Kim Lephart, PT, DPT, MBA
Kim Lephart, PT, DPT, MBA, is a clinical specialist in pediatric physical therapy and owner of STARs in Culpeper, Virginia. She can be reached at klephart.stars@gmail.com.
Practice, location: STARs (School-based Therapy and Resources), Culpeper, Virginia
Size of practice (# of locations, employees): One clinic space; covers 5 counties and one school district for early intervention
Years in practice: 8
Most influential book: You mean besides Dr. Seuss’s Oh, the Places You’ll Go!? The most recent influential book for me is Never Split the Difference: Negotiating as if Your Life Depended on It, by Chris Voss.
Favorite vacation spot: This past year we had a family reunion in Rodanthe, North Carolina—I think it is now my favorite spot. I liked that it wasn’t crowded or touristy and felt more like the “old” Outer Banks. To be fair, any beach is my favorite vacation spot. I feel like I can take deep breaths, get lost in the rhythm of the tides, and drown out my thoughts with the sounds of the waves. I feel renewed at the beach.
Favorite movie: My all-time favorite movie is still The Princess Bride. When Westley asks, “Why won’t my arms move?” and Fezzik replies, “You’ve been mostly dead all day.” Cracks me up every time! “Inconceivable.” Yep, good times.
How do you like to spend your free time? “Free time”? What’s that? Seriously, I like to spend time with my family. We enjoy playing games as a family. Our favorite games are Blokus, Telestrations, and Head’s Up. I recently discovered quilting. I enjoy creating something unique with the specific recipient in mind, choosing the colors, figuring out the pattern, piecing it together, and then giving it away. I used to think quilting was for old people . . . wait . . . does that mean I’m old?!
What do you like most about your job? I tell people I have the best job and the worst job. I have the best job because I love what I do! I get to share in a child’s journey of first milestones. First time they roll, sit, stand, walk, run, and skip. To see a child’s face light up when they realize they can do something is my best thing!
What do you like least about your job? I have the worst job because I have to say goodbye to too many kiddos. Several years ago, I had three students die within six months of each other. I wasn’t sure I was going to survive that year. In August, another one of my kiddos died due to complications of pneumonia. He was 5 years old. I had been with him since he was 6 months old. Saying goodbye never gets easier.
Most important lesson you’ve learned: When I was a young therapist working in early intervention, I had a mom teach me to never set limits on a child’s potential. Her daughter was a 25-week-old preemie and had a grade III intraventricular hemorrhage (IVH) on one side and a grade IV IVH on the other. I know what those babies look like functionally. The mom told me in no uncertain terms that “baby’s gonna walk.” I said, “Ok, let’s get to work!” A year later, at this baby’s annual Individual Family Service Plan (IFSP) review, she no longer qualified for services because she was walking and did not have a 25 percent delay in any area of development. That baby was not only walking, she was running!
Describe your essential business philosophy: At STARs we recognize and respect the unique abilities of each child. We are dedicated to providing evidence-based, innovative, and functional therapeutic services to children who have disabilities, through fun and engaging interventions. We understand the importance of providing valuable resources to children, their families, and their community. We believe a child’s work is play and we are passionate about our work! At STARs, we aim high, we aim big, we shoot for the stars, and we get there through small, incremental, doable steps.
Describe your management style: I am a flexible pacesetter. I am open to however the job gets done, as long as it gets done. I set the vision for our team, clearly and compellingly, then step back and allow my employees to work. I step in from time to time to reiterate the vision if required, but that’s it. In pediatrics, you have to be flexible, readily able to adapt, and conform to new situations.
Best way you keep a competitive edge: I keep a competitive edge by plugging into different networks of knowledge and expertise. For instance, MSM 20, a national group of diverse pediatric clinical owners; the Virginia Physical Therapy Association Pediatric Special Interest Group (VPTA PSIG); Private Practice Section (PPS); Academy of Pediatric Physical Therapy (APPT); Integrative Training Collaborative; and the Knowledge Broker Network (KBNet), to name a few.
How do you measure your success? I know key performance indicators, return on investment, and productivity are quantitative measures to track success, but I tend to use more qualitative measures of success. For our clients, success is when they want to come to therapy and when they reach their goals. I had a mom call to cancel her son’s appointment because he had a neurologist appointment earlier that day and she felt it would be too much for him to have physical therapy later that day. Ten minutes later, the mom called back and said, “Never mind.” When she told her son she had canceled his physical therapy, he said, “No! I want to go to PT! I’ll miss out on the fun!” For our employees, success is when they have the resources and support they require to reach their specific professional goals, enjoy coming to work, and want to make a difference in their profession. For me, success is when I make a difference in a child’s life, have fun while helping them reach those goals, and still make it home in time to get my youngest son off the school bus. That’s how I measure success! Having said that, we do look at cancellation/no show rates, number of new evaluations, and number of monthly visits per clinician for more quantitative measures of success.
Goal yet to be achieved: In addition to the physical therapy services STARs provides, I would like to expand the services we offer to include occupational and speech therapy. I also want to increase STARs’ collaboration with the community and increase access for children of all abilities through an all-abilities community playground.
Best decision: The best decision I made was hiring an employee. That was a big decision for me. I was happy being a solo practitioner. I wasn’t even looking for an employee. I received an email from a physical therapist moving from North Carolina to Virginia; we agreed to meet mainly so I could help provide her with leads to other pediatric practices. When I met Kristin Sanders, we had this great synergy and the seed to grow STARs was planted. I walked away from that meeting thinking, “If I don’t hire her, someone else will hire her in a heartbeat!” Kristin is well informed, driven, follows through with commitments, optimistic, and has a ready smile. Yes, Kristin shares the workload; she also has helped shape the culture and vision at STARs.
Worst decision: Several years ago, I lost a contract to a school district because I chose the wrong approach when negotiating with the new special education director. I realized too late that she viewed my knowledge of IDEA, the children’s needs on the caseload, and tenure in the district as a threat and not a benefit. I failed to realize she was an analyst and interested only in the numbers. When she asked if I would drop my contract rate, my reaction was to say, “No. However, I won’t raise my rate despite the fact that the workload has increased by 35 percent.” I went on to extol all the reasons why my company was a better choice than the competition. In hindsight, the special education director might have responded better if I explained how using my company was a financial benefit to her district. That school district’s contract was 40 percent of my company’s revenue. That was an expensive lesson.
Toughest decision: Honestly, my toughest decision is trying to figure out what EMR [electronic medical record] system will best meet my practice’s needs.
How do you motivate your employees? During our initial interview and at employee annual reviews I ask, “What does your ideal job look like?” I gain insight as to what areas I can support my employees in and what motivates them. Motivation is personal; what motivates one person may not motivate another. I also motivate employees when they know their work is appreciated and will be rewarded, and that they are valued members of the team.
If you could start over, what would you do differently? I would learn more about social media, how to use it to my practice’s advantage, and start using it right away.
Describe your competitive advantage: STARs is distinguished from its competition by the quality, experience, and competence of its staff; evidence-based treatments, participation in research studies; ability to communicate in Spanish; and all of STARs’ clinicians are board-certified specialists in pediatric physical therapy.
Describe your marketing strategy and highlight your most successful action: In a word? Practical. Our business cards are magnetic; that way teachers and referral sources can put it on their filing cabinets where they are readily available. Our families put our business cards on their refrigerators, again easily accessible. Our favorite promotional items are sunglasses. Every year for the past 10 years STARs hands out sunglasses at the Annual Multi-School District Special Games. We see our sunglasses everywhere! Recently we started asking our client’s caregivers to fill out a physician feedback form that we attach to each plan of care (POC) and review. Not only have the POCs been signed and returned faster, we have seen an uptick in referrals.
What unique programs do you offer that set you apart from the competition? STARs has a reputation for providing stellar services, advocating for their clients, and initiating innovative programs, such as JAMmin’ Minute and Achilles Kids. STARs is known for providing beneficial resources, such as workshops, play groups, and fitness classes for children in the community.
What are the benefits of PPS membership to your practice? I recently became a PPS member when my MSM 20 group encouraged me to participate. I am still exploring what PPS offers me, but so far, I have used the EMR Checklist, read resources on Payer Contracts, and looked at press releases and templates. The articles in Impact are educational and pertinent; I found Impact’s article, “The Secret to Success,” by Brian Gallagher, timely for me. I am looking forward to viewing the Free Webinar Recordings.
What worries you about the future of private practice? Worrying is like rocking in a rocking chair, you won’t go anywhere, but it gives you something to do in the meantime. I think decreasing reimbursement rates and rising costs to provide quality services are universal concerns for private practices in all settings. While I’m not worried about this, I do keep a close eye on the American Physical Therapy Association’s work on the therapy cap and other issues that affect private practice.
What are you optimistic about? I’m optimistic about the future. I think there are a lot of untapped opportunities for my practice and I look forward to discovering them.
What are your goals for the next year? We are opening up a new clinic in Culpeper, Virginia. I am looking to hire a front office coordinator and another PT. I also want to increase STARs’ presence within the community by supporting volunteer activities such as Special Olympics’ FUNfitness.
Where do you see the best opportunities for your practice in the future? A new physical therapy assistant program opened in my area. I think tapping into the local physical therapy and physical therapy assistant programs is a great opportunity to keep my pulse on what’s going on in academia, stay current, and have a resource for prospective employees.
What do private practitioners need to do to thrive in today’s health care environment? I think private practitioners need to be flexible and adaptable to the changes in health care. We need to be creative in how we provide value-based care. I also think we need to redefine success. As T.S. Eliot wrote, “Where is the Life we have lost in living?” I think our definition of success needs to have more qualitative measures and more balance between work and life.