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!

1 comment:

Your Therapy Source Inc said...

Wonderful read. Can't wait to see the rest in the series. Would love to hear from an OT inventor. Occupational and physical therapists are so lucky. There are so many avenues to work all in one field, whether it be direct services, consultation, business owner or entrepreneur. There are not many occupations that can accomplish so much in so many different domains. Not to mention, each can be accomplished with babies, teens, adults or the aging population!