Which came first: the location or the specialty? It’s private practice’s own version of the classic chicken-and-egg conundrum. Your location will absolutely influence who you treat and thus determine the relevancy of your specialty, and your specialty will certainly impact where you set up shop and what market you serve. Luckily, in this toss-up, there is a variable: choice. As the clinician, you have to decide what’s more important: your specialty or where you treat.  

Location, Location, Location

Whenever I pass vacant buildings, I think: that should be a movie theater, restaurant, retail store, clinic. Very rarely do those buildings become what I think they should be. That’s because investing in commercial real estate takes much more thought and planning than my random musings. So, if you have a location in mind for your practice, make sure you do your homework. After all, location plays a huge factor in the success of your practice. As you browse for a village, town, city, or region for your clinic to call home, answer these questions:

  • Are you in a direct access state?
  • What are the tax implications and fees for small businesses in your state, city, and county?
  • How many people live or work in the community? What are the demographics of the community? (To learn that, check out US census data or demographic data on your city’s website.) How many people do you estimate will seek your services?
  • How many referral providers work in the area? How many of them routinely prescribe physical therapy?
  • How many other physical therapy providers are there in the community? Is the area already saturated or can you identify a gap in services that you can fill? (The latter question can help you identify a niche or specialty.)
  • How do you become a preferred provider for payers in your area? Will it be difficult?
  • What is the typical reimbursement rate for providers in your area? What should you expect to write off as a result of denied reimbursements or failure to collect?

Once you’ve conducted your market research and you have a feel for the area, it’s time to start browsing real estate. You can do this alone or with the help of a leasing agent. However, “most commercial real estate brokers work for property owners and represent the owners' interests,” the APTA warns. If you want an agent who will advocate for you, try retaining the services of a tenant broker. He or she—along with a real estate attorney—will help you negotiate your contract so you get what you need in terms of lease length and landlord renovations. 

As you shop for the right spot for your practice, consider these questions:

  • Is the location easily accessible by foot, car, or public transportation? Will signage be visible from nearby streets?
  • If your patient population is mostly baby boomers, how accessible are the building and its restrooms? How far is the parking lot from your office?
  • If you’re the first PT moving into your building, is your landlord willing to include an exclusive use clause in your lease so no competitors will crowd you out?
  • If you plan to offer after-hours services, like gym memberships or Pilates, are those time frames acceptable within the terms of the lease?

One more thing to consider: How much space do you really need? In this article, PT and clinic owner Jack Sparacio suggests asking yourself if you “really need...the 3,000 square foot office and [to] pay rent for space you are hoping to grow into? Or can you get your practice up and running in the 800 to 1,000 square foot office for one-third the rent?” In his opinion, growing too big for your office space is a much better problem than throwing money away for office space you’re not using. Not quite ready to nail down your own space? Sparacio offers up the following advice: “Subleasing space from other health professionals or health clubs can also be an affordable alternative.“

Specialty is Everything

Perhaps you already know your specialty, be it sports medicine, pelvic health, or aquatic therapy. If that’s the case, skip down to the end of this section.

For those of you on the fence about specialty, you must choose your niche. Essentially, pinpoint what services you can provide that will set you apart from your potential competitors. Of course, pinpointing is easier said than done. Jeff Worrell has a few suggestions, though, in his whitepaper, “Build Your Practice by Finding Your Physical Therapy Niche.” He recommends taking “some time to jot down your experiences on a piece of paper...be as specific as possible. Look for similarities and highlight the experiences that are similar.” Also, ask yourself the following questions:

  • What type of physical therapy work do I enjoy doing?
  • What is the market potential for my specific area of interest?
  • What type of patients do I enjoy working with?
  • What experience do I have that can help me achieve success in my chosen niche?
  • Are there other physical therapists who have built a successful practice in this niche?

Still drawing blanks? Try immersing yourself in several different specialties to find where your heart truly lies. You can also peruse Monster’s list of emerging PT specialties.

Once you determine your specialty, research what areas lack those services—or even better, have a growing demand for those services. When you know that, follow the steps detailed under the location section above to pinpoint the area and leasing locale best suited for you. After you open your doors (or maybe in preparation of opening your doors), check out this article for advice on marketing your specialty.

Now that we’ve sorted out the location-or-specialty scenario, can we get down to brass tacks on this whole chicken-and-egg thing? At the very least, can we make an omelet?

Unwrapping MIPS and the Final Rule: How to Prepare for 2019 - Regular BannerUnwrapping MIPS and the Final Rule: How to Prepare for 2019 - Small Banner
  • Where Is My Money Going? 6 Surprising Hidden Costs of Running a Private Practice Image

    articleJun 9, 2016 | 7 min. read

    Where Is My Money Going? 6 Surprising Hidden Costs of Running a Private Practice

    You have to spend money to make money. This tenet of business is as true now as it was when my dad gave me a loan to cover the start-up costs for my lemonade stand back in third grade. And like many small business owners, I had a tough time forfeiting nearly half of my revenue to cover the cost of the lemons and sugar (it was a slow day on the cul-de-sac, and despite my best …

  • Combatting Health Insurance Illiteracy: How to Help Patients Understand Their Plans Image

    articleApr 24, 2017 | 5 min. read

    Combatting Health Insurance Illiteracy: How to Help Patients Understand Their Plans

    Last week, WebPT’s Brooke Andrus wrote a post explaining why patient confusion about insurance coverage can translate into problems for your clinic—everything from angry and frustrated patients to unpaid balances. According to PJ Cloud-Moulds—author of this Physicians Practice post —“there is a huge gap between reality and what the patient thinks happens with their insurance plan.” That’s why—whether it should fall on providers’ shoulders or not—many PTs, OTs, and SLPs are stepping up their educational game to …

  • Why I Paid $75 Per PT Visit for Two Months Image

    articleAug 24, 2018 | 9 min. read

    Why I Paid $75 Per PT Visit for Two Months

    When I woke up after a night of boot-scootin’ my way down Lower Broadway—Nashville’s famous honky-tonk alley—my head wasn’t the only thing that hurt. In fact, the moment I stepped out of bed, I knew I was in serious trouble, even if I wasn’t quite ready to admit it to myself. Part of me was in denial that I could actually injure myself from swinging through one too many do-si-dos. But, the shooting pain I felt on …

  • 4 Subtle Ways You're Killing the Patient Experience Image

    articleJun 22, 2018 | 6 min. read

    4 Subtle Ways You're Killing the Patient Experience

    A positive patient experience is essential for instilling confidence and security in your patients—and for sustaining a healthy practice. When patients feel rushed, dismissed, or expendable, they’ll often drop out prematurely —and possibly seek care from a different PT (or move on to a whole other discipline). With that in mind, here are some of the common ways you’re subtly sabotaging the patient experience that you work so hard to create in your practice: 1. Providing a …

  • New Business Checklist for Private Practice PTs Image

    articleJul 29, 2016 | 8 min. read

    New Business Checklist for Private Practice PTs

    In the world of tasks and to-dos, there’s nothing quite as satisfying as completing a checklist (amirite?). I certainly believe this is true—which means, I can check “being right” off of my list of to-dos for today. Cha-ching! But, enough about me. If you’re starting a physical therapy clinic , you’ve probably got enough tasks floating around in your mind to make a list a mile long—and that list has to cover all of your bases. Feeling …

  • 5 Reasons You Should Attend Ascend 2015 Image

    articleApr 28, 2015 | 4 min. read

    5 Reasons You Should Attend Ascend 2015

    Have you heard? Ascend— the ultimate business summit for rehab therapists —is back. Last year, the inaugural event took Dallas—or at least, Dallas physical therapists and private practice owners—by storm for one jam-packed day . This year, Ascend is upping the ante—big time. For starters, our 2015 event will run for two days instead of one—and trust us, you don’t want to miss it. Here are five reasons you should attend Ascend 2015: 1. You’ll earn CEUs. …

  • Things to Consider When Taking Out a Loan to Start Your PT Practice Image

    articleAug 6, 2018 | 5 min. read

    Things to Consider When Taking Out a Loan to Start Your PT Practice

    So, you graduated from PT school—congrats! At this point, you may be thinking, “Now what?” A DPT education can take you down many paths, but if you have dreams of starting a physical therapy private practice, there’s one item you’ll need to check off your list first: securing the money to get started. And if you’ve considered taking out a business loan, there are some things you need to know. PT is a fast-growing industry, and private …

  • 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 …

  • 3 Common Rehab Therapy Credentialing Mistakes Image

    articleJul 18, 2018 | 6 min. read

    3 Common Rehab Therapy Credentialing Mistakes

    Proper credentialing is a crucial step in running a successful physical therapy clinic. If your clinic and therapists aren’t properly credentialed with insurance providers from the get-go, your bottom line might suffer. And it’s not just new clinics that are susceptible to making credentialing mistakes; in fact, any clinic that has gone through a change in ownership, rapid growth phase, or any other transition might find itself mired in credentialing headaches. But before we get to the …

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