Ann Wendel of PranaPT Shares How to Start a PT Clinic
Tell us a little bit about you and your practice.
I graduated from University of Delaware in 1992 with a BS in P.E. Studies, concentration in Athletic Training. My goal was to work in sports medicine. I worked as an ATC in a sports medicine clinic for 3 years while taking more pre-requisites, then applied and was accepted to University of Maryland’s Physical Therapy Program. I graduated with with my Masters in 1998. I started working in a hospital right after graduation. They rarely hired new graduates to work PRN; but, I had more experience because of my years as an Athletic Trainer, so I got the job. I worked in acute care, neuro, and outpatient ortho. From 2003 to 2006 I went out on my own and ran my private practice in space I sublet from a Pilates studio. My next step was to work for a larger Orthopedic practice. I worked there for 4 years until October 2011, when I went back to my own business, Prana Physical Therapy. I now work as an independent contractor for Core Wellness and Physical Therapy in a co-op building. We end up co-treating patients and being more collaborative. We do different but complimentary techniques.
Tell us something we wouldn’t know. This can be an interesting fact, a fun anecdote or even a more formal piece of information about starting a PT clinic.
For my current business, we don’t take insurance. We’re a cash-based clinic, and out of network providers. As I left to start my new business, I had some Medicare patients that wanted to follow me. What I learned through research is that if you don’t accept Medicare, you can’t treat Medicare patients. It’s illegal to accept cash payments from Medicare patients for physical therapy (see Section 40 of the Medicare Benefit Policy Manual from CMS). Medicare patients can only pay out of pocket when they see a P.T. for “Wellness” (i.e. general conditioning and not treatment). This is a little known fact that is devastating for a small practice (read Ann's blog post on the topic for more info). These are the folks that typically need care beyond what Medicare can pay, and they are not able to come see you. If you didn’t know about this and you got audited by Medicare you’d be in trouble. The way the code is written, the only practitioners who cannot opt-out of Medicare are P.T. and Chiropractic.
What is the number one thing you think PT’s need to know before starting their own clinic?
New clinic owners need to understand that they will work about 18 hours a day to start out. People think having your own business is great, and it is; but, you’re never done. When you work for someone else, you see your patients and go home. If you go out on your own, you do it all yourself. You’re responsible for answering all of the questions from your patients. You do all the marketing. And of course you treat all the patients. Part of that is exciting, part of it surprises people. A lot of physical therapists who have always worked as salaried employees are used to a full case-load appearing every week. So, when you go out on your own, it is surprising to see a blank calendar the first few weeks you’re open. You have to work really, really hard until you have sizeable number of patients.
What is something that you wish someone had told you before starting your clinic?
My first time around I thought everyone would be really excited and happy for me. What I learned is that you can’t expect people in your industry to be happy for you. I’m always really happy for others and supportive. I was shocked to find that people were not so supportive. You have to be sure of what you’re doing and don’t listen to anyone else. It’s a big risk. You just have to surround yourself with big supporters who are happy in their own lives. Don’t be shocked by negative responses.