Have you ever wondered how we built a marketing agency that now serves 1200+ clinic locations? Here’s how we built Practice Promotions, expanded our vision, and hit the key milestones that shaped our first 15 years.

You can also listen to Neil and Amy reflect on the past few years on their special episode of the Practice Marketing Podcast: Celebrating 15 Years With Practice Promotions!

The Beginning: AIM Physical Therapy

Before they started a physical therapy marketing agency, Neil and Amy Trickett were physical therapists!

After just one year of marriage, they decided to start their own private practice together, so they could treat patients the way they knew patients deserved to be treated.

Neil and Amy opened AIM Physical Therapy in August 2002 in Boynton Beach, Florida. It began with just the two of them, a small facility, and a strong work ethic. They had no formal business education and no marketing blueprint. We learned and built every system ourselves in real time.

The Early Reality

Remember what it was like when you started your own clinic? Amy and Neil know that pain. In the early days of AIM PT, they experienced…

• 70 to 80 hour workweeks
• Trial and error marketing
• Learning business fundamentals on the fly
• Hiring the wrong people 
• Managing growth without formal systems

Like many private practice owners, they faced constant insurance pressures and competition from hospital networks. Growth required more than clinical excellence. It required business skill.

What Changed?

They invested in business and marketing education. Slowly, the practice strengthened.

Neil and Amy ensured their success using key systems like:

• Consistent patient marketing with patient newsletters
• Learning how to hire the right people
• Clearer systems
• Better branding
• Improved reputation
• Stronger team leadership

Over eight years, they grew AIM PT to 19 employees and served thousands of patients. It became a respected and rewarding business.

(Christmas Photo AIM Physical Therapy 2008)

Selling AIM Physical Therapy for 7 Figures During a Recession

As they marketed their practice, Neil and Amy realized something. 

Marketing is what grows your clinic. 

But the problem was, most clinic owners had no idea how to market!

Neil and Amy Trickett also saw a shift in the profession. Physical therapists no longer had to depend entirely on physician referrals. Direct to consumer marketing was becoming necessary in order to grow!

They realized that instead of impacting one clinic and one community, they could support many clinics and many communities!

In late 2010, they successfully sold AIM Physical Therapy in a seven-figure exit – despite the ongoing recession! They shifted their attention toward building a marketing company designed specifically for PT practices.

The Launch: Practice Promotions Is Born

Practice Promotions officially launched on February 1, 2011.

We began at a desk in Neil and Amy’s Florida bedroom — while they raised two young children. 

In the early phase, they singlehandedly managed every responsibility, from sales and design to client communication and financial oversight.

The Startup Phase

In the beginning, Neil and Amy were a jack of all trades. They handled everything. That includes…

• Sales calls
• Graphic design
• Client communication
• Financial management
• Marketing strategy

The mission was ambitious: Help physical therapists, help more people, and become the leading PT marketing agency in North America.

Phase 1: Print Marketing

For the first three years, Practice Promotions specialized exclusively in print. We helped physical therapy clinics boost patient volume with…

• Patient newsletters
• Physician newsletters
• Brochures
• Printed promotional tools

These products gave clinics consistent communication systems and brand visibility. You can still buy all of these products at PTMarketingStore.Com! 

Within six months, Deena Fournier joined the team. She brought valuable experience from AIM Physical Therapy. Soon after, they hired Nick, their first graphic designer! Growth began to feel real.

Early Challenges

The transition from clinician to agency owner required reinvention. This led to challenges that were going to break or break the business. It was important that Neil and Amy were able to:

• Establish credibility as marketing experts
• Build scalable systems
• Manage cash flow in early years
• Balance startup pressure with family life

There was no external funding. Every step forward required discipline and reinvestment. Neil took the lead on products and strategy as the CEO of Practice Promotions, while Amy focused on people success. 

Phase 2: Entering Digital Marketing

By 2013, the market was shifting. Websites were no longer optional.

Practice Promotions introduced website design services, along with blogging and updates. Print alone was no longer enough.

In 2016, we launched a strategic shift, which included…

• Expanding digital offerings, like Search Engine Optimization (SEO) and Reputation Management 
• Lowering upfront website pricing
• An emphasis on long term subscription plans

This shift allowed us to create recurring revenue and build long term client retention.

The Breakthrough

In February 2017, Practice Promotions launched the Ultimate Physical Therapy Marketing System! 

This combined the newsletter system with the website program into one integrated solution.

From that point forward, growth accelerated dramatically.

Scaling the Agency: From Startup to Industry Leader

Growth created opportunity, but it also required sharper focus and stronger decision making.

As demand increased, we stepped into a new level of leadership. We shifted from operating as founders doing everything to leading a company with multiple departments and layers of responsibility. Instead of thinking week to week, we began thinking in years. Instead of solving small problems, we made decisions that shaped long term direction.

We grew into a 70 person digital marketing agency by committing to disciplined execution, clear expectations, and consistent performance. Each stage of growth required us to raise our standards, strengthen accountability, and lead with greater clarity.

Scaling the agency was not just about adding people. It was about growing into the kind of organization that could sustain momentum and continue winning at a higher level.

Expanding Into Google Ads PPC for Physical Therapists 

In 2021, we introduced Google Ads PPC services. We integrated our Google Ads with call tracking systems, so we could track the source of every patient call. We strengthened measurable patient acquisition for our clients by adding Google Ads and call tracking.

Today, Google Ads are our #1 most successful marketing tacticB All of our most successful clients use Google Ads to attract new patients for less than $75 per call. 

Practice Promotions was no longer just a print company. We became a comprehensive digital and print marketing partner.

Building the Team

As we grew as a company, internal structure became a priority.

Clear roles and responsibilities replaced ambiguity so every team member understood what success looked like. Strong communication channels eliminated confusion and increased accountability across departments. Leadership development became intentional, ensuring managers could confidently guide expanding teams. Culture stopped being accidental and became something we actively reinforced.

Rather than leaving culture to chance, we defined it clearly.

Our core values shape how we hire, lead, and make decisions:

• Enthusiastically support, help, and acknowledge each other.
• Practice open and real communication, even when conversations are uncomfortable.
• Do the right thing and take ownership with a make it happen attitude.
• Set high standards and consistently hit targets.
• Challenge ourselves to innovate instead of settling for average

This approach allowed us to scale with clarity, accountability, and high performance standards.

Recognition and Milestones

We earned national recognition! Here are the most memorable awards we received: 

• INC 5000 Fastest Growing Companies in America in 2019, 2020, and 2021
• Seven Figure Agency’s “Agency of the Year in 2024”

(INC 5000 Award Received for the first time Oct 2019.)

These milestones reflected disciplined growth and strong client results.

The Big 3 Focus

Throughout our company’s expansion, we kept 3 key priorities front and center:

• Loyal clients achieving measurable success
• Clients utilizing multiple marketing products
• A viable, expanding company with highly rewarded staff

As we grew as a company, leadership responsibilities expanded significantly.

Running a small startup required marketing expertise and hustle. Leading a national agency required a completely different skill set. The CEO role evolved beyond building campaigns and selling services. It demanded financial oversight, operational discipline, and long term strategic planning.

That meant managing cash flow forecasts, setting profit targets, and protecting margins. It meant designing scalable operational systems that could support dozens of team members and hundreds of clients. It meant hiring senior leaders, developing managers, and building accountability structures that ensured consistent performance across departments.

Growth also required making difficult decisions quickly and confidently. Pricing models had to adjust. Service lines had to evolve. Organizational charts had to change as new departments formed.

Instead of focusing only on marketing strategy, leadership shifted toward building an organization that could sustain momentum year after year.

Scaling the business required continuous learning, sharper decision making, and a commitment to thinking several years ahead rather than just several months.

The Vision Forward: What’s Next for Practice Promotions?

We are so proud of the thousands of physical therapy clinics across North America that we’ve helped in the past 15 years.

But this is only the beginning!

Bigger Reach

Over the next five years, we plan to expand our impact to more than 2000 clinic locations across North America. Growth at that scale requires more than adding clients. It requires building stronger systems, smarter technology, and deeper partnerships with practice owners who want to lead their markets.

We see hybrid practice models shaping the future of physical therapy. Clinics that combine in clinic excellence with digital marketing strength will win. That means integrating in person care with online visibility, paid advertising, reputation management, and patient education across multiple platforms.

Physical therapy operates inside a 3 trillion dollar health and wellness economy. Competing in that environment demands confidence, positioning, and consistent brand presence. Clinics cannot afford to rely solely on referrals or outdated outreach methods. They must actively claim their market share.

Direct to consumer marketing now drives sustainable growth. Practices that invest in visibility, authority, and measurable patient acquisition control their future instead of depending on outside referral sources.

Our goal is simple. Help clinic owners build marketing systems that give them control, predictability, and long term growth in an increasingly competitive healthcare landscape.

We’ll Continue to Innovate in AI, EMR Integrations, and More!

We built this company by adapting early and moving fast. First, we shifted from print to websites. Then we moved from websites to Google Ads. Now we’re stepping into the next evolution of marketing.

Technology is changing how patients search, choose providers, and engage with healthcare. We are not waiting to react. We are building ahead of it.

In the near future, we will…

• Help PT practices actively implement AI into their marketing workflows, including content creation, automation, and lead nurturing
• Optimize clinic websites for AI driven search platforms, including ChatGPT powered discovery and conversational search
• Integrate directly with Prompt and other leading EMRs to streamline marketing data, patient tracking, and reporting

Plus, we’ll…

• Build stronger marketing systems for cash based and hybrid practices that rely on direct consumer acquisition
• Expand hybrid marketing frameworks that combine paid ads, SEO, reputation management, and automated follow up
• Strengthen digital advertising capabilities across Google, YouTube, Meta, and emerging platforms
• Integrate subscription services, software tools, and print marketing into one cohesive ecosystem
• Deliver deeper performance tracking and analytics so clinic owners can see clear ROI and make data driven decisions

Our goal is not just to provide marketing services; We design marketing systems that generate predictable growth and scale with your clinic. 

Supporting the PT Industry

While we grow our agency, we stay focused on strengthening the profession itself.

We work to:

• Empower private practice owners to take control of their marketing
• Reduce dependence on unstable referral pipelines
• Increase visibility for direct access physical therapy
• Help more patients discover high quality care in their communities

Everything we build ties back to one outcome. Stronger clinics create greater access to care. When practices grow, more patients receive treatment that improves their lives.

15 years ago, Neil and Amy started with clinical skills and hard earned business lessons. Today, we operate as a national marketing agency with defined systems, measurable performance standards, and a long term strategic vision.

We remain committed to one mission: equip physical therapy practices with the marketing infrastructure they need to grow confidently and serve more people.

We’re the PT marketing agency you wish you hired first!

Stop second-guessing yourself. Schedule a FREE PT Marketing Strategy Call today. You deserve the #1 PT Marketing Agency in North America. 

You’re Just 1 Call Away from a PT Marketing Agency That Gets You No-BS Results! Book a PT Marketing Strategy Call TODAY!