“Work for insurance or work for yourself.”   

That post prompted me to write this article on the Catalyst PT blog nearly a year ago (click here to read). Since then, I’ve done a lot of reflecting as I work to grow my own concierge PT practice and it’s safe to say my opinions have not changed very much. I do my best to stay up to date with industry trends, both in practice models and hiring practices. This is not an article about why the cash-based model is better than a traditional, insurance-based practice, but rather a deep dive into that quote I started with. Is it really one or the other? Is the physical therapy world better off with hundreds of small, locally owned, private practices? Are customers better served that way?  Can young, new PTs learn and grow in that manner? And is it really true that the only options are big insurance-based clinics or small solo practices? 

I think back to my days as a young PT; the clinical AND professional mentoring I received was priceless. While I grew out of those jobs, I still value those lessons and relationships and use what I was taught as I mentor other new PTs. Each experience shaped me not only as a therapist but also a business owner. My values as a provider include helping patients receive what is best for them, and as a business model this does involve a cash-based concierge model. However, it is also my belief that not every physical therapist needs to become her own boss. There are ways to have the benefits of a group practice without having to succumb to greedy insurance contracts. And, as a clinician, there are employers out there who do value you, and want you to thrive in the profession.

The problem with this industry-wide push for PTs to open their own cash-based practices is that it diminishes the idea that employers can create thriving, employee-focused cultures that value autonomy, flexibility, paying clinicians what they are worth and the power of collective energy.  Somewhere in the process of denouncing insurance-based, “big box” companies, trusted coaches and industry leaders also began to turn their followers’ eyes away from considering employment in any form, unless it was for themselves. I get it; there is a lot of money to be made coaching young therapists on how to start and build their own practices. However, I question whether this strategy is good for our profession. I frequently talk about my vision for Catalyst, as a place where not only patients can thrive but also as somewhere PTs want to spend their time. I do my best to stay true to our vision and values, and that includes helping staff be amazing therapists, administrators AND moms. After all, if we are teaching our patients that they can have both, it would only make perfect sense that we would want the same for ourselves. I know I am not alone when I state my belief that you can create a company culture that supports and encourages not only professional growth but also personal goals - having a family, spending time with loved ones, having the energy to do the things that matter. There are many other PT business owners who feel exactly the  same. If you are reading this, and thinking about an ideal work setting, I encourage you  to consider private practice (and especially cash-based or concierge models) as a  setting that provides you all the benefits of working for yourself, without the risk of starting a business, AND allows you to grow alongside like-minded clinicians who have your back.