|Author: by Dina Melchiorre|
|PT Reveals Key to Helping More Patients|
|Physical Therapy in 1983, Suzanne Balistreri, M.S.P.T., has experienced a variety of practice settings, from clinic employee to private practice owner. She overcame the challenges of managed care and all the other barriers that typically slow down or prevent successful practice ownership. Her determination to help as many patients as she could, doing it the way she knew she should, won out. Balistreri says the successful formula was her education, clinical experience, and her incisive management and marketing training. She now has three thriving practices in Wisconsin and helps an increasing number of patients every year.
I've always had a desire to offer patients the utmost in manual physical therapy," says Balistreri. After working as an employee in acute care, inpatient and outpatient rehabilitation practices, Balistreri entered private practice through ownership in a partnership, and then she went on to open her own practice, Balistreri & Associates, Inc., in Kenosha, WI. "I learned a lot of things the hard way, but I was energized by the thought of doing this myself. I want to let other therapists who are interested in the kind of practice I run know that it is not only possible, but extremely rewarding as well."
Balistreri's experience in these varied settings taught her not only what she would change when she would go out on her own, but gave her some idea of what she would need to learn to help her make her own practice a successful business. During the two-year stay with Spalding Rehabilitation in Denver, CO, she developed an interest in treating people with neurological and developmental problems, earned a certificate, and eventually got into management. "I was an outpatient coordinator, and was responsible for homebound and outpatient services. This position gave me a good background, and a variety of managerial responsibilities which provided me with experience to draw from for my work in private practice," she explains.
Her first taste of private PT work came when Balistreri's senior supervisor from Spalding went into private practice. Balistreri was eventually asked to step in to cover when this colleague was out on a maternity leave. "That practice was run by three exceptional women. It was a wonderful opportunity for me to get good experience in a private practice setting."
Balistreri opened her first office in May 1991 in Kenosha, WI. "I had a following of clients and a great staff who wanted me to continue," she recounts. "In a way, my private practice fell into my lap. There was no fore planning, no money, just a signature on a loan. I was very fortunate." She was determined to offer thorough care and quality hands-on manual techniques. "I really wanted to deliver care to my clients the way I felt it should be provided. I wanted to have the power of choice on how I practiced. I had worked in a variety of very good facilities before, but often I felt as though I wasn't able to treat patients the way I knew I could, since I felt rushed," she says.
Balistreri admits she's always looked for something more than being an employee, and believes there are other therapists who feel the same. One reason she wanted the private practice environment was her strong belief on how to treat clients. "I've always been manually-oriented with my services. I prefer a hands-on approach, and never enjoyed the concept of seeing a large volume of patients each day by only giving them a limited amount of my time," explains Balistreri.
"I remember what impressed me was an experience I had when I was working in a corporate clinical setting. I walked through the gym and saw at least five patients looking at me as if to say 'Am I next?'" Balistreri says she was opposed to the demands of seeing five patients per hour. "I always felt better about spending time with clients so I could do an excellent job." She says her present practices are designed to serve patients by working closely with them on their accomplishments.
She now remotely runs the three sites of Balistreri and Associates Physical Therapy, Inc. Her clinical staff is made up of nine physical therapists and two PTAs. There are approximately 34 support staff that round out the teams at the sites. The major focus of her facilities is manual physical therapy services. "We also specialize in treating patients who have had previous treatment with no results, and often see patients with chronic pain and other involved cases. About 99 percent of our cases are orthopedic, and we like to treat complicated cases," she explains. "All my therapists and I have a love for manual therapy rather than the use of modalities."
Only 330 patients are seen each week at all three of her rehabilitation offices combined. "That's not a lot in comparing these numbers to the demands of some larger clinical operations," Balistreri says, "But now that we know how to handle managed care organizations and insurance companies we don't have so much attention locked-up in the problems of reimbursement. We spend more time helping our patients. We operate with one PT seeing each patient on a consistent basis," she continues. "They all have one-half to one hour of treatment time to spend with each client."
Raising consumer awareness is also a goal of Suzanne's private practice. "I believe we need to be on the forefront in assessing our clients' needs for service and educating our clients regarding their insurance, coverage of services, and options they may have if the services are not covered under their insurance plan." She says patients are receptive to this approach, noting that her offices are seeing more private pay patients who are making choices about their services and not being solely directed by what or whom their insurance carrier will reimburse.
"As a physical therapist and owner I am in remote management - which means that I operate my business from an 'arms length' position. I am not in my offices on a day-to-day basis. I oversee all of my sites from my home office," she delights. "I do treat patients on a fill-in basis or a patient schedule will be booked for me." This management method has worked well for her, both in her career and in her private life. Suzanne is now able to home school her four children.
Balistreri says that her success in being able to achieve her practice goals and create the lifestyle she dreamed about, was the result of teaming up with a business consultant. She found Survival Strategies, Inc., one of the country's largest management and marketing consultant companies, who focus on physical therapists and other healthcare professionals. "Our training with their seasoned consultants gave us the tools to organize and expand stably. We now have a great team who all pull together and love what they do," Suzanne explains.
Balistreri entrusts her practices success to a management team made up of Executive Director, Administrative Director, Clinical Director, and Marketing Director. She says these positions represent an "Executive Council" who oversee the goals and progress of the whole company. The members of this council have juniors at the practice level who manage day-to-day functions.
Suzanne says she allows the management and clinical staff to come up with innovative programs and practices. "My most fun and greatest pleasure is fostering creativity among the staff," she says. "If the staff or I want to be creative, I promote that. I want our practice to be pro-active and offer services that will best suit our clients' needs."
Managing remotely has afforded Suzanne the ability to plan future expansion for her practices. "I have the time now that enables me to take advantage of opportunities that can enhance our quality of service and increase the stability of the business. This has come about only because of the training and consulting I've received from Survival Strategies," she explains. "That is how I've learned to develop the framework on which our business is organized, and how to produce codified data so I can evaluate and make effective decisions."
Part of the expansion Balistreri mentions includes the purchase of a Body Balance for Performance franchise housed in her Waukesha office. Body Balance for Performance is the first-of-its-kind golf health and fitness program. Paul Callaway, PT, (first Director of Physical Therapy for the PGA Tour), co-founded Body Balance for Performance with the principals of Survival Strategies four years ago. To date there are over 70 licensed centers across the U.S. and Canada that deliver fitness programs to golfers at all levels. Balistreri says how a golfer's "most important piece of equipment is his body." She says the focus of the program is working with golfers to improve their physical structure and function which results in improved performance.
Along with her many successes, Balistreri says one of her greatest challenges is, "to not become too affected by the managed care system; while at the same time keeping up with a dynamic creative staff and the growth of our practices."
While her practices follow appropriate guidelines, she is glad that she has not joined multiple HMO and PPO groups. "I had some ethical and philosophical differences with being told that I could only see clients for three or so visits. I knew with limits such as this I could not provide complete care to my patients or meet their needs."
In her 17 years as a Physical Therapist, Balistreri has observed significant changes in the field. She says she understands how a career in PT may not seem as rewarding as it did in the 1980s. "I have met PTs who are looking into other careers such as personal training, alternative medicine, massage therapy, etc. There have been changes in healthcare that have dampened Physical Therapists' creativity and good intentions." Balistreri would like to put considerable energy toward supporting the profession by sharing good news with fellow physical therapy practice owners that there are tools available to help PTs remain independent and improve their businesses. "You can help more patients if you have the know-how to handle the considerable problems related to managed care." "One of the most important things I can share with my fellow PTs is that there is a way to own a successful practice while treating patients as you see fit. The key is to learn and use the tools that are available," she emphasizes. "Best of all, you don't need to sacrifice family or personal life to do it!"
Suzanne Balistreri earned her Bachelor of Science Degree in Physical Therapy from Marquette University in 1983. She received her Masters of Science Degree in Human Kinetics/Exercise Physiology and Motor Control from the University of Wisconsin, Milwaukee in 1996, and is a graduate of management and marketing training from Survival Strategies, Inc. in La Crescenta, CA.
Dina Melchiorre is a freelance writer from the Philadelphia area. She is on the Editorial Staff of NEWS-Line for Physical Therapists and PT Assistants.