Finding Your Niche


Designing and growing innovative programs.

By Michael Velsmid, PT, DPT, MS

If statisticians are correct, there are currently more than 100,000 physical therapy facilities in the United States.1 In other words, there is plenty of competition for patients in search of professional rehabilitation. To woo clients to your clinic and highly trained individuals to your staff, it is essential to uncover your niche as well as establish innovative programming. While this may seem easier said than done, the task is doable if you want to exceed others in your market.

In the greater Boston area where I and my team practice, a fair amount of physical therapy practices exist. Still, with a population base of seven plus million that is rapidly aging,2 the flip side is that there are tremendous opportunities. When we opened our doors in 1999, we knew we had to get creative quickly to make sure we rapidly became a serious player. The key, we discovered, was to offer therapies and experiences that would set us apart. It was a challenge, but in the highly volatile health care industry, it was also a necessity.

Delve Deeply into Your Competitors’ Strengths and Weaknesses

The first step we took was to evaluate our competitors. We had to know their strengths and weaknesses before we could determine how to fill the gaps and meet client needs. One area we rapidly noticed was unfulfilled was aquatic therapy. Aquatic therapy is useful for so many populations, from senior citizens to seniors in college. When performed correctly, it can improve postsurgical and post-injury outcomes and even shorten rehab time.

Making the decision to become a leading provider of aquatic therapy was not tough, but finding the right venue turned out to be problematic. The first issue was choosing a location nearby where we could work with clients in a pool. We wound up at area YMCAs and Boys & Girls Clubs, which worked on some level, but were also problematic. The advantage was that we could perform physical therapy in their pool, eliminating the need for us to pay for pool maintenance; the negative aspect was that the hours we were given by the organization to use their pools were severely limited.


Despite these drawbacks, we spent several years driving back and forth from our main clinics to the swimming pools. This ate up our physical therapists’ time, and thus reduced their productivity, but it was terrific for building our brand. We soon became known as an innovative physical therapy facility for those seeking aquatic therapy. Being close to a number of universities, sports teams, and performing centers, we established relationships with trainers, doctors, and other referral sources, which grew our base.

In time, we took our aquatics program one step further and opened a facility boasting two, high-tech, warm-water therapy pools with underwater treadmills: our Allston aquatic therapy center. Doing so removed the need for our therapists to spend time in their cars, constantly driving back and forth to appointments, and opened the door for us to offer aquatic therapy times that were more convenient for clientele. Furthermore, with the advanced technology of these aquatic therapy pools, including underwater treadmills, resistance jets, and deep tissue massage, we were able to expand our patient mix. It allowed for more flexibility than the pools at the health clubs. Within a few years, the pools proved profitable. Now, we enjoy a stream of reliable revenue thanks to the energy we spent in developing aquatic therapy as a niche.

Create a Working Environment That Elicits Interest from High-Quality Physical Therapists

The second element of finding your niche and being innovative with programming is to “up the bar” when it comes to working environments for your team members. Again, we looked at our competition to uncover what we could do better. An analysis revealed that there were significant opportunities to achieve an atmosphere that practically drew high-quality personnel to our door.

Let us face it, most employees spend more time in their workplaces than they do in their homes, so when we leased the space that became the Allston aquatic therapy center, we made sure it was equipped for health and comfort. This meant a bright space with high ceilings and pristine amenities. By delivering as many tools as we could, we ensured that our physical therapists could effectively treat their patients and would stay with us for as long as possible. Before I had a well-considered employee retention strategy, I had problems finding good physical therapists; now, I get at least one unsolicited resume from an eager candidate every two weeks.

One of the other personnel-related areas we improved was providing consistent, cutting-edge training for our physical therapists. While this is not unusual for physical therapy practices, the types and amounts of training we routinely offer are second to none, and they keep the physical therapists excited about their jobs. We spend a sizeable part of our budget making sure that our physical therapy professionals are exceptionally skilled. This effort translates into an eagerness to take their newfound education and apply it in the clinic. Clients are the ultimate beneficiaries of this kind of investment in our staff, and they go back to referrers with positive stories. It is a healthy, dependable cycle that repeats itself regularly.


Ignore Social Media at Your Physical Therapy Facility’s Peril

One of the greatest methods of showcasing what differentiates your facility from others is social media. Too many physical therapy clinics ignore how important Facebook, Twitter, Instagram, Pinterest, YouTube, and other social media platforms have become. Alternately, some clinics simply do not believe time online is time well spent. That is a mistake. Billions of people are using these channels collectively on a daily basis, and that means you have an unprecedented way to connect with the public.

We use our social media to highlight everything from success stories, to exercises, and community outreach events. It is a vehicle to tell our story, as well as share what we learn. Additionally, it is a terrific way to connect with orthopedic surgeons, doctors, acupuncturists, nutritionists, personal trainers, CrossFit gym owners, and anyone else who might have a need for aquatic or physical therapy down the road.

Open Your Mind to All Possibilities

Yes, it can be somewhat scary to take the plunge and step forward in your field; however, taking calculated risks is essential to keep your practice growing. Currently, the growth rates for the number of physical therapy clinics are steady at around 4 percent per year. This means that new competition will pop up on a regular basis, perhaps across town… perhaps across the street.

By finding and honing your niche, you can become the well-respected physical therapy innovator in your region. There is no better feeling than knowing you are leading the pack while providing your patients with extraordinary care. 

Dr. Michael Velsmid, PT, DPT, MS, is the director of Boston Sports Medicine Physical Therapy. He can be reached at


1, 2. American Physical Therapy Association.

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