(Not) Working 9 to 5

The evolution of a mobile physical therapy and wellness practice.
By Caroline Buths, PT, DPT
When I was a brand-new physical therapist having a difficult time adjusting to a new city and new career, the life coach I was working with suggested I write down three long-term goals.
Although I’m not a huge fan of the goal-setting mentality (too much opportunity for self-loathing when said goals aren’t met), I remember writing down “being a part-time physical therapist and a part-time yoga and Pilates instructor.” I suppose I knew early on that I was not cut out for the 9-to-5 life. What I did not know was what would grow from that seed I planted years ago.
Fast-forward six years, and I am honored to be serving the greater Washington, D.C., area as a 100 percent mobile physical therapist, yoga instructor, Pilates instructor, and Reiki practitioner, for three and a half years running (and hopefully many more!). The path I took was a winding one, and never has the adage “Life is what happens to us while we are making other plans” been more applicable, in a most positive way.
When the boutique outpatient physical therapy clinic I was working for was acquired by a large corporation in 2015, I had already been feeling burned out as a staff clinician. The timing was right, and I resigned in favor of a lifestyle change, planning to contract with a home health care agency and teach yoga classes at my local studio. It wasn’t long before the phone started ringing and the emails started coming in: A former patient called for private at-home physical therapy after his total knee replacement. Two others called asking for at-home yoga and Pilates instruction. A fourth was emailing for continuation of her Reiki treatments. I soon realized that the Greater Washington, D.C., area was seriously in need of concierge-style physical therapy and wellness services. Saving patients a trip to and from the physical therapy clinic and/or fitness studio, as well as saving them the money for downtown parking (upwards of $25 for the hour), was extremely appealing to the always busy, fast-moving Washingtonian. An LLC was born—practically overnight. Malpractice insurance was secured, and licenses in both Maryland and Virginia were applied for in order to serve the suburbanites. After a few short months, I discontinued my contract with the home health care agency and eventually cut back on teaching yoga at the local studio, in order to tend to my budding LLC clientele. Patients and clients spread the word to their physicians, spouses, neighbors, trainers, and friends about the unique service model I was providing, and my business has been growing and self-supporting ever since.
The biggest perks of my current role are time and variety. Time, meaning I have the luxury of spending 60, 75, at times 90 minutes with each patient, depending on their needs. Variety, meaning that on a given day, I am providing a combination of orthopedic physical therapy care, neurological physical therapy care, yoga instruction, Pilates instruction, and Reiki. This variability significantly helps reduce the chance of burnout for me, as no two days are the same.
There are some key factors in the success of this model, and I would be remiss if I didn’t give them recognition. Washington, D.C., and its surrounding suburbs are not only affluent but also are full of people who are committed to a healthy, active lifestyle, and happy to invest their resources on out-of-network health care and wellness. Also, this is a self-sustaining model, as many patients, upon recovering from their ailments, want to continue some form of intelligent movement/fitness. The crossover from physical therapy patient to wellness client is plentiful.
The challenges of this business model are obvious: the ubiquitous “working 24/7” that most small business owners report, means spending many extra hours in front of a computer or telephone screen on nights and weekends. Washington, D.C., traffic is abundant and at times unpredictable. Profit loss occurs between patients while driving from place to place. Finding parking in downtown D.C. is a headache. And lugging a 30-pound treatment table down the busy sidewalks and up and down tight staircases in the old rowhomes in D.C. is fatiguing.
Despite all of that, this unexpected role I have found myself in is wildly rewarding. Not only am I fulfilled by the work I am doing but I foresee this model as a sustainable, career-spanning one. I am ever grateful for life’s twists, turns, and surprise destinations.

Caroline Buths, PT, DPT, is the owner of Integrative Physical Therapy & Wellness, providing mobile physical therapy, yoga, Pilates, and Reiki to the greater Washington, D.C., area. She can be reached at caroline.buths@gmail.com.