How Many PT Patients Come Back for a Second Visit? One Clinic's 832 Courses of Care

At one owner-led physical therapy clinic, 45 of every 100 patients starting a course of care didn't come back for a second visit. That comes from the clinic's own records: 832 courses of care, counted as of October 3, 2026. A much larger study saw something similar: of 122,723 patients in the US Military Health System who used PT for a new episode of low back pain, 41.7% attended only one session (Childs et al., 2015).

Once a patient had been in twice, the odds changed. At each visit after that, between 70.8% and 87.8% came back for the next one.

At this clinic, the biggest loss came between the first visit and the second.

The numbers, visit by visit

The clinic's records cover 832 courses of care. Here is how many of every 100 reached each visit.

The same numbers, with the chance that a patient on one visit came back for the next:

The patients who made it to a second visit went much further. Of the courses that reached visit 2, 44.2% reached visit 6, 28.1% reached visit 8, 17.9% reached visit 10 and 11.1% reached visit 12.

What the data does not tell you

The records say who came back. They don't say why the others didn't, and it would be easy to invent a reason.

One published study asked. Researchers interviewed 26 people who came to an initial evaluation and had no follow-up visit within 30 days. The reasons they gave included trouble getting to appointments, already feeling better, seeing no value in coming back, needing a different kind of care, and problems with the provider (Thomas et al., 2025). A front desk can help with some of those, like trouble getting to appointments.

Some of this clinic's one-visit courses may never have been meant to be more. A second opinion, a one-off screen, a home program handed over at the first visit: each counts as a course with one visit. So 45 of every 100 is not the same as 45 lost patients; it's the most that could have been lost. A patient who came back after more than 45 days also counts as starting a new course, so their first one shows as a single visit.

The records also leave out patients who never made it to visit 1. At one orthopedic and sports PT clinic in a large academic medical center, about 10% of 6,971 scheduled initial evaluations were no-shows (Briggs et al., 2021).

What it means at the front desk

If the second visit is where this clinic lost the most patients, the fix starts before the first visit ends.

• Book visit 2 before the patient leaves visit 1. Put it on the calendar, with a day and a time, while they're still at the desk. A patient who leaves without a time booked has to remember to call.
• Confirm it the day before, so a forgotten visit 2 is caught while there's still time to fill the slot. More on that in the unconfirmed slot.
• Call the same day when visit 2 is missed. At this clinic, the step to visit 2 was where courses of care most often ended. Early misses are common, too: across 444,995 patients at one national provider, 51% had at least one visit cancelled or missed within their first seven appointments (Bhavsar et al., 2021).

None of this is new advice; the first three visits covers more of it. At this clinic, the numbers point to visit 2 above all. Patients leave later in a plan too: in a San Diego study of a 20-visit program for low back pain, patients who stopped early averaged 6 visits (Shahidi et al., 2022). At this clinic, no later step lost as many as the first.

How to run your own number

You don't need new software for this. You need one export and an afternoon with a spreadsheet.

1. 1

   Export your completed visits

   One row per attended visit, with a patient ID and a date. Leave out cancellations, no-shows and anything that isn't a PT visit, such as wellness memberships.

2. 2

   Group the visits into courses of care

   Sort by patient, then by date. A course starts when a patient starts care, and again whenever they come back after more than 45 days away.

3. 3

   Use each course's first 120 days

   Count the visits in those 120 days, and keep only courses whose 120 days have passed. A course that started last month is still running.

4. 4

   Divide

   Courses with at least two visits, divided by all courses, is your second-visit rate. Do the same for visits 3, 4 and on.

The 45-day gap and the 120-day window are this clinic's choices. Yours can differ, but pick them before you look at the result and keep them the same each time you run it, so the number can move for real.

Your patient mix moves the number too. Among Medicare patients newly diagnosed with low back pain in 2014 who had a PT episode, 22% had a single visit, counted with a 60-day gap, according to an industry-commissioned report (The Moran Company for APTQI, 2017).

Then run it again each quarter and compare it with your own last number, not this clinic's. When it moves, write down what your front desk changed.

How these numbers were counted

• One clinic: an owner-led physical therapy clinic in North Carolina.
• The records: 832 courses of care, each with its first 120 days complete. PT visits only; wellness members excluded.
• A course of care: starts when a patient starts care, or returns after more than 45 days away. It is their visits no more than 45 days apart, counted over its first 120 days.
• As of: October 3, 2026.
• What it is not: an industry average. One clinic's records show one clinic's pattern.

Related reading

• Plan of care completion rate: how to calculate yours
• Patient churn rate for PT clinics
• The first 3 visits: why they make or break patient retention
• The visit 4 drop-off

Frequently asked questions

How many physical therapy patients come back for a second visit? At one owner-led PT clinic in North Carolina, 55 of every 100 patients starting a course of care came back for a second visit, and 45 did not. That comes from the clinic's own records: 832 courses of care, counted as of October 3, 2026. It is one clinic, not an industry average.

Where do PT patients drop off the most? At this clinic, between visit 1 and visit 2. The chance of a second visit was 55.2%. Once a patient had been in twice, the chance of each next visit ran between 70.8% and 87.8%, so the first gap lost far more patients than any later one.

How do I calculate my clinic's second-visit rate? Export your completed visits with a patient ID and a date. Group each patient's visits into courses of care: a new course starts when a patient starts care or returns after more than 45 days away. Count only courses whose first 120 days have passed. Your second-visit rate is the share of courses with at least two visits.