people want in a career, more than money. Chloe, thank you so much for being on the podcast and sharing your insights, and congratulations on all your success. To our listeners, thanks for joining us — follow us on the podcast, YouTube, and social media, and find tons of advice at practicepromotions.net. This is Neil Trickett, wishing you much success in your practice.