The Electronic Medical Records (EMR) Wish List for Cash Practices

Aaron LeBauer
December 4, 2023
min read

#CashPT Aaron LeBauer Weighs in on the EMR Every Cash-Based Medical Practice Needs

Many of you may be surprised that while I recommend electronic medical records (EMR) for cash-based practices, I used paper notes in mine for a long time.  

I had a manila folder for each patient. It was the type with two metal tabs at the top of each side—the left side for treatment notes and the right for patient history forms, objective measures, and any reports or medication lists the patient brings. I also had a two-drawer file cabinet for current patients. At the end of each year, I took out the files of patients I hadn’t seen in three or more months and put them in a file box in my closet.

This system was anything but efficient.

But the main reason I didn’t adopt an EMR when I first started my practice was the start-up cost of $2,025 and $495/month, or 8% of collections. It was a dealbreaker for a small, low-overhead, cash-based practice. Plus, at the time, there was no physical therapy template, and creating my own would have been just as time-consuming.  

This was in 2008; luckily, the EMR landscape has changed.

Considering how far EMRs have evolved, you don’t have to settle for outdated methods anymore. To help you choose the best one for your cash practice, here's my wish list and must-haves for a good system today.

My #CashPT EMR Wish List

As a cash practice owner aiming for the most efficient EMR setup, these are must-haves that will streamline your operations and save costs:

  1. Simple, low-cost, high-value pricing structure
  1. Dedicated mobile app to schedule patients and access records on the go
  1. Integration with Gmail & Google Calendar, even with Dropbox, Evernote, and other web-based platforms
  1. A dedicated iPad and Android tablet app that allows for the customization of all patient intake questionnaires, objective measures, and consent forms
  1. Zero paper required for patient contact
  1. Easy to use and simple web-based platform for documentation
  1. The feeling that this is saving me time, money, and energy

EMR Pros

Understanding the ideal features is one step; the next is seeing them in action.

Here's how a well-chosen EMR system can directly benefit your practice:

  • It offers remote access to complete my patients’ notes from home after my kids are asleep or when I'm away from my office.  
  • It doesn't require storage space for older patients' notes.
  • It offers a hassle-free method for sending patient documents and notes — no trips to the post office or waiting by the fax machine.
  • It’s a modern, tech-savvy approach to patient management.

EMR Cons

However, as with any system, EMRs can have their downsides, too. Let’s break down the major hurdles you shouldn’t overlook:  

Time-consuming document uploads eat away at time.

Who will upload all the paper documents still generated with a patient visit? Me?  

Currently, I have each patient fill out a 4-page patient history, consent forms, no-show/cancellation policy, and objective measures. I do not have time to sit around and wait for my computer and scanner to crunch the images.  

An easy solution would be to take a picture with a smartphone or iPad, convert it automatically to a PDF, and attach it directly to the patient file.

Better yet, the iPad would have the forms and objective measures programmed so the patient can use the tablet to enter all the information. Thus, the best solution is customizable forms using a tablet for intake.

The cost structure can limit small practices.

Most start at $49.95 and go up depending on the number of therapists or users and add-on services. Other add-ons include extra storage space for uploaded files, the ability to send a fax with the click of a button, billing, text message reminders, and more.

Lack of electronic verification creates a bottleneck in patient onboarding.

When I first looked into an EMR years ago, electronic insurance verification was not available. So, someone (i.e., me) would still have to spend time on the phone with each patient’s insurance provider verifying their coverage. I don’t have office staff to do this. Plus, calling insurance providers and running their gauntlet is exactly why I don’t participate in their networks or “take insurance.”

The Smartest EMR Choice for Cash Pay Practices

For all of these reasons, I use intakeQ. Their forms alone have made a huge difference in our practice, allowing us to save so much time and money. Plus, it directly addresses limitations I've encountered with other EMRs. Its user-friendly interface and customizable forms simplify the patient onboarding process. Not to mention, its integration capabilities with various platforms and mobile accessibility make it a seamless fit for my practice. Most importantly, it's cost-effective, so even small practices can leverage its top-notch features without breaking the bank. Without a doubt, PracticeQ's been a huge win for my patients, my staff, and my business.

About Aaron LeBauer

Aaron LeBauer PT, DPT wears many hats in the healthcare industry. He’s the voice behind The CashPT Lunch Hour Podcast and the author of The CashPT Blueprint. As the creator of The CashPT Nation Facebook community and an international speaker, Aaron guides thousands of passionate physical therapists in building insurance-free practices. He operates LeBauer Physical Therapy in Greensboro, NC, a fully cash-based clinic staffed by multiple therapists. Committed to reducing unnecessary surgeries globally, Aaron focuses on empowering healthcare professionals to market directly to patients.


Cassio. (2020, January 20). Creating Customized Intake Forms for More Personalized Care. IntakeQ .

Fisher, J., & Starck, E. (n.d.). Should You Consider Cash Based Medical Practice Alternatives? The National Association of Medical Doctors. Retrieved September 29, 2023, from

Honavar, S. G. (2020). Electronic Medical Records – The Good, the Bad and the Ugly. Indian Journal of Ophthalmology, 68(3).

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