Driving to Firehouse Fitness in downtown Kalamazoo, Michigan, I wondered to myself, why
the name Firehouse?

As I walked in, the 14-foot tin ceilings, exposed brick, and old woodwork immediately provided my answer – the building was an actual old firehouse.

Firehouse Fitness is the home of New Seasons Physical Therapy and
. Emily Wilson, DPT and founder of New Seasons Physical Therapy, greeted me as I was inspecting the gym and its ornate tin ceilings. I wanted to capture her story about what it’s like to start a physical therapy private practice.  After a building tour (awesome facility) Emily escorted me to her office upstairs.  Emily is a busy mother of two children (a 3-year-old and 7-month-old).  She loves taking walks with her family and two dogs.  She often combines family walks with her other love, shopping locally for good food and beverages.

About Emily

Emily graduated from Oakland University in 2010 and has continued her physical therapy education with courses in women’s health through Herman and
Wallace Institute for Pelvic Rehabilitation and manual therapy through NAIOMT consistently over the past eight years.  Until starting her own practice, Emily worked in hospital-based outpatient clinics with a focus on women’s health.

Here are some highlights
of my interview with her.  To hear
the entire interview, visit our podcast channel.

Devin: “Why start a private practice?”

Emily wanted to run a clinic where she could have the flexibility to personalize care and run the clinic “how {she} wanted it run.”

Devin:  So what were the first steps in starting your practice?

Emily explained she started listening to physical therapy podcasts from Jarod Carter – The Cash-Based Practice and Aaron Lebauer- The CashPT Lunch Hour.   “I knew after listening to so many inspiring stories that I had to just jump in and do it.”  She said she started laying the legal and marketing groundwork in the Spring of 2016. “I did everything myself.  I designed the website on Wix, designed business cards and filed all the necessary details with a lawyer.”  Things progressed quickly, and Emily took the plunge in January 2017 and saw her first patient!   Emily admits that she wasn’t quite ready, but the first patient opportunity provided the push she needed.

Devin:  What was the first six months like?

Emily described how scary it was not having anyone on the schedule for weeks at a time.  But, she utilized the time to market her services to other physical therapy private practices and physician offices.  Her focus was to present herself as a resource to both physical therapists and physicians.

Devin:  I notice you participate with Medicare but not other commercial insurance.  How did you make the decision to be a cash-based practice?

Emily: “Medicare recipients are not allowed to pay cash for services.  I didn’t want to operate in the “grey area” with Medicare deciding if my services were either a wellness or a physical therapy benefit.”

Devin:   How was your experience applying for Medicare?

Emily reported that applying to Medicare was an exercise in perseverance.  “You have to stay persistent with them.  It took about three months to finish all the paperwork.”   First, you are required to submit paper bills until you are approved to bill online.  After the first couple of rejections, I learned how to fill them out and then was approved for online billing.  Now I receive payments in a couple of weeks.”

See also  Q: Do you think being a travel therapist enhances your resume?

Devin:  What surprised you most about starting a PT practice?

Emily was blown away by the administrative load. She describes that answering emails, website changes, follow up calls, and billing add a significant time burden.   She currently treats an average of five patients per day and stated if she saw the same number of patients per day as in previous jobs she would not be able to keep up.  “I was also surprised by how tied I was to the phone,” Emily states. “I thought I needed to respond right away, so I was always checking my phone for voicemails and emails. The line between my home life and work became blurred.”  She has since learned to try to separate home life and work life better.

I asked Emily what advice she would give someone who is thinking about starting a clinic. Here is a list of things she recommends to keep in mind:

  1. Are you the primary income
    generator?  If so, then you need develop
    a specific business plan.
  2. Hire a business coach if you are the
    primary income generator.
  3. Cultivate an abundance mindset.  Don’t think we are fighting for the
    same patient with other PT practices.
    There are plenty of patients to go around.
  4. Develop a NICHE:  You have to stand out.
  5. Identify administrative hours and
    book them into your schedule.
  6. If you are a cash-based practice, you
    may not find value in direct marketing to physicians.  Cash based is too new for physicians to trust.
  7. For the General Orthopedic Clinic-
    you have to do something different. Focus on your customer service and patient

Devin:  What are the positives of running your own private PT practice?


1. “I really feeling proud of the professional work I am

2.  “Cash Based means the onus is on ME to provide a valuable service.”

3.  “It is really rewarding professionally.  I feel more integrated with the physical therapy profession.”

As I was driving home, I was really impressed with Emily’s courage and her abundant approach. I know that private practice isn’t for everyone, but I hope this blog
has helped you decide whether a private practice is an option for you. I’d love
to hear your thoughts and experiences of starting our own private practice, and
if you are cash-based or insurance-based.   To hear the full
interview with Emily, listen here.

Blog and Podcast Notes:





Small Batch Education and Mentoring:



Also APTA/MPTA membership has been huge. Many patients have found me here:


and here:


Mother of Two Starts Cash-Based Physical Therapy Practice was last modified: by



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