Cash-Based Physical Therapy: A Step by Step Guide to Your Successful Start-Up

By David Mesnick

Discover the Nuts and Bolts of Starting a Cash-Based Physical Therapy Practice

Want to open your own physical therapy practice but not sure where to start? In his new book, Cash-Based Physical Therapy: A Step by Step Guide to Your Successful Start-Up, David Mesnick, physical therapist and founder of PT 360, walks you through the critical steps to starting a viable PT business. Information in the book includes:

• Entrepreneurial opportunities in the cash-based physical therapy field
• Start-up costs, taxes and incorporation
• Market research and marketing strategies
• Choosing the right location and real estate options
• Worksheets to keep you on track
• And much more

Unlike other books selling a dream, Cash-Based Physical Therapy offers help rather than hype, so that you can begin taking steps to owning your own practice today. For the physical therapist wishing to make the transition from an employee or in-network owner to cash-based PT business owner, Cash-based Physical Therapy is the effective playbook with the answers and guidance you need to make your dream a reality.

• Language: English
• Publisher: Turnkey Physical Therapy Consulting
• Release date: Jan 13, 2020
• ISBN: 9780578611464

Book preview

Chapter 1

Entrepreneurship in Physical Therapy

The PT Entrepreneur

Entrepreneurship is the process of designing, launching, and running a new business. Most cash-based physical therapy start-ups are small businesses with one or two practitioners. These practitioners tend to have some level of experience, have developed a niche, and/or have an established following which can be incubated as the business gets off the ground. Being a successful entrepreneur requires the development of some key skills. These skills include, but are not limited to:

1. Emotional intelligence (EQ)

Emotional intelligence is a term coined by Daniel Goleman and goes a long way in business. The five components of EQ are self-awareness, self-regulation, motivation, empathy, and social skills.

Self-awareness will allow you to do a real-life assessment of your strengths and weaknesses as a businesswoman or businessman. This is helpful when deciding what to outsource and what to work on yourself. Starting a business is tough, and it is important to be honest with yourself before investing time and money in a new endeavor.

Self-regulation is an important skill as you get your business off the ground. Owning a business demands discipline that the average worker usually cannot sustain. Knowing where to put your time and effort can make you a more efficient owner. All too often, the emotional cost of a start-up can drain a person’s self-confidence, so knowing how to regulate your emotions will help you through the ups and downs as you grow your practice.

Motivation, whatever it may be for you, is what drives our day-to-day lives. When it comes to owning your own PT practice, that motivation might be having autonomy in your schedule or in your style of practice, or it could be a goal of being your own boss. Whatever the case may be, a cash-based PT start-up requires you to be a self-starter and motivated by the cause.

Empathy is a skill that usually comes easily to physical therapists, as most of us went to school to help others. But it is important to note that you may need to develop a different type of empathy when you open your doors, and that is being empathetic to patients’ financial constraints and knowing how to adjust your business plan accordingly. Not all patients will be able to afford to see you, and you will soon find that your patient list may be quite exclusive in regard to socioeconomic status. Many of the patients that would like to follow you will not be willing and/or able to afford you. Be prepared for the moral dilemma that goes along with being exclusive.

Social skills involve understanding the nuances of interpersonal communication so that you will be able to read people properly and react accordingly. If there is anything I’ve learned in my 20 years of business, it isn’t what you know: it’s who you know. Many therapists think they should get all of the patients simply because they are at the top of their game. The reality is that often the most likeable PTs get the referrals. Don’t assume because you were at the top of your PT class that you are going to be the top dog in the city. You’ll need to put yourself out there and continually build business relationships with your referral sources and clients.

2. Determination

The old saying only the strong survive certainly applies to cash-based physical therapy start-ups. Fifty percent of small business start-ups fail within the first five years. There will be many times where you feel as though you are trying to swim upstream and that you are competing with giants for new patients. Staying focused on your goals and business plan will keep you on track and help you keep moving in the right direction.

3. Creativity

Being creative as you learn your niche market can be beneficial as you navigate and adjust your new business model. Understanding that you may need to improvise your way to the top is a key skill to have in the beginning and as you grow. Forcing yourself to think outside of the box will oftentimes provide you the solution that you need.

4. Open-mindedness

Throw out any preconceived notions that you have regarding cash-based PT practices right now so that you are not biased when making important decisions. Forget about things you have read on a Facebook page about how easy it is to be successful. The truth is that starting up a cash-based PT practice is hard, filled with obstacles, and other people will be telling you that it can’t be done. There isn’t a special formula or system for becoming successful that you can buy on a website. You must be open-minded in your decision making to succeed.

To test your EQ, visit EQ test.

Growth of Cash-Based Physical Therapy Practices

As mentioned earlier, many insurance-based PT practices are now seeing three or four patients an hour to turn a modest profit. Most corporate outpatient practices incentify therapists to see more patients and to charge a certain amount of units to keep up with the tight profit margins that exist in the industry. I’ve observed that at some point most PTs get to the point where they ask themselves, Am I really helping people? Because most of us went into PT to help others, many of us feel disillusioned at some point as we consider whether or not we are making a difference. With this disillusionment comes poor job satisfaction and performance, ultimately leaving you searching for a way out.

I believe that PTs have never been more capable coming out of school than they are now. The skill set learned in school, on rotations, in fellowships, and while working in a first and second job, coupled with evidence-based continuing education, makes physical therapy primed to provide true value to the medical model. The skill set requires time spent with patients and can only be truly developed in a setting that allows providers adequate time. Couple this with an emerging value-driven medical economy, and I believe PTs and other ancillary providers will continue to choose to work in cash-based practices.

Cash-based PT practices are the right thing at the right time.

Risk vs. Reward

Before you move forward with your start-up, you’ll need to have an honest discussion with yourself about whether you are prepared to risk the stability of your current situation for the unknown of your