I f you are going to open your own practice, it is necessary to remember that you will now be not only a PT, but also a business owner, an entrepreneur, and a risk-taker. As a business owner, you’ll have the duty of providing continual service to your growing legion of patients, paying the bills, guaranteeing your employees an exciting place to work, and signing paychecks—and you also better remember to pay yourself. Before you go any further, the first thing you should do is have a business plan. Remember that your business plan is not cast in stone—it needs to be flexible and evolve as circumstances change.

On the following page, you’ll find important questions to address in your business plan. Each question will likely lead you to further related questions. Try not to be overwhelmed, but answer them to the best of your ability. A solid business plan will ease your decision-making process throughout the growth of your practice.

Elements of a Business Plan
Positioning
• Do you want to have a general practice or one that specializes in orthopedics, sports, neurology, workers’ compensation, pediatrics, geriatrics, women’s health, or any/all of the above?

• What size practice would be ideal for you?

• Will you be the only practitioner, or would you like a staff of PTs, PTAs, and ATCs?

• How much will that ideal size cost?

• Will the size you can manage now be ideal 2, 5, 10, or 20 years from now?

• Where would you like to locate?

• Do you want to be in a big city or a small town?

• Is public transportation or parking important in your community?

• Would you like to be in a medical building, close to a large hospital, in a heavily trafficked area, or in a more private location?

• If you have a partner, how will you split the financial and time investment and disbursement?

Operations
• What physical therapy and medical equipment will you purchase? Make lists of everything you could possibly want. You may not purchase all of it, but you can pare your list down later based on budgetary restrictions. This will also help you envision the physical structure of your facility. Consider:

• Evaluation/exercise equipment;

• Modalities;

• Treatment rooms/tables.

• What workflows and technologies will you use?

• How much will you computerize or automate?

• Should you buy practice-management software?

• Will you be billing, scheduling, and/or docu- menting electronically? Consider using software designed specifically for physical therapy. At first, billing/management software will be sufficient. You can add scheduling and documentation modules in time.

• Will you need assistance with this? If you are tech-savvy, you may be able to get started with the assistance of tech support from the software vendor. As you expand, a reliable networking company will be invaluable.

Marketing
• You may be the best PT in your region, but unless people know it, your talents will go untapped. Getting people in your door will be an ongoing crusade vital to the success of your practice.

• Where will your patients come from?

• What geographical region?

• Which physicians?

• Do you have a pool of former patients?

• What additional referral sources can you mine?

• How will you present your practice to physicians and prospective patients?

• Mailings

• Advertising

• Yellow pages;

• Local newspapers/magazines;

• Radio/television;

• Public Relations

• Attend health fairs;

• Appear on radio/television;

• Word of mouth

Personnel
• How will you staff the practice? At the beginning, you may be the PT, the receptionist, and the biller. Eventually, you’ll need a plan to hire, manage, and pay employees.

• Consider using a payroll service such as Paychex (www.paychex.com) or ADP (www.adp.com).

Finance
• Where will you be getting the finances to open?

• Personal funding

• Family seed money or loans

• Bank/Small Business Association loans

• You’ll likely need 2 years’ worth of income tax forms, bank statements, and any other financial documents.

• Presenting a solid business plan will likely help you acquire greater funding and possibly lower your loan rates.

• Credit card loans

• Financing the purchase of equipment

• Many rehab vendors will direct you to their financing companies. Their rates are often significantly greater than a bank loan. Consider a 3-year "rent-to-own" program.

• Most computer companies will give you up to 6 months without interest.

• How will you manage cash flow?

• Do you want to take private insurance, no-fault cases, Medicare?

• How much will you charge for private-pay patients?

Additional Resources
Some additional resources for writing a simple business plan are the following:

• How to build a business plan. (www.entrepreneur.com/businessplan);

• www.bplans.com;

• Planmagic business 9.0. Write a medical clinic business plan. (www.planmagic.com/business_plan/medical/medical_clinic_business_plan.html);

• American Physical Therapy Association’s Private Practice Section (www.ppsapta.org); and

• Your state physical therapy association.

Daniel Seidler, MSPT, has been a PT for 10 years. He owns Westchester Square Physical Therapy, with two clinics in the Bronx, NY. He can be reached at dseid@wspt.org.