Don’t Do It My Way


7 tips for success in today’s physical therapy market

By Jerry L. Henderson, PT*

When I started my first practice 33 years ago, I did not know what the heck I was doing, yet I was successful. In retrospect, it was the easiest business one could imagine: The barrier to entry was low, and you could be reasonably profitable within months with very little business acumen or planning. Of course, all of that has changed.

I started my first practice without any planning, any research, any idea what I was really doing or how to make it a success (and don’t even think to ask me how to replicate it). I was lucky at the time that practically anyone with a physical therapy license could be reasonably successful in a private practice. Today’s market is much different. Apart from the influx of competition, regulations are much more complex, and there is red tape seemingly everywhere. Unlike when I first started out, profit margins are razor thin. It’s plain to me that there’s very little room for error in today’s private practice, so you need to be better prepared than I was.

Based on the benefit of hindsight from all the mistakes I made in private practice, plus the unique opportunity I have had to learn by observing and working with thousands of our colleagues in private practice over the past 15 years, here is some advice for those who would like to make the leap.

1. Assess Yourself
Most importantly, before doing anything else, assess your own personal strengths and weaknesses. Do you have a great reputation in your community? Do you have any business experience, background, or education? Do you understand the nuts and bolts of billing and claims management? What about compliance? Do you have a good working knowledge of regulations and requirements? Will you be comfortable selling yourself, or will you need help? Are you willing to work very long hours to get started? How are your computer skills?

Additionally, what is your personality type? Are you more type A or type B? Are you detail oriented? If your strengths align more on the business side but you lack in organization or administrative skills or financial background, you might want to think about hiring someone who has the skills you lack. Do you understand what’s happening with changing payment models? With the payment models evolving as I type, you’ll be happy to have someone on your side who understands the ins and outs of that area of health care. There is no shame in admitting that you don’t have every attribute necessary to run a business. Trust me, you’ll be happy you were honest with yourself from the start.

Based on your self-assessment, you will have a much better idea of where you need help and where you should be spending your own time. By the way, starting a private practice is not for everybody. At this point, you may decide that this whole thing is not for you.

2. Build a Gap Analysis
Taking your personal assessment into account, do a formal business gap analysis (you can search for this online if you want more information). The intention of this is to identify what you want to achieve and the time frame you want to achieve it in. From there, you can work backwards and figure out what is needed, who is needed, and plan for any problems that you may have. I recommend using a spreadsheet as an ongoing to do list for your practice.

3. Research
Now that you “know what you don’t know,” dig in and do some research to fill in the gaps. Some of my favorite sources of information are the Private Practice Section (PPS) website and Impact magazine. Signing up for weekly newsletters from industry publications and blog feeds is a great way to stay up to date on regulatory measures and best practices for your business.

4. Network Like Crazy
Luckily, it is easy to find lots of experienced, knowledgeable colleagues who are willing to exchange ideas with you in the PPS membership. Get involved, go to meetings, attend conferences, listen, and network. Use social media to start building relationships as this will make the transition to face-to-face interactions much easier. Buying a PPS member a cup of coffee or adult beverage might be the best investment you ever make.


5. Get a Coach
Find someone who has done this before and ask if they would be willing to coach you. Meet with them regularly, ask them questions, and learn from their mistakes. Having a mentor in this industry can be indispensable. It’s also important to remember that mentorship is a two-way street. You have newfound information to offer to physical therapists who have been in the industry for decades, so offer it up and see what relationship you can build from there.

6. Develop a Team
Now that you have assessed your own strengths and weaknesses, completed your homework, and have a mentor, you should have a good idea of where you need help. I cannot stress enough how important it is to develop a team of people to help you. Our industry is simply too complex to do everything yourself in a private practice.

7. Have Fun
Last, but not least, remember to enjoy the journey! No matter how well you prepare, you will face some challenges, and you will not be able to anticipate all of them. Resolving to take care of yourself, have fun, and start every day with a smile on your face will help you get through it all.

Good luck!

Jerry L. Henderson, PT, is a cofounder and vice president of clinical strategy at Clinicient. He can be reached at

*This author has a vested interest in the subject of this article.

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

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