PTPN Insights

Developing stronger revenue streams and healthier communities: Lessons learned from private practice owners.

October 22nd, 2013 |

October 2013 — National Physical Therapy Month

Developing stronger revenue streams and healthier communities: Lessons learned from private practice ownersAs Americans’ health and wellness needs evolve, so does the role of the physical therapist — and so do practice owners’ opportunities to develop new sources of revenue.

For example, with wellness and exercise programs continuing to be in high demand as Baby Boomers age, physical therapists are ideally suited to help people of all ages and fitness levels reach their wellness goals. As the medical community’s leading experts in helping people improve the way their bodies work, feel and move, many PTs are expanding their range of services, focusing on both prevention of and recovery from injury and illness. This expansion not only increases options for patients, it is critical for the future of private practice therapy, as we described in a blog post earlier this year.

Here are some examples of PTPN members who have developed new ways to meet the changing demands of their communities while diversifying and increasing revenue.

(Editor’s Note: PTPN members can access more case studies, webinars, how-to guides and other resources on expanding via wellness and other specialty programs on our Physiquality website. Log on at physiquality.com/clinic, then click on “Advice.”)

Sell PT products

One of the easiest ways to add cash-pay services to your clinic is to sell products that your clients can use at home. Janet Yamada Soto, the owner of Berkeley Physical Therapy, a PTPN member in Berkeley, California, founded her clinic in 1984 to treat musculoskeletal disorders, so it makes sense that she offers foot orthotics for sale in her clinic. While they have offered custom orthotics for a while, the expense is high, and patients have to wait two to four weeks for the inserts. Now, Janet also offers orthotics from VASYLI, a PTPN Physiquality vendor. “We love them,” she says. “VASYLI is such a good product that custom orthotics may not need to be made, thus saving the patient both time and money.”

While some therapists may initially resist the idea of selling products, it’s actually an excellent fit for private practitioners and a benefit to patients, says PTPN President Michael Weinper. Therapists have the expertise to point clients to products that are best for their needs, especially when it comes to things like orthotics, exercise bands and equipment, and heart rate monitors. PTs can also learn from other clinicians that sell products, like dentists or dermatologists, and turn clients into customers for wellness products — a relatively easy way to generate cash-pay revenue without investing a lot of time or money. “Not only can therapists get these wholesale,” Weinper says, “but through PTPN’s Physiquality program, we’ve established relationships with vendors who sell to our members at great discounts, so that profit margins can be even better.”

Listen to your patients

Venise Mule-Glass, the owner of Sunshine Physical Therapy, a PTPN member in Commack, NY, listens to her patients — several of her cash-pay programs were developed with the help of qualified patients who developed the programs with Venise; a fitness program for obese teens and yoga classes for kids are two examples. Venise also has a massage therapist on-site who rents out space within her clinic, perfect for patients who need a sports massage now and then. In addition, Sunshine PT gives patients the option to continue exercising with PT aides after their therapy sessions have come to an end. They can pay a small fee per visit to have the aides take them through their home exercises.

Start small and plan for growth

Venise has been expanding the wellness programs at her physical therapy clinic for several years. Last year, she says, cash-pay services made up 10% of her business; this year, her income is 20% cash-pay and 80% from insurance. Her eventual goal is for cash-pay business to be one-third of her practice, a goal that may be achieved in the next couple of years if her expansion continues at the current rate. For those PTs considering the shift to cash-pay services, Venise advises, “Don’t think you need a big space to offer a variety of programs. Start small with a short trial and your existing staff — and have your staff develop programs. If they have ownership of the program, they’ll be more invested in it.”

Help clients avoid injury

Like Venise, PTPN member Chris Nawrocki and his staff at The Center for Physical Rehabilitation are always looking for new programs for their clinics to help their patients stay healthy and fit. Everyone keeps their ear to the ground, taking suggestions from patients on what they need, and paying attention to new programs discussed at conferences and continuing education programs.

In addition to a gym program and personal training, the center offers more than 10 specialty programs among its four locations in Michigan. They include a variety of sports conditioning and injury prevention programs, as well as gait analysis. The center also offers clinical specialties like aqua therapy and has staff members who are certified in such areas as women’s health and balance and dizziness problems.

The goal of most of these programs is maintenance and injury prevention. “These types of programs can really help consumers avoid injury and prevent repeated episodes,” Chris says. “For a nominal fee upfront, it can help people avoid significant setbacks and preventable injuries, which will help keep their long-term healthcare costs down.”

If you develop one program, Chris suggests looking for ways that you can use that training and/or equipment to expand into other programs. “We originally started with video gait analysis, for which we purchased some expensive video software,” he says. “From there, we developed other programs that could also utilize the video equipment, like our Throwers Athletic Performance and golf swing analysis programs.”

Offer a unique specialty

When her clinic’s owner approached her about starting a lymphedema treatment program, Suzanne Cavanaugh, the regional director of PTPN member Allegheny Chesapeake Physical Therapy in Pittsburgh, Pennsylvania, had eight years of general physical therapy practice under her belt but no experience with lymphedema. Only one other PT in western Pennsylvania worked with lymphedema patients; Suzanne would meet with that therapist on weekends to discuss their patients, what worked and what didn’t.

Now, 28 PTs in the area practice as certified lymphedema specialists, a certification Suzanne earned several years ago. The treatment is often used for people who have had chemotherapy for breast cancer, but it can also be applied to anyone suffering from edema, or swelling, especially in the legs. Suzanne and her staff have found that their referrals come from a variety of directions — not just oncologists, but also cancer support groups and journals and even the general public. “Our PTs educate everyone about their skills,” she says. “Don’t limit yourself to advertising only to doctors.”

If you’re considering starting a niche program, Suzanne recommends researching the demographics in your area to see if there’s a need for the program before starting it. She also reminds owners to consider what kind of case load you’ll have and the space you’ll need. Even with the same lymphedema program offered in different locations, they need different equipment in the rural location compared to the city location because of the prevalence of obesity in the rural location (for example, their equipment, like tables and chairs, needs to be larger).

Help patients transition from treatment to fitness

Many patients struggle with the transition from post-rehab to independent fitness. Joyce Klee, co-owner of Clinton Physical Therapy Center, a PTPN member in Clinton, Tennessee, says that patients would come to the end of their physical therapy treatments and realize they needed a structured environment in which to continue their home exercise programs. “We have always tried to keep the medically oriented focus at our clinic,” she says. “Many of the people who come here need supervision that they can’t get at a health club. We can cater their exercise programs to specific health issues, whether they are orthopedic or neurological problems, or other issues, like obesity.”

At the Take Charge Fitness Program, most of the fitness programs are available throughout the year and include aerobics, Zumba, line dancing, yoga (including chair yoga and yoga for seniors) and Pilates. The program’s fee schedule is simple: a one-time fee to join, and then a variety of monthly membership levels based on the type of classes one takes.

When creating similar programs at your clinic, Joyce advises making sure that any staff member offering classes is properly qualified; all of the fitness instructors at Take Charge Fitness have degrees or advanced training in their area of expertise. She reminds fellow therapists, “A PT degree does not necessarily qualify a person to create a fitness routine for the general public, and not every fitness instructor will know how to accommodate for a client’s physical limitations or needs.”

A special thanks to our contributors:

Suzanne Cavanaugh, PT, DPT, CLT-LANA

Joyce Klee, PT

Venise Mule Glass, PT, DPT, OCS, CSCS

Chris Nawrocki, PT, MSPT, Cert. MDT, OCS

Michael Weinper, PT, DPT, M.P.H.

Janet Yamada Soto, PT, DPT, FAAOMPT
Suzanne Cavanaugh, PT, DPT, CLT-LANA, is a physical therapist and the regional director for the Allegheny and Butler County offices of Allegheny Chesapeake Physical Therapy, a PTPN member with 10 locations in Pennsylvania. She is accredited by the Lymphology Association of North America as a Certified Lymphedema Therapist.

Joyce Klee, PT, is a physical therapist and a co-owner of Clinton Physical Therapy Center, a PTPN clinic in Clinton, Tennessee. She opened Clinton Physical Therapy Center with her co-owner Kelly Lenz in 1988 and has 24 years of experience working with spinal dysfunction patients, and a variety of neurologic disorder cases.

Venise Mule-Glass, PT, DPT, OCS, CSCS, is the owner and founder of Sunshine Physical Therapy, a PTPN member in Commack, New York.

Chris Nawrocki, PT, MSPT, Cert. MDT, OCS, is the chief operations officer for The Center for Physical Rehabilitation, a PTPN member with four locations in western Michigan. Chris has completed over 200 hours of courses at the North American Institute of Orthopedic Manual Therapy, and he is certified as both an orthopedic specialist by the APTA and in mechanical diagnosis and therapy by the McKenzie Institute.

Michael Weinper, PT, DPT, M.P.H., co-founded PTPN in 1985. A physical therapist with more than 40 years of experience in clinical practice, management consulting, administration and program development, Weinper is also a principal in Progressive Physical Therapy, a private practice, with four locations in Southern California.

Janet Yamada Soto, PT, DPT, FAAOMPT, is a physical therapist and the owner of Berkeley Physical Therapy, a PTPN member in Berkeley, California. She is a fellow of the American Academy of Orthopedic Manual Physical Therapists and a consultant to the Kaiser Hayward Physical Therapy Fellowship in Advanced Orthopedic Manual Therapy.

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