Scott Hadley’s path into physical therapy started traditionally as an undergraduate student with a focus on pre-physical therapy.

As a pre-physical therapy undergraduate at Grand Valley State University, Scott fell in love with anatomy and became a teaching assistant for the anatomy lab. He decided to change his focus to pre-med and was accepted to medical school.

Short-lived Pre-Med

After he was accepted, he shadowed a medical resident. He described 14-16 hour days and was worn out. “I was with the medical resident for 14 hours and at one point in the day, he looked at me and said, ‘If you’re interested in anything else, go do it. Don’t ruin your life by being a doctor.’”

Grad School

“I went to an advisor and said I don’t think the physician lifestyle is right for me,” reported Scott. His anatomy advisor recommended he apply to a Ph. D anatomy program. He was accepted into Wayne State University’s anatomy program.

During his graduate studies, Scott worked with a program for spinal cord injury patients and discovered a real passion for spinal cord injuries and neural plasticity. He completed his Ph.D. in 1998 and during his graduate work published three papers on spinal cord injuries.

Anatomy Professor

Scott graduated and began his role as a professor at Hope College. His second teaching position was a tenure track position at GVSU and taught anatomy for four years.

During his time at Grand Valley, Scott continued to work with spinal cord injury patients. “We had an FES (functional electrical stimulation) bicycle unit and monitored SCI patients as they cycled.” During the FES program, Scott worked closely with PT faculty.

Back to PT School

As the years passed Scott became less satisfied with teaching anatomy and decided to return to physical therapy.  “Leaving a tenure track position to go back to school didn’t make any sense!” He resigned his tenure track position, enrolled at PT school and his second child was born one week into PT school.  “It was really taxing on my family because not only was I going to PT school, but I was also teaching anatomy part-time. I found my strong anatomy base made all PT classes actually pretty easy,” Scott reported.

During his clinical affiliations, he became increasingly aware that patients’ reports of pain were not addressed. “I saw many clinicians follow a set protocol for how they treated back or knee pain for example- treadmill, bike, etc. This generic approach did not make sense to me,” explained Scott.

Patients had pain and yet it was not addressed and many times ignored.

Introduction to Manual Therapy

On his third clinical affiliation, Scott met a manual therapist in Muskegon, Michigan, who addressed pain with manual therapy.

After graduating, Scott accepted a position at Health Motion with a European model of physical therapy with the goal of continuing manual therapy training to effectively treat his patients.

“After a short time at Health Motion, I realized I was starting to develop my own manual therapy theories that did not align with the clinic.” He describes his physical therapy approach as being rooted in neuromechanics and the role that neural reflexes play in muscle control.

Clinic Owner

After starting his own clinic in 2010, Scott intended to gain partnerships with all the insurance carriers. However, Priority Health-a regional Health Care provider-never accepted his application. Scott reported,” I provided a free consultation for all my patients. I began to notice that 90% of Priority Health patients would decide to pay out of pocket anyways!” Scott related, “This taught me a valuable lesson about the value that people put on health. People place a high value on their health and many people are willing to pay out of pocket for it.”

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Cash-Based Clinic

In 2016 Scott decided to dissolve his clinic with a staff of four to transition completely to a cash-based clinic. “Initially I dropped all insurances except Medicare and Blue Cross. I maintained Medicare and BCBS for 1.5 years then dropped all insurance.”

At the time he started his current clinic 50% of patients were pay out of pocket. Currently, his rates are $130 for a 45-minute appointment. Scott explained that the current consumer perception is clinics that are cashed based offer a higher quality product.

Scott does not market his services. He relies mostly on referrals where people know he is a cash-based physical therapy practice.

Typical Week at the Clinic

“I schedule most of my patients Tuesdays through Thursdays,” Scott explained. “My treatment approach requires a heavy load of manual therapy and I only have about 30-35 visits in my hands each week. In my experience, the four-day break allows me to provide intensive manual therapy most effectively.” I asked Scott, how far out he is booked and he smiled and explained, “I try to only have one week fully booked out. I don’t want new patients to wait too long. My goal is to get new patients in for treatment within two weeks. “

Scott also has started to teach his approach which he calls neuro mechanics for PT. It is a sub-discipline of the biomechanics field in physical therapy. The kinetics of motion influences the nervous system. Walking primarily is a reflex or subconsciously controlled movement. To hear Scott’s explanation of his research, click here listen to my latest podcast with him.

NeuroMechanicsPT is Born

Scott’s passion for neuromechanics and the drive to share his experience and research has fueled him to create two courses focused on neuromechanics. He currently offers a two-hour course and an eight-hour course both of which have been approved by the Michigan Physical Therapy Association.

Both courses are lab-based practical applications of neuromechanics, which Scott describes below:

NeuroMechanicsPT treatment is a manual medicine approach that produces immediate changes in motor recruitment, muscle contractile force, range of motion, and painful symptoms. PTs already know biomechanics and basic neurophysiology. NeuroMechanicsPT bridges the disciplines to provide a new lens to view the interaction between motion, motor control, and PT practice.

Tips For Starting Your Own Cash-Based Practice

Scott has been successful at sustaining his cash-based practice. He offers this advice for anyone looking to start one.

  • Identify the area of PT or patient groups you are passionate about.  “For example, I enjoy running and I love to work with runners. So, I initially focused on reaching out to runners with free-running assessments.”
  • Provide excellent customer service.  “Word of mouth referrals will continually bring in new patients. I do not have to do any marketing because each person I treat is connected to family and friends that they refer to me because of the great service I provide.” Providing excellent customer service is also at the forefront of our vision.

If you are interested in more information on starting a cash-based clinic Scott recommends Aaron LeBauer who offers consulting for starting a cash-based practice.

More information on Aaron can be found at

If you are interested in more information about neuromechanics, please visit Scott’s website:

You can listen to the entire podcast below.

Running a Successful Cash-Based PT Clinic and a Look into Neuromechanics Continuing Education was last modified: by



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