Innovation Through Disruption
The Health Hub Practice Model.
By Gene Shirokobrod, PT, DPT; Ryan Smith, PT, DPT; and Ben Fung, PT, DPT, MBA
Innovation is often associated with creating something novel. Rarely is innovation associated with the connections of multiple perspectives or a combination of ideas; typically, business strategists refer to this as “disruption.” A new approach that places “health” first and “care” second is emerging as a blue ocean space to an increasingly savvy base of health literate consumers, a space where disruption can open the way to innovation for private practitioners.
For a long time now, there has been discussion of moving away from a sick care system to a true health care system. And while health care may be one of the slowest adapting industries out there, fitness is one of the fastest moving yet congested industries. It is at the intersection of physical therapy and fitness that disruption can become innovation.
Traditionally, wellness, fitness, and rehab maintenance service lines have been seen as physical therapy extensions of service. Once patients finished their treatment plan with a skilled therapist, many practices would offer them access to supervised exercise and equipment use, much like a gym membership. This transitional phase for patients thus became a move from physical therapy services to treat a specific problem(s) to an emphasis on health, wellness, and fitness. This pattern, however, still matches the sick care system.
But what if health became the business standard and physical therapy became one component of it? What if the health care provider chose to own and operate a membership- driven hybrid entity that began with the pursuit of health but also offered the respite of clinical services, should members require it? What if fitness became the standard to which private practitioners scaled their clinical services so that their customers would include both general and health care consumers?
Enter the health hub practice model. By empowering members in their pursuit of best health, clinical entities can now expand beyond the business of providing physical rehabilitation services. They can now become community anchors that provide care for those who wish to be healthier, with clinical services as the backup. The mindset shift is on the paradigm level; rather than avoid the bad, pursue the good!
The significance here is the empowerment of the member. Typically, the culture of health care has been one that emphasizes avoidance: “Don’t eat this.” “Don’t do that.” “Lifting this object is bad for you.” “Sitting this way is bad for you.” At a health hub practice, instead of being assaulted with negative instructions, members are encouraged to explore what they can do while being directly connected to a health care clinician.
From a business perspective, a health hub champions health and fitness as prime revenue producers and keeps clinical services in reserve. Ownership over the fitness side of the business allows private practitioners to develop recurring revenue that does not need to be maintained by increasing volume. Rather, we can maintain and achieve a higher recurring revenue by improving the quality of the services and the available options for individuals in their pursuit of best health. This quality is derived from the knowledge and communication skills of the physical therapist as both clinician and health coach. As health care providers at a health hub, physical therapists are valued just as much for their time and productivity as they are for their connection and combinations of ideas that improve the quality of health of those whom they come into contact with and the relationships they make in growing the membership of such a health hub.
It is truly rare to combine a clinician’s role with that of health coach or personal trainer. For many, this seems like overkill or, in the case of physical therapy, an overqualified misappropriation of human resources. This is where disruption serves as an innovative force, by turning this sentiment on its head: In this role, in order to promote health the provider must know the entire spectrum of injury rehabilitation as well as how to work toward optimum levels of human performance.
Customers of such a health hub feel that the practice isn’t just a clinic; it’s not a place to be avoided because it means they are injured or in pain. The health hub is now a picture of health for the local community, its members guided by watchful clinicians while exploring the upper limits of their health pursuits in the most positive of ways. This approach makes a clinician as valuable in a one-on-one scenario as in teaching a group fitness class.
What stands out most in the innovative health hub approach is this establishment of clinicians as coaches and leaders. The employees in such an organization quite literally walk the walk. They understand the importance of health within their own lifestyles, and it allows them to have those sometimes difficult conversations on how to do so with the local community. Such an organization not only disrupts the idea of monitoring units, billing, and productivity as key management metrics, but also functions as a business of the community, first, and as a community clinic, second.
Gene Shirokobrod, PT, DPT, is an adjunct faculty member at University of Maryland School of Medicine, residency trained and certified in manual therapy and dry needling. He specializes in treating runners, golfers, spine-related conditions, and youth athletes. He also co-hosts a top-rated physical therapy podcast called Therapy Insiders, which has been downloaded over 500,000 times and is a top 100 iTunes medical podcast.
Ryan Smith, PT, DPT, is a lead instructor for the Institute of Clinical Excellence in the Fitness Athlete division. He specializes in treating individuals who participate in CrossFit, Olympic lifting, powerlifting, and other recreational sport activities. He also specializes in pelvic health therapy, utilizing an external approach that focuses on education and management of diastisis recti, pelvic organ prolapse, and postpartum issues. He is an avid supporter of the Senior Rehab Project and promoting individuals to strength train throughout their lifetime.
Ben Fung, PT, DPT, MBA, is an independent media producer and startup entrepreneur. He is a health care clinician turned social media connector; with experience in optimizing growth for companies and investors in various industries including health care, geo-technology, human resources, and marketing. Ben currently serves as COO of UpDoc Media, a marketing agency for health/tech businesses, and, as a CFO of Recharge, an investor-backed CrossFit-Physio-Mindfulness hybrid with a mission to redefine the health care experience by breaking down the silos of medicine, health, fitness, and wellness.