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Physical Therapy Private Practice: Secrets of the Top 10%

Episode 106: How to Adapt and Evolve Your Practice in a Time of Crisis

This week, Brian discusses what you can do now to help your patients by taking new actions to keep up with the ever-changing circumstances of PT during Covid-19. He attempts to steer the mentality away from hoarding and cost-cutting, and more towards growth and perseverance in business. You need to “out-create” it by expanding and strengthening your practice. Tune in for tips on how to adapt and evolve your business in response to this crisis, and beyond.

KEY TAKEAWAYS

  • Personal integrity – doing the right thing, even when no one else agrees
  • Now is the best time to change old ways, and even to open a practice!
  • There is more opportunity now than ever
  • Time is yours to control, it’s up to you
  • Good control comes from the combination of knowledge and responsibility
  • Be at Cause, as opposed to at Effect (of the government’s decisions, etc.)
  • You must disconnect emotion from money
  • Now is a great time to invest in training to be a better CEO
  • Once this is all over, DO NOT GO BACK TO TREATING LIKE IT’S 1995
  • You need to restructure to have 3 revenue streams
  • 3 most important things in practice: a) driving new business to your door b) enhancing employee satisfaction c) giving back to your referral sources – Focus on these!
  • Ideal Practice Model components (from executive training*):
    • Out-source your billing (this is a clerical job – there’s no reason you should be doing it)
    • Land a market differentiator such as with advanced, innovative technologies (Ex. Telehealth, Neubie)
    • Invest in mastering digital social media marketing
    • Master rapport by forming golden relationships with your patients, medical professionals, allied health professionals, community business leaders/organizations, charitable organizations, and local media outlets
    • Providing cash-based services to hit the target of 20% per year in cash out of total GI (Ex. nutritionist, dry needling, laser)
    • Better manage your personnel through a CDT program

 

*To gain a more detailed understanding of each of these key elements and how to utilize them as a soft reset for your practice (or how to take advantage of this ideal time to open up your office):

**Join us on ZOOM live chat session on Wednesday the 25th, at 7pm EST @ https://zoom.us/j/119549213

***Links Brian mentioned:

In the meantime, if you have any questions about how to manage your practice during this pandemic, please reach out to us. We’re here to help give you the information you need to effectively manage your personnel and your business during this time of crisis.

Click the image below to access our Covid-19 Resource page:

COVID 19 resources PT owners

Episode 105: The Difference between E-Visits and Telehealth: What to Know


In light of current global events, Brian tackles a topic of major relevance and concern: telehealth and e-visits. He covers some specifics that practice owners should be aware of as they explore this avenue for patient care? Brian addresses common questions that we have been receiving from clients at this challenging time. Tune in to get Brian’s helpful tips and advice. Please note, he uses the APTA guidelines as a source for this podcast.

KEY TAKEAWAYS

  • Some clients are having to close their doors, while others aren’t feeling as much of the heat – we’re trying to help as many owners as we can and connect you with 
  • We want you connected to legitimate resources
  • E-Visit in regard to Medicare patients is defined as  “Non face-to-face patient initiation, which requires clinical decision-making, to help the patient.” E-Visits are only to be administered to current, active patients (not new patients). These are intended for short-term periods of coverage for assessing and managing patient’s care (7-day period of time).
  • There is talk about waiving HIPAA regulations so you can use the phone, Zoom, Skype, Google Hangout, FaceTime (although APTA is discouraging this).
  • Online Patient Portals are secure, online websites that gives patients convenience and 24-hour access to healthcare information. However these are not the only platform you need to use right now.
  • Codes to know for e-visits:
    • G2061 – From the first e-visit, you have 7 days to care for the patient. You bill at the end of the 7 days. Use modifier CR, and bill under the place of service (POS) using code 11. The reimbursement rate is $13.70.
    • Code G2062 reimburses at $23.24.
    • Code G2063 reimburses at $35.98.
  • You can market that you’re doing e-visits, however you can not put people on them. They have to initiate the desire to do them.
  • In regards to telehealth, many insurance carriers are reimbursing you in parity for Telehealth service. Note that the key word to look for is parity, or treating your coverage the same as if you were in office, reimbursing you at the same rate. 
  • Bill out with a GT or 95 code.
  • You will still need to have appropriate documentation to show medical necessity. Currently, PT’s are NOT covered under Medicare to do telehealth. 
  • For more information on setting up telehealth and compliance issues, reach out to TelePT Solutions, or email Daniel Seidler.

LINKS OF NOTE

As always, it is our mission to help as many owners be successful in private practice. While success might look a bit different during the current public health crisis, we are here to be a resource so please do not hesitate to contact us with any questions, or if you’re looking for any advice regarding your practice management.

Episode 104: How to Help Your Patients with Telehealth Services (Feat. Daniel Seidler, PT)

We’re shuffling things around a bit this week so we can provide you the most relevant information that’s going to help you in light of the environment surrounding the growing Coronavirus concerns and pandemic. Up until recently, telehealth was a largely unknown thing.  We’ve invited Daniel Seidler, PT, founder of Tele PT Solutions to talk about how to get started and some basics to know if you’re interested in offering telehealth services. Daniel is a successful private practice owner turned telehealth consultant. After implementing telehealth services with a large PT group, Daniel now consults other practices on how to add telehealth services within their own business. He is committed to bridging the gap between practice owner, technology and people; and now, more than ever, is an excellent time to explore ways to best serve your patients during this global health crisis. 

KEY TAKEAWAYS

  • Practices are currently looking to minimize the number of missed visits, and keep their staff busy and keep practice running. Telehealth allows you to have contact between patients and providers. 
  • Many practices are moving to a model that replaces cancelations and no shows. 
  • With the right telehealth platform, you can treat patients from home or consult/screen them remotely.
  • Every state has different telehealth regulations – you can look at the state practice acts here:. Most states you can treat from anywhere, but you need to be licensed in the state where your patients are.
  • Telehealth typically has 30 minute sessions because it’s all one on one, versus 55-60 minute in office visits, 45 minute evaluations. 
  • Coverage and reimbursements are different – but many states have parity. This means coverage and/or reimbursement is the same as if the patient were being seen in office.
  • Many owners who have succeeded having telehealth in their practice started offering the service as a cash-based service. 
  • There are some forces in play to pressure Medicare to cover telehealth services from the administration, as well as APTA and PPS. This will allow people who need services to continue receiving care. 
  • What are the consequences of us not doing anything when we know we could? People notice those who go above and beyond to provide care to their public regardless of whether you get paid. 
  • PTA should not be treating patients from their own home, but if they are in an office supervised by a PT they can perform remote telehealth services. 
  • You do need a HIPAA compliant platform – meaning the technology you’re using to connect with the patient. There are telehealth platforms that do this and are secure. 
  • Telehealth complements your care, it does not replace it. All of healthcare and medicine is going to skew towards this in the next few years. 

About Daniel Seidler, PT

Daniel has a Masters in Physical Therapy from Columbia University and has been practicing since 1996. He is the founder and former owner of WSPT in the Bronx, NY. He specializes in treating back pain and chronic pain conditions. Daniel is an innovator in the delivery of Physical Therapy and a national leader in Telehealth PT.

You can reach Daniel via email.  

Worth Checking Out

In the meantime, if you have any questions about how to manage your practice during this pandemic, please reach out to us. We’re here to help give you the information you need to effectively manage your personnel and your business during this time of crisis.

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Episode 103: Successful Patient Care Strategies (feat. Lisa Chase, PT)

Ever wonder about the doctor that your doctor goes to? Well, this week Brian is chatting with Lisa Chase, PT, owner of Back to Normal PT in St. Petersburg, FL. She’s an expert physical therapist and shares her background in Physical therapy and how she has built a unique and successful practice, with innovative technologies and education. Today, she’s sharing her experience, and the technology she utilizes that has catapulted her success as a therapist, practice owner and has helped her treat thousands of patients and professional athletes in a holistic way. 

KEY TAKEAWAYS

  • Being a therapist sometimes means having a love of teaching, and making therapists. Going into private practice often gives you the opportunity to perpetually teach and train others around you. 
  • The mystery is in the history. If you take the time to listen to your patients, and ask the right questions, your patients will tell you exactly where you need to go. They feel better feeling like their story is being listened to. 
  • You need to fully commit in your heart and soul, and then figure out what it costs to run a practice based on a lease in your community. Know what your ideal scene is, like Lisa, who knew she couldn’t accomplish her goals alone. 
  • Find the game changers and the differentiators – Neubie E-Stim, Dry Needling, ASTYM, magnet therapy, etc… 
  • Find a way to have 20% of your GI come from self-pay if you’re still in the insurance model. 
  • Stop treating patients like PT in 1995. How do you educate, and gain compliance from your patient? So you can take them above their baseline to the optimal level of health to insulate them through reinjury. 
  • Use technology that compliment your therapy approach, through exercises and put the balance of responsibility on the patient and the therapist. Only working together will your patients truly succeed. 
  • Think through the full journey of the patient. 
  • Use technology and differentiators. 
  • If you have a foundation in manual therapy, Lisa can come in and teach the Exercise foundational course. If you want to get patients better faster or if you want to get a certification, go to Michigan State. You do not need to take the exercise course to use Rehablinks. 
  • Lisa can be reached at: healing@back2normalpt.com or by visiting her website.

SPECIAL DISCOUNT FOR OUR LISTENERS

Interested in trying a free demo of Rehab Links and getting a discount on membership? DISCOUNT: 4 month trial for $100 for unlimited clinicians and all modules. In order to get the discount when you visit RehabLinks.net and ‘request the demo” be sure to complete the following  information, in the “your message” box:  DISCOUNT CODE: Rehab Links from Podcast with Brian Gallagher/Megbusiness

ABOUT LISA CHASE, PT 

Lisa Chase founded Back 2 Normal Physical Therapy in 1998. She  is an internationally recognized physical therapist, educator, lecturer and published author, with a specialty in rehabilitation, performance and wellness. She is a compassionate healer with a wealth of knowledge obtained through 25+ years of orthopedic manual physical therapy, sports injury management and total body wellness. She uses a holistic, whole body approach by applying cutting edge technology, osteopathic manual therapy and functional integration to restore joint biomechanics, soft tissue mobility and movement patterns to speed healing results.

Lisa received her Bachelor’s Degree in Physical Therapy from the University of Pittsburgh in 1991. She lectures nationally and internationally, and has been an Adjunct Clinical Professor at Michigan State University, College of Osteopathic Medicine, since 1998. Additionally, she is the Co-Chair and Co-Developer for the Certification in Functional Manual Medicine at MSU, College of Osteopathic Medicine. She has been an assistant Instructor for Functional Movement Systems since 2010; and is a published author of several books on aquatic rehabilitation, as well as a published co-author in the British Journal of Sports Medicine.

Lisa is founder and co-owner of Rehab Links, a unique exercise software for medical, health and fitness professionals. She brings much of her expertise to the community, and was nominated as a finalist for the Iconic Women of St Petersburg, named Entrepreneur of the Year in 2014, and received the Outstanding Volunteer Organization of the Year, award by the City of St. Petersburg in 2017.

Worth Checking Out

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Episode 102: What does it Take to be a Successful Practice Owner

This week’s podcast covers what it takes to be a successful practice owner. We’re not talking about the executive characteristics and traits that you need to be a successful practice owner, but rather, how to overcome a lack of confidence or uncertainty to take the leap into practice ownership. We’re working to get you in the mindset, and how to overcome common barriers that prevent you from making the leap into private practice starting with your ideal scene. 

KEY TAKEAWAYS

  • So many potential owners know what they don’t want, but have not considered their ideal scene. You need to first put your mind to what your ideal scene is otherwise you will not achieve it. 
  • Is your current employer investing in you as a person and a professional? Or are you just a workhorse working for units so the clinic can hit its numbers?
  • Don’t peg your happiness to the statistics. Peg your happiness to the enthusiasm and energy, and growth of the group and that you had within the group. 
  • What are your reasons for going into physical therapy? To make a difference in the life of everyone you treat by providing superlative service, and that you create a system that maximizes your efficiencies so you can help as many people as possible in the community life the life of optimal health that they deserve. 
  • To discover your ideal scene, bullet point out what your life would look if everything went exactly as you envisioned in your professional life in private practice and what your personal life would look like. 
  • Three categories of success in private practice – primary focus should be 1-3 offices (3 or less is family practice) – these should be a dynasty before you consider a multi-site clinic (4-8 clinics). 
  • Do not open your second or third office within a 20 minute drive of your first office. 
  • 45 – 60 visits per week is break-even. Most startups that we work with break-even within 3-6 months. 
  • Once you’re in a power condition, you can plan out offices 4-8 in 24 months 
  • Stop thinking of money like you do in your personal life – like you’re giving something away. You need to lose the emotional connection to money
  • You never received the training or skills in PT School – be willing to invest in the training you need to be a successful practice owner. 

If you’re interested in role playing and enhancing your skill in some area of personnel management or conflict management – contact us or email us and we’ll get you scheduled with Brian to do a zoom session. We’ll record it and send it your way. We’re committing to you a free training session so you can have some enhanced skills. 

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Episode 101: What the Heck is Going on in DPT Schools?

This week, Brian is elaborating on some conversations with students that he had at CSM. Students and new grads, you have to be willing to look at yourself and where you are in the profession. New grads and students often have a slightly resentful attitude towards employers based on solely on the ideas that they have before even entering the workforce. This is playing into what many consider to be an already over inflated self-entitlement point of view from today’s graduating students. This is not only having a negative impact on their careers and the profession of PT overall, but also is impacting private practice owners across the country.  At a time when PT owners are already dealing with excessive regulations, decreasing reimbursement, increased competition from hospital systems and physician owned clinics.  We are all DPT’s and we need more understanding and collaboration – not less – in order to strengthen our profession.  So let’s talk about how to get on the same page. 

KEY TAKEAWAYS

  • Hire the applicant that is excited to get the invitation to join your group. Not the one who wants to explore all their options.
  • The best people in life are people who strive for success personally and professionally. Life your life to the maximum potential while advancing personally through the investment of helping others reach their goals. Win because you give to others to help them win.
  • Salary is based on math. Run the numbers based on efficiency and productivity. You need to generate 4x your salary.
  • Intrapreneurs under the umbrella of a current practice.
  • Blame academia and the federal government. This story from REVEAL shares the real student loan crisis going on.
  • Having a student loan compensation plan is a great benefit – so long as your employee is in full exchange (i.e. working tues – sat for an extra $10,000 on their salary).
  • Have an in-house CDT system to help train todays new grads so that they can get the truth about what it means to be successful in PT private practice.
  • Never hesitate to ask yourself or any employees why they became a PT to begin with. Share your answer to get them to see that you are not so different and there is no reason to be resentful toward you or anything you have accomplished. Professional or personal success should not be shunned or discouraged.  

Our goal is to keep it real and share what it really takes to run a practice that is successful, and that cares deeply about staff, referral sources, and the community. If you like what you heard, please forward this to a friend or make sure you’ve subscribed. If you’re interested in learning or professionally enhancing you and your staff, contact us to set up a free practice assessment.

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