Over the years, I’ve spoken to many physical therapists with aspirations of someday owning their very own PT practice. It’s a noble goal, and when successful, it can help fill the gaps in access to quality conservative care that exist in many communities across the country. However, practice ownership requires a lot of time, energy, creativity, and money—the latter of which is something many people are in short supply of these days. Luckily, there’s more than one way to make your practice ownership dream a reality—and some are more financially friendly than others. So, without further ado, here are six ways to start a physical therapy business:

1. Building from the Ground Up

Starting a brand-new practice is probably what most would-be practice owners picture when they dream of striking out on their own. After all, there’s something to be said for building a business from scratch versus acquiring an already-established one: you can make it as large or small as you want, and you don’t have to worry about changing long-standing procedures and practices with an existing team. You can also choose to make it a joint venture with another owner versus flying solo. However, building a new PT practice from the ground up is also a lot of work. Some things to consider are:

While you may encounter some of these same steps with other avenues to practice ownership, they are all things you will absolutely have to do when starting from scratch. There are also a lot of financial risk factors to consider when it comes to founding a startup, and during a time of substantial market volatility—like the one we’re experiencing right now—you may want to consider an alternative path to your ownership goal.

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2. Acquiring an Existing Practice

One alternative to starting a brand-new practice is acquisition—whether that means purchasing a single independent clinic or one location in a franchise. This option cuts out a lot of the initial groundwork, and it basically guarantees immediate income, as the clinic will have an existing patient load. If you go this route, however, there are still plenty of considerations to ponder. For instance:

  • Do you need to acquire a new Type2 NPI number?
  • Will you change the clinic’s branding and logo?
  • Are you and your clinical staff credentialed with all the right insurance payers?  
  • Do you need to hire additional staff to make up for employee attrition?

For more key items to mull over before acquiring a PT practice, check out this post from Meredith Castin, PT, DPT.

3. Partnering with an Existing Clinic

Another viable gateway to becoming a practice owner is entering into a partnership with an existing clinic. One way to do that is to join the team at a practice and work your way up through the ranks. If a future partnership is on your mind when you become an employee at a new practice, you should make these intentions known to the current owner(s) right away. According to Carolyn Josey, who is now the owner and CEO of Everything-Green, it’s important to first establish yourself as an excellent provider within that practice and build positive relationships with the other providers on your team. As Josey explains, “If things go OK, [new hires] are going to be offered a partnership as they move through a given time frame. That should be outlined in their contracts. They should never go into a contract with [the time frame] left open.”

However, you shouldn’t assume that a partnership is in the bag just because you’re a capable and well-liked physical therapist with great rapport across the company. Many times, the current owners will have set milestones that an employee must meet in order to become a partner. If no such benchmarks exist, you should find out if the company is willing to create some for you. In this Physicians Practice article, Mark Bair, MD, advises, “If you are interviewing with a group that has not developed specific requirements for advancement, you should determine why. If that group is not willing to disclose, or simply does not want to make any promises, you should carefully reconsider.”

A few other things to think about before jumping into a partnership track include:

  • culture fit,
  • the clinic’s long-term goals and business plan, and
  • how the practice handles the financial side of the business.

4. Partnering with Another Business

Thanks to their vast understanding of anatomy, physiology, and musculoskeletal conditions, physical therapists can be valuable partners to any business in the health and wellness space. Plus, partnering with a local gym or fitness studio is a great way to gain immediate access to potential patients as well as establish a niche that sets your practice apart from the competition. That’s precisely what Kaci Monroe, PT, DPT, owner of River Bend Physical Therapy & Preventative Care, aimed to do when she partnered with a local gym.“Being part of the athletic club has brought so many clients,” Monroe explains here. “I’m surviving right now on word-of-mouth alone. I haven’t even marketed to MDs yet because I haven’t had a need to. I’m full every week.”

Legal Considerations

Partnering with a gym can be incredibly lucrative, but there are also some special liability precautions to consider when doing so. As we mention in this post, “if the therapist’s qualifications include the skills necessary to administer aid in an emergency situation or detect early risk factors for certain health issues, then he or she could be held legally accountable for failing to do so.” That said, the law does not hold non-medical professionals and technicians—such as massage therapists and personal trainers—to the same level of liability. So, it’s crucial that you cover your legal bases should you choose to go down this path.

5. Starting a Side Hustle

Dreaming of owning your own practice, but worried about quitting your day job? Starting a side hustle is a great way to explore practice ownership without taking on as much financial risk. One option, as physical therapist Paul Potter suggests in this post, is to start a micropractice. “A micropractice is a lean business that capitalizes on a provider’s expertise in delivering a specific service or product,” Potter explains. “Micropractices:

  • leverage technology to reach and serve ideal clients in a market niche, and
  • streamline workflows to keep overhead low and profits high.”

If you elect to go this route, you can try your hand at practice ownership without investing in a brick-and-mortar location. And if you decide to go the cash-based route—and plan to practice in an affluent area—you may even be able to avoid dealing with payer-related headaches. Here are a few different examples of micropractice business models:

  • a cash-based yoga or Pilates center,
  • mobile endurance and strength training,
  • fitness and sports coaching, and
  • in-home PT care.

That being said, working as a full-time staff therapist while also treating patients on the side means you’ll be logging a lot of hours. It also typically requires some upfront financial investment for things like independent malpractice coverage, website creation and maintenance, and marketing. However, once you’ve established a loyal client base, you can open up a physical location knowing you have plenty of patients to fill it with—and that’s definitely worth the extra effort. 

6. Joining a Partner Network

Finally, a lesser-known alternative for future physical therapy practice owners is joining up with a partner network such as the equity share business model used by Health & Rehab Solutions (HRS). This model works well not only for PTs who are looking to build their own practices from the ground up, but also for practice owners who have acquired a new clinic and are looking to expand their reach. As HRS mentions on its website, “We work to develop your business strategy and implementation plan collaboratively, and then equip you to manage your own business.” In this example, you will also have access to your partner’s professional team, who will help you refine and improve all of your practice’s processes.

The biggest benefit to joining an existing partner network is the amount of time and money it will save you when it comes to building up your clinic’s name and reputation. It’s also nice to have immediate access to a larger company’s team of experts. However, it’s important to research all of your options and find the network that works best for you and meets your needs, paying special attention to the level of autonomy you’ll have as an owner.


So, there you have it: six unique ways to become a physical therapy practice owner. Can you think of any we missed? Or do you have questions about any of the methods above? Let us know in the comment section below!