Breakthru Physical Therapy & Fitness honored as Best PT Practice.

By Jennifer Romanchick

Need a physical therapist? Take a number. As baby boomers file into rehabilitation facilities with a laundry list of aches, pains and strains, clinicians are feeling the squeeze of too many patients, too little time. Combine this patient population spike with therapist shortages and fickle insurance regulations, and it's no surprise rehab centers are forgetting a crucial aspect of care — personal attention.

Lance Knaub, PT, DPT, OCS, CSCS, and his wife Jodi Goldman, PT, owners of Breakthru Physical Therapy & Fitness in Medford, N.J, have witnessed this transgression while working in various therapy settings. And it's what prompted them to start their own practice in 2004. "I became frustrated with the inability to utilize the physical therapy skills I developed, and provide the time and attention patients need to achieve good outcomes and have a positive physical therapy experience," Knaub says.

Knaub and Goldman envisioned a practice devoted to achieving top-quality outcomes for rehab patients, and providing personalized prevention and performance enhancement for healthy clients. Today their dream is a reality, and paying attention to customers' needs is what separates the practice from the rest.

As a result, Breakthru Physical Therapy and Fitness has earned the distinction as ADVANCE's Best PT Practice of 2007. Three judges, all physical therapists in private practice, gave Breakthru the highest combined score in categories such as revenue growth, recruiting/staff development, customer service and practice growth.

Smart Decisions

Breakthru's success is well earned. From the beginning, the couple laid the groundwork for a lucrative business.

"We chose our first location within a fitness center so we could sublet with small start-up costs," says Goldman. Though small, the space gave the practice access to the center's members, and facilitated a symbiotic relationship between medicine and health fitness. Fitness services are additional profit generators that are independent of third-party payers. This offering improves Breakthru's cash flow, increases its exposure to a broader population, and positions it as the provider of choice when fitness members need therapy.

Demographics also factored into Knaub and Goldman's location in New Jersey. The couple wanted to reach intelligent consumers who would recognize one-on-one time, evidence-based treatments and diverse offerings as superior quality of care. "We knew this type of community would see the value in what we would be providing and be willing to pay for it, if necessary," Goldman says.

To build its customer base, the company immediately began using direct access for clients seeking weight loss, massage, personal training and general fitness services. As word about the practice spread, massage therapists and personal trainers referred people with pain or functional problems to Breakthru for consultations. Staff conduct thorough systems reviews and medical screenings to determine whether physical therapy or a referral to a physician is the best plan of care.

Knaub feels that providing appropriate referrals and getting patients better quickly are among their best marketing efforts. "Patients appreciate our advocacy in navigating a [complex] health care system, where it's easy for them to get lost in the shuffle or simply get bad advice," he says. Satisfied patients are faster patients, which allows doctors to stay on schedule and be more profitable, he adds.

Customers First

Attracting customers is one thing; keeping them is another. Breakthru caters to clients' wants and anticipates their needs.

The practice schedules 30 to 60 minutes of direct patient care per visit, and offers early, late and weekend appointments. Customers are greeted by a decorated and designed environment that accommodates modern equipment and amenities without sacrificing intimate space for personalized attention.

On-site health and fitness experts include board-certified therapists who specialize in sports medicine, neurological movement disorders and balance, and arthritis and rheumatologic disorders.

Therapists work together with personal trainers, performance coaches, massage therapists and nutritionists to design comprehensive, evidence-based programs to reach health goals. Three personal training meetings are complimentary with fitness enrollment, and clients can choose one-on-one, partnered or group training.

In addition, the company's Web site receives more than 900 visitors per month, and provides patients with a convenient way to access facility and class information, schedules and staff biographies. The online store lets customers purchase cash-based services, such as yoga, tai chi and massage sessions from home.

"Absolute proof that we are meeting and exceeding our customers' expectations is the fact that we receive 50 percent to 60 percent of our patients through word of mouth referrals," says Knaub.

As a result, the practice is able to stand on its own merit without fee-splitting arrangements, physician ownership or other health system affiliations.

Nurturing Growth

Each year, Breakthru establishes projections and goals for the future. In the first 6 months of 2007, the practice increased monthly physical therapy visits by 148 percent compared to 2006, and achieved 71 percent growth in referrals. Instead of being discharged, Breakthru patients "graduate" and remain part of the practice through fitness services, events and educational newsletters, says Goldman.

Breakthru's recent expansion to a 6,000-square-foot, state-of-the-art center was also good for business. So good, in fact, that the company just opened its first satellite office to meet customer demands in other locations.

Breakthru's reputation continues to attract and retain experienced employees. A professional development coordinator helps cultivate and hire talented, diverse clinicians to meet the community's broad needs. To ensure its commitment to lifelong learning, Breakthru budgets for continuing education and devotes $1,250, plus time, for each therapist.

Sharing knowledge among staff and clinicians across other disciplines is equally important. Knaub and Goldman promote their practice and the profession by hosting evidence-based educational programs and conferences, participating in journal clubs and research projects, teaching at local universities and facilitating student internships.

Breakthru uses its burgeoning staff of experts to provide education to the public. Activities such as screenings, consults and massages at local races and events, and injury prevention seminars at senior centers, semi-pro and high school football games and women's health fairs showcase the practice's talents and draws new customers. Breakthru is also forming partnerships and strategic alliances with businesses, including spine care companies, running stores, yoga centers, karate studios, sporting good stores, private audiology practices and medical equipment companies to solidify its community presence.

Goldman admits that creating the infrastructure to support a growing organization has its challenges. However, the company has developed a systems and practice management philosophy that supports its customer-driven mission.

As a result, Knaub and Goldman haven't lost sight of their most important goal — helping patients get better faster through efficient, personal rehab regimens.

Jennifer Romanchick is associate editor of ADVANCE and can be reached at jromanchick@merion.com

Judges and Sponsors

Advance for Directors in Rehabilitation would like to thank the sponsors and judges of this year's 2007 Best PT Practice Contest.

JUDGES

Kevin McGovern, PT, CSCS

McGovern Physical Therapy Associates

Revere, Mass.

Tourage Rafeei, PhD, PT, OCS

Center for Physical Therapy and Sports Medicine, PC

Glen Allen, Va.

Ed Ramsey, DPT

Ramsey Rehab Inc.

Leominster, Mass.

SPONSORS

Healthcare Providers Service Organization (HPSO)

Hatboro, Pa.

ReDoc Software

Nashville, Tenn.

SpectraSoft Inc.

Tempe, Ariz.