Many physical therapists dream of owning their own practice one day. While some clinicians wait until they’ve been working for years before they take the plunge, more and more new graduates are opting for clinic ownership right out of school.

Regardless of when the timing feels right, one of the biggest decisions facing an aspiring clinic owner is whether to buy an existing PT practice or start one from scratch. Many folks wind up purchasing existing practices so they don’t have to build a patient load from the ground up or worry about forging relationships with referral sources.

However, there are some important questions to ask when buying any type of medical practice. With that in mind, here are a few things to ponder before you purchase a PT practice:

The PTs Guide to Starting a Private Practice - Regular BannerThe PTs Guide to Starting a Private Practice - Small Banner

1. An amicable transition is invaluable.

John Baio, PT, DPT, owner of Martino Physical Therapy, strongly advises that anyone purchasing a PT clinic do everything possible to keep things amicable during the transition. He notes that it’s always preferable to have the previous owner in your corner as your biggest cheerleader. After all, he points out, “One malicious letter or unpleasant meeting with a referral source can freeze the stream of incoming patient referrals.”

Continuity with staff and technology providers can help keep things running smoothly.

It’s also important to consider how the transition will impact the clinic’s current personnel situation. To do that, Lilyanne Pagador, PT, DPT, owner of Pagador Physical Therapy, recommends asking yourself:

  • Will the current staff want to stay on with you as the new owner?
  • If they choose not to stay, with whom will you re-staff the clinic, and how will you train those employees?

She also points out that you’ll need to decide whether you’ll continue using the same EMR provider, billing service or solution, bookkeeper, accountant, and legal counsel. Pagador opted to stay on WebPT, and she retained the previous owner’s office assistant, bookkeeper, and accountant. “I felt that patients seemed more comfortable knowing that [the office assistant] stayed during the transition,” she explains. “I also felt better working with the existing bookkeeper and accountant for better continuity.”

2. Announcing the transition is an art form.

Even if you do everything in your power to ensure a smooth transition, you might still run into unanticipated roadblocks. For example, according to Pagador, some patients may feel shell-shocked by the announcement that their beloved clinic is under new management. That’s why it’s so crucial to establish trust and build a positive rapport with the patients you will “inherit” from the previous owner.

Putting a celebratory spin on the change helps keep morale high.

When Pagador purchased her clinic, she made it a point to maintain the warm, family-oriented atmosphere the previous owner had created. “I threw him a ‘Happy Retirement’ party and invited current patients as a way to show a positive transition of ownership,” she says. She believes this helped keep the good vibes flowing after his departure, as his current and returning patients really trusted his judgement.

3. Patients often follow their therapists to new clinics.

Despite your best intentions, though, many patients will stay loyal to their therapists. You might assume that when you purchase a practice, the existing patient pool will come as part of the deal. But, if that practice’s top clinicians decide to join or open another clinic down the street after you come on board, you could lose many of their patients, too.

Employment contracts can help prevent staff attrition.

Baio says one way to combat this is to include an employment contract with current employees as part of the sale. “This can prevent you from having your dreams of a turn-key clinic crushed,” he explains.

If patients do leave when you take over the clinic, though, Pagador cautions against taking it personally. “It’s not your fault; they may just have been blindsided by the transition, or they are just very picky about who they want to work with,” she says.

4. Your treatment style may clash with the status quo.

Pagador also stresses that it’s vital to understand the clinic’s treatment style or philosophy (if there is one) before you take over. For example, if a manual-based practice were to switch over to a movement-based one, it could cause some raised eyebrows from patients.

A gradual approach to shifting methodology will help foster buy-in.

She recommends gradually transitioning over to your preferred techniques and treatments styles, rather than switching overnight. This will help maintain the trust and support of current patients. She also points out that simply understanding the existing clientele is critical during a practice buyout. If you’re unfamiliar with pelvic floor treatments, but 20% of existing patients are in the clinic for those diagnoses, you’ll need to know that in advance and plan accordingly.

Pagador does add that if you have a strong following from your previous clinic or setting, then this may not be as much of an issue. But, if you’re expecting to simply take over an existing patient load, it’s essential to understand how treatment differences will come into play.

5. Marketing and branding are key from before day one.

One of the biggest benefits to purchasing an existing practice—especially a successful one—is the fact that the prior owner has likely done quite a bit of marketing and branding. If you want to keep the transition seamless, Baio recommends that you start working out the details of taking over marketing efforts—including doing any necessary re-branding—well before you start seeing patients under new ownership. “A costly mistake would be to begin marketing after you start seeing patients at your newly purchased practice,” he says.

6. The renaming and insurance credentialing processes can take time.

Pagador originally purchased a clinic that bore the name of the existing owner. So, she decided to change the name to reflect the new ownership, as well as create a whole new employee identification number (EIN) for the new entity. She anticipated that this would take time, but it ended up taking much longer than she expected. Thus, she recommends working with a legal professional who can help you understand all of your options before you decide to rename an existing company with an existing EIN (as opposed to, say, creating a whole new entity).

Similarly, Pagador advises looking at provider-payer relationships before making the purchase. If you’re going to transition to cash-only, a name change won’t make a huge difference when it comes to collecting payments. But if you’re hoping to maintain the same insurance contracts, a name change can cause lots of headaches!

7. Change is often good, and making the clinic your own is key.

As much as you want to respect the way the former owner(s) ran the clinic, Pagador maintains that making the new practice your own is key to building your brand and establishing your own loyal clientele.

That said, she believes you should be as upfront as possible with your staff regarding the things you would like to change or improve. “Enlist their help as far as how to explain changes to patients,” she says. “Have a script prepared in case patients get curious as to why certain changes are occurring.”

Your attitude influences staff and patient attitudes.

If your explanation has a positive spin, most patients and staff will be happy about the changes. She recommends using wording such as:

  • "We are excited to announce updated office hours”
  • “We are pleased to add the following additional services”
  • “We are thrilled to introduce new staff members"

With change comes opportunity, and Pagador suggests leveraging the transition period to consider all the new ways you can grow the practice. “Just because the former owner did things a certain way does not mean you need to keep doing the same,” she explains, noting that you can borrow from the things that worked well for the previous owner and brainstorm fresh, creative ways to make things work even better for you.


Have any of you purchased existing PT practices? Please share your words of advice in the comment section below!

Meredith Castin, PT, DPT, is the founder of The Non-Clinical PT, a career development resource designed to help physical, occupational, and speech therapy professionals leverage their degrees in non-clinical ways.

  • The Pros and Cons of Selling Your PT Practice Image

    articleJan 13, 2015 | 4 min. read

    The Pros and Cons of Selling Your PT Practice

    The start of a new year typically inspires resolutions, and you want to make it the year you tackle that list of things you’ve always talked about doing—joining a gym (and actually going), watching less TV, spending more time with loved ones, or finally taking that trip to Europe. If your list includes selling your physical therapy practice—or if you’re just starting to consider it—you’ve got a lot to think about. You probably thought long and hard …

  • Everything I Wish I’d Known Before Opening My PT Practice Image

    articleJul 30, 2018 | 18 min. read

    Everything I Wish I’d Known Before Opening My PT Practice

    A little more than three years ago, Kaci Monroe realized her dream of opening her own physical therapy private practice (to learn more about Kaci’s entrepreneurial journey, check out this blog post ). Since then, she’s grown her small, Bigfork, Montana-based clinic into a very successful—and very busy—operation. So busy, in fact, that she decided to open a second location this past year. Oh, and she also remodeled a house, had a baby, and sped her way …

  • Exit Strategy: Succession Planning vs. Liquidation vs. Buyout Image

    articleJan 15, 2015 | 4 min. read

    Exit Strategy: Succession Planning vs. Liquidation vs. Buyout

    In my last post , I offered you some food for thought as you ponder selling your practice—specifically, the need to find a buyer. Regardless of your reasons for moving on from private practice (increasing expenses, reduced compensation, ever-changing regulations, administrative headaches, retirement, or perhaps a lack of passion), you have a number of options for getting out: Succession Planning Why it Works An important part of selling is withdrawing yourself from your clinic—a particularly emotional process, …

  • Partnering for Profit: The Opportunities and Challenges of Bringing in an Investor or Buyer for Your Therapy Practice Image

    articleJan 26, 2015 | 5 min. read

    Partnering for Profit: The Opportunities and Challenges of Bringing in an Investor or Buyer for Your Therapy Practice

    The physical therapy and rehabilitation care industry market is large and growing. Merger and acquisition activity remains on the radar for many of our nation's largest rehabilitation providers. In fact, private equity firms now own six out of the ten largest players. There are several reasons for this industry phenomenon, which has driven multiples to a 20-year high and has attracted both financial and strategic buyers from all walks of life. Here are a few of those …

  • Beat the Burnout: Time Management Tips for Private Practice PTs Image

    webinarJun 2, 2015

    Beat the Burnout: Time Management Tips for Private Practice PTs

    Between treating patients, completing CEUs, running a business, and managing staff, it’s hard to have a life outside of work; heck, it’s probably difficult to keep your head on straight some days. Such are the trials and tribulations of a private practice PT. And with so many tasks and people competing for your attention, you might find yourself dealing with a bad case of burnout. So, how do you wear so many hats—and juggle so many responsibilities—while …

  • 5 Signs You're Not Ready to Sell Your Practice Image

    articleMar 11, 2019 | 8 min. read

    5 Signs You're Not Ready to Sell Your Practice

    Rehab therapy market consolidation is a hot topic that’s only gotten hotter over the last few years . But when large companies start to absorb your local competition faster than you can blink, that hot topic suddenly becomes uncomfortably close—and you may feel pressured to consider a voluntary sale before you’re swallowed up by the flames. I mean, why resign to getting gobbled when you can form a mutually beneficial partnership, right? But what happens if—after going …

  • 3 Options You Should Consider When Starting a PT Practice Image

    articleJan 22, 2015 | 5 min. read

    3 Options You Should Consider When Starting a PT Practice

    Owning your own PT practice could be a dream come true. But if you aren’t sufficiently prepared, the process might end up feeling more like a nightmare. A crucial step in the planning process is determining your ownership approach and business structure. You’ll need to decide whether to start a clinic from scratch, partner with a colleague, or purchase an existing business. In its practice administration guide, the American Physical Therapy Association (APTA) emphasizes the importance of …

  • 8 Pitfalls for Startup PT Practices Image

    articleJan 11, 2019 | 8 min. read

    8 Pitfalls for Startup PT Practices

    When I was growing up, I used to love watching Indiana Jones reruns with my dad. Whenever one of us found good ole’ Indy playing on TV, we’d plop down and watch the rest of the movie, regardless of how many times we’d seen it. I especially loved watching Indiana duck, dodge, and outsmart every booby trap he encountered during his adventures (the giant rolling boulder was always my personal favorite). While founding a startup practice may …

  • 4 Surprising Factors Potential PT Hires Want in a Job Image

    articleApr 25, 2018 | 5 min. read

    4 Surprising Factors Potential PT Hires Want in a Job

    When you’re looking to hire a new physical therapist, you clearly want to find the best one possible: someone who is competent, committed to lifelong learning, conscientious, and caring. During the the search process, you probably pore over average salaries in your area , doing everything you can to ensure you’re providing a competitive payment and benefit package . After all, most PTs want the best possible compensation, right? Well, that’s partially true. With the cost of …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.