Joshua Kinsinger, PT, Cert. MDT
Joshua Kinsinger, PT, Cert. MDT, is a PPS member and owner of MRS Physical Therapy in western Pennsylvania. He can be reached at j.kinsinger@mrsphysicaltherapy.com.
Practice, location: MRS Physical Therapy, Meyersdale, Pennsylvania
Size of practice (# of locations, employees): MRS Physical Therapy has multiple locations in western Pennsylvania. Three FTEs: One PT, one PTA, one office manager
Years in practice: I have been a physical therapist since graduating from The Ohio State University in 1993. I went into private practice in 2003.
Most influential book: Stephen King’s IT was the first book that I ever voluntarily read. This book allowed me to enjoy reading for the sake of reading, not analyzing symbolism, memorizing phrases, breaking down characters, etc. IT opened the doors for me to read for enjoyment. Many more Stephen King books followed!
Favorite vacation spot: Bethany Beach, Delaware, has become a traditional vacation location for our family. We have come to know the towns in the area, our favorite restaurants, where to get the best ice cream, and where to go for some putt-putt fun!
Favorite movie: Star Wars, the original (Episode IV, for all the other Star Wars geeks out there).
How do you like to spend your free time? My favorite outdoor activity is spring turkey hunting. I also watch my daughter and son play spring soccer and baseball. Through the summer, I’m gardening and landscaping. We try to get a little camping in, as well. We also love our Ohio State Buckeye football! The winter is spent training for the Obstacle Course Race (OCR) season that starts in late spring and lasts through late fall. While I try to run in a few smaller, local OCRs, the primary organization that I participate with is the Spartan Race. This keeps me motivated to stay in good physical condition.
What do you like most about your job? To be able to help a person become whole again, to return them to their previous lifestyle, to see them smile on their last day of treatment, thanking us for the work we did for them—that has to be the best aspect of this job.
What do you like least about your job? Insurance companies dictating the course of care, and questioning what I perceive to be the best treatment for the person sitting on my treatment table is quite frustrating. The unmotivated or perhaps secondary-gain client who comes in and just will not participate in the treatment session or follow through with their home exercises is another annoyance that can sometimes feel like a failure on my part. And I truly hate having to confront an employee, no matter the reason behind it.
What is the most important lesson you’ve learned? I always try to learn from my mistakes. I should be a genius by now! Ha! One very big lesson learned: Don’t question or second-guess a diagnosis from an orthopedic physician, especially one that is consistently in your top five referral sources, no matter how sure you are that you are correct! It can take a very long time to get back on the good side of that doctor, and build the referrals back up.
Describe your essential business philosophy: We do our very best to provide the patients with the care that they need, create a positive experience for them, and convey to them that it is our privilege to treat them. This starts at the front desk, from the first phone call that the patient makes, to walking into our facility and being greeted at the window. We offer friendliness, and a compassionate attitude that allows for quick development of patient rapport. Each person is treated as if they are a family member coming in to be cared for. We let them know that we are here to listen to their concerns and will do our best to address and help them overcome those concerns. In the end, we want each patient to feel like we treat them as a person, not a condition.
Describe your management style: I try to keep things fairly loose in the clinic. I make sure each employee understands the role that they play in the operation of the facility. If and when I need to remind an employee of their role, I do so in the least threatening manner I can. I simply let them know that they did not perform to my expectation, the consequences for the clinic and the company, and how I hope they will execute their tasks going forward.
How do you measure success? Besides the basics of cancel/no-show rates, number of referrals, number of visits, profit margins, etc., we view every satisfied patient as another success story for us. If the patient is happy, then generally the referring physician is happy, and that makes me happy. This will lead to the other aspects of measuring the success of a clinic: Happy individuals will refer more patients to us, and that will increase visits, which increases profitability, which also makes for a successful business.
Goal yet to be achieved: Making my first million dollars! Also, I haven’t really gotten to the point where I feel comfortable stepping back away from the clinic yet. I still feel the need to be there full time treating patients. This obviously cuts into the time being able to spend with the management duties. This in turn takes up time that should be “free time” spent doing leisurely activities and family time.
Best decision: Joining the Private Practice Section of the APTA, and attending the annual conferences. I have met and talked to so many other private practitioners, gaining insight to how they run their practices, and attending seminars given by the best in the private practice PT business world. It has been an invaluable source of information, giving me the resources that I have needed and implemented in my own practice.
Worst decision: Placing too much trust in other individuals.
Toughest decision: Transplanting my family from an area that my wife and I had decided to settle, plant roots, and raise a family, to pursue this dream of becoming a private practitioner when an opportunity arose in another location. The move did bring us back to the area where my wife and I grew up. Many of our family members and our old friends are still in the area, and this has proven to be a bonus to the business.
How do you motivate employees? I try to instill in them a sense of purpose within the company. I make them feel they are a part of the company, and their contribution is important for the operation to succeed. I let them know I need them to help make my job easier, that without them I cannot do the vital things I need to do to keep the clinic going. We all go out to a local restaurant to hold staff meetings, which gets all of us out of the clinical atmosphere for a short period together. At the end of the year, I make sure that they get bonuses to reflect my appreciation for their efforts throughout the year.
If you could start over, what would you do differently? I would have done more research on what it takes to become a private practitioner. I depended on my business partner, who had been in private practice for decades, to make many of the business decisions. That has worked out fine, but I would have felt more comfortable knowing some of those things myself. I also would have moved into a physical space that allowed for expansion! We seem to always want more space to accomplish different tasks, offer more programs, or accommodate the clientele, but there just simply is no more room.
Marketing strategy and most successful action: MRS focuses on community-based marketing. We sponsor youth sports programs, attend community events such as blood drives, local racing events, and parades. Probably the most successful has been to provide athletic training services to local high schools. This really gets our name out into the community. The Athletic Trainers are visible on the sidelines at every sporting event wearing our logos. They are able to quickly refer the injured athlete to our clinic for an early assessment and treatment of the injury. Many of the athletes are transported to the clinic by a parent or other family member, which further increases knowledge of our facility and its location to someone who otherwise may not have known about us. The communication with the school district has also led to the implementation of sports injury prevention programs, again increasing visibility within the community.
Unique programs that set us apart from the competition: I have been certified in Mechanical Diagnosis and Therapy by The McKenzie Institute since 1996. This certification has given us a reputation of outstanding care in the field of neck and back conditions. We have the only onsite therapeutic pool in the area. We have an adjacent fitness facility that we use for our patients, but it is also open to the public. My PTA is certified in a Parkinson’s disease treatment called LSVT BIG. We are able to market this to the neurologists, which, in turn, increases our referrals from them on other neurological conditions, such as concussion and stroke. And our BioSway device is a great tool at our disposal for balance training, as well as postconcussion rehabilitation.
Worries for the future of private practice: There are challenges that we are going to have to face: insurance companies determining the course of care for the patient instead of the practitioner, declining reimbursement, the possible change to our current procedural terminology (CPT) coding system for submitting our charges, the ever-growing physician-owned physical therapy services (POPTS) and hospital-based outpatient physical therapy clinics, potential pay-for-performance, and the list goes on. But, I think private practitioners have a unique way of adapting to challenges. We find ways to keep going, and we have the potential to grow ever stronger. The baby boomer population is a treasure trove of clients. There are many opportunities to diversify, and specialize, find that niche market that is a missing piece of patient care in your community, develop and implement that program.
What do private practitioners need to do to thrive in today’s health care market? Going back to several of the points made earlier, we must recognize trends, and be ready to respond to them. We must keep up to date on the best practices for treatment of injuries and diseases. Know your community. What type of population base is there? What do they do for activity? Is there opportunity to get in front of them before their injury, some way to educate them and at the same time increase awareness of your facility and skills so that when they need a physical therapist, you are top of mind? Look into diversification of your offerings. Is there a need for a niche program, and a way to develop one to meet that need? And, when that patient comes to you for care, treat them like you would treat a family member, or how you would expect to be treated. That person can become one of your best marketing tools. We need to stay the course, provide the best care that we are capable of, and continue to prove that we are a very valuable component to the health care field.