Ruth Backway, PT

Ruth Backway, PT, is owner of Backway’s Physical Therapy, PLLC, in Prescott, Arizona. She can be reached at

Practice location: Prescott, Arizona

Practice specifics: I have a main office and two satellite clinics where one practitioner works at each site. Our staff includes nine therapists (one speech-language therapist and eight physical therapists) and three part-time office staff.

Years in practice: I have been in this group practice for 10 years. I have been a physical therapist (PT) in independent practice for 29 years and a licensed PT for 37 years.

What has been the most influential book/person/event that enhanced your professional career and give a brief description of why? My journey started through a class in the temporal-mandibular joint taught by Dr. Mariano Rocobado. I learned that the jaw alignment and function is often dependent on the alignment/posture of the body creating the jaw’s “base.” I then began to study structural integration, and became a certified Hellerwork Structural Integration Practitioner in 1984. One pivotal course I attended after my structural integration training was Barnes’s myofascial unwinding.

The eclectic mix of information and skills from these sources are the foundation of what I do now as a PT with an integrative medicine practice and “whole body” perspective.

Describe the flow of your average day: I found that it was easier for me to have patient days and administrative days—although you can never really get away from administrative duties on your patient days, but this concept does make it more manageable. So I treat five to six patients for one hour each on Mondays and Tuesdays and four to five patients for one hour each on Thursdays, which leaves me Wednesdays and Fridays for more in-depth administrative management and marketing time.

Describe your essential business philosophy: My business philosophy is if you allow people to use the skills that they have while doing what they love, your practitioners will do a good job with the clients and your business will grow.

Additionally, I expect therapists to behave as responsible practitioners, including providing the best patient care they can provide, documenting, and communicating with other staff members and referral sources in a comprehensive and respectful manner.

What have been your best, worst, and toughest decisions? The toughest decision was what to do during a billing program meltdown nightmare, and I had to select a billing program—bundled together with an electronic medical record (EMR). We are not on EMR yet as I am reluctant to jump back into the fray.

How do you motivate your employees? I treat them with a great deal of respect and let them know that I appreciate them as skilled practitioners and as human beings. Our practitioners are independent contractors, so they set their hours and time off, attend the continuing education they want to attend, and are paid well for their treatment time, which all are motivating factors. Our office staff “job share” their positions, and I give them great flexibility in scheduling their work times—as long as the front desk is covered during hours of operation, the telephones are answered, and the work gets done, I am happy, and I don’t care how they arrange their schedules around that.

How did you get your start in private practice? I started out by renting a room from a nurse practitioner and working two days a week for myself and three to four days a week doing in-home and convalescent care contract work. I went to area physicians and found out what their physical therapy referral needs were and explained how I could meet some of those needs. As my private practice got busier, I started cutting back on my contract work until I was working full-time for myself. When starting in private practice, I also realized that all I really needed was a room, a treatment table, a few weights, a copier/fax and phone, some business cards, and my skills. This kept my overhead low and made it easier to start.

How do you stay ahead of the competition? I stay ahead two ways: I created a niche practice that provides physical therapy to clients who have failed to get better at other clinics, and I offer very personalized service to the clients so that they give their friends and physicians good reports about our services.

What are your best learning experiences (mistakes) since the inception of your practice? I learned while doing home care that you do not need the brightest, newest, and best equipment to get the job done. Since I was not worried about this, I was able to keep my overhead lower and concentrate on service instead of gadgets.

What are the benefits of PPS membership to your practice? APTA and PPS help me stay apprised of all the current issues in physical therapy, especially regarding billing, documentation, and Medicare, which makes up 50 percent of our billing and receipts.

What is your life motto? Do the best you can at whatever you choose to do.

What worries you about the future of private practice and what are you optimistic about? I am most worried about the movement in physical therapy to use more technology and machines than one-on-one care, which is a double-edged sword. In a private practice with a lot of overhead, you have to make enough money to pay the bills and still pay yourself enough to live, which may mean delegating more work to non-licensed or lower-tiered licensed personnel.

I am most optimistic that there are people interested in group practice models and that I talk to PTs who are most focused on providing excellent care for their clients. This makes me hopeful about the future of PT, whether it is cash-based or 3rd-party payer based.

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