Resilience, ingenuity, and adaptability are key characteristics of those businesses that have managed to weather the economic turmoil of the COVID-19 pandemic. But these principles have guided Summit Physical Therapy’s business model since day one.
In this Q&A, we chat with Summit PT co-founder Jay Cherok, PT, DPT, Cert. MSKUS, about what it takes to build a PT clinic in a rural Alaskan town of 6,000 people—and how the lessons he and his team learned early on helped them navigate the fast and furious changes stemming from COVID-19. Jay also shares:
- significant challenges Summit PT overcame during the pandemic,
- how he was able to maintain a full staff and provide them with bonuses post-lockdown,
- how they’re doing now compared to before COVID-19, and
- his advice for other therapists who are in the process of fully reopening their practices.
How long have you been a PT?
I have been a physical therapist since 2011, and I have loved every minute of it. My wife and I started as traveling PTs until we found a home in Alaska in 2013.
Can you tell us a bit about your background leading up to co-founding Summit PT?
I have always enjoyed solving problems, being creative, and working with people, so pursuing a career in physical therapy felt like a natural fit. After graduation, I became a travel PT—along with my wife/co-founder—and we moved around the country for about two and a half years. I was placed as managing PT in several clinics during those years, which allowed me to see different management structures and business models. My wife and I moved to Alaska in the spring of 2013 with a travel contract that became a salaried position for the next five years. During that time, I managed a small, three-PT clinic, which I helped grow to twice its size as well as expand to another location offering aquatic PT. Eventually, the growth model I employed—along with our goal to provide services to the growing Medicare and Medicaid populations—did not align with the clinic owner’s goals. So, in May 2018, I made the decision to part ways and strike out on my own.
Summit Physical Therapy was conceptualized one late night with the help of colleagues whom I had worked with and managed for a few years. This group was young and talented, and they had a clinical chemistry that I’ve never experienced elsewhere. They also shared my ambition for growth and supporting the underserved. We decided it was time to take the risk and be our own bosses. Summit PT opened on June 4, 2018, and it was a major turning point in my career—one I couldn’t imagine doing differently.
What inspired you to launch a PT clinic in a remote Alaskan town of 6,000 people?
Physical therapy is something I love to do, so I figured, why not also do it in a place I love? Homer, Alaska, is a dream location that many people from around the world travel to for just a week or two. So, having the opportunity to call this place home while pursuing my passion was an easy sell for me. As I mentioned, I love solving problems and being creative—and being adaptive is a prerequisite for living in rural Alaska.
What were some of the unique challenges that came with setting up shop in such a far-flung location?
Logistics is the first thing that comes to mind. Every time we tried to order something, we came across high fees, time delays, or a flat-out denial. I couldn’t count the number of times we were told, “We don’t ship to Alaska.” It took some finagling—and a great deal of price negotiation—but we managed to figure out an alternative shipping method. We would order our supplies to be sent to Washington, and then place them on a barge to be picked up at a local store in Homer. We also ended up making a lot of our own equipment or hiring local friends and builders to construct some of it. We called on friends to help us paint the clinic, install the flooring, and put together the furniture so that everything was ready in time for our opening.
We also had to adapt our marketing strategies to fit our target population. We found that one of the best ways to get the word out about Summit PT was by being out in public, volunteering, and attending a variety of events. This helped our community associate us with this new company and brand. We also used digital media, newspaper articles, and direct contacts to increase public awareness.
How have you used these challenges to your practice’s advantage?
These challenges have taught us to be adaptable and to not be afraid of veering from the norm. For example, instead of buying some of the supplies we needed, we used our resources to make those things instead. We also learned that we can’t be passive in our marketing—we need to get out there and grab our patients’ attention. These lessons carried over in our business model. We don’t always have the ability to simply buy solutions to our operational problems. Rather, we have to create solutions and actively adapt processes to make them work for us. This mindset has helped us not only save money, but also give our staff a sense of accomplishment knowing that they helped create what we have today.
Do you feel the business model you created prior to COVID-19 helped you weather the pandemic storm? If so, how?
Absolutely! We were constantly faced with unforeseen challenges and last-minute changes prior to COVID-19, so it felt like just another day at the office when we started planning for the virus’s inevitable arrival. We had myself and my wife, our office manager, and a few others in the war room laying out closure policies and telehealth procedures, verifying telehealth reimbursement and coverage, creating public statements, finessing marketing strategies, and looking over our risk-mitigation plans. We often collaborated in this way: first gathering the minds, and then setting out to divide and conquer.
How did the pandemic affect Summit PT’s business operations (i.e. patient volume, staffing numbers, and services offered)?
Being in rural Alaska, we initially had an advantage, as cases were slow to rise in our area—that is, until tourism season and spring break hit. During that time, we closed our doors to inpatient visits for six weeks out of an abundance of caution for our patients, community, and staff. Throughout the lockdown, we continued to pay our staff while they worked from home, and I’m happy to share that we didn’t have to lay off or furlough a single person. We also utilized telehealth with any patients who were a good fit for virtual care and interested in the service.
When we opened our doors, there was a minor decrease in patient volume, but we staggered appointments and only had two PTs working per day—one in the morning and one in the evening—so it all worked out according to our mitigation plan. As we built the therapists’ schedules back up to 40 hours per week over the next few weeks, we maintained the offset appointment schedule to minimize the number of patients in the common areas at the same time. We continue to employ this tactic, along with requiring everyone to wear a mask, wash their hands before and after their appointment, answer screening questions before each appointment, and have their temperatures taken before appointments, among other social distancing and cleanliness protocols. Our patient volume has continued to grow steadily post-lockdown—so much so that we had to hire an additional PT to keep up with demand.
How were you able to maintain a full staff and provide each employee with a bonus once Summit PT reopened?
We maintain a set minimum of cash available to cover operational costs during events like this pandemic. We were also able to apply and demonstrate inclusion criteria for the Paycheck Protection Program (PPP) loan, which allowed us to seamlessly pay our staff while the practice was closed and until cash flow resumed. The bonuses were paid to administrative and clinical staff for their continued efforts and the increased risk they took on to continue providing care for our patients. Having a keen eye on your numbers and planning for a rainy day truly did come in handy for us here.
What was the most significant challenge you’ve had to overcome during the pandemic?
Misinformation and no information about COVID-19 has been our most difficult challenge. As the pandemic evolved and the Internet became flooded with altering views on masking, social distancing, vaccines allegedly containing computer chips, and other fake news, it became increasingly difficult to make clear, objective decisions for the health and safety of our patients and staff. It is not often that we are faced with a new virus in which decisions are being made based on information that is rapidly being discovered. That said, each of our protocols had to be carefully researched and considered to ensure we were doing the best for our patients.
What has this pandemic taught you about continuity planning, and how will you adjust your long-term strategy as a result?
This event taught us that things can go wrong in an instant. It’s relatively easy to plan for the ebb and flow of the seasons in the rehab therapy industry once that pattern is recognized and able to be forecasted. The pandemic, however, was not on our radar. We learned that planning for a setback and keeping a close eye on our finances allowed us to maintain staff and continue operations in a newly adapted model. However rare something of this magnitude is, there are other events that could compromise the health of our business, and we must be prepared for the worst. Increasing our cash-on-hand minimums, having a very low debt-to-income ratio, and staying within set budgets for purchases and commitments will allow us to not only stay afloat, but also thrive when the next storm hits.
How is Summit PT doing now?
Summit PT is doing very well. We are proud to have new clinicians joining our team, and we have even begun thinking about growing to another satellite location (we already have one located in the even more remote town of Seldovia, Alaska). Best yet, our patients are confident that our precautions and protocols are working, which has brought our September visit count for this year to that of last year.
What would you say to other therapists who are reopening their practices and navigating the PT world post-lockdown?
As you reopen your clinics, be sure your decisions are made objectively and that they prioritize the health of your patients, your staff, and yourself above all. At the end of the day, people—and their livelihoods—are all that matter. These are stressful and challenging times, but there are many hidden opportunities. And while we don’t get to choose the cards we’re dealt, we do get to choose what we do with them.
You all have faced adversity before—and won. Now, more than ever, it’s time to win again.