As the common business saying goes, "A rising tide raises all ships." The translation is that even businesses that are founded on weak fundamentals and business models can do well in a thriving economic climate.

Don't believe it? Take a look back at some of the dot-com millionaires that benefited from long-defunct entities like pets.com. But what about health care? Is health care recession-proof? Does a lowering tide have the same effect on all businesses?

Opportunity Knocking?

With the stock market causing more whiplash than car accidents and Congress bailing out Wall Street, there is little doubt that Americans are feeling less wealthy than they were just a few months ago. Over breakfast during the last economic recession, I was asked by one of the nation's premier health care CEOs as to what I thought the impact of a contracting economy has on our business. Here are some of the talking points.

In certain markets, there may be more opportunity. Consider workers' compensation for example. While the case could be made that there is less hiring due to rising unemployment, employers also have to make due with less resources. That means more overtime and more demand for productivity with the same number of workers.

Studies show many work-related injuries occur toward the end of shifts or into overtime due to attention lapses and fatigue. There have also been many that suggest that the sheer volume of claims increases with the increase in pink slips. Real cases or not, there is impact to physical therapists.

There is a tremendous opportunity that will likely come from this economic downturn. Physical therapists who focus on the occupational medical market have an opportunity to get closer to their clients by understanding their changing needs during these trying times.

By providing services that employers value, a strong rapport and relationship can be built that will pay off when hiring resumes and work forces start to grow again. Remember, the economy is cyclical and while things seem bleak right now, it won't stay like this forever.

Steady Demand

In the group health markets, the analysis becomes more complicated. In some aspects, demand for health care services will certainly rise because older workers who are forced from their jobs are unlikely to return to the workforce and are more likely to enroll in Medicare rather than fund their own health care insurance.

With the projected numbers of baby boomers getting ready to retire this coming decade, demand should be steady at the very least, if not elevated. What is interesting to note is the trend toward the demand. Home health care, for example, is expected to grow at more than 65 percent through 2014. It's a reasonable assumption that a good deal of those services will be physical therapy.

On the other hand, patients who have co-pays for each physical therapy visit may be more reluctant to keep scheduled appointments or even commit to a schedule. If they are out of work, co-pays may fall victim to other priorities including rent, food, gas and medicine. Again, this can represent some opportunity for therapists to build a reputation in their communities as a business that truly cares for its patients.

Clinic Growth

There are also economic forces at work here for the clinic as well. Is it better to get 50 percent of a co-pay or have an open appointment in the schedule? Therapists very well may be put in the position of some doctors who are frequently asked to just take what the insurance will give them and forgive the patients' obligations. These decisions are difficult and need to be made on an individual basis.

In analyzing the economy's impact on health care, it is comforting to know that while the revenue streams within each individual business segment may be impacted, the demand for health care workers remains strong.

Indeed, as of the writing of this column, the United States Department of Labor has reported that national unemployment is now 6.1 percent, marking an increase of 1.4 percent over the past 12 months. During that time, however, opportunities for health care professionals have continued to expand.

Perhaps the message to take away from this analysis is that when the general public can no longer afford the flat screen television or the lavish vacation, they will value health care as one of the most important financial priorities. So, is health care recession-proof? You tell me.

Brett Frankenberg has been a licensed practitioner for more than 11 years and has spent the past five years working full-time in industrial rehab and ergonomics. E-mail him at frankenzig@yahoo.com