The Background
Ever since I was a kid, I knew I wanted to be my own boss one day. Even while in PT school, I was interested in what it would take to manage my own business, but it never crossed my mind to take business classes in conjunction with studying for PT school, either while in college or while in grad school.
Once I started working full-time as a licensed physical therapist, I was already looking for the opportunity to find a way into ownership. So, when months into my first job I was presented with an opportunity to negotiate buying out a practice looking to sell, I jumped on it. Negotiations lasted nearly a year, but it turned out that we couldn’t find an agreement with which both parties were comfortable. I tried to continue working as the employee for a few more months, but my soul was dissatisfied; I still wanted to be my own boss, and soon.
Within weeks after deciding not to buy, I came across a business program that promoted an opportunity to stop trading my time for money and to enjoy serving as a healthcare provider in the way I wanted to serve and not sacrificing my financial comfort. It took me a couple of months to finally enroll into the program, mostly due to the significant financial investment, but the program quickly revealed how much more valuable it truly was. Within a couple of months of trying to go through the program to start up my business while still working full-time at someone else’s clinic, I quit the clinic job, realizing it wasn’t sustainable for me to juggle both. February 2022 began my year-long journey through the Smart Success Health Care program with Greg Todd, who is also a PT. The SSHC community wasn’t only limited to PTs, however, I would come to meet dietitians, pelvic floor PTs, and other entrepreneurs in the health care world. With us all in the same boat or at different phases of the journey, I knew I would have plenty of resources and network connections to figure this out on top of the guidance I was receiving from the program and coach itself.
Getting Incorporated and Choosing a Market
With that, I jumped full into starting my own business: a concierge physical therapy service. The start-up process took a while, as I found out, because of the paperwork I needed to ensure I was following California state and national laws as a clinician, a business, and a health-care business all in one. I would later find out that I was supposed to form a professional corporation and could not form an LLC, which turned into a long, winding process with numerous emails, phone calls, and lots of self-and-external encouragement to get that straightened out. Below is a list of items I needed to obtain for my incorporation and legal set up (I settled on going through SIMAS & Associates for my consultation and help).
1. Employer Identification Number through the Internal Revenue Service (IRS)
2. Confirmation of Articles of Incorporation provided by SIMAS offices and the Certified Articles through Secretary of State (SOS)
3. Certificate of Status through Secretary of State (SOS)
4. Certified Copies through Secretary of State (SOS)
5. Statement of Information provided by SIMAS offices and through Secretary of State (SOS)
6. Secretary of State, Business Programs Division – Welcome Notice provided by SIMAS offices
7. Corporate Bylaws provided by SIMAS offices
8. Minutes of Initial Board of Directors meeting provided by SIMAS offices
9. Fictitious Business Name Statement through the County and the ad that ran in the local newspaper with my business’s FBN
10. Certificate of Insurance Professional Liability through Healthcare Providers Service Organization Purchasing Group (HPSO)
11. Business License through the Cities in which I am working
12. Zone Clearance Certificate through the City out of which I am practicing
13. Employer Tax Number through Employment Development Department
14. California Seller’s Permit through California Department of Tax and Fee Administration (CDTFA)
15. A business bank account through my bank of choice
16. Terms and Conditions, Privacy Policy, Medical Disclaimer forms, etc
Finally, I got incorporated in June 2022, and even after these were obtained, I still needed to wait for a correspondence from the IRS that I was all set, which took another four months to receive. I had to notify SIMAS of this correspondence to makes sure nothing was missing in my packet.
At this point, I didn’t start seeing clients until October 2022, partially because I was still waiting to make sure everything cleared legally, and partially because marketing was not my strong suit (it still isn’t at the time of writing this). One of the biggest pieces was deciding on a target demographic–my business program advised honing in on a subcategory to assist finding key words, hot phrases, and verbiage that could help me build rapport quickly and gain a reputation within a community because I was using their language. This made me a specialist in this category and with my services would now being solutions-based, I would be able to see these individuals through to their end goal. It would result in me not taking insurances, but then I wouldn’t be limited in how far I could help them along their journeys.
I decided to market to the older adult pickleball athletes. My parents had gotten into it in 2018 and introduced it to me. They got obsessed with it; I was too busy in the past with school and subsequently work to get as involved as I wanted. By the time I started the business program, I was playing more and falling in love with the community and seeing the need for physical therapy services and injury recovery/protection education. The older adult population had overwhelming statistics of injury rates and urgent care visits and many of them weren’t getting in to a physician or physical therapist’s office to get their questions answered. Either that or they would continue to try to play in pain, only to exacerbate chronic injuries. My heart was with this community, and I started introducing myself to the players on the courts and even bought an SEO service to help buff up my online marketing reach (which has been in development).
I hired Tannersmark to create my logo. Tanner is a friend from college and not only one of my favorite graphic designers, but one of the best people I’ve ever worked with. She worked as a physical therapy aide at the clinic I used to work at, and we had a really solid workflow together. That communication, collaboration, and creation process carried over to the logo design project, and I am so thrilled by the final result:
Between October to the end of the year, I only had two clients sign on with my solutions-based programs, which wasn’t going to cover much of the financial investment I had made across all the fees, programs, permits, and services obtained for my business. At that point, the enjoyment of having two clients I was able to work on in line with my values and approach wasn’t enough to override the rising fear and disappointment of the financial loss I was taking this year. Everyone said it’s normal for a business to take a couple years to break even, but given the hope I had based on the program I was in, I wasn’t satisfied with this result.
Still, I recognized that I wasn’t getting anywhere with marketing myself (because I wasn’t marketing much at all), and even when I did market, people weren’t entirely buying into the model I was trying to introduce to the community. “How does a solutions-based method work and do you take my insurance?” People weren’t interested in the method because perhaps they weren’t ready for the commitment, weren’t interested in a way to come up with the money or perhaps I wasn’t communicating the value and how it would answers their questions and pick up what the rest of health care had failed to catch up to that point. It was challenging to explain that the way I approach recovery isn’t in line with how insurance bills, thus the reimbursement rate for me wasn’t going to allow me to do what I want to do without going out of business—plus, individuals would likely have to pay more going through insurance that my flat-rate offer. People weren’t buying, and I was continuing to lose money trying to pay out of my own pocket, whose savings were now virtually gone.
Along the way, I entertained the idea of picking up a part-time PT job at another local clinic, mostly to keep me from getting rusty as a clinician. I’d spend the past year focused on being an entrepreneur and businessperson that I felt lacking in exposure and practice in my original trade. I needed to find a way to continue seeing clients, hone my clinical skills more, and practice the techniques I’ve been learning.
Obstacles Turning to Opportunities – Present
Around July of 2022, one of my friends introduced me to a physical therapist who owned a clinic in the same town where my parents were living, which also shared a demographic of people I talked to in the pickleball community. He had encouraged me to reach out to him if I’m ever looking for a job, understanding that I was starting my own business several cities north, at the time. I thanked him for the consideration and kept his name in my back pocket.
As life would have it, a couple of months passed and I was getting discouraged about my cash-pay practice’s caseload. I got word from our mutual friend that he was desperately looking for more PTs for his clinic. He was the only PT clinic in this particular town, thus he got ALL the referrals from the local providers regarding patients living in the area.
With that knowledge, I reached out to him and inquired about a part-time job. Just one day a week so I could spend the other 3-4 focusing on my business. He was more than thrilled to hire me and even encouraged me to promote my concierge services to these individuals.
“There are more than enough people in need for the both of us to be in this town,” he told me. “In fact, we can come to an arrangement where you could use our facilities for your clients outside of our operating hours.” I was more than thrilled with this news.
Presently, I’m working the one day at this clinic, but that gives me enough exposure to at least see 8-14 patients a week to start and transition back into practicing my trade. Additionally, it gives me a full week between visits with those patients to research how I want to plan their upcoming treatments. I have the freedom to treat how I see fit, which gives me a chance to explore my education and techniques and methods. By being part-time at this clinic, it’s also giving me exposure into the community. The clinic is trying to schedule more pickleball athletes on my schedule and that has been energizing for me and for the clients because it gives me opportunities to treat. With my own business, I’m teaching local workshops on Pickleball Injury Recovery and Prevention and hosting online webinars which have been great opportunities to educate.
Oh yeah, I’ve gotten a haircut since the start of this process.
In either situation, I’m filling my personal cup of treating and educating, and it’s consistently energizing seeing the clients walk away feeling even a little more empowered about their knowledge of their body, stirring up hope and easing fears of their potential to recover and play more games after all. I’m hopeful myself that this journey will continue my trajectory towards having my business run independent of my personal pocket, and not only paying my personal account back, but compounding exponentially and allowing more financial stability and freedom for me and my family.
All in all, I know it’s supposed to take time. Admittedly, I’m impatient and need constant reminders—and to internalize that the timeline is really undetermined. This is a new journey specific to me, and I really can’t compare to other business’s growth. My path is going to look very unique to me, and in reality that will be for the best for me. It’s openly extremely challenging to stay positive and motivated, but I also recognize that optimism and hope acknowledges the struggles that come with taking risks and stumbling through the exploration. And that’s not to say I don’t cry every now and then–growing a business takes work. But I know that when this thing starts to run itself, I’m going to have built myself a world that will feel less like I’m working in it and more like I’m getting to play in it with the people I’m serving.
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