The Changing Face of Private Practice

By Sarah Black, MS

It’s something physical therapists in our Section have known for a while: the face of private practice has changed significantly in recent years.

While brick-and-mortar physical therapy practices remain the cornerstone of private practice, technology has made it possible for physical therapists to set up shop in innovative new ways. Here, we highlight four personas of today’s private practice physical therapy business, derived from in-person interviews with current members representing different facets of private practice physical therapy.

TRADITIONAL PHYSICAL THERAPY CLINIC OWNERS

While new approaches to private practice change the face of the industry, traditional physical therapy clinics and the people behind them are a significant driver of innovation in the industry. These owners are strategic thinkers who devote their time to business management and strategy development for practices of all sizes offering everything from physical therapy to nutrition and fitness classes for a range of patient populations including pediatrics, geriatrics, pelvic health, pain management, and more. Short-term goals include increasing an already high standard of care and growing the business, while long-term goals focus on identifying successors to maintain the business so they can step away from day-to-day management.

A core concern for them is staffing — either retaining talent or minimizing the disruption caused by turnover and getting a new physical therapist up and running efficiently. They recognize that people are at the center of their business and focus on what they can do to create the best environment for employees and patients alike.

These owners value connections and relationships the most, as they learn from their peers in other markets. Being able to connect with others in challenging situations, as well as share and celebrate successes, is invaluable for this group.

This group has typically made up the most significant portion of our membership and has played a critical part in the development of the resources and education that have been the foundation of our Section. As membership grows, this group is vital to the forward momentum of the organization.

SOLO/HYBRID PHYSICAL THERAPY PRACTITIONERS

Professionals who belong to this eclectic group may have a wide range of titles: owner, founder, head therapist, physical therapist, president, and more. As solo practitioners, they wear all hats in business and are responsible for seeing patients, taking notes, managing patient records, finances, compliance, marketing — the list goes on!

But in addition to all those hats, their practice is often focused not just on physical therapy — though that is at its core. They may focus on health, strength, wellness, nutrition, and coaching to provide holistic and varied services to clients. This group is incredibly active online, generating webinars, blogs, videos, podcasts, and other online content in addition to in-person training. As such, they enter the realm of wellness lifestyle expert and generate an online following to match.

Members of this group are entrepreneurs at heart and are perpetually in growth mode, continuously looking for further diversification opportunities. They look for opportunities to offer services that larger practices offer, like fitness and balance classes, as alternative income streams. While their brand is built around themselves, this doesn’t stop members of this group from the long-term goal of growing their business, hiring others, and even scaling enough to franchise their practice.

Solo and hybrid physical therapy practice owners see tremendous potential to learn from and collaborate with other owners from other types of physical therapy practices, making the connections and education offered by our section their top-cited benefits of membership.

NEXT-GENERATION PHYSICAL THERAPISTS

Most established private practice owners have belonged to this group at one point or another. Next-generation physical therapists are generally physical therapists and DPT students who maintain a full-time position treating patients. They are in learning mode, soaking up the experience and guidance of the experienced physical therapists and practice owners around them. This constant state of discovery means that they are open to learning and discovering, though time demands — balancing patient care with school, in many instances — mean that they appreciate when those around them refer resources to them.

Their primary concern is income, as both insurance and Medicare regularly reduce reimbursement rates. As new graduates, they are often carrying student loans that require a significant monthly payment that may be difficult to make with declining entry-level salaries. This group advocates for fair pay and is motivated to seize opportunities to grow their career in private practice.

While next-gen physical therapists are just getting started in their careers, their ambition doesn’t stop at patient care: long-term goals include owning their own practice someday and employing a staff of physical therapists.

Not surprisingly, education is what they value most in membership. Next-gen physical therapists appreciate being able to connect with been-there-done-that private practice owners who can help them navigate their career. They see our Section as a place to learn the leadership and business management skills unique to private practice physical therapy.

NON-CLINICAL PHYSICAL THERAPISTS

Not all who carry PT and DPT credentials are in clinics. Non-clinical physical therapists have made a career for themselves outside of the clinic or in an aspect of practice management that no longer includes managing the patient care aspect of physical therapy. These professionals may have titles that include chief operations officer, consultant, or business advisor. Their background in physical therapy makes them uniquely qualified to help guide private practices to success.

Whether working directly with a private practice or as an external consultant, non-clinical physical therapists share common goals of sustaining and growing private practices. They are service-minded, with a focus on helping their client practices maintain viability in what has become a volatile market amid COVID-19. While helping practices achieve great success is their primary goal, a long-term goal is to be able to exit the industry and retire comfortably.

Affecting both their work and their clients’ practices, declining reimbursement rates from insurers and Medicare is a primary concern, as it affects their ability to help practices achieve financial goals. They also see the proliferation of third-party utilization management (UM) companies and larger corporate practices as a potential challenge; they build their business on highly personalized services that may be undermined by larger UM companies and corporate practices that may apply a one-size-fits-all approach to practice management and problem solving.

In response, this group feels strongly about advocating for the industry and increasing reimbursement rates to ensure the long-term viability of private practices. They are often involved in advocacy efforts on a federal level and support legislation that helps small business.

Our section represents an opportunity for this group to network with private practice owners, share resources, and participate in lobbying — all things they see as vital to their role in private practice physical therapy.

THE FUTURE OF PRIVATE PRACTICE

The personas presented here showcase the incredible diversity of those in private practice physical therapy and in our section’s members. Each persona brings a depth of knowledge, experience, and perspective that will be vital to the future of our section and private practice.