STI Physical Therapy builds professional strength through exceptionalrehabilitation programs.

In the past 2 decades, Strength Training Inc (STI) Physical Therapy has gradually grown from a single location to 10 clinics serving all corners of the vast Phoenix metro area.

"We started by providing information to firefighters, giving direction about their injuries and rehab services, and that turned into our creating a medical health-fitness program for them," says James Maher, Bsc, CSCS, president of STI. The program involved having STI staff demonstrate the correct biomechanical movements for tasks, such as pulling hose, raising ladders, and lifting gurneys. "Working with the prevention and wellness skills with the firefighters made it natural for us to provide the same types of services for employer groups."

Providing these services to the general public helped solidify the business Maher envisioned while still in college.

"I had ideas about methods for using resistance training and functional items—mostly progressive strengthening—for rehabilitating knees, backs, shoulders, and the like," explains Maher. In the mid-1980s, this approach was more familiar in sports medicine than occupational rehabilitation. It didn’t take long to cultivate a business. "Doctors and other therapists liked what we were doing because we had a reputation for taking patients who had bounced around to other therapy groups without success—until we’d move into the strengthening protocol."

Such success helped STI quickly evolve into a full-service company that accepts acute-care patients for treatment immediately following an injury or surgery.

Today, STI’s relationship with the Phoenix Fire Department remains strong and includes job-specific training designed for applicants. Working out with the staff at STI helps prepare hopefuls for the demanding candidate physical agility test required to join the fire department. 

"The Firefighter Prep-aration Conditioning Program is customized to give them what they need to pass the test," says Mark Hyland, OTR/L, CHT, DABDA, director of rehabilitation, STI Physical Therapy. "They need good aerobic and anaerobic systems strength to get through it, so we prep them for that."

This approach to performance-specific training is still part of STI’s business and is not limited to local firefighters and weekend athletes.

"We can create a program for anybody who wants to perform better at what they do," says Hyland. "Whether it’s to be a better basketball player, or if they just want to lose weight and live a more healthy lifestyle."

A Full-Service Approach

Performance-specific therapies comprise only a small aspect of a full range of services offered at STI. Staying true to its strength-conditioning roots, every STI clinic has service lines primarily designed around treating orthopedic musculoskeletal patients on an outpatient basis.

"We provide physical and occupational therapy and rehabilitation, as well as subspecialty areas, such as hand therapy," says Hyland. "We also offer industrial rehabilitation and ergonomic programs and services related to each of those areas."

One such program, called TheraComp (a division of Strength Training Inc) is specifically centered around workers injured on the job. Treating industrial rehabilitation as a stand-alone entity left STI free to tailor conditioning and ergonomics programs to individual businesses, including services such as functional-capacity evaluations.

Carving out this niche program helped STI on two fronts. It not only made it possible to track the number of workers’ compensation cases that were being seen at STI, but it provided a way for STI to differentiate itself to area businesses.

"It let them know we were different from the usual clinic in our ability to manage the individual concerns of all parties involved," explains Hyland, who emphasizes the importance of understanding the various concerns and needs of the lawyers, case managers, employers, adjustors, and injured workers. "TheraComp lets them know we are specialized and experienced in this area and deliver services geared to the workers’ compensation market."

A Team Effort

Regardless of what leads patients to STI, they benefit from an interdisciplinary approach to outpatient care. Each client works with both a physical or occupational therapist, and a complement of high-level support personnel, including licensed athletic trainers and master’s-educated strength and conditioning specialists.

"This interdisciplinary combination of clinicians ensures each client the greatest opportunity for a successful outcome," says Cerie Smith, PT, DPT, CSCS, coclinical manager of STI. "Using a team method in an outpatient setting helps clients reach their goals by the time they leave us."

Fewer clients, however, are leaving STI, due in part to the growth of the company’s wellness programs, including ongoing gym memberships. For a monthly fee, individuals can continue using the equipment at STI’s 10,000-square-foot facility in northwest Phoenix even after their treatment is completed.

Through this program, patients are able to work out at their own pace—often following the routines put in place for them during their physical therapy treatment—but have the added security of knowing that professional assistance is only a few steps away, if needed.

In addition to expanding postrehabilitation options, STI is also committed to adding modalities such as aquatic therapy and driver’s education courses aimed at improving the skills of aging drivers.

Maintaining a Steady Pace

STI’s substantial growth has been fueled in part by its diversified client base.

"We have a good mix of payors, with a balance of Medicare, workers’ compensation, private pay, and managed-care cases," says Hyland. "And we’ve got over 400 different referral sources, so we don’t depend on any one physician or employer for our business."

A varied client base is as important to expanding business as is a uniform philosophy of service and care. To maintain the company’s basic approach to patient care, the team at STI takes the time needed during the recruitment process to find the best fit.

"My philosophy has been to hire tough and manage easy," advises Hyland. "If you have people you trust and who understand your mission, they will carry it out on a day-to-day basis."

When bringing on new staff, Hyland and Maher both search for individuals drawn to physical therapy and rehabilitation as a career rather than a job. A passion for helping people often wins out over technical ability.

"Though clinical skills, education, and experience are a close second, interpersonal and communication skills, along with a customer-service attitude, are the number-one priority," says Hyland.

Maher concurs. "We want people who put their concentration and efforts into making people feel better," he says. 

Once on staff, clinical managers at each location are generally tasked with hiring their own techs and office-support people, acquiring help from the corporate office for the more extensive process of bringing on another therapist or certified trainer.

STI also uses a centralized billing system so individual clinics are not burdened with collections. The company is currently moving toward a comprehensive electronic medical records system. Approximately midway through the project, all clinics now share an online scheduling and billing program, with work under way to add a therapy-documentation functionality.

"Our goal is to be totally automated and integrated so therapists can use wireless networks in the clinic," says Hyland. "This will allow us to intake a patient, document the visit, report to the referral source, and have a bill generated automatically from the therapists’ note that day, streamlining what used to be a cumbersome process."

Timing is Everything

For those hoping to duplicate STI’s even growth, it is imperative to understand that it did not happen by accident. Maher advises that clinics should make the most of their existing situation before considering expansion.

"Look at the efforts you’re putting in your primary location first. Did you get the maximum you could out of it, out of every referral source, through each patient, and by developing other services?" asks Maher. "Don’t consider opening the next one until you’ve got it down and you know you’re doing your best. Otherwise, your efforts will be split if you open another one."

Once the commitment is made to expand, the first step should be lots of research.

"Plan, plan, plan," advises Hyland. He adds that a business strategy that was successful in one location may not translate directly to the new address. "Talk to your referral sources, your patients, your employees—get as much information on an area. Don’t take anything for granted."

Most of STI’s ventures were preceded by consistent feedback from referring physicians and employers that a particular region lacked physical therapy services. Maher also suggests asking the city’s insurance providers where they’d like to see services offered.

Word on the Street

Having only recently added a formal marketing team, STI can credit much of its growth to satisfied customers and their commitment to be active participants in the community.

"We do a lot of community-service events, such as attending different health fairs hosted by employers," says Hyland. "We’ll set up a booth and take blood pressure or offer some sort of public service." Other opportunities include speaking with employee groups and offering seminars about health-related or fitness-related topics as requested by area companies.

Another way STI made a name for itself while learning about business in the area was by attending functions hosted by professional organizations. The marketing team regularly attends meetings of four or five groups in the industry, such as the Workers’ Compensation Claims Association (WICCA). Often, they will host a booth or other presence at annual conferences and similar large meetings. Recently, efforts were made to begin marketing directly to customers.

"A newer strategy for us is to target some of our marketing energies toward the consumer, who has the power, because they can usually ask their doctor where they want to go for therapy, so we advertise with some of the employers we work with," says Hyland. "For example, we’ll run an ad in newsletters or in union literature that goes out to members." He adds STI is also considering expanding its marketing efforts to include radio and television spots.

Perhaps most importantly, all marketing is seen as a team effort.

"Our marketing team is great and can open doors, but they aren’t the ones delivering the service," says Hyland. "The therapists and trainers are responsible for that, so making them available and providing the best care we can is ultimately the best marketing you can have."

Thriving on Service

More than anything else, STI’s dedication to service is what sets it apart from its competitors. STI’s fundamental approach to care is treating the entire person, not just their injury.

"With STI, we take care of patients from beginning to end," says Smith. "First and foremost, we want to resolve their symptoms, but that is just a fraction of the care they’re going to get. We create independence in our patients, strengthening the injured area, as well as full-body conditioning to prevent a future injury."

Along with that emphasis on patient education is STI’s philosophy that patients should be made to feel welcome in whichever location they go to for care.

"When people walk into the clinic, they automatically look up to you as a member of the medical profession," Maher says. "If you look down on them, become condescending, or don’t listen to them, you’re actually violating their trust."

He reiterates his belief in staffing clinics with professionals who really care about people and are there to give them a complete service, showing them respect and care. This level of attention, he feels, also improves the physician’s comfort level when referring their patients to STI.

"We always have to be conscious that when we’re servicing patients, the physician has put his trust in you," says Maher. "The bottom line is you want to make him believe he did a good thing."

To help ensure that these goals are being met, customer service is measured regularly through satisfaction surveys. In addition to on-site feedback forms patients can fill out at any time, a questionnaire is mailed to every client at the completion of therapy. All responses are reviewed and, if necessary, follow-up is done quickly.

"Fortunately, our customer-service efforts have resulted in a high patient-satisfaction rate," says Smith. "However, when dissatisfaction is noted, we immediately address the issue and make the necessary amendments."

Satisfaction of employees and staff is just as important to STI as the happiness of clients.

"I think STI provides a refreshing environment that enables each individual team member to play an important role in the environment we provide to our clients," Smith says, noting that necessary decisions are able to be made rapidly due to an open-door policy. "Because I have direct access to Jim, decisions can be made more readily, which I think ultimately benefits the staff and the patient."

A Philosophy of Business, a Way of Life

For the team at STI, making people feel welcomed, cared for, and respected is not only the foundation of their business, it’s the right thing to do.

"The first step in serving as a physical therapist is helping to resolve symptoms. However, this is only a stepping stone in the path to recovery and resolution. It is our obligation as clinicians to provide clients with the education required to maintain the functional success achieved in therapy," says Smith. "As long as we are providing good care and a pleasant experience, our clients will be left with a good outcome and the business will succeed. Good service results in a successful business."

Dana Hinesly is a contributing writer for Physical Therapy Products.