2016 PPS Election

Notice of Nomination

Posted for your consideration is the slate of candidates unanimously selected and approved by the Nominating Committee for the PPS 2016 Election. After a careful review we believe the individuals slated possess the background, talent, and character needed to achieve the goals established in the Strategic Plan and to carry out the mission of the Private Practice Section.

Voting will take place at the 2016 Annual Conference & Exhibition in Las Vegas, Nevada.

Voting is an important membership benefit and we urge you to participate in this election.

Candidates for Director


Craig Johnson, PT, MBA

2016 Candidate – Director

Craig Johnson, PT, MBA, is a partner and Chief Operations Officer at Therapy Partners where he directs internal operations and support services to 15 practices with 32 locations in Minnesota and Wisconsin, focused in the areas of care management, outcomes management, compliance, and reimbursement. He has many years of involvement in PPS and APTA, serving as president of the MNPTA, and on key APTA and PPS payment and policy committees.

Candidate Statement:
I feel very fortunate to be slated for the Board of Directors of PPS. My passion for private practice stems from growing up with and being mentored by a father who was a dentist that started his own practice, was president of the Minnesota Dental Association, and served on many national committees of the ADA. I recognized his example to me when, after attending my first state conference, I sat down and wrote him a long letter about how proud I was to be a physical therapist, and a member of this professional organization. This passion for our profession burns inside me; I know it is fueled from those years growing up.

I value what I believe most private practice owners value: creating a quality service that will attract customers, and receiving reasonable payment for those services. It is a simple formula that can work even when health care reform is swirling around us. It is keeping this formula alive for current and future private practitioners that I most fervently want to see continued for a long time.

I started my first private practice five years after graduation. I have been a clinician, manager, and owner, wearing all the hats within a private practice. Currently, I am a partner and Chief Operations Officer of Therapy Partners, Inc. (TPI), a management service organization, with 15 independent member practices and 32 clinics in Minnesota and Wisconsin. TPI is involved in value-based payer contracts and has successfully leveraged outcomes to improve payment. I direct internal operations and lead the support services to the practices in the areas of care management, outcomes management, compliance, and reimbursement.

My work within the profession has prepared me to be an effective board member to lead us through this time of change. I served on the APTA POPTS Committee, and was active on an APTA Governance Workgroup. I put together two innovative models of care for value-based payment, which were presented at ATPA Innovation 2.0, one of which received a small grant as honorable mention. As a two-term president of Minnesota PT Association, I lead a chapter governance model change and an extensive strategic planning process to position physical therapy higher in care delivery and more prominent in society. I currently serve on an APTA and Industry Outcomes Task Force, the PPS Payment Policy Committee and APTA Public Policy and Advocacy Committee, and am a PPS Key Contact.

I believe there is tremendous opportunity ahead for private practice, if we focus on delivering value, defined as outcome/cost. By collecting and analyzing cost and outcome data we can improve our competitive advantage in the marketplace. PPS should help practices develop strategies that leverage data to achieve a better strategic position.

Our challenges in practice and payment are changing the clinical pathway, innovative strategies, and leadership in the health care industry. We have to change our place in the continuum of care, which will require collaboration with other providers. PPS and APTA must put a major push on changing the clinical pathway that will better deliver value and increase access. Innovative value-based payment models are evolving, but further strategy development is required with regional or national payers, and CMS’s payment reform. PPS is a leader in the profession, yet must lead in the health care industry by supporting innovators, bold leaders, and change agents through developing a platform where members will be educated and heard.

With my knowledge and experience, I am able to leverage my influence and contribute to a visionary board and elevate private practice as the valued provider. It would be an honor to serve on the PPS board.


Bill Pfister Jr., PT, MPT, CLT

2016 Candidate – Director

Bill Pfister Jr., PT, MPT, CLT, is one of seven partners in RET Physical Therapy, a group of independent, 100 percent physical therapist–owned practices with 19 locations in Washington State. He also sits on the Board of Directors for RET, helping provide strategic insight to guide the future of the practice. He manages a full clinical caseload and assists in operations management and business development for RET.

Candidate Statement:
I would like to thank the Nominating Committee for slating me as a candidate for Director. I am honored to be considered for this position. I have been a physical therapist for 13 years. I am very fortunate to have supportive partners that understand the value of PPS to our profession and support my involvement in leadership within PPS. My experience and passion have always been in private practice and promoting the profession of physical therapy. I believe serving as PPS Director will be the perfect opportunity for me to blend my innovative and entrepreneurial spirit to help further the goals we all share for our profession and our section.

I began my journey 11 years ago when I became the Clinic Director of a struggling practice in a community called Puyallup, a suburb of Seattle. At that time, there were 13 clinics in our group and my clinic was at the bottom of the company for both production and revenue. With hard work and perseverance (and no personal life), I was able to right the ship in four short years and turn it into one of the top-performing clinics. Of the 19 clinics we now have in our practice, we have grown successfully through innovation, hiring great physical therapists, collaborating with other health care professionals, and providing mentoring and guidance to staff.

My prior experience growing a small, individual private practice and now being responsible for growing a larger, multipractice physical therapy business has forged a unique perspective in understanding the challenges that face both large and small private practices alike. It is because of these experiences that I feel qualified to represent our Private Practice Section membership in the pursuit of keeping private practices—both small and large—healthy, viable, and profitable delivering undeniable value to the patients we have the privilege to serve. I want to help private practice owners grow and continue to protect their businesses.

Presently, I serve as the assistant managing editor of our PPS Impact magazine and have done so for two years. Prior, I served on the Impact Board for one year, and have also contributed as an author. By serving in these capacities, I have had the distinct pleasure of meeting many innovative physical therapists and practice owners who are willing to share ways to improve, innovate, and thrive in private practice. More importantly, I have had the opportunity to develop some amazing friendships and encounter established mentors along the way. I believe the more involved and engaged you are, the more effective you can be in fostering growth and change. I will be a voice of progress and represent the daily challenges of private practices of all varieties, sizes, and settings.

I believe that quality, payment reform, and population health via the Triple Aim are present opportunities for our profession to improve the way we do business; however, without continued persistent engagement from PPS we may not successfully capitalize on them. These factors will have an impact on our revenue streams. It is imperative that PPS be able to help its membership adapt and continue to thrive as these opportunities unfold. I intend to be a catalyst of change, working diligently to move our profession and businesses forward. Please vote for me so that I may advocate and become an agent of change to meet our collective goals.


Brett Roberts, PT, DPT

2016 Candidate – Director

Brett Roberts, PT, DPT, grew up in a family business selling worms. While working for Wormart he gained the skills and entrepreneurial creativity required to grow from 19 locations to 140 locations in three states. Because of this experience, he decided to make the leap into private practice less than three years after graduating from UW Madison’s Physical Therapy Program in 2002. He has been the sole owner of Roberts & Associates Physical Therapy, S.C., and its three locations for over a decade. He recently launched Inertia Solutions, LLC, which combines the convenience of a 24-hour fitness facility with the expertise of Doctors of Physical Therapy. He is also a founding member of Kinexcare, a collaborative effort between eight independent private practice owners. At the state level, he is one of the founding members of Wisconsin’s Private Practice Special Interest Group and served in the dual role of Director (2011-2015) and Legislative Action Committee Chair (2006–present). At the national level, he served on the PPS Innovative Business Model Task Force in 2015 and gave an “I Believe” talk at the Graham Sessions in 2014.

Candidate Statement:
We are facing a monumental shift in health care and the opportunity to thrive as a profession has never been greater. Legislative strategy and a creative approach to problem solving are two strengths that I bring to the table that can help guide our profession into the future. We are seeing the cards fall in many favorable ways and how we respond to these opportunities and avoid missteps will help create our future. The three critical issues facing our profession can be summed up in three words: Drugs, Money, and Jobs.

Drugs—Big Pharma dealt us a winning hand by pushing our nation to the tipping point in the opioid addiction epidemic. Appropriately, physical therapy is being pushed to the forefront to help address this growing problem. Continuing to ride this momentum holds the key to our future success. As Director, I will ensure we always look at ways to effectively market our services to the right person at the right time and help to establish and promote connections with other health care providers and decision makers.

Money—With a dramatic shift in patient financial responsibility and the emergence of cost control measures (narrow networks, inability to opt out of Medicare, etc.) the financial future of our profession will continue to evolve rapidly. While many see this as a negative, bleak future, I feel there is great opportunity if we understand how to identify and effectively communicate the benefits of our profession to the appropriate stakeholders. I’ll advocate for shifting control from third-party entities to individuals and self-funded companies. This will help demonstrate our true value in the health care marketplace.

Jobs (Steve Jobs, that is)—Our profession is ripe for technological disruption. I believe this could be the very catalyst to propel our profession forward into the 22nd century. Having a well-thought-out legislative agenda can help us balance potential threats (such as tele-PT provided by non-PTs) against potential opportunities for growth. For example, should an artificial boundary such as a state line really limit who can benefit from tele-medicine? Direct access took over 56 years to pass in all 50 states. Can we survive another drawn out state-by-state battle or do we push for something bigger? As Director, I will help ask the challenging questions and won’t be afraid to express alternative ideas to push our profession forward.

Thank you for considering my nomination. I look forward to creating a better tomorrow!


Ali Schoos, PT, OCS

2016 Candidate – Director

Ali Schoos, PT, OCS, is a founding owner and current owner and director of Peak Sports and Spine Physical Therapy in Bellevue, Washington. Ali served on the board of PPSIG in Washington state for six years, was state insurance reimbursement chair for nine years, and is currently serving on the state legislative committee and the standards of practice panel for ACOs and ACNs. She was named “Washington State PT of the Year” in 1993. She has been a national delegate, attends PPS conferences, and presented a “What I Believe” talk at the Graham sessions this year.

Candidate Statement:
I am passionate about physical therapy, and especially about delivering it from a private practice model. I, along with my PT husband, helped develop Peak into 7 clinics, offering ownership via sweat equity to PTs who had worked with us or one of our partners. It is a great source of pride and accomplishment to witness the number of PTs with whom we’ve worked who are now owners, some in our company, and others on their own, including the president of PTWA and the chair of PPSIG. Mentoring the next generation of private practice owners is something we should all embrace, recognizing that every good PT who opens a clinic “in my backyard” is raising the profile of our whole profession and opening our doors to a wider audience. I have opened multisite private practices twice, ran 15 clinics for a large national company, and am now back to owning and operating one PT clinic as I focus on other venues. This includes promotion of PTs as primary care practitioners and raising Alzheimer’s awareness, and learning how to tweet and be a guest speaker on podcasts to advocate for physical therapists via social media! I believe in giving back and following your passion, so I also serve on the board of my local YMCA-facilitating development of a larger community center where so many healthy living services can be accessed inexpensively. I am fortunate to serve on the King County Regional Alzheimer’s Advisory Committee.

I believe the role of PPS is simple, and the job is big: to help the private practitioner thrive and add value to the health care continuum, while promoting private practice physical therapists as the primary care provider for musculoskeletal health.

We need to:

  1. Identify the needs of the upcoming generation of DPTs as potential private practitioners. PPS should work to build a bridge between the current generational way of doing business with all of the knowledge and mentorship that brings to the table, to the social media savvy and disruptive business models of the #FreshPT (the up and comers!).
  2. Provide information, education, and metrics to our membership to be able to advocate and negotiate for collaborative contracts with payers, engage politicians for our inclusion in health care bills, and demonstrate the value of “PT first” to consumers.
  3. Develop a marketing campaign and social media presence to educate the public about what private practice PTs do and the value we add to the health care consumer. We should learn from, and perhaps join forces with, the PT collective that is leading the online promotion currently. Physical therapists should be providing the premier online content for the consumer about musculoskeletal health: i.e., “WebPT.”

I envision a world where physical therapists are the primary care providers, and most cost effective choice, for musculoskeletal health care. We will be seeing patients once a year to make sure they are keeping their bodies moving well. We will be using telehealth to make some visits easier, more accessible, or less costly. PTs will be the providers of online content for injury avoidance and recovery. Thank you for the opportunity to help move us toward the future vision of physical therapists as a Board member of PPS.


Kathryn B. Stenslie, PT, DPT

2016 Candidate – Director

Kathryn B. Stenslie, PT, DPT, is Vice President of Operations for HPRC, Inc., a rehabilitation organization that serves patients in 10 locations across 3 states in the Southeast. She has 18 years of private practice experience in clinical practice, personnel management, and business management for outpatient orthopedic, home health, and hospital contract settings. Kathy resides in Columbus, Georgia, with her husband and three children. She is heavily involved in the triathlon community and currently training to complete her fourth Ironman.

Candidate Statement:
Thank you to the Nominating Committee for the opportunity to run for the Private Practice Section’s Board of Directors. I had the privilege of serving on the PPS board from 2007–2010 and am honored for the potential to serve once again during a much different time for private practices around the country. We will be celebrating a 60-year legacy for the Section this October. The many mentors I have in the Section have had a tremendous impact on my professional path and I am humbled when I reflect on the ways they have shaped and directed the path of this Section. I am truly grateful to them as this serves to deepen my belief in the business of private practice and motivates me to contribute to the Section and its leadership.

I have been in private practice for all 18 years of my career and actively involved as a PPS member for the past 12. My career has been filled with diverse opportunities to serve patients and communities across the spectrum of clinical and business perspectives. I currently serve as Vice President of Operations for HPRC and contribute to patient care 20–25 hours a week. I oversee our home health division, hospital contracts, and recently facilitated a new mobile business model of practice. I am also currently establishing an outcomes program initiative for our company. Due to this experience in diverse practice environments, I feel well equipped to serve you and the Section during a time filled with challenges but also great opportunity.

During the past several years, through involvement on the Membership Development Committee, I gained knowledge and experience about what is meaningful to the member. Significant increases in membership occurred as a result of this Committee’s efforts including a 30 percent increase in student memberships. As Vice President of the Private Practice Section Institute Board, I assisted in the planning and execution of the 9th Annual Graham Sessions. This year’s attendees were effusive regarding their experience in attending the “think-tank”-style event. No doubt one of our greatest challenges has been physician-owned physical therapy services. While these entities remain, I believe health care consolidation is one of our most critical issues now and into the future. We currently face restructuring of payment methodologies, including bundled payments. We must demonstrate our value by providing data that shows the effectiveness of our services. I hope to bring my experience in balancing our role as a strong private practitioner in an environment that is dominated by expanding hospital-based health care systems. My expertise in relationship building and negotiation contributed to the efforts enabling our practice to be the first to provide services under direct access within a hospital system in Georgia.

It is incumbent on leadership of the Section to foster innovation and support the growth of new and emerging models that are beginning to make headlines. There is a need for new private practices to open and expand in spite of the challenges today. I believe they will need to look much different than the traditional brick and mortar practice we have been accustomed to. For example, an emerging trend that is being seen are physical therapy private practices employing or contracting with physicians. I believe this is just one example and there is opportunity for many more.

With continued strong efforts in grassroots, state, and national advocacy efforts, we will demonstrate our value and ensure that we have a place at the table to negotiate our position as a recognized leader in health care. I ask for your support and vote for the Board of Directors.

Candidates for Nominating Committee


Alan Balavender, PT, MS

2016 Candidate – Nominating Committee

After graduating from Quinnipiac University with a Bachelor of Science in Physical Therapy, Alan began his career in outpatient orthopedics. Alan went on to complete his master’s degree in Organizational Behavior from the University of Hartford. He left the field of PT to pursue his entrepreneurial spirit as a partner in a health care consulting firm. The firm focused on the development of provider networks and alternative care delivery systems throughout the United States. Longing to return to the profession, Alan accepted a clinical position with Physical Therapy & Sports Medicine Center of Waterbury, Connecticut. In 2000, he purchased the practice. Alan remains committed to private practice with a vision to create a company driven by customer service, clinical excellence, and meaningful relationships.

Candidate Statement:
I found the profession by accident, left it, and I am very fortunate to have returned!

My parents were both small business owners. As the youngest of five boys, I grew up on stories about business ownership. My parents believed that having “your name on the door” meant something. While I was in high school, two of my older brothers graduated from PT school. I soon followed: same degree, same school. It was what I knew!

I left PT after five years to experience a broader scope of health care and be an “entrepreneur.” Those eight years were great lessons in success, risk, and failure. I had the privilege of working with great people, seeing the country, and occasionally making a living! I was drawn back to the clinical environment, missing the satisfaction of caring for people. I started working once a week at a small practice. Two years later, I purchased the clinic with the goal of creating a private practice which encouraged ownership by clinicians. Since 2000, PTSMC has grown to 17 locations in Connecticut. There are 15 partners and 180 employees. PTSMC has been fortunate to be recognized by our employees as a Top Workplace in Connecticut for the last six years.

In my opinion, the three most critical issues facing PPS in the next three years are:

Payment: This has been and always will be one of the top concerns of private practice. The three-party system we operate in can create disconnects among the provider, customer, and entity paying for the service provided. Regardless of the evolution of payment models, it is imperative we remain engaged in the conversation at every level. We must continue to create value to all stakeholders.

Collaboration: I believe we are living through an unprecedented, systemwide health care change. As private practice physical therapists, we will be offered and encouraged to consider business models and care delivery systems that look very different than they did just a few short years ago. We need to be open and proactive in creating and supporting collaborative efforts that don’t compromise our principles.

Profession Adaptation: As one who grew up in the profession that has historically been perceived as an “ancillary provider,” I think our profession has made extraordinary progress. To recognize the APTA vision of “Transforming society by optimizing movement to improve the human experience,” we must accept the position of movement and musculoskeletal experts. We must be willing to work to the limits of our license and push those limits further. Physical therapists must transition from “episodic care” and take the lead in becoming our customer’s “PT for Life.”

Most of my career has been finding the best people, challenging, growing, and supporting them. With your vote, I would like to continue to do so as a member of the PPS Nominating Committee


David Qualls, PT

2016 Candidate – Nominating Committee

David Qualls, PT, has been president of Rehab Institute, Inc., dba Qualls & Co., in Sulphur, Louisiana, for the past 37 years. The corporate name has changed several times to meet the demands of the community and the advancing scope of professional practice. In addition to providing treatment, prevention, and wellness to patients and clients, volunteer service to the church, community, and profession have always been a high priority at Qualls & Co.

Candidate Statement:
I am honored to be slated for a position on the PPS Nominating Committee. I take this nomination very seriously. The Nominating Committee is the most important committee of an organization. This is the committee that interviews and recommends a slate of candidates that will lead the organization. Pretty awesome task, I think.

I have practiced for 42 years, the last 37 in private practice. After starting my career in the hospital setting, I saw there were rules and regulations that hindered me from practicing the way I wanted. In 1979, I opened my first practice. I have been a solo practitioner and have had partners, up to four. I have experienced practice from hospital inpatient, hospital contracting, extended care facilities, home health, wellness, geriatric psychiatry, large national corporate outpatient, and independent practice. I have had administrative, financial, and patient responsibilities at one to 30 sites in five states. After the Balanced Budget Act, I returned to my original practice and grew it. Now I have downsized and practice in a small rural community. With the exception of two years in the early 90s, I have treated patients and carried out the administrative duties.

I have been a member of the Private Practice Section for almost 30 years. After my first meeting, I was hooked. I thought that first meeting was the greatest! Finally, someone was speaking about the business of physical therapy and not getting chastised for it.

I served on the PPS Board of Directors from 2009–2012. After one term, I felt I had accomplished the goals I was called to do, so I chose not to seek a second term. I currently serve as a director on the Institute of Private Practice Physical Therapy Board and also served on the most recent PPS Strategic Planning Committee. Last fall, I was asked to represent the Private Practice Section on the Louisiana Patient Access Resolution Committee. The recommendation of this committee lead to the draft of the Patient Access to Physical Therapy Legislation, which just passed the Louisiana legislature. While preparing for my presentation to this committee, I reviewed the PPS History Project and once again appreciated the dedication of our early founders and their goals for private practice in physical therapy. Also, I have served in leadership positions in the local and extended church, my community, as well as in LPTA and APTA.

As PPS leaders work to achieve our mission of supporting the physical therapist in business, we must continue our advocacy for appropriate payment for our expertise as movement specialists. Support for access to physical therapy without restrictions remains paramount. It is important that we continue to recognize and promote the importance of private practice physical therapy and its impact on our profession and on government advocacy now and historically. We need to continue our support of the small private physical therapy practice from which this section birthed. This includes increased public awareness of their importance in the local community. These smaller practices need the Section’s expertise and guidance. They have ideas to share, just as our large corporate members do.

If elected, I do not need to possess all the skills required to complete our Section’s Mission but rather need to be able to recognize and recruit individuals who exhibit the skills needed to accomplish this mission. I can do that. I have served for a long time and I love it. I know and understand the commitment that is required to serve. I have the ability to share my experience with those who are considering serving PPS as we evaluate what might be the best position for them. I love to talk to people and enjoy individual one-on-one conversation. I am a good listener. Everyone needs affirmation and the simple ask validates that.

I would love to serve PPS again, this time as a member of the Nominating Committee. My service has prepared me for this position. The time is right for me, and the position is ideal for my skill set. I ask that you give me your vote of confidence. See you in Vegas!

2015 PPS Election

Notice of Nomination

Posted for your consideration is the slate of candidates unanimously selected and approved by the Nominating Committee to serve on the PPS Board of Directors and Nominating Committee. After a careful review we believe the individuals slated possess the background, talent, and character needed to achieve the goals established in the Strategic Plan and to carry out the mission of the section.

Voting will take place at the 2015 Annual Conference & Exhibition in Orlando, FL, starting on Thursday, November 12, 2015 and ending on Friday, November 13, 2015 at 3:00 pm (ET).

Voting is an important membership benefit and we urge you to participate in this election.

Join us at the swearing-in ceremony taking place on Saturday, November 14, 2015 at the Plenary Keynote and Networking Breakfast starting at 8:00 AM (ET).

Candidates for Treasurer


Christopher Albanese, PT, MS, CSCS

2015 Candidate – Treasurer

Christopher Albanese, PT, MS, CSCS, is a founding partner of Access Physical Therapy & Wellness, a rehab organization with 18 locations across states of which he cofounded with his wife, brother, and sister-in-law. His main areas of focus lie in Strategy, Finance, Legal, IT, and Talent Acquisition and Retention. His passion is to develop leaders within ACCESS PT that can help us prosper in this challenging health care environment.

Candidate Statement:
As a deeply dedicated and longtime member of the American Physical Therapy Association and PPS, I’m asking for the opportunity to serve as your treasurer. My experience at my company and on the finance committee makes me uniquely qualified to take on the role of treasurer, and I have some great ideas that will ensure you see the full benefit of your membership.

I’m the longest serving member of the finance committee, and in the six years I’ve been part of that team, one of the most rewarding experiences has been reading the member surveys. It’s so helpful to review them right before budget time so that we can ensure that PPS is providing its members with the programming and experiences that will benefit them most. This includes third party payment, POPTS/HOPTS, increased lobbying efforts, and marketing support.

As treasurer, I’ll implement plans that will:

  • Enable the board to better monitor our fiscal position;
  • Use improved methods of reporting that would make our complex budget and financials easier to understand; and
  • Make sure that every member gets a great return on his or her investment.

In 2003, I launched Access Physical Therapy & Wellness along with my brother, wife, and sister-in-law. Today, we have 19 locations in three states and a hospital contract with three locations. But it wasn’t so long ago that we were struggling to keep our doors open, support a handful of employees, and stay competitive in an aggressive marketplace. PPS gave me the tools, support, and connections that I was able to apply to my business to better serve our clients and support our staff. It has had a significant impact on our ability to succeed, and that’s an experience I want every PPS member to have.

With my talent and experience as a leader and in finance, which I oversee for our practice, along with my past 6 years on the PPS finance committee, I look forward to being able to give back and serve the section where I can best apply my talent and experience.

I am a father of three, husband, private practice owner, Assistant Scout Master and Eagle Scout. Since joining PPS while still in school almost 20 years ago, I’ve had the opportunity to meet and get to know so many of you. We are a large and diverse group, but we have many things in common, including our commitment to building great private practices that truly help the communities we are blessed to serve live with less pain and improve quality of life. I am very proud of my work I have done on the finance committee and I look forward to expanding my duties and service as treasurer.

I hope that I can count on your vote for treasurer, and I look forward to working with you and on your behalf.


Angela Wilson Pennisi, PT, MS, OCS

2015 Candidate – Treasurer

Angela Wilson Pennisi, PT, MS, OCS, has been president of Lakeshore Sports Physical Therapy, PC, in Chicago since 2000. She was also president of Physioview, LLC, from 2004 until its sale in 2012. She has many years of involvement with PPS, including the Impact editorial board and finance committee, and was the managing editor of Impact. Angela has also served as the former president of her state private practice group and is its current Network Task Force chair.

Candidate Statement:
Serving as your treasurer over the past year has been an honor, and I thank you for your consideration in the upcoming election. I am passionate about promoting the mission of PPS, recognizing the influence of being a physical therapist in business on my own life.

I founded Lakeshore Sports Physical Therapy, PC, in Chicago only 3 years after graduation. Through the knowledge and growth I gained through involvement with PPS, I grew from a new solo practitioner to the sole owner of two clinics over 15 years, employing five other physical therapists and collaborating with two independent associates. I currently divide my time among practice management, staff development, and 20 to 25 hours per week of patient care.

I opened a practice early in my career due to dissatisfaction with the status quo and a commitment to finding a better way—two qualities that define my approach to my work as a physical therapist. I knew I could offer my patients more than I was able to provide in a hospital system treating 19 patients a day, so I created that environment for my patients by opening a solo practice. While options for patient education materials may abound today, I created and founded one of the first online patient education programs more than a decade ago when few choices were available. Rather than accepting the world as it is presented to me, I bend the trajectory to where I believe we must go.

I am well qualified to serve as your treasurer through my history of service to PPS and the profession. I served on the editorial board for Impact for 8 years and as managing editor from 2011 to 2014. I was a member of the Finance Committee for two years and have held roles on a state level, as well. As your treasurer, I developed a deficit budget that both balances PPS’s priorities for supporting our members’ success in these challenging times with the need for ensuring financial stability for the future of PPS. While I fully understand where PPS has been, I also bring a fresh perspective to the board regarding where we may go as a section.

PPS is well positioned to address the most critical issue for our current and future members: preserving the path to private practice for physical therapists. However, private practice and business success for tomorrow’s physical therapist may not be identical to that of years past. I believe that PPS can serve as an incubator of innovation and leadership development that will ensure we accomplish our vision of society demanding access to physical therapists’ businesses.

Beyond innovation, we support the mission of PPS through targeted and strategic advocacy. As a Key Contact, I am well versed in government advocacy, but I believe that PPS also has a role to play in advocating with payers for policies that promote improved outcomes at a lower cost and meet the aligned needs of patients, payers, and providers.

Finally, PPS needs a steady hand on the finances over the next several years. PPS is fortunate to be in a healthy financial situation with reserves to buffer against changing tides while continuing to maximize benefits for our members. As your treasurer, I will keep a keen eye on the horizon and be prepared to adjust course for clouds or a squall over that next wave. I respectfully and appreciatively ask for your vote this November.

Candidates for Secretary


Amy Snyder, MPT, DPT

2015 Candidate – Director

Amy Snyder, MPT, DPT, received her bachelor’s and master’s degrees from the University of Florida. Following graduation, Amy worked briefly in Washington, D.C. After a year, she returned to her hometown of Milwaukee to work in private practice with her parents and husband. She returned to school in 2006 and received her Doctorate in Physical Therapy from Creighton University.

Candidate Statement:
I am honored to be slated to run for the position of Secretary for the Private Practice Section’s Board of Directors. My training as a private practice physical therapist began long before I intended. I am the daughter of two physical therapists who built their career in private practice. Shortly after graduation, I also married a physical therapist and we joined my parents as their business partners.

We own a mid-sized practice in southeastern Wisconsin. We support a Management Service Organization model with a total of 5 clinics. We offer wellness services, supporting a holistic approach to health care. I continue to treat patients, oversee marketing, and work on a variety of administrative tasks. We are working to diversify our income with growth in retail, wellness, and industry.

I am one of the founding members of the Wisconsin Physical Therapy Association’s Private Practice Special Interest Group (WPTA’s PPSIG). From our by-laws to our website, I worked on a team to create the PPSIG. I have served as Secretary and currently as Chair. We negotiated group purchase rates to decrease the fixed costs of business for our members. We established income outside of membership dues, securing our financial position. We sponsor networking events and host nationally recognized speakers at our state meetings, elevating the knowledge and conversations amongst all physical therapists in Wisconsin. As a results, we also have more private practitioners than before holding leadership roles within our Chapter.

I served for the last 3 years on the Annual Conference Planning Committee for PPS. In those years we have seen continual growth in attendance. Participating in this process has left me inspired by the innovation and talent amongst our membership.

I am also a member of the PR and Marketing Task Force for the WPTA. We are launching a statewide campaign to promote direct access and consumer choice for physical therapy services.

The core issue we face as physical therapists is the changing health care environment. While gains have been made to move us to a doctoring profession, I am concerned that physical therapy remains a protocol-driven commodity that is not valued by the health care system or consumers. I believe that private practice physical therapists have the ability to lead the efforts to support autonomous practice and help to solidify our role as the primary care providers in the health care system.

The upcoming years will also bring change of administration in Washington, D.C. PPS needs to continue efforts to be present on the Hill and to support the PT PAC. We also need continued support of research not only on the value and outcomes that physical therapy provides, but also on the cost savings.

Lastly, we face a branding issue. If consumers remain unaware of how and when to access physical therapy services, our practices remain at a disadvantage. We need to take our message of quality outcomes and cost savings directly to the consumer. I believe that PPS can serve as a vehicle for consistent message and content that can systematically be distributed by each of our practices and span across our states.

As in my practice, I believe that the knowledge of the past partnered with an optimistic view of the future will serve our section and membership well. My experiences and background make me uniquely qualified to serve on the PPS Board of Directors. I pledge to each of you my commitment to elevating our profession, protecting each of your practices, and helping to lead this section as we face changes in the health care system.


Amanda Somers, DPT

2015 Candidate – Secretary

Amanda Somers, DPT (Greer, SC) is co-owner of Sports Spine & Industrial, with two locations in upstate South Carolina, one which houses their 400-member health club. Amanda is a longtime political advocate successfully battling POPTs in SC and a regular visitor on “The Hill.” Amanda has an unrelenting passion for physical therapist–owned practice. Amanda’s strengths of strategy, vision, and “woo” have served PPS well during her 5 years on the BOD and will assist her in successfully serving on the Executive Committee and as your Secretary.

Candidate Statement:
I am excited about the opportunity given to me by the nominating committee to serve as Secretary and on the Executive Committee of PPS. I have an unrelenting passion for physical therapist–owned practices. Even though many fear our practices may “not fit” with the proposed health care changes, I disagree. Small businesses are the backbone of our country and even though the environment is challenging, our ability as practice owners to be nimble, creative, community driven, and think outside the box are just some of the qualities that will help us prevail. PPS continuing to provide benefits, services, and tools will also be vital to our success. There is strength in numbers. And as colleagues that work in similar settings continue networking at PPS events and sharing experiences our entrepreneurial spirits will continue to be boosted as we remember we are not alone in this fight.

During the last 4 years that I have served on the Board, all of us have seen drastic changes in the health care environment. My practice is located in a community where 95 percent of the physicians are employed by the hospital systems. HOPTS have replaced the threats of POPTS. After almost having to close our doors 2 years ago, we have been able to restructure and grow in these conditions. I know many of your practices suffer under similar conditions in addition to declining reimbursement. That is why I believe that it is imperative that PPS continue aggressively lobbying on Capitol Hill for elimination of the therapy cap, locum tenens, and inclusion in all health care bills that affect our patients and businesses. I, like others, grow weary in these battles but we must maintain our strong presence on the Hill and continue to grow our grassroots program. I also believe that PPS must continue to offer education and tools for our members to use in marketing, business development, payment, and compliance. In addition, we need to continue to search for outside partners to assist us in the navigation of these uncertain times. I am excited to learn of opportunities when the board-directed task force presents its findings. And I am even more excited about taking action when the opportunities become available.

I am the founder and co-owner of Sports Spine & Industrial, a 2-office practice with one office incorporating a full-service health club serving over 400 members. I continue to treat patients 2 days a week in addition to the many hats I wear administratively. I am very involved in my community and serve as VP for a Christian-based Free Medical Clinic and VP of my City’s Park & Recreation Board of Trustees. In the past, I have served as Chairman of the Chamber of Commerce and as board member for several organizations. I am currently in my second term as a Director for the PPS Board. I have served as the liaison to the marketing and PR committee since its conception and oversaw the section’s last major by-laws review. I am highly involved in my home state of South Carolina’s fight to keep POPTS illegal and in lobbying federal issues.

I credit much of my success as a practice owner to the relationships I have obtained within PPS. Also the programming at the annual conference and webinar topics have increased my business knowledge and assisted with practice growth.

I would like the opportunity to continue giving back to the section that has given me so much. If elected Secretary, I will use my experience and passion to lead our section and practices to a better future.

Candidates for Director


Stacey Alberts, PT, OCS, CSCS

2015 Candidate – Director

Stacey Alberts, PT, OCS, CSCS, was the chair of the Annual Conference Program Work Group 2012–2014 and is owner of Total Rehab-Orthopedic & Sports Specialists with two locations in Iowa. Stacey has been active in legislative and payment policy initiatives for Iowa, regionally, and nationally, and has held several leadership roles with the IPTA and PPS. Stacey brings with her experience from other leadership opportunities in the areas of finance. She can be reached at stacey@totalrehab-pt.com.

Candidate Statement:
My name is Stacey Alberts and I am running for a Board of Director position with the Private Practice Section of the APTA. I am the owner of Total Rehab, which has two clinic locations in central Iowa. Total Rehab primarily deals with an outpatient orthopedic population in which my main role is 60 percent administrative and 40 percent clinical. I made decisions early in my practices to refrain from signing substandard contracts. Our clinics have utilized direct access to market to the public, which has been critical in withstanding the changes with health care reform and health care consolidation. About 70 percent of our clinic referrals now come from word of mouth. Our clinics have been very specific with the services we offer as a way to maintain our quality while being extremely cost efficient.

Annual Conference 2014 was my third year as chairperson for the conference and fourth year as part of the annual conference committee. Attendance for the conference in this time rose by 10 percent each year. During my term, I had the opportunity to interact with PPS staff, the PPS board, most of the PPS committees and task force chairs, and numerous members and nonmembers. I have been active on the state and national level, which includes being past president for our state Special Interest Group, organization of the Midwest Therapy Network where I am a director, several APTA and PPS Capitol Hill visits, previous State Policy and Payment Reform Forums, state reimbursement committee and government affairs committee, and am the current Iowa Physical Therapy Association Treasurer. Other leadership positions outside of PPS and APTA include: Church Foundation President, Board of Directors for First State Bank, and Head Varsity Softball Coach, Lynnville Sully High School.

The most critical issues affecting us in the private practice section are health care consolidation and restructuring of the payment system. Generally, health care consolidation poses a risk to small business in that referral networks and the pressure for cost containment can restrict outside services such as physical therapy in an effort to control the spend on a consumer. There has already been much groundwork in restructuring the payment system from members of the Private Practice Section. We continue to see more and more reduction in insurance payments with the multiple procedure reductions. I believe in the coming years, there will be a greater movement to per diem payments, bundled payments, and cash pay services. Establishing a value for our practices and professional services will be necessary to thrive in the coming years.

Thank you for your time and consideration, I would greatly appreciate your vote this fall for Board of Director of the Private Practice Section.


Brian J. Boyle, PT, DPT

2015 Candidate – Director

Brian J. Boyle, PT, DPT, an entrepreneur, a helper, a connector, a futurist, an investor, a public speaker and a Doctor of Physical Therapy. I am all of these and yet defined by no single one. I live in Utah with my wife, Brittney, and our 3 boys. I have 11 years of private practice experience, 17 years of PT experience, and 39 years of experience in storytelling.

Candidate Statement:
It all started as a High School Senior. In the early fall of 1992, I turned down an appointment to the Naval Academy and dashed my Mom’s dreams of having two sons in Annapolis and no student loans. I took a blind leap of faith in hoping that I would get early admission or any admission at all for that matter, into an entry-level PT program. There was no turning back; I was determined to make it.

In 2004, I opened my first PT private practice. It allowed me to realize my dream of practicing PT how I wanted to practice. As with all good things though, they eventually come to an end. Those highest of highs were replaced by the lowest of lows in 2012 when we made the difficult decision to close the practices we had spent almost every waking day building over the prior 8 years. It was at that time, I joined with Mountain Land Physical Therapy and Rehabilitation and we moved to Utah, where I am currently working as the Director of Industrial Rehabilitation. I had left a company with 10 employees and joined a private practice with almost 1,000 employees almost overnight. I now have experience working in both small and large PT practices. I know the struggles you are going through and I believe this sets me apart.

As for my involvement in the profession, I am currently a member of the PPS Government Affairs Committee (GAC) and since joining that committee in 2014 I have taken multiple trips to lobby on Capitol Hill and countless times, before and after, have contacted my elected officials at their local offices to fight for issues such as the therapy cap, SGR, and locum tenens. Prior to my involvement on the GAC, I was elected to and served a 3-year term on the PPS Nominating Committee and I have served in leadership positions with numerous non-profit organizations over the last 10 years.

The three priority areas we must address over the next 3 years, in my opinion, are membership, defining value of physical therapy in the health care open market, and payment for the services we provide. While there are other areas for sure, I believe based on the 80/20 principle, these three areas make up 80 percent of our ability to stay in business and help guide this organization.

Members and their willingness to volunteer and be a part of this organization are paramount to the success of any initiatives we set forth. We must continue to develop leaders as part of this organization if we wish to sustain the efforts we have made so far. As for value, if we do not define our own value, we will have it defined for us. We cannot and must not allow this to happen. We must show the value in the services we provide and allow ourselves to be able to compete within the health care market. And lastly payment and payment policy must continue to be rigorously analyzed; we must remain in constant discussion and contact with payer sources, and continue to be diligent with any legislative efforts to ensure payment reflects the value we provide.

In closing, as I look back, amongst all of the change and different directions my life has taken me, the one constant was and has always been physical therapy. I am as committed today as I was 22 years ago when I entered into PT school. I will bring that same determination and commitment to the PPS Board of Directors, but only if I have earned your vote.


Mike Horsfield, PT, MBA

2015 Candidate – Director

Mike Horsfield, PT, MBA, received his master of Physical Therapy degree from the University of Iowa in 1993. He joined Rock Valley Physical following graduation and has enjoyed his many roles with them since that time. Mike is currently a partner with Rock Valley and serves as their president and chief executive officer. His prior responsibilities within Rock Valley included clinic manager, director, and chief operations officer. Mike received his MBA from the University of Iowa in 2001 and enjoys teaching as an adjunct faculty member at Bradley University, St. Ambrose University, and the University of Iowa. He is an active member of the PPS Education Committee and is a partner in PT1 and Midwest Therapy Network. Mike enjoys helping the children of his community through his work with the Rock Valley Philanthropic Committee, HAVlife Foundation and the Davenport Noon Optimist Foundation. He spends his free time biking, golfing, and relaxing with family and friends.

Candidate Statement:
My passion for therapist ownership in our profession and the belief that these dynamic times are filled with great opportunity for private practices has led me to run for Director of PPS.

Growing up on a farm with a self-employed father taught me that hard work, discipline and stewardship accompany ownership. After graduating from the University of Iowa in 1993 I joined Rock Valley Physical Therapy. This position provided both an opportunity to advance my clinical skills and an ownership pathway. In 2001 I received my MBA from the University of Iowa and became a partner in Rock Valley. Since 2011 I have been serving as their CEO. During this time Rock Valley has experienced rapid growth and now has 11 owners (all PTs) and 27 locations throughout Iowa and western Illinois. My current roles include: strategic planning, leadership development, practice growth, enhancing our culture, providing patient care, and ensuring that we are good stewards of this wonderful profession we have inherited.

In addition to Rock Valley I am also privileged to be a partner in PT1 and cofounder of Midwest Therapy Network. These organizations were established to ensure private practices succeed during these challenging times.

My involvement with PPS began with membership in 2003. More recently I have volunteered on the PR and Marketing Committee and am currently serving on the Education Committee where I have the privilege of chairing the Peer Advisory Group task force. This past year I was also honored to be invited to participate in the PPS Strategic Planning process. Serving alongside so many talented and passionate professionals has been a truly humbling and inspiring experience.

My love for education extends into my adjunct faculty roles at Bradley University, St. Ambrose University, and the University of Iowa. These positions allow me to share business insight and professional development principles with our profession’s future leaders.

In order to thrive in this dynamic health care world PPS must work to ensure private practices have the following:

Access to Customers
Given a level playing field my money will always be on the PT entrepreneur. Unfortunately ACOs, narrow insurance panels, HOPTs and POPTs have unleveled the playing field by restricting customer access for many in private practice. We must work to ensure that practice owners are armed with current information, innovative business models, and the collaborative strategies necessary to be successful in navigating this rapidly changing world of vertical integration. Expanded efforts to brand the benefits of the therapist-owned practice will also help ensure we grow our customer base.

Fair Payment
The value we bring to the health care experience is clear. Unfortunately most payers still only focus on the cost side and neglect the benefit portion of the value proposition (Value=Benefit/Cost). Changes in payment with the Physical Therapy Classification and Payment System, risk-sharing models, and pay for performance plans will alter the payment landscape dramatically over the years ahead. We must actively engage in this process and work toward ensuring fair payment for the value we bring to the health care team.

Decreased Administrative Burden
In addition to receiving fair pay we must work to minimize the escalating administrative burden. Much of this red tape provides no value to the customer, increases the cost of care, and takes therapists away from doing what they love—caring for customers.

With your help I will work to ensure we are good stewards of the “PPS land” and leave our profession in a better place than we found it. Thanks for your time and consideration. It would be a pleasure and honor to serve you as a PPS Director.

Candidates for Nominating Committee


Jerry Durham, PT

2015 Candidate – Nominating Committee

Jerry Durham, PT, has been a physical therapist for 22 years. Over the past 14 years, along with my cofounder and partner Sturdy McKee, I have grown San Francisco Sport and Spine Physical Therapy from one location to three, serving the San Francisco Bay Area. I am passionate about creating and driving the customer experience component of the business through building relationships.

Candidate Statement:
I have always been passionate about meeting people and developing mutually beneficial relationships. From my start as a treating physical therapist to my current ability to connect globally with health care professionals and consumers, I have networked with individuals who are as passionate about driving change in society as I am. In my experience, there is a great deal of value in connecting with not only physical therapists and health care providers, but also leaders outside our industry. There is much we can learn from innovative thinkers in the fields of general business, hotel and restaurant management, marketing, branding, and technology. My strengths lie in seeking out these relationships and nurturing them, sometimes taking the lead on projects, but other times playing a supporting role on the team. I believe that all of these characteristics make me an excellent candidate for election to the Nominating Committee.

I have been an active member of the Private Practice Section for 7 years. During that time I have not only attended annual conference, but also presented there on 4 occasions, including this year. Additionally, I have both attended and presented webinars for PPS. My involvement with PPS has led to connections with several people who remain my closest friends to this day. My active role in the section has allowed me to build relationships with members from all over the country, who regularly assist me in my personal and professional growth. Our discussions focus not only on my current practice, but also on the wider topic of moving private practice physical therapy forward on a larger scale nationwide. Through challenging each other’s ideas and perceptions, we have robust discussions that catalyze change. I find it important to focus these discussions on solutions, rather than rehashing problems and complaining. My goal is to drive change through new thinking and new solutions.

I believe that PPS serves as a hub for forward-thinking individuals who want to continue to position physical therapists as the expert in musculoskeletal issues. PPS is only as strong as the collective voice of its members. We need to continue to motivate each member to lend their particular skill set to the collective voice of the section.

Over the next three years, I believe it is vital to educate and inspire private practice owners to challenge the status quo. As part of the Nominating Committee, I will recommend focusing on bringing out the unique skills of current members prior to a focus on driving membership. Once we instill a sense of culture and value in current section members, the members themselves will drive new membership. I believe that the leadership of PPS can drive the culture, and as a member of the Nominating Committee, I will focus on identifying individuals who possess the skills to engage and inspire our membership. These leaders will keep our focus on moving forward as a profession and a section, because they will inherently know that looking backward is no longer an option.

Thank you for your consideration of my candidacy.


Jennifer E. Green-Wilson, PT, Ed.D, MBA

2015 Candidate – Nominating Committee

Jennifer E. Green-Wilson, PT, Ed.D, MBA, is a principal of the Institute for Business Literacy and Leadership (also referred to as the Leadership Institute); formerly the director of the Institute for Leadership in Physical Therapy (LAMP) for HPA the catalyst of the American Physical Therapy Association (APTA), as well as a member of the Private Practice Section (PPS) Education Committee of the APTA. Recently serving as a director on the Board of Directors of the APTA, she speaks nationally and internationally on topics related to leadership, business literacy, and management in health care; has been invited to submit short articles for APTA’s Business Sense section of PT in Motion; and was awarded a national research grant from the HPA Section in 2009. Additionally, she was awarded HPA the Catalyst’s LAMPLighter Leadership Award in February 2014. Dr. Green-Wilson works with several entry-level physical therapist programs and diverse health care organizations across the country, helping to strengthen the development of practice management, business literacy, and leadership skills at entry level and in contemporary practice. She is experienced in igniting faculty development efforts in order to implement sustainable change and innovation in education and has been working with F.A. Davis on a new leadership textbook for physical therapy students (which will be released in 2016). Dr. Green-Wilson also serves as the Vice Chair of the Board of Directors of Rochester Hearing and Speech Center in Rochester, New York. Dr. Green-Wilson holds an Ed.D. degree in Executive Leadership from St. John Fisher College in Rochester, NY, a MBA degree from the Rochester Institute of Technology, and a BS degree in physical therapy from Queen’s University in Kingston, Ontario, Canada.

Candidate Statement:
I am self-employed as a principal/consultant for the Institute for Business Literacy and Leadership located in Rochester, New York. I work directly with private practitioners and physical therapy/health care organizations across the country to develop fundamental business, management, and leadership skills, and to increase their leadership and entrepreneurial capacity. In addition, I work with a variety of DPT programs to strengthen the integration of business, management, and leadership skill development at entry level. Recently, I was appointed as the Chair of the Private Practice Special Interest Group (SIG) for the Pennsylvania Chapter (PPTA). I am a member of PPS, HPA the Catalyst, and the Education sections because I believe that these sections are facilitating vital—and sometimes coinciding—conversations about the many critical areas upon which we need to focus and enhance to keep physical therapist practice advancing. By working within each section in different ways, I am constantly looking for opportunities in which we can support or augment each other’s work and in which to collaborate.

I served as Director on APTA’s Board of Directors (BOD) from 2011–2014; was the director for the new beginning for HPA-LAMP’s Institute for Leadership in Physical Therapy from 2009–2012 and continue to serve as faculty; and served on HPA the Catalyst’s Nominating Committee from 2009–2012. Currently, I am the vice chair of the Rochester Hearing & Speech Center’s BOD in Rochester, NY and chair of its Long Range Planning Committee.

I worked diligently from 2010–2012 as one of the founding members of the PPS Education Committee to: help develop a curricular framework for education within PPS; develop, coordinate, and deliver specific courses sponsored by PPS; and coauthor a chapter in the newly published How to Start a Private Practice. I was accepted to present the following topics at several PPS annual conferences: “Superior Benefits of Integrating Students in Private Practice” (2007), “How to Build Your Business: Getting Your Employees to Think More Like an Entrepreneur” (2009), “How to Build Your Business: Implementing Innovation to Renew Your Practice” (2010), and “Igniting Women and Men in Leadership: Overcoming Gender Bias in Physical Therapist Practice to Strengthen Collaboration” (2015). I have participated in the Institute for PPS Annual Graham Sessions from 2011–2015.

For my doctoral studies, I investigated: “Expanding the Role of the Physical Therapist by Integrating Practice Management Skills into Entry-Level Physical Therapist Preparation in the United States” and currently, I’m in the process of submitting this manuscript for publication in one of our peer-reviewed journals.

Priority #1 for PPS: Staying relevant for PPS members in delivering our value; being nimble enough and truly innovative to produce and provide timely and vital support information, education, mentorship, resources, and tools, for owners and practitioners in private practice.

Priority #2 for PPS: Leaders drive change and innovation. It’s up to us to invent our future. I believe physical therapists have a tremendous capacity for leadership at all levels in practice because we have IQ and EQ and the evidence suggests that highly effective leaders have a high degree of emotional intelligence (EQ).

As a member of the PPS Nominating Committee, I see my role as four fold: (1) to foster a culture of inclusivity; (2) to encourage and recruit members to run for formal leadership positions within PPS and beyond; (3) to strengthen membership engagement within PPS by integrating intentional networking, mentoring, and coaching into the work that we do. I believe it’s up to each one of us to reach out and invite others to become an integral part of a dynamic and connected membership actively engaged in PPS; and (4) to boost leadership development efforts explicitly within PPS.

HIPAA-Compliant Sharing Solutions for Physical Therapists


With the right tools, you can use text messages, emails, and cloud-based file-sharing services to help you share and manage patient information—without violating privacy regulations.

By Asaf Cidon

Physical therapists today have more ways than ever to communicate with colleagues, other health care providers, and patients.

Consider a hypothetical case that happens all the time: A patient’s regular physical therapist cannot make an appointment, so the therapist text messages her colleague some details about the patient’s case, including a list of his medications. This colleague makes progress notes on her iPad during the session, and the document is automatically backed up to a file-sharing service the physical therapists use to store patient files and other information. When she returns to work, the regular therapist reviews the notes on her laptop, and then emails them to the patient’s primary care provider.

The possibility of a data breach is particularly troubling for smaller practices that all too often ignore security—thinking that their practice is unlikely to be audited. But they do so at their own peril. Any medical professional who stores or transmits patient information online must comply with HIPAA security rules or face steep fines. Even a single lost client record can expose providers to liability.

Here are a few tips to keep in mind for each way you might share Protected Health Information (PHI).

Secure Text Messaging

Secure text messaging will not help you store and manage large numbers of patient files, but it is a must-have if you use texting to communicate about patient care.

  • User experience. Do not skimp on the user experience. The best secure text messaging apps replicate the texting experience.
  • Message storage. In order to mitigate the risk of a breach, ensure that your provider stores messages on its servers—not your phone. Look for solutions that encrypt data at rest and in transit to minimize risks associated with hacking. Because the PHI-laden messages are not stored on the therapists’ phones themselves, a lost or stolen phone would not result in a data breach—or a violation. You should be able to set preferences for messages to be automatically deleted either after a set time period or once they have been read.
  • Control forwarding. For text messages to be truly secure, messages should not be saved, copied, or forwarded to other recipients, in order to prevent sensitive content from being viewed by anyone except the intended recipient.
  • Audit. The fact that messages are not stored on your phone might seem to complicate audit functions, but if your provider makes usage data and monitoring information easily available to administrators, you will preserve compliance with HIPAA’s audit rules.

Secure Email

Email remains an extremely helpful tool for quickly sharing files, but it is not secure. However, encrypting your email will enable HIPAA-compliance and ensure that only authorized users will be able to open and read your messages.

  • Identity validation. Find a provider that validates the recipient’s identity. Common approaches including requiring recipients to answer a secret question or otherwise verify their email methods.
  • Audit. Seek out tools that provide the option of tracking and logging emails, which is necessary for auditing purposes.
  • Mobile. Because lost or stolen mobile devices pose such a big HIPAA breach threat, it is essential to use an encrypted email provider that also works on mobile devices—key for therapists working on the go.
  • Sender support. One of your biggest email threats lies in emails sent by patients. If your encrypted email setup is too onerous, patients are far less likely to use it. Many email encryption programs do not make it easy for non-users to collaborate. That’s where cloud-based file encryption can come in handy, because it can allow patients to launch encrypted files securely to you without requiring downloads or setup.
  • Message storage. Many email encryption products do not securely store and back up all files in a centralized way. This can pose problems down the line with record retention, so ask questions of your provider about how you can obtain an audit trail.

End-to-end Encryption

Cloud-based file sync and share programs make it extremely simple to store files, exchange them with other health care professionals and patients, and sync them across computers and mobile devices. When a provider makes changes to a file from a tablet, for instance, a cloud-based file-sharing program will store and show the changes when the file is opened again from the provider’s laptop or desktop.

  • Encryption. Most cloud providers encrypt data at rest and in transit, but the real key is finding solutions that encrypt on devices; otherwise, file synchronization poses a tangible risk of an HIPAA breach. Protecting your files in the cloud with file-level end-to-end encryption, however, adds that additional layer of protection that ensures that the file is always encrypted, regardless of its location, turning the cloud into a HIPAA-compliant safe haven.
  • Easy sharing. One of the nice features of cloud sync and share programs is that shared folders make it easy to exchange information with frequent collaborators. The ability to sync across different devices and share files externally makes cloud-based file-sharing ideal for managing patient files at a clinic that contracts with multiple physical therapists, or at a practice that frequently interacts with external organizations. But it is essential to find a security provider that preserves encryption while sharing data.
  • Seamless security. Bear in mind that encryption solutions, like everything else, should preserve the user experience that makes the cloud so convenient. Otherwise, therapists and others will not use them, exposing you to potential violations.
  • Separate data from keys. Ideally, you should seek out a security provider that is independent from your storage provider. This way, the encryption keys will be totally separate from the content, which means that neither your encryption program nor your cloud storage provider can access your files. This assures that only you and the users you authorize are able to retrieve and work with encrypted data.

As we have outlined, employing these safeguards can help health care providers take the necessary precautions to keep patient records safe and meet HIPAA security requirements—and even boost productivity.

Asaf Cidon is the chief executive officer and cofounder of Sookasa. He can be reached at asaf@sookasa.com.

Making a Difference

By Stacy M. Menz, PT, DPT, PCS

While the phrase above is not why so many of you give back, it illustrates the obvious as it relates to each of us—both individuals and companies—doing their part to create a productive society. Specifically, private practice physical therapists have many ways to “give back”; the most obvious is with our services and expertise. This month, there are a collection of articles discussing how to integrate providing treatment to underserved populations, with successful private practices. The articles in this issue do a great job of looking at how you can thrive as a business in an underserved area, various ways that underserved populations can be accessed, as well as how you can decide as a practice owner how best to integrate this into your existing practice.

Emily Monson’s article “Integrating Treatment of Underserved Populations in Today’s Private Practice” provides insight on what it takes to become successful and thrive in a small, rural area. The points she brings up are applicable to anyone in practice, whether small, large, rural, urban, overserved, or underserved. She discusses diversification of services, getting to know the clients that you serve and their specific needs, becoming involved in the community, and doing your research. What private practice could not also benefit from these same ideas?

Ann Wendel’s article “Transforming Society on a Global Scale” paints the picture that there is no one way to access underserved populations. There is no right way. It can be a pro bono clinic at a university, it can be educating and providing services in foreign countries, it can be staffing a hospital that serves people who are low income and may have nowhere else to go. Each of these scenarios are just one way we as a profession can access those who need us.

And lastly, Scott Spradling’s Administrative Edge article “Practical Programs for Providing Pro Bono Services in Your Practice” outlines options and a practical guide for how you can integrate pro bono services into your existing practice. He laid out a road map and options for how it may best work for your practice.

These articles provide a starting point for practices looking to expand their footprint to address Principle 8A in the American Physical Therapy Association’s Code of Ethics. I know that as I read these articles, I began to look at how my practice could better serve the health needs of the children and families who are either lower income or in an area that has less access to services. I do not have an answer yet, but I at least have the question to start.

How are you and your practice integrating the provision of services to underserved populations? We would love to hear your stories! 


What’s in a Name?


How do you classify nontraditional workers in your clinic?

By Christine V. Walters, JD, MAS, SHRM-SCP, SPHR
August 2015

The spring and summer months seem to revive the eternal questions about classifying certain nontraditional, contingent workers. Employers seek to provide learning opportunities for students in their home communities. Some do so with the hope that the student might return to seek regular employment postgraduation. Others do so simply based on their belief in corporate citizenship as a way to pay it back and forward to the local communities that support them. But take care. The best of intentions can go awry.

This year is no exception. On April 20, 2015, the U.S. General Accounting Office (GAO) sent to the U.S. Senate Health, Education, Labor and Pension (HELP) Committee a “Contingent Workforce” report.1 That report has also been shared with the Secretary of the Department of Commerce, the Secretary of the Department of Labor, and other “appropriate” Congressional committees.

The GAO reports with a +/-1.7 percent confidence rating that the core group of contingent workers, such as agency temps and on-call workers, comprised about 7.9 percent of the employed labor force in 2010. They found that compared to standard full-time workers, core contingent workers are more likely to be younger, Hispanic, have no high school degree, and have low family income. These contingent workers are also more likely than standard workers to experience job instability, and to be less satisfied with their benefits and employment arrangements than standard full-time workers. Because contingent work can be unstable, or may afford fewer worker protections depending on a worker’s particular employment arrangement, it tends to lead to lower earnings, fewer benefits, and a greater reliance on public assistance than standard work.

Knowing that myriad entities within the executive and legislative branches of our federal government are giving these relationships due consideration, employers need to be savvy when classifying workers whom they do not intend to be employees. These may include: temporary workers, direct hire, hire from an agency, independent contractors, volunteers, and unpaid interns. So, let’s take a quick look at some of the more common nontraditional worker relationships.

Independent Contractors
Today at least 22 states have signed a Memorandum of Understanding (MOU) with the United States (U.S.) Department of Labor (DOL) and Internal Revenue Service (IRS) agreeing to share payroll, tax, and other records for the purpose of identifying employers who have misclassified workers as independent contractors instead of employees.2 Modified from the former 20-factor test, today the IRS tends to use a three-factor test for assessing proper classification of a worker as an independent contractor. This is described in Publication 1779.3 The DOL uses a different test. It describes its factors in Fact Sheet 13.4 In 2007, I had the honor of testifying during a joint U.S. Congressional subcommittee on this very topic. In addition to the federal guidance, which varies as described above, many states have statutory definitions that may vary such as in the state’s unemployment insurance or workers’ compensation codes as well as in state administrative agencies, which use factors that are different from the IRS’s factors. With so many different rules, tests, and factors it can be extremely difficult for employers to get this right.

Unpaid Interns
Just because an employer partners with a local academic institution to find and use unpaid interns does not insulate the employer or guarantee that the use of such unpaid interns is legal or proper. The DOL applies a six-factor test that must be checked to properly classify an intern as unpaid.5 Unlike many multifactor tests this is an all-or-none assessment. If the employer cannot “pass” each factor of the test then the worker must be classified as an employee and paid. To date at least four states (Illinois, Maryland, New York, and Oregon) plus the District of Columbia and several local jurisdictions have enacted laws providing fair employment practice protections for unpaid interns, protecting them from unlawful harassment.

Similar to but different from unpaid interns, the DOL applies a three-factor test to employers’ use of volunteers. Private sector employers should note that the status of volunteers in the public sector is more readily recognized than in the private sector. The three-factor test is described in guidance published by the DOL.6

Shared Workers
In today’s labor market some employers seek to save costs by sharing workers. If you are sharing workers with another corporate entity, be cognizant of whether a joint-employment relationship might be created. There are advantages and disadvantages to this; be sure whatever you create is the relationship you want. Whether it is a temporary agency or some other entity who will be the employer of the worker will be in question. Ensure your contract addresses the intended relationship and any liability that might arise from that designation. For example, imagine a physical therapist works as a full-time employee of a physical therapy clinic. She also works part-time with an agency that just happens to place the physical therapist in a temporary assignment at the same clinic, but at different facility or location. Who is the employer while the physical therapist is working at the clinic on the temporary assignment, the temp agency or the clinic? What difference does it make? Who is responsible for overtime pay when the physical therapist works 40 hours for the clinic and an additional 15 hours through the agency at the clinic in the same workweek? What about workplace accidents and Occupational Safety and Health Administration (OSHA)? Or providing reasonable accommodation under the Americans with Disabilities Act (ADA)?

Unauthorized Workers
And for those workers you do intend to employ as employees, be sure they are legally authorized to work in the United States. The U.S. DOL, Equal Employment Opportunity Commission (EEOC), and more have ruled on more than one occasion that U.S. employment laws that provide for a minimum wage, overtime, and nondiscrimination protections apply to workers in the U.S. (as compared to U.S. workers) regardless of citizenship or work authorization. While federal law prohibits employers from employing individuals who are not legally authorized to work in the U.S., employers who nonetheless employ undocumented workers are prohibited from discriminating against them.7


1. http://gao.gov/assets/670/669766.pdf Accessed June 2015.

2. www.dol.gov/whd/workers/misclassification/ Accessed June 2015.

3. www.irs.gov/pub/irs-pdf/p1779.pdf Accessed 2015.

4. www.dol.gov/whd/regs/compliance/whdfs13.htm Accessed June 2015.

5. Fact Sheet 71, www.dol.gov/whd/regs/compliance/whdfs71.htm Accessed June 2015.

6. www.dol.gov/elaws/esa/flsa/docs/volunteers.asp Accessed June 2015.

7. www.eeoc.gov/policy/docs/qanda-undoc.html Accessed June 2015.

This article does not constitute the rendering of legal advice. You should consult with your practice’s legal counsel for advice on employment-related matters.

Christine V. Walters, JD, MAS, SHRM-SCP, SPHR, is an independent human resources, and employment law consultant for DBA FiveL Company out of Westminster, Maryland. She can be reached at info@FiveL.net.

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