This installment in the OT Entrepreneur Series is Sue Ludwig, president and founder of the National Association of Neonatal Therapists (NANT). This is a professional organization designed to support, network, and educate the OTs, PTs, and SLPs in the NICU.
What was your background before starting your business?
I’ve been an occupational therapist for over 20 years. At least 17 of those years have been spent in the neonatal intensive care unit (NICU). For the past decade, I’ve also been a national speaker as well as a consultant to NICUs in the US in the areas of neonatal feeding, developmental care and leadership.
Why did you decide to start your OT business?
I started the National Association of Neonatal Therapists (NANT) for several reasons, including:
1) as I consulted around the US, I realized that therapists who worked in the NICU had no way to connect with each other. Often we didn’t even know of another therapist who did what we did! We were isolated and didn’t know where to go for specialized education, mentoring or validation. That also meant we recreated the wheel for every project, goal, and directive.
2) Every neonatal therapist I met was passionately invested in their practice. They LOVED working in the NICU. And they were self-motivated which is something I admire in anyone.
3) The babies in the NICU deserved knowledgeable, highly specialized therapists. You can do harm in the NICU if not properly trained. This gnawed at me.
4) I had more to give. I had a vision. It just took me a long time to believe that I could be the leader of this grand endeavor.
What was your tipping point to get started?
I had previously worried about if I would have the approval of my peers when starting and leading this organization. I wasn’t sure if I fit my own definition of a powerful leader. My mentor kept telling me, “No one is going to anoint you worthy. Only you.” (This statement stops one in her tracks.) I remember lying in bed one night wondering how I’d feel if someone else decided to start this organization. I was afraid they wouldn’t have the same perspective or that they’d limit it to one discipline. It was then that I realized that I did, in fact, have a very specific vision and I wanted to see it come to life.
How did you take your first steps to starting a business?
My first step was to hire a business mentor. I still have the same mentor 5 years later. This was a critical and invaluable step. We need to learn from those who are several steps ahead of us. High level mentoring saves time, mistakes, and money while adding depth, strategy, and forethought to business. I’m thrilled that this is the route I took.
Have you found a benefit from social media marketing (twitter, facebook, blogging)? What are some of the strategies that you have used to maximize your success in this field?
Yes I have found huge benefits from using social media. I’m not sure many businesses can afford NOT to have a social media presence. I have a very personal approach to all of my communication, whether it’s social media or our weekly newsletter. I did not want NANT to be just a ‘big organization’ that didn’t relate to its members. I AM them. I want them to know I have their backs. Everything I do is to support them professionally and personally and in turn, support babies and families.
What were some lessons that you learned in the initial stages of your business? Were there challenges that were difficult to answer during this time?
I learned thousands of lessons. I learned that I actually really love business (who’d have thought?!). Being an entrepreneur is stressful and highly rewarding. I learned that my colleagues around the world are doing amazing work that often goes (or went) unnoticed. I learned that every NICU in the world needs therapists who see infants through our unique lens. I learned that there are many opportunities out there, but to let my true vision guide the choices I make. If the opportunity isn’t in alignment with that vision, I let it go.
The challenges were similar to those any new business faces: learning how to hire the right people, how to make the business more scalable, how to avoid being the bottleneck for decisions and creative content. Each challenge helps me grow and learn. It’s not for the faint of heart.
How long did it take for you to hire additional help?
I hired help before NANT even went ‘live’ in the world. My mentor was very clear in teaching me that there are some things I just never need to do. That I could start small (hiring-wise) but needed to learn to delegate immediately to people who were fantastic at executing work that I should never do. That way I could focus on what only I can do. This was sage advice.
What was your original goal, the hope you have for the business?
My vision was for NANT to become a sustainable business so that we could keep serving our members. But my goals are more long-term. I’ll consider it successful if I leave a legacy…if NANT outlives me and continues to thrive beyond my wildest imagination…if neonatal therapists fully understand the value they bring to the NICU team and stand in that value – humbly, decidedly, intentionally.
What is the best thing about owning your own business? The worst? What surprised you most?
-The best thing: Freedom. Being able to bring my kids to school or be there for sporting events and other important moments. Even if it means working extra hours on other days, the freedom to be present for my husband and kids is priceless. I’m also so grateful to work every day toward a vision that inspires me, grounds me and pushes me. Not everyone loves their work. I am fortunate that I do.
-The worst: The stress of responsibility. I want to make sure I’m moving this field in the right direction. Luckily I’m surrounded my amazing colleagues who contribute to this journey.
-What surprised me the most: Selling out our first national conference in 2011! And the nearly instant acceptance of NANT by other neonatal associations and professionals as well as AOTA. The neonatal community is small (no pun intended) and I’ve found it to be supportive beyond measure.
What are some tips that you could give to OT practitioners considering starting a business?
-Be prepared to live outside your comfort zone- personally, professionally and perhaps financially at first. This isn’t a bad thing. You’ll emerge stronger.
-Get a mentor. You might have your MBA already and that’s great. It’s just not the same thing as knowing the steps to take when you begin on Monday morning or how to implement all you know.
-Consider your true motivation for starting the business. All the money in the world won’t make you want to get out of bed and work at a job you hate. Look for the deeper meaning and stay true to that vision.
-Have fun with it!
Surround yourself with people who buoy you and are not prone to drama. Support them in the same way.
-Be kind to yourself. Schedule self-maintenance. Sleep.
-Understand that you have a unique contribution to make to the world. Express that through your business to serve others.
Many thanks to Sue for sharing her perspective on business ownership! If you're thinking of practicing in the NICU, NANT is a great resource to make that a reality. Check out their annual conference and website!
The musings of an OT about the profession, the future, school, work, and the everyday successes that keep me going to work.
11.26.2013
11.21.2013
Entrepreneur Series: Tonya Cooley of Therapy Fun Zone
This special Thursday-edition of the OT Entrepreneur Series features Tonya Cooley, author/owner of the Therapy Fun Zone blog and online therapy store. Tonya is a prolific OT blogger and has some great tips on starting down that path for others.
Can you tell me a little about your business?
When asked questions about my business, it is a little difficult to answer because it is not straight forward, and it is very atypical. Therefore, I will first explain what my business is. I currently work contract for a school district as an OTR, and in my off time, I run a therapy blog called Therapy Fun Zone. I post about fun and different therapy activities to help inspire creativity. I also create therapy games and share some for free, and some are available to purchase. It is the blog aspect of my business that I will focus on since it is interesting and unique.
Why did you decide to start your business? I initially started Therapy Fun Zone near the end of my first year as a school therapist. I was a very experienced therapist, and had been treating kids for 20 plus years, but most of my experience was in a well-established setting with plenty of home program and activity resources, so I never lacked for activities and inspiration. When I started in a small school district, they had never had their own OT before, so they had no eval template, no worksheets, activities, or toys, and no home program resources. I was also not used to working with kids that were so high functioning, and needed to come up with some activities that would really challenge them. I scoured the web to find ideas and had to make some stuff of my own. Then I had a parent tell me that their last therapist only worked on practicing the same thing over and over, and she loved how I made the activities fun. That really hit a nerve, and I don't think children will fully participate in therapy if it isn't fun.
It was right after that exchange that I decided to make my own website for fun therapy activities in order to make it easy for people to find them.
Can you share a bit about the financial side of your business?
When I started Therapy Fun Zone, I had no expectation of making money. I just wanted to share ideas and connect with other therapists. I was already set up as a business though because I had invented a baby product a few years earlier, and already had a business license, business bank account, business name (TMC Adaptations), accounting software, and a tax id number. I made a lot of mistakes with my baby product (Hug n Hold) financially, and so I tried not to make those with Therapy Fun Zone. I planned to just spend my time on it, and not spend money on it.
Have you found a benefit from social media marketing? What are some of the strategies that you have used to maximize your success in this field?
Therapy Fun Zone is essentially dependent on social media as it is a blog, and I get a lot of traffic through the blog from facebook and pinterest. I would say that some of the keys to success with blogging and social media is to get on a schedule. I have been blogging on and off on other sites since 2005, and none have been successful until Therapy Fun Zone. From the beginning I had to treat it like a business even though it wasn't making any money because I wanted it to be successful even if it wasn't in a monetary way. I post at least once a week, and people can count on that. Sometimes I schedule my posts way in advance, but make sure they are spread out to once a week. I have seen some therapy blogs that post a bunch of articles all at the same time once a month. That does not work in your favor. If you have a bunch of articles, don't post them all at the same time. Spread them out and keep people coming back at a steady pace. I have also found that I can't keep up with more than once a week and get completely burned out. I also then post my blog posts to facebook, pin on pinterest, and then share other people's interesting things on facebook and pinterest.
What were some lessons that you learned in the initial stages of your business?
I would still consider my business to be in the baby stage. I am still learning a lot, am getting better and more efficient, and am learning the extra computer design stuff. Maybe in my next life I will be a computer programmer. Financially I think that I currently break even, or make a couple hundred dollars a month. It is not yet an option for me to quit my job, and if I did, where would I get the ideas for new therapy activities. I think that the website may finally now pay for the web hosting. Maybe someday it will pay for more. The moral is, if you think you can make a bunch of money by blogging, don’t kid yourself. It is a lot of time expense with no financial reward, but it has other rewards. I consider it a success because it is currently one of the largest therapy blogs out there, and gets over 100,000 page views a month. In big business blogger terms, that isn’t a lot (they get 1,000,000 hits a month), but in small OT blogger terms, it is darn good.
What was your original goal, the point that you aspired to reach and consider that you had "made it" as an entrepreneur?
My original goal was to share therapy ideas, and I think that I have definitely accomplished that. In the beginning, I wanted Therapy Fun Zone to not suck as a blog/website. I now think that it is pretty awesome, and I am quite proud of myself and my website design skills. I am currently working on taking it to the next level, and making it more of a joint effort. I recently added a new shopping cart that makes it so that other therapists can sell their products on my site too. I think that it could be really useful to have all of the resources that therapists make out there and available to other therapists. We will see where it will go.
What is the best thing about owning your own business? The worst? What surprised you most?
The best thing about having started Therapy Fun Zone is that it really stimulates my brain, and it keeps me inspired. The worst part is keeping track of the finances (not my thing). Most surprising is how much I love making therapy games, and that I enjoy website design. I am also surprised to find that I don’t like writing. My joy comes from creating, but then I have to write about it or no one else can benefit from what I have created.
What are some tips that you could give to OT practitioners considering starting a business?
As far as advice about starting your own therapy blog, I say just do it. Either you love it or you don't, and you never know where it might take you. Specific blogging advice would take many many posts, so I will try to work on those over at Therapy Fun Zone. If you want to try your hand at creating products, come join me and open up your own shop at Therapy Fun Zone. You could try your hand at blogging by being a guest blogger too.
Either way, you must have fun.
Thank you Tonya for your insights! Very helpful information for our next era of OT bloggers and innovators! Be sure to check out all of Tonya's fun activities on her blog, facebook, or pinterest sites. And come back next week for our last interview of 2013!
Can you tell me a little about your business?
When asked questions about my business, it is a little difficult to answer because it is not straight forward, and it is very atypical. Therefore, I will first explain what my business is. I currently work contract for a school district as an OTR, and in my off time, I run a therapy blog called Therapy Fun Zone. I post about fun and different therapy activities to help inspire creativity. I also create therapy games and share some for free, and some are available to purchase. It is the blog aspect of my business that I will focus on since it is interesting and unique.
Why did you decide to start your business? I initially started Therapy Fun Zone near the end of my first year as a school therapist. I was a very experienced therapist, and had been treating kids for 20 plus years, but most of my experience was in a well-established setting with plenty of home program and activity resources, so I never lacked for activities and inspiration. When I started in a small school district, they had never had their own OT before, so they had no eval template, no worksheets, activities, or toys, and no home program resources. I was also not used to working with kids that were so high functioning, and needed to come up with some activities that would really challenge them. I scoured the web to find ideas and had to make some stuff of my own. Then I had a parent tell me that their last therapist only worked on practicing the same thing over and over, and she loved how I made the activities fun. That really hit a nerve, and I don't think children will fully participate in therapy if it isn't fun.
It was right after that exchange that I decided to make my own website for fun therapy activities in order to make it easy for people to find them.
Can you share a bit about the financial side of your business?
When I started Therapy Fun Zone, I had no expectation of making money. I just wanted to share ideas and connect with other therapists. I was already set up as a business though because I had invented a baby product a few years earlier, and already had a business license, business bank account, business name (TMC Adaptations), accounting software, and a tax id number. I made a lot of mistakes with my baby product (Hug n Hold) financially, and so I tried not to make those with Therapy Fun Zone. I planned to just spend my time on it, and not spend money on it.
Have you found a benefit from social media marketing? What are some of the strategies that you have used to maximize your success in this field?
Therapy Fun Zone is essentially dependent on social media as it is a blog, and I get a lot of traffic through the blog from facebook and pinterest. I would say that some of the keys to success with blogging and social media is to get on a schedule. I have been blogging on and off on other sites since 2005, and none have been successful until Therapy Fun Zone. From the beginning I had to treat it like a business even though it wasn't making any money because I wanted it to be successful even if it wasn't in a monetary way. I post at least once a week, and people can count on that. Sometimes I schedule my posts way in advance, but make sure they are spread out to once a week. I have seen some therapy blogs that post a bunch of articles all at the same time once a month. That does not work in your favor. If you have a bunch of articles, don't post them all at the same time. Spread them out and keep people coming back at a steady pace. I have also found that I can't keep up with more than once a week and get completely burned out. I also then post my blog posts to facebook, pin on pinterest, and then share other people's interesting things on facebook and pinterest.
What were some lessons that you learned in the initial stages of your business?
I would still consider my business to be in the baby stage. I am still learning a lot, am getting better and more efficient, and am learning the extra computer design stuff. Maybe in my next life I will be a computer programmer. Financially I think that I currently break even, or make a couple hundred dollars a month. It is not yet an option for me to quit my job, and if I did, where would I get the ideas for new therapy activities. I think that the website may finally now pay for the web hosting. Maybe someday it will pay for more. The moral is, if you think you can make a bunch of money by blogging, don’t kid yourself. It is a lot of time expense with no financial reward, but it has other rewards. I consider it a success because it is currently one of the largest therapy blogs out there, and gets over 100,000 page views a month. In big business blogger terms, that isn’t a lot (they get 1,000,000 hits a month), but in small OT blogger terms, it is darn good.
Button Pizza... yummy ADL |
My original goal was to share therapy ideas, and I think that I have definitely accomplished that. In the beginning, I wanted Therapy Fun Zone to not suck as a blog/website. I now think that it is pretty awesome, and I am quite proud of myself and my website design skills. I am currently working on taking it to the next level, and making it more of a joint effort. I recently added a new shopping cart that makes it so that other therapists can sell their products on my site too. I think that it could be really useful to have all of the resources that therapists make out there and available to other therapists. We will see where it will go.
What is the best thing about owning your own business? The worst? What surprised you most?
The best thing about having started Therapy Fun Zone is that it really stimulates my brain, and it keeps me inspired. The worst part is keeping track of the finances (not my thing). Most surprising is how much I love making therapy games, and that I enjoy website design. I am also surprised to find that I don’t like writing. My joy comes from creating, but then I have to write about it or no one else can benefit from what I have created.
What are some tips that you could give to OT practitioners considering starting a business?
As far as advice about starting your own therapy blog, I say just do it. Either you love it or you don't, and you never know where it might take you. Specific blogging advice would take many many posts, so I will try to work on those over at Therapy Fun Zone. If you want to try your hand at creating products, come join me and open up your own shop at Therapy Fun Zone. You could try your hand at blogging by being a guest blogger too.
Either way, you must have fun.
Thank you Tonya for your insights! Very helpful information for our next era of OT bloggers and innovators! Be sure to check out all of Tonya's fun activities on her blog, facebook, or pinterest sites. And come back next week for our last interview of 2013!
11.19.2013
Entrepreneur Series: Paul Fontana, Center for Work Rehabilitation
I am very pleased to present the next interview in the OT Entrepreneur Month Series- Paul Fontana. This is an exciting moment for me since Paul is the first "OT celebrity" that I ever met, so it's great to be able to share this story. Paul is the owner of both the Fontana Center, a fitness center that offers OT and massage therapy; and the Center for Work Rehabilitation, a multi-functional industrial rehabilitation and consultation business. Read on for some great insights on starting a very unique business.
What was your background before starting your business? How did you take your first steps to starting a business? Did you have a mentor?
I was very fortunate to have worked for a private practice contract company in northern Indiana. The company would contract to provide OT / PT services to hospitals, schools, outpatient clinics, home health agencies, etc. Our owner, Mr Jack Gamet, RPT understood that the OTs and PTs that he hired did not go into therapy to run a business. So if he did not train his key people on basic business principles then he knew that his business and how to manage both people and the business that we would soon become unmanageable. So Jack purposefully decided not to accept one new contract for a year while he hired expert in the field of management to teach his select group of therapists how to become managers - they taught us strategic planning, goal setting, budgeting and financial planning, supervision and leadership skills training, program development and marketing / selling technique training, etc. I was fortunate enough to be one of the therapists selected to participate in this training.
As I developed the programs at 2 sister hospitals that I was the chief OT for, my immediate supervisor, Mr Thomas Cole, OTR brought me up into an area supervisory position where I was then charged with assisting other facilities with program development and growth. Under Tom’s leadership and growth I learned how to analyze a business potential objectively looking at my strengths and weaknesses from a critical standpoint, develop a business plan then analyze that plan critically to see if it would be worthwhile. This process of leadership development was quite successful as we eventually grew to have facilities in 9 different states.
As I progressed in the company I eventually became Director of Operations for the OT / ST divisions. As such part of my job was to look to the future and develop strategic plans to ensure the growth of the OT and ST programs offered by the company. In the early 1980’s managed care was just beginning to appear on the horizon and from where I was it appeared the goal of managed care had little to do with quality improvement and all to do with cost containment. And this centered around reducing the payment to the providers. At the same time Medicare underwent some significant changes that had the potential to adversely impact our business. As part of my job of looking to the future and trying to ensure that our company was strategically aligned to meet the changes on the horizon, I heard about this "new" concept in care that was being performed out in California – work hardening and functional capacity evaluations.
I traveled out to California and spent a significant amount of time visiting Dr Leonard Matheson (clinical psychologist) and Linda Ogden, OTR who were running the program. I became convinced that this was the future for OT for our company. This was an area of practice that centered around occupation and in my opinion was a perfect fit for OT. And no one was doing it in the 9 states that we had facilities. I brought this concept back to my owners (jack had sold out and there were now 4 owners) but they said that the company was in the medical business and they were not interested in expanding out into this area of practice. I decided that this was an area that I was interested in so I gave the company a 1 year’s notice and made plans to open my own clinic in this area of practice.
My time with Restorative Services and through the mentoring of Mr Jack Gamet, RPT, Mr Tom Cole, OTR and Dr Leonard Matheson I believe that I had the skills and knowledge base to venture out on my own into this new area of practice. Using the strategic planning / program development skills that I learned I was able to do market analysis in the states that I was interested in working thereby helping me to narrow down the state that I would eventually move to. Furthermore the fiscal management and budgeting training helped me to plan for the future as well as help both myself and my wife to feel comfortable with my decision .
Prior to my moved to Louisiana in 1986, Dr Carolyn Baum was very helpful in allowing me to spend time observing in the work hardening program that she had at Washington University in St Louis. In addition to this I spent several weeks working in south Louisiana meeting with potential referral groups (physicians, rehab nurses and medical case managers, vocational counselors), insurance company personnel and claims adjuster as part of the environmental analysis to see if my idea of the industrial OT programs would a) be reimbursed, b) whether there was any competition, and c) whether or not I could get referrals.
To this day I am convinced that without the mentors that I had that I would never have been able to develop the industrial programs and sustained the business that has served the communities in south Louisiana and Houston Texas where I have clinics for the past 27 years. I did not get an MBA but feel that with the executive management training that was provided by my company and the mentoring I had from both Mr Gamet and Mr Cole that I had the necessary skills to move forward with my own practice.
Nobody likes talking about money, but how long did it take for you to turn a profit/hire additional help/be able to quit your other jobs?
When my wife and I decided to open up our own business I did not have another job, nor was she working outside the home. She felt comfortable that I had done the preliminary work and that I could make this work before I announced that I was leaving my job as Director of operations. We did the budget to see what was the absolute least amount of money we needed to bring in to keep the roof over our heads and the family fed for the first year and were confident that we had enough in savings to get us through until revenue started coming in. Also, being an Occupational Therapist where I knew that if I needed to I could always do home health in the evening and weekends if I needed some additional revenue to keep us going until the business took off was a very valuable help.
When I opened the Center for Work Rehabilitation in 1986 I was the only employee. I not only did all the marketing but evaluated the clients, typed my own reports and performed all the rehab on the clients. It did not take me long before I realized that I could not make money at this by typing my own reports. Within the first 6 months I was in the black, paying all my bills, including paying myself enough to keep the roof over our head and food on the table. By the end of the first year I hired additional professional help to allow me to get out of the clinic to meet new customers, stay in touch with current customers and perform work on site to ensure growth.
With the ups and down of the business I have had years where I made more money as an OT than I ever imagined I would and other years where I paid my OT Technicians more than I took home, just to keep the business open. At one point my wife and I had to liquidate all the kids’ college fund monies we had set aside just to keep the doors open until the industry turned around, which thankfully it did.
What were some lessons that you learned in the initial stages of your business (first year, first five years)? Were there challenges that were difficult to answer during this time?
Having worked in a private practice environment before opening my own business I already was used to working long hours and even 7 days a week if need be. Therefore this was not something that I had to get used to. Luckily the business growth was close to what I predicted and my wife was able to stay home with our growing family. This was an important aspect of the growth and financial wellbeing of the company because as I was making inroads with industrial customers I would be called to travel to job sites, including to offshore drilling rigs, salt mines, and manufacturing facilities out of state where I would be working for multiple weeks at a time. Some of these requests were spur of the moment where I did not have time to preplan but rather had to be at a heliport in 4 hours. Had I not had the advantage of a supportive family this would have been extremely difficult.
The business model that I was developing was something the insurance industry as well as the physicians were not exposed to so I was starting from scratch to get folks to understand what I was doing and why. At times this was difficult.
Having grown up with ethical training (where my word and a hand shake was sufficient for work) had some drawback as associates I worked with took my idea and opened their own programs to compete against me. That was a challenge that I did not anticipate having. I was also surprised to have physicians directly and indirectly seek compensation for referrals – “what’s in it for me” was asked of me by several important referral sources. Another important referrer wanted me to train LPN’s how to do therapy then give him space in my clinic where he would send all his clients and my professional staff would provide the supervision. When I told him that I would not do this as I felt it was both unethical and illegal his response was, "I have 300 – 400 clients that I can send you".
Developing "partnership" with my industrial customers was a huge asset to my business. By becoming a critical part of their "fit for duty" program I had customers provide me with equipment needed for simulations, access to their training to improve my knowledge of their business, etc. At one point when I was unable to access my equipment nor facilities until the courts intervened, the Vice President of Human Resources for a major drilling company told me “I cannot run my business if you are not in business.” In 2 days I had use of an 8,000 square foot warehouse to use as my clinic. During another time when the price of oil dropped to such a low that made drilling in the Gulf of Mexico too expensive that companies stopped all hiring, one of the claims manager for a major drilling company asked me how this was affecting my business. I told him that business was so slow that I may not be able to stay in business. A week later I had a contract to travel offshore and develop 31 physical job descriptions for this company. The claims manager told his boss that they needed to make sure that I stayed in business because when they needed me to rehab their employees, I needed to be there.
What is the best thing about owning your own business? The worst? What surprised you most?
It allows me to set my agenda professionally, to devote time and energy on giving back to the profession. I did not have to get approval from anyone to spend the time / energy to become actively involved with the Louisiana OT Association (President for 4 years), AOTA (Region III PAC Chair then AOTPAC Chair followed by a term as a Director on the Board then Secretary to the Board of Directors). I enjoy the opportunity to work with business and industrial customers who are generally only interested in results. Being able to go on site, help them with problem resolution and implementation is what I like best. That and this work allows me to do a fair amount of teaching which I really enjoy.
Worst can be the lost family time. Working with industrial customers as a private individual you have to be there when they call or they may go elsewhere. There were vacations that I missed because of a job request or because a therapist I had working for me quit so I now had to miss the vacation to cover in the clinic.
Also, having continual staff turnover. Many of the OTs that work with me stay 1 ½ - 2 years then leave to work in the hospital, out patient clinics or nursing home for fear that they are losing their “treatment” skills. That certainly is true. Having worked in this industry for 27 years I cannot imagine how to treat a stroke patient or a pediatric client. However I have skills that others do not have. But trying to find clinicians to work in a non-climate controlled environment doing industrial fit for duty programs and not having to retrain every 2 years has been tough.
What are some tips that you could give to OT practitioners considering starting a business?
- First and foremost have a mentor. Not only regarding business management but therapy skills management
- Be ready to devote the time and energy it takes to make it work
- Be sure to do a good objective market analysis and self analysis of your skills and abilities before hand
- When planning financial areas, although you need to be realistic, be extremely conservative regarding revenue generation and high on cost expectations. If you can make it during the worst case predictions you will be ok. If not, you may need to re-evaluate. Things beyond your reach of influence will occur.
Thank you so much Paul for your detailed responses! Great wisdom regarding mentorship, needs assessment, and preparedness. You can learn more about the business at the Fontana Center Website - http://www.fontanacenter.com/
What was your background before starting your business? How did you take your first steps to starting a business? Did you have a mentor?
I was very fortunate to have worked for a private practice contract company in northern Indiana. The company would contract to provide OT / PT services to hospitals, schools, outpatient clinics, home health agencies, etc. Our owner, Mr Jack Gamet, RPT understood that the OTs and PTs that he hired did not go into therapy to run a business. So if he did not train his key people on basic business principles then he knew that his business and how to manage both people and the business that we would soon become unmanageable. So Jack purposefully decided not to accept one new contract for a year while he hired expert in the field of management to teach his select group of therapists how to become managers - they taught us strategic planning, goal setting, budgeting and financial planning, supervision and leadership skills training, program development and marketing / selling technique training, etc. I was fortunate enough to be one of the therapists selected to participate in this training.
As I developed the programs at 2 sister hospitals that I was the chief OT for, my immediate supervisor, Mr Thomas Cole, OTR brought me up into an area supervisory position where I was then charged with assisting other facilities with program development and growth. Under Tom’s leadership and growth I learned how to analyze a business potential objectively looking at my strengths and weaknesses from a critical standpoint, develop a business plan then analyze that plan critically to see if it would be worthwhile. This process of leadership development was quite successful as we eventually grew to have facilities in 9 different states.
As I progressed in the company I eventually became Director of Operations for the OT / ST divisions. As such part of my job was to look to the future and develop strategic plans to ensure the growth of the OT and ST programs offered by the company. In the early 1980’s managed care was just beginning to appear on the horizon and from where I was it appeared the goal of managed care had little to do with quality improvement and all to do with cost containment. And this centered around reducing the payment to the providers. At the same time Medicare underwent some significant changes that had the potential to adversely impact our business. As part of my job of looking to the future and trying to ensure that our company was strategically aligned to meet the changes on the horizon, I heard about this "new" concept in care that was being performed out in California – work hardening and functional capacity evaluations.
I traveled out to California and spent a significant amount of time visiting Dr Leonard Matheson (clinical psychologist) and Linda Ogden, OTR who were running the program. I became convinced that this was the future for OT for our company. This was an area of practice that centered around occupation and in my opinion was a perfect fit for OT. And no one was doing it in the 9 states that we had facilities. I brought this concept back to my owners (jack had sold out and there were now 4 owners) but they said that the company was in the medical business and they were not interested in expanding out into this area of practice. I decided that this was an area that I was interested in so I gave the company a 1 year’s notice and made plans to open my own clinic in this area of practice.
My time with Restorative Services and through the mentoring of Mr Jack Gamet, RPT, Mr Tom Cole, OTR and Dr Leonard Matheson I believe that I had the skills and knowledge base to venture out on my own into this new area of practice. Using the strategic planning / program development skills that I learned I was able to do market analysis in the states that I was interested in working thereby helping me to narrow down the state that I would eventually move to. Furthermore the fiscal management and budgeting training helped me to plan for the future as well as help both myself and my wife to feel comfortable with my decision .
Prior to my moved to Louisiana in 1986, Dr Carolyn Baum was very helpful in allowing me to spend time observing in the work hardening program that she had at Washington University in St Louis. In addition to this I spent several weeks working in south Louisiana meeting with potential referral groups (physicians, rehab nurses and medical case managers, vocational counselors), insurance company personnel and claims adjuster as part of the environmental analysis to see if my idea of the industrial OT programs would a) be reimbursed, b) whether there was any competition, and c) whether or not I could get referrals.
To this day I am convinced that without the mentors that I had that I would never have been able to develop the industrial programs and sustained the business that has served the communities in south Louisiana and Houston Texas where I have clinics for the past 27 years. I did not get an MBA but feel that with the executive management training that was provided by my company and the mentoring I had from both Mr Gamet and Mr Cole that I had the necessary skills to move forward with my own practice.
Nobody likes talking about money, but how long did it take for you to turn a profit/hire additional help/be able to quit your other jobs?
When my wife and I decided to open up our own business I did not have another job, nor was she working outside the home. She felt comfortable that I had done the preliminary work and that I could make this work before I announced that I was leaving my job as Director of operations. We did the budget to see what was the absolute least amount of money we needed to bring in to keep the roof over our heads and the family fed for the first year and were confident that we had enough in savings to get us through until revenue started coming in. Also, being an Occupational Therapist where I knew that if I needed to I could always do home health in the evening and weekends if I needed some additional revenue to keep us going until the business took off was a very valuable help.
When I opened the Center for Work Rehabilitation in 1986 I was the only employee. I not only did all the marketing but evaluated the clients, typed my own reports and performed all the rehab on the clients. It did not take me long before I realized that I could not make money at this by typing my own reports. Within the first 6 months I was in the black, paying all my bills, including paying myself enough to keep the roof over our head and food on the table. By the end of the first year I hired additional professional help to allow me to get out of the clinic to meet new customers, stay in touch with current customers and perform work on site to ensure growth.
With the ups and down of the business I have had years where I made more money as an OT than I ever imagined I would and other years where I paid my OT Technicians more than I took home, just to keep the business open. At one point my wife and I had to liquidate all the kids’ college fund monies we had set aside just to keep the doors open until the industry turned around, which thankfully it did.
What were some lessons that you learned in the initial stages of your business (first year, first five years)? Were there challenges that were difficult to answer during this time?
Having worked in a private practice environment before opening my own business I already was used to working long hours and even 7 days a week if need be. Therefore this was not something that I had to get used to. Luckily the business growth was close to what I predicted and my wife was able to stay home with our growing family. This was an important aspect of the growth and financial wellbeing of the company because as I was making inroads with industrial customers I would be called to travel to job sites, including to offshore drilling rigs, salt mines, and manufacturing facilities out of state where I would be working for multiple weeks at a time. Some of these requests were spur of the moment where I did not have time to preplan but rather had to be at a heliport in 4 hours. Had I not had the advantage of a supportive family this would have been extremely difficult.
The business model that I was developing was something the insurance industry as well as the physicians were not exposed to so I was starting from scratch to get folks to understand what I was doing and why. At times this was difficult.
Having grown up with ethical training (where my word and a hand shake was sufficient for work) had some drawback as associates I worked with took my idea and opened their own programs to compete against me. That was a challenge that I did not anticipate having. I was also surprised to have physicians directly and indirectly seek compensation for referrals – “what’s in it for me” was asked of me by several important referral sources. Another important referrer wanted me to train LPN’s how to do therapy then give him space in my clinic where he would send all his clients and my professional staff would provide the supervision. When I told him that I would not do this as I felt it was both unethical and illegal his response was, "I have 300 – 400 clients that I can send you".
Developing "partnership" with my industrial customers was a huge asset to my business. By becoming a critical part of their "fit for duty" program I had customers provide me with equipment needed for simulations, access to their training to improve my knowledge of their business, etc. At one point when I was unable to access my equipment nor facilities until the courts intervened, the Vice President of Human Resources for a major drilling company told me “I cannot run my business if you are not in business.” In 2 days I had use of an 8,000 square foot warehouse to use as my clinic. During another time when the price of oil dropped to such a low that made drilling in the Gulf of Mexico too expensive that companies stopped all hiring, one of the claims manager for a major drilling company asked me how this was affecting my business. I told him that business was so slow that I may not be able to stay in business. A week later I had a contract to travel offshore and develop 31 physical job descriptions for this company. The claims manager told his boss that they needed to make sure that I stayed in business because when they needed me to rehab their employees, I needed to be there.
What is the best thing about owning your own business? The worst? What surprised you most?
It allows me to set my agenda professionally, to devote time and energy on giving back to the profession. I did not have to get approval from anyone to spend the time / energy to become actively involved with the Louisiana OT Association (President for 4 years), AOTA (Region III PAC Chair then AOTPAC Chair followed by a term as a Director on the Board then Secretary to the Board of Directors). I enjoy the opportunity to work with business and industrial customers who are generally only interested in results. Being able to go on site, help them with problem resolution and implementation is what I like best. That and this work allows me to do a fair amount of teaching which I really enjoy.
Worst can be the lost family time. Working with industrial customers as a private individual you have to be there when they call or they may go elsewhere. There were vacations that I missed because of a job request or because a therapist I had working for me quit so I now had to miss the vacation to cover in the clinic.
Also, having continual staff turnover. Many of the OTs that work with me stay 1 ½ - 2 years then leave to work in the hospital, out patient clinics or nursing home for fear that they are losing their “treatment” skills. That certainly is true. Having worked in this industry for 27 years I cannot imagine how to treat a stroke patient or a pediatric client. However I have skills that others do not have. But trying to find clinicians to work in a non-climate controlled environment doing industrial fit for duty programs and not having to retrain every 2 years has been tough.
What are some tips that you could give to OT practitioners considering starting a business?
- First and foremost have a mentor. Not only regarding business management but therapy skills management
- Be ready to devote the time and energy it takes to make it work
- Be sure to do a good objective market analysis and self analysis of your skills and abilities before hand
- When planning financial areas, although you need to be realistic, be extremely conservative regarding revenue generation and high on cost expectations. If you can make it during the worst case predictions you will be ok. If not, you may need to re-evaluate. Things beyond your reach of influence will occur.
Thank you so much Paul for your detailed responses! Great wisdom regarding mentorship, needs assessment, and preparedness. You can learn more about the business at the Fontana Center Website - http://www.fontanacenter.com/
11.12.2013
Entrepreneur Series: Christel Seeberger of tOTal Ability
Today's entry in our ongoing series reflecting OT Entrepreneurs is Christel Seeberger of tOTal Ability, a private practice in Canada with a secondary online resource store.
Why did you decide to start your OT business?
I was an occupational therapist with almost a decade of experience in different countries (Canada and the USA) and a variety of settings with a clientele across the lifespan before starting my private practice in 2002. I decided to start my private practice while training to run a marathon. I run very slowly, so I had a lot of time to think! I thought a lot about occupational therapy and gaps that I saw in the public system. I was motivated to fill the gaps.
How did you take your first steps to starting a business?
I started small and really built the practice client by client. I sought out both formal and informal mentoring opportunities, many from women in business style entrepreneurial groups.
Have you found a benefit from social media marketing (twitter, facebook, blogging)?
Using social media is like learning a new language! What I appreciate the most about using social media is being connected with such a huge community of knowledge and leadership.
What were some lessons that you learned in the initial stages of your business?
A lesson that I am still practicing every single day is to say, “no”. It enables me to say, “yes” to something better in the future.
How long did it take for you to turn a profit?
One of my oft quoted personal and business mantras is, “only spend money you have, on things you really need”. So, I have always made a profit from day one, never spending more than I earn to grow the business
What was your original goal, the point that you aspired to reach and consider that you had “made it” as an entrepreneur?
Like many entrepreneurs, I started out creating a job for myself. My private occupational therapy practice ( www.totalability.ca ) has grown, now with 8 contract OTs on the team, and we provide mobile occupational therapy in three cities in our province. It was only when I started my second business, www.totalabilitysolutions.com which has downloadable eBooks with occupational therapy resources, activities and advice for parents, teachers, caregivers and professionals that I realized, I truly was an entrepreneur.
What is the best thing about owning your own business?
My worst day running my own business in private practice is still better than my best day in public practice working for someone else!
What are some tips that you could give to OT practitioners considering starting a business?
Do your research first! Not every idea you have is a good one. Be business smart. As occupational therapists, I think we always want to help. But when you make smart business decisions you get to help more people at the end of the day.
Thanks to Christel for participating in the series! Definitely some great advice on being business savvy and improving the OT world. Be sure to check out tOTal Ability around the internet to see great OT content!
11.05.2013
Entrepreneur Series: Chris Alterio and ABC Therapeutics
This entry in the OT Entrepreneur Interview Series is Chris Alterio of ABC Therapeutics, a pediatric private practice in New York state.
What was your tipping point to go into private practice?
I was a part time private practitioner since my entry into the profession. At first I did contracting and home health care in addition to my primary employment. I think that this is a very common entry point to private practice for many therapists.
Over time I learned that I enjoyed my consulting and contract work much more than work within institutions. Most of that likely has to do with my own sense of intrinsic control that I prefer to have over my work, and sometimes working within institutions felt somewhat stifling.
A tipping point for me came after a period of employment where I was very disenchanted with the power structure at my job. I was working in a hospital that was going through a merger and it was stressful in many ways. I disagreed with the strategic direction of the institution and of my supervisors and it was no longer a healthy 'match' for me. At that time I 'liberated' myself and began my private practice, which initially involved private pediatric home care. That is how ABC Therapeutics was started - 14 years ago!
I hired my first employee sometime in 2003. At one time I had nearly 25 employees, but I did not like the 'feel' of that as it seemed I was spending all my time with personnel management and contracts. I prefer the intimacy of the private clinic and home care - so now we do very little contracting and I have decreased my staff rather significantly. When I had a larger staff I felt like I was turning into a contract agency and that is not what drew me into private practice, so we refocused our efforts on outpatient clinic and home based care.
What was your original goal, the point that you aspired to reach and consider that you had "made it" as an entrepreneur?
My 'original goal' was to help families interact with their school systems and learn how to navigate their systems and advocate appropriately so their children could receive the most appropriate services. Families were seeking out private in-home care with me because they were dissatisfied with their school-based services. In the beginning I believed that I would spend 2-3 years educating families and helping school districts to appreciate what these families wanted - and then things would just be 'better' and there would no longer be a need for my services. That was incorrect thinking.
What I learned over time is that although the people working within these systems are generally kind and they generally have the best interests of the children in their hearts, the systems themselves are unwieldy and overly bureaucratic and in fact they are not always designed to be user friendly for parents. I am not sure why it didn't occur to me, but this was precisely why I wanted to leave institutional employment! So, it was a rather naive thought that I would 'fix' these systems from an external perspective when I couldn't even fix them from an internal perspective!
So after a while I came around to a new way of thinking, and that was that there were a lot of needs in the world and that it was my goal to help parents meet those needs no matter what the systems in place were. Sometimes that means working within those systems. Sometimes it means helping families doing things on their own. Each day that goes by is a reminder that the work will probably never be done, because each day the phone rings and it is new people calling.
With regard to measuring if I 'made it' as an entrepreneur, I never really consider it all too much. In honesty, at the end of each very long day I walk through my building and look around at the equipment and I remember the echoes of children's voices - and I actually just give thanks and say a prayer for how blessed I am to be able to do this work every day. Those moments, at the end of each work day, kind of help me to keep things focused.
How did you take your first steps to starting a business?
I had some concerns about my ability to support my family and start what seemed to be a risky venture at the same time, so I took a position as academic fieldwork coordinator at a college and used that as a 'base' while my private practice grew. I was able to complete the fieldwork coordinator tasks on a part time basis and this gave me the flexibility to develop my business.
Early on in the process I learned a lot of information by trial and error. Over time I learned what I needed an attorney for, what I needed an accountant for, and what I needed marketing consultation for. I developed a network of other small business providers who in turn provided their expert services to me.
My early success was attributable mostly to the experiences I had previously in paid employment as a Supervisor. I already understood personnel management, and I had experience with billing systems, and I understood the care delivery systems that I was interacting with. With the help of consultants to guide and teach me about areas I did not know I was able to develop a solid base for my private practice.
After three years I was able to leave my position at the college and focus on the private practice full time. Also, at that time I returned to school for doctoral study. That experience was also instrumental in my professional development and I want to emphasize my appreciation for my doctoral program and the excellent faculty at Nova Southeastern University.
Have you found a benefit from social media marketing (twitter, facebook, blogging)?
I began blogging in 2005. In one of my first posts I wanted to express to whoever might be reading what starting a private practice was like. I was still struggling with the technology and quirky inconsistency of the format and I was unable to upload a picture that captured my feelings. This is what I wrote:
"I wanted to talk about private practice, and perhaps talk a little bit about what I went through in the last 36 hours, and perhaps talk about a broader desire to help other people get involved in private practice - but now that I can't upload my picture I am feeling a little deflated."
It was of Thelma and Louise, flying over a cliff, preferring to face death than capture. That is kind of what entering private practice is like. I am not sure how important my blog was for promoting my practice specifically. In many ways I think the blog is more widely read and considered by OT colleagues, and in fact that is mostly who my topics are intended for.
I did not start social media marketing until 2009 and by that time my private practice was fully established. Again, I do not know if social media marketing was directly responsible for reaching an audience about my practice. Rather, I believe that what happens is that if someone Googles 'ABC Therapeutics' then they see a heavy web presence. That may matter to some people - and if so - then I suppose that social media marketing is helpful in that regard. Actually, I think that more traditional print and other media has been most effective for direct marketing of my business. Social media is supportive.
What is the best thing about owning your own business? The worst? What surprised you most?
The best: The ability to serve. My 'bosses' are the families. I get to tell kids daily - "YOU are the boss of ME!"
The worst: Financial concerns, payroll, cash flow management, frighteningly high account receivables, and of course the uncertainty of health care in general these days.
Surprising: My ability to very effectively manage the worst parts of it successfully!
What are some tips that you could give to OT practitioners considering starting a business?
Every day brings new lessons. Every day is an opportunity for more learning and more growth. If I learned anything early on, it was that I need to learn lessons every day. I think that when I first started I didn't realize that.Continue your education, every day. Identify a passion, believe in it, and live it. Finally, don't be afraid of holding tightly onto the things you believe in and speeding over a cliff.
Thank you so much Chris for your story! Please be sure to check out the ABC Therapeutics online world including great blog entries from Chris.
ABC Therapeutics Website!
ABC Therapeutics Blog!
Like ABC Therapeutics on Facebook!
What was your tipping point to go into private practice?
I was a part time private practitioner since my entry into the profession. At first I did contracting and home health care in addition to my primary employment. I think that this is a very common entry point to private practice for many therapists.
Over time I learned that I enjoyed my consulting and contract work much more than work within institutions. Most of that likely has to do with my own sense of intrinsic control that I prefer to have over my work, and sometimes working within institutions felt somewhat stifling.
A tipping point for me came after a period of employment where I was very disenchanted with the power structure at my job. I was working in a hospital that was going through a merger and it was stressful in many ways. I disagreed with the strategic direction of the institution and of my supervisors and it was no longer a healthy 'match' for me. At that time I 'liberated' myself and began my private practice, which initially involved private pediatric home care. That is how ABC Therapeutics was started - 14 years ago!
I hired my first employee sometime in 2003. At one time I had nearly 25 employees, but I did not like the 'feel' of that as it seemed I was spending all my time with personnel management and contracts. I prefer the intimacy of the private clinic and home care - so now we do very little contracting and I have decreased my staff rather significantly. When I had a larger staff I felt like I was turning into a contract agency and that is not what drew me into private practice, so we refocused our efforts on outpatient clinic and home based care.
What was your original goal, the point that you aspired to reach and consider that you had "made it" as an entrepreneur?
My 'original goal' was to help families interact with their school systems and learn how to navigate their systems and advocate appropriately so their children could receive the most appropriate services. Families were seeking out private in-home care with me because they were dissatisfied with their school-based services. In the beginning I believed that I would spend 2-3 years educating families and helping school districts to appreciate what these families wanted - and then things would just be 'better' and there would no longer be a need for my services. That was incorrect thinking.
What I learned over time is that although the people working within these systems are generally kind and they generally have the best interests of the children in their hearts, the systems themselves are unwieldy and overly bureaucratic and in fact they are not always designed to be user friendly for parents. I am not sure why it didn't occur to me, but this was precisely why I wanted to leave institutional employment! So, it was a rather naive thought that I would 'fix' these systems from an external perspective when I couldn't even fix them from an internal perspective!
So after a while I came around to a new way of thinking, and that was that there were a lot of needs in the world and that it was my goal to help parents meet those needs no matter what the systems in place were. Sometimes that means working within those systems. Sometimes it means helping families doing things on their own. Each day that goes by is a reminder that the work will probably never be done, because each day the phone rings and it is new people calling.
With regard to measuring if I 'made it' as an entrepreneur, I never really consider it all too much. In honesty, at the end of each very long day I walk through my building and look around at the equipment and I remember the echoes of children's voices - and I actually just give thanks and say a prayer for how blessed I am to be able to do this work every day. Those moments, at the end of each work day, kind of help me to keep things focused.
How did you take your first steps to starting a business?
I had some concerns about my ability to support my family and start what seemed to be a risky venture at the same time, so I took a position as academic fieldwork coordinator at a college and used that as a 'base' while my private practice grew. I was able to complete the fieldwork coordinator tasks on a part time basis and this gave me the flexibility to develop my business.
Early on in the process I learned a lot of information by trial and error. Over time I learned what I needed an attorney for, what I needed an accountant for, and what I needed marketing consultation for. I developed a network of other small business providers who in turn provided their expert services to me.
My early success was attributable mostly to the experiences I had previously in paid employment as a Supervisor. I already understood personnel management, and I had experience with billing systems, and I understood the care delivery systems that I was interacting with. With the help of consultants to guide and teach me about areas I did not know I was able to develop a solid base for my private practice.
After three years I was able to leave my position at the college and focus on the private practice full time. Also, at that time I returned to school for doctoral study. That experience was also instrumental in my professional development and I want to emphasize my appreciation for my doctoral program and the excellent faculty at Nova Southeastern University.
Have you found a benefit from social media marketing (twitter, facebook, blogging)?
I began blogging in 2005. In one of my first posts I wanted to express to whoever might be reading what starting a private practice was like. I was still struggling with the technology and quirky inconsistency of the format and I was unable to upload a picture that captured my feelings. This is what I wrote:
"I wanted to talk about private practice, and perhaps talk a little bit about what I went through in the last 36 hours, and perhaps talk about a broader desire to help other people get involved in private practice - but now that I can't upload my picture I am feeling a little deflated."
It was of Thelma and Louise, flying over a cliff, preferring to face death than capture. That is kind of what entering private practice is like. I am not sure how important my blog was for promoting my practice specifically. In many ways I think the blog is more widely read and considered by OT colleagues, and in fact that is mostly who my topics are intended for.
I did not start social media marketing until 2009 and by that time my private practice was fully established. Again, I do not know if social media marketing was directly responsible for reaching an audience about my practice. Rather, I believe that what happens is that if someone Googles 'ABC Therapeutics' then they see a heavy web presence. That may matter to some people - and if so - then I suppose that social media marketing is helpful in that regard. Actually, I think that more traditional print and other media has been most effective for direct marketing of my business. Social media is supportive.
What is the best thing about owning your own business? The worst? What surprised you most?
The best: The ability to serve. My 'bosses' are the families. I get to tell kids daily - "YOU are the boss of ME!"
The worst: Financial concerns, payroll, cash flow management, frighteningly high account receivables, and of course the uncertainty of health care in general these days.
Surprising: My ability to very effectively manage the worst parts of it successfully!
What are some tips that you could give to OT practitioners considering starting a business?
Every day brings new lessons. Every day is an opportunity for more learning and more growth. If I learned anything early on, it was that I need to learn lessons every day. I think that when I first started I didn't realize that.Continue your education, every day. Identify a passion, believe in it, and live it. Finally, don't be afraid of holding tightly onto the things you believe in and speeding over a cliff.
Thank you so much Chris for your story! Please be sure to check out the ABC Therapeutics online world including great blog entries from Chris.
ABC Therapeutics Website!
ABC Therapeutics Blog!
Like ABC Therapeutics on Facebook!
11.01.2013
Happy Entrepreneur Month!
It's been a long time since I've done an entry... definitely a lot going on it Cheryl-world. Though I haven't had a lot of time to sit and put my ideas to paper, I did take a page from my internet-pal Abby and will be running a series of interviews this month.
November is national entrepreneur month, and I want to take that time to recognize some super OTs who have braved the business world. Many people aspire to start a business or create the job that they truly want. I hope that the interviews this month will provide some inspiration to students and practitioners, and some guidance about what the "first steps" would be to get started.
Stay tuned for some terrific stories of OT success! A new entry each Tuesday of November plus extras thrown in!
November is national entrepreneur month, and I want to take that time to recognize some super OTs who have braved the business world. Many people aspire to start a business or create the job that they truly want. I hope that the interviews this month will provide some inspiration to students and practitioners, and some guidance about what the "first steps" would be to get started.
Stay tuned for some terrific stories of OT success! A new entry each Tuesday of November plus extras thrown in!
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