Every practice management system for physiotherapy is a monthly subscription that keeps your patient records on somebody else’s server, and the meter goes up as your list grows. Session Notes is a Windows application that runs on your own machine. Dictate an appointment note and the speech model transcribes it locally, so nothing is uploaded. SOAP notes, the week ahead, standing appointments, fees, and an encrypted record with a passphrase only you know. It makes no network requests of any kind, and it costs fifteen dollars once.
One payment. No subscription, no account, no per client pricing, no renewal.
Three speech models ship inside the download, so you can trade speed against accuracy without connecting to anything. The audio goes to a process on your own computer and never anywhere else, and you decide whether it is kept.
Not a setting you can leave switched on. There is no code in the application that opens a network connection, and the build refuses to compile if any is added.
AES-256. The key is derived from your passphrase and nothing else, so a stolen laptop is a stolen brick without it.
No subscription, no account, no per client fee. There is no meter to raise later and nobody who can change the terms.
Four things and no more: the people you see, the appointments you keep, the notes you write, and the documents you attach. Everything else a practice management subscription sells you is deliberately absent, and the price reflects that.
Six appointments back to back and the notes still to write. Dictation is the obvious answer and almost nobody in this trade uses it, because Otter, Rev and Word dictation all work by uploading the audio to somebody else, and that audio is a patient record.
Session Notes ships three speech models inside the application. When you dictate, the audio goes to a process on your own computer and comes back as text. Nothing is uploaded, because there is nowhere for it to be sent and no code that could send it.
A note takes a few seconds to transcribe, faster than it took to say, so it fits in the gap while a patient is putting their shoes on. You can send the window to a small strip in the corner of the screen while you talk, so it stays out of the way. That strip carries no name and no clinical detail, because it floats above whatever else is on screen.
The recording is kept, encrypted with the same passphrase as the notes, because a transcript is a draft and the only way to settle what was really said is to hear it again. Play it, delete that one, or sweep everything older than a month in one go. You can turn recording off entirely, or off for one appointment.
What comes back is a draft and the application says so. Speech to text gets names, numbers and the word "not" wrong, and in a record of range of movement and pain scores those are the words that matter. Every dictated note is marked an unchecked draft until you edit it. Read it through every time.
If you have an accent that transcription software usually mangles, this is the part that matters. There is no accent setting here, because no such thing exists: one model covers every English accent and the only thing that changes is how much of it the model can hold on to. So the application ships three, from a fast one that is fine on clear speech in a quiet room to a slow one that gets difficult audio right, and you pick. It starts you on the middle one, which is still faster than you spoke. They are all in the download and none of them needs a connection.
Speech to text gets names, numbers and the word "not" wrong, and those are exactly the words that matter in a clinical record. A dictated note is marked as an unchecked draft until you edit it. Read it through every time. Anybody who tells you their transcription is accurate enough to sign unread is selling something.
A physiotherapist treats a shoulder this week and a knee next week, so the body area belongs to the appointment and not to the patient. Choose physiotherapy on the first screen and that is how it arrives: patients and appointments rather than clients and sessions, SOAP notes, forty five minutes by default, and a body area recorded against each visit. Add whatever else you keep track of, on the patient or on the appointment, including tables that repeat down the page for exercises and repetitions. All of it is searchable.
Nothing here is a different version of the application. It is one product that knows seventeen trades, and the mental status exam and standardised measures a counsellor needs are simply never shown to you. Changing trade later never rewrites a note you have already written.
If yours is not on the list, choose Something else. Nothing is missing, you just keep the neutral words.
Physiotherapy practice software is a subscription, every one of them. Noterro, Zanda, Bookem, ClinikNote, Netsmart and PatientNotes all keep your patient records on their servers and bill you monthly for it, and several of them now generate your notes with an AI that reads your audio in the cloud. The honest comparison follows, including the places they win. If you need online booking, insurance or Medicare claiming, an exercise prescription library, or more than one practitioner, they are doing work this does not do and you should keep paying for it.
| Feature | Paper or Word | Noterro, Zanda, Bookem | Session Notes |
|---|---|---|---|
| Notes stay on your own machine | Yes | NoOn their servers, by design | Yes |
| Encrypted at rest with a key only you hold | No | PartlyEncrypted, but they hold the keys | Yes |
| Searchable across every note | No | Yes | Yes |
| Dictation without uploading the audio | No | No | Yes |
| Works with no internet connection | Yes | No | Yes |
| Price stays where it started | Yes | NoRaised for existing customers | Yes |
| Keeps working if the maker disappears | Yes | No | Yes |
| Insurance claim submission | No | Yes | NoNot built and not planned |
| Card payments and client portal | No | Yes | NoNeeds a server, so no |
| Reaches you on your phone | Partly | Yes | NoOne Windows computer |
All of these are deliberate, most follow directly from the notes never leaving your computer, and none of them are changing in version 1. Read this list before you buy rather than after.
Practice management subscriptions for solo practitioners run from about 50 to 100 dollars a month, plus a percentage of every card payment and a fee per claim. This is fifteen dollars, once, and then nothing. There is a free edition to try it on real work first: it holds three people on your caseload, has every feature switched on, and never expires. If you buy the full edition later, the practice you have already built opens straight up in it and nothing needs moving or re-entering.
A major version 2 with substantial new work would be a new purchase, and it would be optional. That is said here rather than discovered later, because a perpetual licence with unlimited free work behind it is how small software companies quietly die, and a product that dies is worse for you than one that charges again in three years.