I recently attended the Northeast Seminars con ed course taught by Brian Mulligan and Kevin Wilk themselves. It was awesome. I definitely plan to take more Mulligan courses because the techniques make such immediate substantial changes for patients. I’ve stated in my cash-practice guidebook and on this site that a huge part of my success in self-pay Physical Therapy comes from getting fast, dramatic results with most of my patients. I do not say that arrogantly. I say it because I need to really drive home an important point … success in a Private Pay PT Practice doesn’t come easy, and you have to set your practice apart in many ways; especially in the results you provide for your patients.
Building a successful cash practice is challenging
I’ve had a reader voice concern that I make the idea of starting/converting to a cash practice sound too easy, or that anyone trying it will be successful. If anyone has been given that impression from this website, I can assure you that it was not intentional and I do apologize. I would guess that the majority of PT practice owners (current or future) would have a difficult time building a fully cash-based practice (partial cash-based practices and private pay ancillary/fitness services are likely much more viable in most cases). The list of factors that will influence the success or failure of this type of practice is incredibly long and will vary from one practice to another.
One of the most important of these success-factors is clinician skill and effectiveness. If you don’t get better-than-average results, why would people forgo using their insurance and pay out of pocket to see you rather than the PT who only costs them a $25 co-pay? With that said, I’d like to describe a bit about what I’ve learned and what I’ve found has made me an effective clinician. I went to the University of St Augustine which gave awesome training in joint-based manual therapy and had some good courses on soft tissue techniques as well. I earned a Manual Therapy Certification and the CSCS credential. I had great mentors who taught me a lot about aggressive myofascial release techniques. I even took a Craniosacral course (don’t laugh/judge) which has proven effective for some of my patients with headaches, concussions, and hard-to-explain symptoms.
I will always have so much more to learn, and I encourage you to adopt the same attitude if you haven’t already. Keep striving to improve your skills and to share what you’ve learned with others! The public deserves to get the best possible treatment available from whatever PT they end up seeing.
Cash-based physical therapy must create noticeable results
I can’t stand when I meet someone who has a long standing pain/injury and I mention I might be able to help, and they respond “Oh, I already had PT and it didn’t work.” I then ask them something along the lines of, “Did you go to a PT clinic where you spent a large amount of time on modalities like heat packs and ultrasound?; and then the PT would watch you do exercises, many of which you could do on your own at home?; and all the while, the PT was helping other patients get through their exercises?” If they answer yes, I tell them they didn’t really get PT, they went to an expensive gym. In most cases, if they received any hands-on treatment it was very brief and rushed. There are obviously cases (especially post-op) in which the needed treatment is much more therex-based than manual. Whatever the case may be, the treatment you provide must be top-notch and go beyond what they would receive from the average clinician.
If you are planning to add cash components to your practice or have a completely Private Pay practice, you cannot operate like a money-mill clinic and expect to succeed.
I’d like to end this post by starting a discussion about continuing education … what courses have you taken that really improved your skills and clinical effectiveness?