HOW TO START A PHYSICAL THERAPY CLINIC SIDE HUSTLE - THE ULTIMATE GUIDE
Are you tired of working in a high volume clinic?
Do you want to work with highly motivated, compliant patients?
Do you have a mountain of student debt from getting your degrees?
Would making an extra $2000 a month make a meaningful difference in your life?
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If you answered yes to these questions, you need to take a serious look at this guide on how to start a physical therapy clinic. We also have this blog post and podcast on starting a side hustle!
This guide is intended to empower you with all of the information needed to get a successful side hustle practice up and running.
The only thing I can’t do...
...is do the work for you. That’s the part you will have to do and honestly, it’s the hardest part.
This brings us to the first and most important decision you need to make.
Are you willing to learn, implement and challenge yourself? There are going to be challenges (even the seasons challenge you in this game; learn how to master them here).
If the answer is no, reading the rest of this guide won’t help you.
CONTENTS
 CHAPTER 1
TAKE THE FIRST STEP
In any business venture, you’re going to get turned down and things will not work out exactly as you planned them. The key is to be willing to learn and grow past those failures in order to ultimately get where you want to go.
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This cannot come from someone else. This has to be a deep desire to want to succeed. Some would call it a rage to succeed that can board on being unhealthy. But if you make up your mind and honestly believe that you can accomplish this, you’ll succeed. If overcoming fear is a problem check out this blog post.
As Yoda once famously said “Do or do not. There is no try.”
If you're ready to succeed and have a positive mental attitude, let’s get into how to start a successful side hustle.
If you aren't and need some motivation to get off the fence check out this podcast and blog post.
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5-Day Challenge
The first recommendation I have in how to start a physical therapy clinic is to go through our free 5 Day Challenge.
This is full of downloads and documents to get you highly organized in your journey to a successful side hustle. It will help you create the financial clarity you need as well as creation of a one-page business plan. Again, this is totally free. All you have to do is click the link below to get signed up.
Sign-up for the 5-Day Challenge Here
Find more info on the 5 Day Challenge in this podcast or blog post!
Once you’ve done that, let’s get into one of the most important elements of your side hustle….your niche.
CHAPTER 2
YOUR NICHE
Have you heard the phrase the riches are in the niches?
This is totally true, especially with a cash-based practice.
It is very hard to gain traction in a cash physical therapy practice by being a generalist. If you want to be pretty good with all types of injuries/niches, you are going to have a pretty slow business.
You need to decide what you want to be known for in your area and build your practice around that.
Let’s say you love baseball. You played growing up and you even coach local teams.
If you want to be the baseball person in your area, you have to narrow down your efforts to that specifically.
Sure you could help swimmers and other overhead athletes with similar arm problems but if you try to do that early, you will slow yourself down.
You’ve got to get ultra clear on your niche. In order to do that, you need to write down everything about this niche.
Here’s an example in regards to a baseball avatar. An avatar by the way is an example person that you are marketing to for your specific niche.
 Avatar example:
Name/Description- Tommy John. 16 year old male. Pitcher. Huge Atlanta Braves fan. Plays in a competitive travel league and for his high school team.
Goals-
-Gain more velocity and throw harder.
-Strike more people out.
-Get a college scholarship.
-Parents- want him to stay healthy but also get a college scholarship because they’ve paid a ton of money for coaches, teams and travel up to this point.
Fears-
-Career ending injury.
-Plateauing while his peers are continuing to get bigger and stronger.
-”Wearing out his arm” and losing velocity/speed.
-Not getting a college scholarship.
-Getting cut from travel team or school. This alienates him from friend groups and decreases chances of a scholarship.Â
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Congregation points (aka where you can find more people like him)-
-Travel teams
-Pitching coaches
-High school coaches/ATCs
-Baseball websites
-Baseball Facebook groups
-Instagram/Tiktok for Johnny and Facebook/Instagram for his parents
-Local showcases
If you really know this person, you can create an entire paragraph about their traits and interests. I highly recommend doing this for any niche you choose to pursue. Here’s an example...
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"Tommy John is a 16 year old male, right handed pitcher. He’s been playing baseball since he was 6 and has played year round since he was 12.
His favorite team is the Atlanta Braves and he models his pitching style after John Smoltz.
For the past year, he’s had on and off shoulder and elbow pain.
These bouts of pain have caused him to miss pitching in some important games.
His parents are his biggest fan and provide any support he needs to stay healthy and get better at his sport.
He works with a pitching coach once a week to fine tune his mechanics.
Even with this additional work, he still suffers from ongoing shoulder and elbow pain.
His parents are concerned his arm will require surgery and Tommy is concerned he will miss games if his arm keeps bothering him.
His parents spend thousands of dollars a year on coaches, travel teams and showcases to help Tommy get the most exposure to college scouts.
He’s fearful that he will get cut from his travel team if he cannot throw enough innings. Not only would this decrease his exposure to colleges but most of his friends play on this travel team."
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Here’s what I want you to take away from this example. If you really know your niche, you know all the right verbiage to use and you can verbalize their fears/frustrations as good if not better than they can.
If you can explain someone’s problem better than they can, you instantly become the likely solution to their problem!
This can be true for any niche, not just baseball.
Take some time to think through and write out your avatar. (If you find yourself a little time poor check out this podcast episode.)
Everything you do from here will be tied back to the niche you decide you want to dominate in your area.
Now that we know who you want to work with, you need to take care of some of the boring business stuff...
CHAPTER 3
GET LEGAL
Now that we know who you want to work with, you need to take care of some of the boring business stuff.
We can’t avoid these things if we want to do the fun parts of building a side hustle.
At a minimum, here are the things I recommend to start a physical therapy clinic.
1. Form an LLC
You may need to form a PLLC in certain states but it’s basically the same thing. An LLC is a legal entity that provides some protection to you personally. It’s very easy to set up and requires minimal work to keep up.
The easiest thing to do is hire a Certified Public Accountant (CPA) to file one for you, but you do need to choose wisely. This will cost you a little more than doing it yourself but at least you know it’s going to be done correctly.
If you want to save a couple hundred dollars, you can also do it yourself.
Sites like LegalZoom and RocketLawyer allow you to form an LLC by yourself.
Either way, forming an LLC is something worth doing early on, especially if you have a goal of growing this into a full time practice.
2. Review Your Practice Act.
The law still applies to cash-based practices! You cannot just do whatever you want just because you aren’t taking insurance directly.
Take a look at your practice act and familiarize yourself with it. There will be certain things you can and cannot do depending on your state.
If you are unsure of what you can and cannot do, reach out to your local APTA chapter. They can be very helpful when it comes to answering state specific practice act questions.
If you want to take it a step further, figure out who that APTA chapter uses for legal help. Hire that attorney to review the practice act with you for an hour. This can be a great use of your time and money because that attorney will be able to answer all your practice act questions.
3. Get Malpractice Insurance
You will want to secure some malpractice insurance for yourself. The good news is, people don’t sue clinicians that often so it’s pretty cheap.
You can go through many different organizations like HPSO or even your local State Farm agency. They are all pretty similar from what I’ve seen, just make sure you have coverage before treating people on the side.
4. NPI Number
You should already have one of these if you’ve been practicing. If you’re a new grad, make sure to get an NPI number for yourself at the link below.
https://nppes.cms.hhs.gov/#/
You do not need an NPI number specifically for your practice if you are cash only. If you’re going the hybrid route and will take some insurance directly, you will need an NPI for your practice.
5. Local Business License
5. Local Business License
Your state and local city/county are going to want their cut of all your success!
Make sure to head to your city tax office and get set up with a local business license.
You may even be able to do this online and not have to set foot in the tax office.
The tax for local businesses is typically very minimal. It’s tempting to skip this step but don’t, you do need a business license.
If you’ve made it past all of the insurance, practice act and business license crap, I commend you! Those steps stop many people from starting a business. Now you can really start to gain some momentum.
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CHAPTERÂ 4
MAKE MONEY
So now that you’re official as hell with your LLC, business license and insurance, you’re ready to make some cash!
It’s important to at least be able to project what you can make from this new venture.
If you want in depth resources that will help you with this, I recommend going through our free 5 Day Challenge. You can click the link below to get started.
https://www.physicaltherapybiz.com/challenge
Let’s start with some simple math.
 The price you charge per visit X The number of visits you see per month = Your revenue per month
Here are some example numbers.
$150 a visit X 20 visits per month = $3000
$150 a visit X 40 visits per month = $6000
This equation is really easy to use and you can change the amount you charge and how many people you see per month.
All you really need to do is set an amount you want to make each month and reverse engineer how much you want to charge. That will give you the target number of people you need to see. Once you are making money, make sure you are managing your finances properly. Check out this podcast!
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Pro Tip!
The more money you charge per visit, the fewer number of visits you need per month to hit your revenue goal. To get your revenue goals started on the right foot follow this plan.
If you charge $200 a visit, you can make $2000 a month in just 10 visits.
If you charge $100 a visit, you need 20 visits to hit that same $2000 a month goal.
The clients we work with charge on average between $150 and $300 per hour long visit. This depends on their area and the niche they serve.
If you are below $150, you will have a very hard time making your side hustle your full time occupation. Another great place to learn about pricing is in this podcast or blog post!
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Ok, now that you have your business organized and you know what you need to charge, you need to find a spot to see people.
CHAPTER 5
LOCATION
We have to find a location but the location has to match up with your niche.
Think about it for a second. If you are trying to dominate the baseball niche in your area, do you want an office that’s in a pilates studio?
It might work out but I sure would prefer an office in a baseball performance facility or at least a sport training facility.
On the flip side, if you want to do performance based women’s health work, a baseball training facility is probably not the spot you want an office in. That pilates studio would work out a lot better for the women’s health niche.
Search online in your local area for facilities that are complementary to your niche.
For the baseball example, search for baseball training facilities, sports performance facilities and gyms. You may also be able to find travel teams that have their own facilities but that’s less likely.
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Make a list of 3-5 options that would work for your physical location.
Once you have these, try to figure out if you have any warm connections with these facilities. Getting an introduction from someone else can dramatically help the likelihood of getting a meeting with one of these facilities.
If you don’t have any warm connections, try and message these facilities via social media or email. The goal should be to set up a meeting with as many options as possible.
You’re looking for access to equipment and ideally a closed office you can use intermittently during the week. (If you can buy your own equipment check out this strategy)
For a true side hustle, you’re really looking at 10-12 hours a week max of patient care. If you have that kind of availability, you can create a pretty solid side hustle.
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Here are the keys with any space you look at:
1. The Owner/Landlord
Many side hustle cash-based practices have been ruined by poor relationships with the facility owner. You want to look for someone who is professional and views you as an asset, not just someone that can offset their rent.
Never agree to give part of your business to a facility owner in exchange for free rent. I have seen this happen on quite a few occasions so please don’t do this. Your business is valuable, do not just give it away.
2. Cheap/Free If Possible
Many people are happy to just have a clinician involved in their facility. This gives credibility to the facility and team. If you’re lucky, you might be able to get a spot with free rent.
3. Sublease or Amount Per Client
If you’re very confident in your side hustle, try and negotiate a sublease rental agreement. This will set your rent at a specific amount each month. Let’s assume $500 for subleasing an office.
The other option you have is an amount per client. Let’s assume $40 per client that you see. In this example, you would have to see about 12 clients to hit the $500 fixed sublease amount.
If you see 20 patients in a month at $40 per client, you end up paying $800 a month.
The amount per client option can be appealing but if you’re successful, you will end up paying more.
Try and go for the fixed amount if you can swing it financially.
4. Location
A location that’s convenient to your target audience can be a huge benefit. This saves them time and makes it more likely that they will come and work with you.
If you pick a location that’s hard to get to, it will decrease your patient volume.
Even if it’s more expensive, I would typically recommend picking the better location if possible.
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Need More?
Do you need more insight on whether you should rent or own your clinic space? Check out this podcast and blog post!
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Before we go on, you do have one other option... mobile.
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I typically discourage people from this route for a few reasons.
1. You waste a lot of time driving around. (8-12 hours a week in many cases)
2. It’s hard to convince people to come see you once they are used to you coming to them.
3. It is very hard to scale a mobile practice past yourself unless you are in a very population dense area.
If you are able to, I highly recommend looking for a subleased office over going mobile.
I’ve helped enough frustrated mobile practitioners pivot to stand alone spaces and I hope I don’t have to do the same with you.
So you’ve decided on your niche and you’re all set up with legal, insurance, a business license and now you’ve got your location. The next big hurdle is getting people to come and see you/pay you.
CHAPTERÂ 6
SALES AND MARKETING
This is all about sales and marketing.
If you really want to take a deep dive into this area specifically, I recommend checking out our Clinical Rainmaker Coaching Program. You can find more info on this program at the link below.
https://www.physicaltherapybiz.com/ptbiz-clinical-rainmaker
Marketing is what gets them in the door and sales is what gets them to pull out their credit card. For another great resource on Marketing check out this podcast and blog post! If your emphasis needs to go toward sales, check out these resources: podcast and blog post.
You need both of these skills to have a successful side hustle and especially if you decide to grow your business into your full time career.
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Here are the marketing strategies I recommend side hustle cash-based practices start using. There are many other more advanced options but I do not recommend starting there. Keep it really simple. You are going to be busy working a full time job and trying to grow a side hustle. Stick to the basics first.Â
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1. Leveraging Friends/Family Relationships.
If you are from the area where you are starting your side hustle, this is a big advantage. You have built in referral sources. Make sure to let your friends and family know what you’re doing. Let them know who you crush it with and who they should send your way.
The last thing they want to do is see you at Christmas and hear about your failed cash-based practice side hustle. They want to see you be successful but you have to ask them to help.
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2. Become Part Of A Community
If you’re going to be the baseball niche guy in your area, you need to be involved with baseball locally. Start coaching, start being an umpire, go to local games and get to know the local coaches/league directors. It will help you grow a reputation and set you apart when starting out.
Being a part of a community that you can uniquely help gives you a massive advantage over everyone else.
You cannot sit in your office and just expect people to knock down your door to work with you. You gotta go out and find your perfect clients!
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3. Workshops
If you can teach something that helps other people, that’s valuable. Workshops are a great way for you to educate small to medium size groups of people.
Once you’ve established yourself in the community you want to serve, you’ll have a much easier time finding places to put on workshops.
If you enjoy teaching, this one marketing technique can build you a sizable practice.
Workshops alone helped me grow from 0 new patients a month to 15 new patients a month by month 6 when I started my practice. Pick the fastest horse for you and hang on tight!
 4. Content
Share your thoughts with other people. I’m literally doing this right now!
Think about this. If you find this blog post helpful, I am probably gaining a bit more of your trust. You may also be thinking to yourself that I sound like I might know what I’m talking about. This is great, my plan is working and eventually you’ll become a client so we can truly help you!
The exact same thing can and will happen when you start sharing your unique knowledge in content for your avatar.
Let’s say you’re great at bulletproofing a pitcher’s arm. Share your philosophy, approach and unique techniques you like to use. Show your avatar just how knowledgeable you are in a manner they can understand. Keeping it simple is really important.
This content could be a blog post like this, a longer form video on YouTube, a short form video on Instagram or a detailed Facebook post. All the channels work, you just have to pick the one that you can stick to and start sharing your thoughts.
Just one of these marketing channels can get you to a successful side hustle. If you find you’re really doing well with one marketing channel like workshops for instance, double down on it and teach like crazy. Another great idea is to create a physical product. Physical products are a more tangible marketing strategy that gives people an idea what you can treat!
Learn more about content creation in this podcast and blog post!
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You have everything in place now and people are finally coming to see you in your side hustle cash-based practice. There’s one last step….you have to collect payment for your services.
CHAPTER 7
GETTING PAID
This may sound like the most awesome step, but I think it’s the most terrifying one for most clinicians.
Very few clinicians ever directly accept payment outside of cash-based practices. A front desk staff member or manager is usually doing that dirty work for you. This means most clinicians have a terrible relationship with money and are fearful to talk about what they charge.
This is something that you have to overcome. You have to be able to talk about what you charge as if it’s no big deal. Even better, as if it’s an absolute bargain compared to the value they will receive.Â
Here’s the most important elements of making the sales process in-office effortless.
1. No Surprises
Your new clients should know exactly how your practice is set up and what you charge. The last thing you want is someone showing up, going through a visit and then handing you their insurance card. I know, I’ve been there and it sucks!
Make sure people know you’re a cash-based practice and know what you charge before they come into your office. This should be done over the phone or as a last resort, via email. Don’t skip this step.
2. Find Out Why They’re Really There
Sure, they’re coming to see you because their back hurts. That’s the superficial reason. What we want to know is the deep reason.
Their back hurts, which stops them from picking things up off the ground. They have a small child and small children live life very close to the ground! This person feels like they are unhelpful around the house and are putting an extra burden on their spouse because of their back pain.
The key is, this person is coming to see you because they want to be able to help their spouse out and pick their kids up. You must talk with them on that level and now just on the superficial level which is their back pain.
This is the biggest mistake clinicians make. They go into a nerd frenzy talking all about the diaphragm and how hip mobility limitations can cause increased shear loads in hinge patterns. The person that came to see you doesn’t care, they just want to be able to help pick up their kids. Give them the bare minimum medical jargon and really focus on the deep problem they are trying to solve.
3. Give Them Your Recommendation and Shut Up
Clinicians talk people out of a buying decision all the time. They ramble and give people too much information or too many choices.
Your goal is to figure out why they are having pain or limitations, explain that to them and then give them your recommendation for what it will take to fix it.
Once you’ve done that, shut up. Seriously, just stop talking and sit there.
Let’s go back to our baseball example for this one.
If I say “Tommy, it looks like you have rotator cuff tendonitis. This is common in throwing athletes but it’s not a healthy thing to just push through. If we don’t address this, it can lead to other problems in your shoulder or even elbow. In order to keep you throwing and even improve your velocity, we will need to see you once a week for the duration of the season, which is 12 weeks. After that, we can drop the volume down to 1-2x a month and really focus on building strength in that shoulder. That will allow us to add some velocity, get rid of the pain and put in the innings to get the college looks you’re hoping for next season. Tommy, do you or your parents have any questions?"
Please don’t try and highlight why you’re a cash-based practice and all the benefits that person will get because of it. Remember, they don’t care what you do or how you do it, they just want the outcome they’re looking for.
If you could sneeze on someone and their back pain went away, they would pay you a lot of money to do so. Everyone is selfish and they just want to get their outcome. If they’re clear on what’s going on and that you can help them, they’ll pay to work with you.Â
To learn more about approaching people and also creating a great customer experience check out this podcast and blog post.
Having a discovery call in place before the visits will help with clarity and get you acquainted with each other to set the entire process off on the right foot.
Once you starting generating capital you can begin to leverage it!
 CHAPTER 8
CONCLUSION
That’s the basics of how to start a physical therapy clinic. To summarize, here’s what you need to do.
1. Figure out who you want to help and get very clear on what problems you need to solve with them.
2. Get you business ducks in a row with an LLC, insurance, your practice act, NPI and a business license.
3. Find an office to treat patients out of that ideally aligns with your niche.
4. Start marketing with the proven simple marketing strategies I went through in that section.
5. Solve their problem and sell them into the plan of care they need to get the desired outcome.
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Again, I highly recommend going through our 5 Day Challenge if you haven’t done so yet. This has a ton of great downloadable resources and video training to get you organized. Click the link below to get signed up for free.
https://www.physicaltherapybiz.com/challenge
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GET IN TOUCH
Lastly, if you would like to talk to one of our team members to get some customized guidance, we can do that as well. This is not a sales call and you couldn’t buy anything on this call even if you wanted to. This is just for us to help you take the next step in what could be a massive change in your life. The least we can do is talk to you about it and maybe share a resource or two that would be helpful.
If having a short conversation is something you’re interested in, click the link below to pick a time to talk to our team.
https://www.physicaltherapybiz.com/the-game-plan
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