Why Every New Grad NEEDS a Cash Pay Practice

Aug 24, 2017
7 min read
7,477 views

Have you dreamed of being your own boss? Setting your own hours, keeping more of the profits you generate, and having the pride of being a business owner? Well if so, then you’ve likely thought of starting your own practice.

Maybe even your own cash pay practice.

If your physical therapy school was anything like mine, there was always the handful of students who knew from the beginning that they wanted their own practice (I was one of them). Our professors often advised us to get a couple years of experience, save some money, get a certification, then open your practice.

Well, I think all of this is wrong, and believe that every new graduate should start their own practice. Actually...

Every new graduate should start a CASH PAY practice!

I probably just violated every piece of advice you’ve been given, but let me explain why.

Dr. Mike Reinold.

These physical therapists are on the forefront of the cash pay movement and have proven the cash pay model can be highly profitable and sustainable.

One of my CIs told me he had to see at least 1 patient every 30 minutes, every day, just to cover overhead for the month. That was 20 patients a day before he made a profit. Because of this, he saw one patient every 15 minutes, and close to 40 patients a day! Crazy.

This type of model does not benefit anyone. Patients get bad care, PTs burn out mentally and physically. It is unsustainable.

The cash PT model solves this problem.

Most importantly, patients benefit. Since patients are paying out of pocket for care, they are seen one-on-one with a physical therapist for the entire session. They usually require fewer visits, and potentially save money and time versus going to the in-network clinic.

The physical therapist benefits because she needs to see fewer patients per day, can provide a higher level of care, and create more personal time to avoid burnout.

It’s easy to go on about the benefits of owning a cash pay practice, but what I really want to explain is why you, a new grad PT, should start your own cash practice! When thinking about starting a practice, it’s easy to feel overwhelmed. Starting a business is no small task, but it doesn’t have to be complicated.

Here is why all new grads should start their own cash practices:

1. You are better than you think!

When I graduated I thought there was no way patients would pay cash to see a new grad. I also thought I needed to be a manual therapy fellow in order to get results. I’m sure you’ve had similar thoughts.

But here is the reality.

Even as a new grad PT you are extremely skilled and knowledgeable enough to get patients great results. I started my cash practice after working for about one and half years in the outpatient setting.

I took my first physical therapy job in that particular outpatient clinic because I was promised “mentorship” by the senior therapists.

I’m happy to say that I was completely wrong. My patients did great and my clinic ran smoothly.

As a new grad, you are fully capable of being on your own.

The limitations you place on yourself are usually self-induced. Be confident in your knowledge and what you offer. You are more than capable of starting a cash practice right now. (I will discuss how to have a mentor while still working independently in a future article).

2. Patients want and will pay for your services

One of the most common things cash PT haters say is, “you’ll never get people to pay cash for physical therapy.”

Well, those people are flat out wrong. Patients will definitely pay for your services if they understand the added value in the cash model.

Plus most patients have very high deductibles and may pay $125 a visit until it’s met. In this case, it’s probably cheaper for them to pay cash for your services.

Ask any patient what they value most in the standard in-network PT visit. They’ll say it’s the one-on-one, hands-on treatment from the physical therapist. When they understand this is an option for every treatment session, they will usually be excited to pay for it.

3. Side hustle

So maybe you don’t want to go all in on a cash PT practice right out of school. That’s understandable. But every new grad PT should have a small cash PT practice outside of their full time physical therapy job.

This could be a mobile practice, seeing patients in their homes or offices. Or you could sublease space from a gym or a room in a massage studio (I’ll discuss how to work out these deals in future articles). Both of these options are low cost, and the experience/respect you gain will be very valuable for your career.

You can use this money to pay your student loans, save for a house, make your car payment, or for investments. As you get busier you can work part-time or PRN for an employer, and part time for yourself.

This will create much more flexibility, more free time, and give you a taste of being a business owner.

4. New opportunities

When I started NOLAPHYSIO, a mobile practice, I thought I’d only be seeing a couple patients a week as side money. However, within the first two months of being a business owner so many new opportunities came up.

One that I was most excited for was a partnership with a local bike shop (I love cycling and race for a local team). When the owners of the shop found out that I had my own company they wanted to help me grow it.

Soon I’ll be helping with bike fits, and they even offered to rent out their upstairs studio to me if my practice grows to that level.

Another opportunity that presented itself was to write for NewGradPhysicalTherapy. I love writing and actually studied journalism in undergrad. Now I have the ability to share my experience of starting a cash practice and help others do the same.

There are endless possibilities, but you have to be willing to take a risk and step out on your own.

The cash model may seem intimidating at first, but that’s only because it’s different. The cash PT model truly creates freedom for the practitioner and better care for the patient.

Physicians, dentists, chiropractors, and massage therapists have all been able to establish successful practices based on cash models because they offer more personalized care with better results. It’s exciting to see so many physical therapists eager to join this movement.

We all can recognize the shortcomings of traditional insurance based practices. Truthfully, many of our patients can too. If we as physical therapists are so unhappy with the traditional model we must be willing to create an alternative answer.

I'll put it this way. If any of these sound appealing to you...

  • Create a career focused on helping people
  • Having more free time
  • Improving patients' outcomes
  • Running your own profitable clinic

...then it’s time to start your own cash pay practice!