Richard Andrascik, PT, DPT
Richard Andrascik, PT, DPT, is a PPS member and owner of MRS Physical Therapy in Bridgewater, Pennsylvania. He can be reached at firstname.lastname@example.org.
Practice: M.R.S. Physical Therapy
Locations: Pennsylvania, Maryland, Georgia, North Carolina
Size of practice: 9 offices, 38 employees
Years in practice: 40
Favorite vacation spot: Grand Cayman Island and Bozeman, Montana
How do you spend your free time? Walking the beach, fly-fishing, and writing
How and why did you choose physical therapy? I didn’t really know anything about physical therapy when I entered college. Most people are exposed to therapy initially as a patient, but I never needed to see a therapist. I actually took a college aptitude test which revealed that I had much in common with the medical field, so I majored in biology. My biology professor talked me into volunteering at a local Easter Seals in the PT department during the summer. The experience was amazing and I was hooked. After the summer, I changed my major to physical therapy.
How have things changed over 40 years of practice? Well, they have changed considerably. Private practices in 1978 were extremely rare and first jobs were either in hospitals or home care. When I graduated from PT school we were not allowed to do evaluations. We had to follow what was written on the script and were not to deviate. We wrote notes, usually once a week rather than daily, (sometimes, I wish for those days). We were mostly doing modalities back then, with a few exercises thrown in. We used to call it “shake and bake”—hot packs, ultrasound, and massage. Since those early times, we have increased our status as professionals and began evaluating and determining the course of treatment for our patients, becoming increasingly autonomous moving toward the DPT degree. The old adage about doctors, being as I was once told “the captain of the ship,” has changed to “Take a look at my patient and tell us what you think.” And the biggest change I have seen is insurance companies paying therapists through direct access.
When did you start your private practice and what would you do differently? I started my first practice in 1985. It grew to 10 locations. The first practice was called Medical Rehabilitation Systems (M.R.S.) and we were in business till 1995 when we were acquired by a large rehabilitation company. Looking back, I think I shouldn’t have sold it. I had a non-compete for five years and decided to contact therapists that worked for my company initially who had moved on to their home cities and states. Subsequently we became partners and formed a new practice (M.R.S). That is partly why we are spread out over 4 states. The second do-over would be to change the M.R.S. Physical Therapy name to something else. We have been called Mrs. Physical Therapy, like Mrs. Fields Cookies and it kind of drives me crazy. That’s why we have the periods between the letters, but it doesn’t really make a difference.
What is unique about your practice? The majority of our practices are in rural or semirural communities and we become an integral part of the community. Our patients become our friends and that is one of our competitive advantages. We put patients first above all other things and attempt to make the latest evidence-based treatments available to them. Since we are in rural settings we need to be able to treat every patient that walks through our door, so we tend to be more of a generalist practice, seeing both orthopedic and neurological patients. That being said, our therapists are specialists in various aspects of practice.
What do you like most about your job? I love the friendship we develop with patients over the course of their treatment.
What do you like least about your job? Ever increasing regulatory demands and mountains of paperwork both from the administrative side and the patient treatment side. I swear I sometimes spend more time treating the patient’s notes than actually treating the patient.
What worries you about the future of private practice? What worries me the most is resistance to change. Over the past 40 years if I didn’t change I am pretty sure I wouldn’t still be in business. Specific threats continue in the form of physician-owned practices and insurance companies trying to decrease reimbursement by any means they can. I’m concerned about the fairness of “pay for performance” and how that will be calculated going forward.
Describe your management style: Over the years my management style has evolved from micro-managing everything to stepping back and surrounding myself with a team of professionals and partners that compensate for my areas of weakness. I tend to get involved more in the big picture items, letting the management team deal with the day-to-day operations.
What is the most important lesson you’ve learned? 1. You have to be one step ahead of change. 2. Never be satisfied with how well the practice is doing. 3. Never forget that we serve the patient.
Best decision? Centralizing our administrative operations to manage our clinics. When you are spread over four states it is essential to have a central operation. We take the burden of administration and regulatory requirements away from the clinics, which allows them to focus on patient treatment and growth.
Worst decision? Opening a practice based on a referral source without doing an analysis of the surrounding market. Complete disaster that cost the company a few dollars.
Toughest decision? Letting an employee go. In 40 years it only has happened once but it was a difficult decision.
Describe your marketing strategy. Our clinics have different identities based on their locations. What works at one clinic may not work at another. Each clinic develops their own marketing plan for the year based on their community needs. One of our clinics has a monthly radio call-in show and recently did Facebook live during the broadcast. We are always looking for new ideas to explore.
What unique programs do you offer to set you apart from the competition? Although we are generalist in nature we offer several unique programs at different locations based on community needs. We offer temporomandibular joint (TMJ) management, balance and vestibular centers, dry needling, and industrial health in both our offices and at employer locations.
What are you optimistic about? I’m optimistic about the newfound attention that the profession is receiving. With the changes in direct access and the evolution of the DPT program I see a greater respect from not only the general public but other health professionals as well. As we become an entry point into the health care system I only see good things ahead.
What are the benefits of PPS membership to your practice? Membership provides the opportunity to talk and network with practitioners with similar concerns as our own. The yearly private practice meeting brings together a variety of practices and ideas under one roof to share our stories. In addition, the various educational programs made available by the Private Practice Section aid in growing our existing offices.
What are your goals for next year? To transition to the value-based payment system that is on the horizon.
Where do you see the best opportunities for your practice in the future? I believe the best opportunities are in direct access. The greater the percentage of our patient population that is direct access, the greater the stability for our practice.
In retrospect, after 40 years would you do it again? Without a doubt! When I first entered the field I was a novice about everything, from interacting with patients to running a business. Over 40 years of being a physical therapist I have grown as a person. I challenge anyone to find a profession that develops the compassion and empathy of the human experience as physical therapy does. To survive 40 years in an ever changing regulatory environment has been a mixture of good and bad, sometimes a bit of luck, sometimes being in the right place at the right time, but always changing to stay ahead of CMS. It was worth every minute of it.