Physical therapy is a logical next step to improve the overall care of your patients and boost your revenues.
When done correctly, adding a physical therapist (PT) to your practice can be a true win-win situation. But, to assure success in expanding your practice in this direction, do your homework, weigh all the factors (both pro and con), then make a decision.
Patient benefits
Let’s look at some of the important benefits your patients receive when you include a physical therapist as part of your treatment team.
- Second professional opinion. Patients gain the benefit of a second opinion from a professional in another discipline.
- Convenience: Patients will be able to get this opinion conveniently, without having to leave your office.
- Expanded rehab. Chiropractic adjustments and rehabilitation exercises go hand in hand, creating a synergistic effect that is usually greater than the effect of either therapy alone. This is why so many chiropractors also add rehab modalities to their treatment plan. With a PT on board you will be able to offer expanded rehab services to your patients along with their chiropractic treatment. Your patients will appreciate this extra care and attention.
- More one-on-one time. In a busy practice it is unlikely that you would be able to spend the same amount of time as the PT doing rehab with your patients. This is because physical therapy emphasizes active care.
- More extensive insurance coverage. Insurance companies don’t always recognize the value of chiropractic services in their reimbursement policies, as reflected in limits on chiropractic benefits. This is not usually the case for physical therapy. PT benefits under many insurance plans are greater than chiropractic benefits. This means that in some cases long after a patient has exhausted their chiropractic benefit they will still be able to receive physical therapy in your office.
These are just a few of the benefits that will accrue to your patients. As you do your homework, you will surely think of others. Few services you offer can give so much for your patients.
Practice benefits
Having a physical therapist on board can also provide some very substantial benefits to your practice.
- Stand-alone business. The physical therapy department in your practice can function as an autonomous business.
This opens up a business opportunity to an entire demographic of patients you currently don’t see — such as patients who do not want or are not candidates for chiropractic treatment, but clearly need some form of rehab; patients who have excellent PT insurance benefits, but poor chiropractic benefits; Medicare patients who are only covered for modalities and rehabilitative exercises performed by a licensed physical therapist; and post-surgical patients who you may have referred out to orthopedic surgeon for surgical consultation.
Of course, all of the family doctors, pain-management specialists, orthopedic surgeons, neurologists, and rheumatologists who currently do not refer patients to you become potential referral sources for your physical therapy department.
- More free time. Much of the rehab you now do yourself or is currently done under your supervision can be done by the PT. This leaves you free to concentrate on marketing and running the practice.
- A step toward financial freedom. As a practice owner, you will also be able to gain more freedom and take a big step towards financial independence and perhaps retirement, when you hire a physical therapist. This is because you will be creating a business system that is capable of running itself, without your presence in the office.
Eventually you could hire an associate and put the whole practice on auto pilot. In the future, you can sell the business for a lump sum, or let associates run it to provide you with stress-free retirement income.
Before you start
Although the benefits can be great, the decision to hire a PT is an important one, and mistakes can be costly. Here are some basics to help you.
- Assess your situation carefully. Consider that adding a PT may not be right for you. Examine your own practice philosophy. If you believe that chiropractic alone is the answer to every problem and don’t feel that physical therapy will help your patients, then obviously a PT will never be right for your office.
- Consider using a consultant. You may not have the capital to cover the cost of hiring the PT until third-party payments begin to come in. Similarly you may need to get your PT enrolled on several insurance plans, which can often take several months.
A knowledgeable practice consultant can help in these scenarios, by arranging credentialing and by helping with financial projections.
- Be realistic about costs. If you decide to add a PT to your office, the process of finding and hiring the right person can be frustrating. PTs are in great demand now, and there is a shortage. Those who are available can be expensive.
Assess your financial situation carefully and be realistic about pay, benefits, and the cost of setting up a separate business entity.
- Weigh the PT’s philosophies. Other potential obstacles include PTs with a prejudice against chiropractic, PTs who don’t want to work in a physician’s office, and PTs who prefer to supervise and create treatment plans as opposed to providing hands-on services.
- Bone up on the Stark law. Under the guidance of a healthcare attorney and/or your consultant, become knowledgeable about Stark law. (The Stark law prohibits physicians from making referrals for certain designated health services to any entity with which the physicians have a financial relationship.)
However, if you have made the decision to add physical therapy to your office and you can surmount these obstacles or be lucky enough not to encounter them, the rewards will be great for your patients and your practice.
Marc H. Sencer, MD, is the president and founder of MDs for DCs, which provides intensive one-on-one training, medical staffing, and on-going practice management support to chiropractic integrated practices. He can be reached at 800-916-1462 or www.mdsfordcs.com.
