Simply the Best

Center for Physical Therapy & Sports Medicine, PC, honored as ADVANCE's Best PT Practice.

By Tisha Nickenig

When Tourage Rafeei, PhD, PT, OCS, arrived in the United States from Iran in 1985 he dreamed of owning a physical therapy practice that would one day stand out among his peers.

A physical education and coaching background sparked Dr. Rafeei's interest in attaining a bachelor's of science degree in physical therapy in 1990, and then a master's degree in physical therapy in 1991.

"Being from Iran, I was trained to think high," says Dr. Rafeei. "The philosophy there is that in order to excel you must attain the highest educational background."

Being from Iran, he felt that he was at a disadvantage, which prompted him to obtain a PhD in combined physical therapy and anatomy in 1999. In 2001, Dr. Rafeei opened the Center for Physical Therapy & Sports Medicine, PC, in Glen Allen, Va.

Now, four short years later, Dr. Rafeei and the Center for Physical Therapy & Sports Medicine, PC, have been selected as ADVANCE's Best PT Practice for 2005. Dr. Rafeei's practice received the highest combined score from three judges, all physical therapists in private practices, in categories such as customer service, practice growth, revenue growth and recruiting/staff development. The Center for Physical Therapy & Sports Medicine, PC, treats a variety of different orthopedic conditions and concentrates on spinal disorders and sports medicine.

With his advanced degree, Dr. Rafeei believes he can look at the big picture during treatment, and he often tries to close the gap between researchers and clinicians. With experience in both areas, Dr. Rafeei can combine the two professional viewpoints. Specifically, Dr. Rafeei has extensive research experience examining muscles using different contractions, which enables him to apply a complex understanding of anatomy while treating patients. Clearly, it has translated into good patient care.

Just look at the results. From 2003 to 2004, the Center for Physical Therapy & Sports Medicine, PC, treated 49 percent more new patients; the clinic had a total of approximately 11,000 patient visits in 2004. The clinic has also enjoyed steady revenue growth over the years for an increase of 293 percent since 2001, says Dr. Rafeei.

Dr. Rafeei believes most of this growth stems from excellent customer service. "We never treat patients like a number," he says.

In fact, the desire to offer patients quality one-on-one care inspired Dr. Rafeei to open his practice after working at other prestigious clinics, such as the Texas Back Institute and Plano Sports Rehabilitation Center in Dallas.

"In the larger corporate practices, and even smaller clinics staffing more than two or three people, I found it difficult and time consuming to convince the chain of command to implement suggestions that would improve customer service," says Dr. Rafeei.

After researching how to start up a practice, Dr. Rafeei opened his doors in January 2001. Although he had plenty of experience and a strong vision, Dr. Rafeei faced two major challenges right away—convincing insurance companies to carry him and persuading doctors that he was a worthy referral source. He succeeded by sending these groups his curriculum vitae and highlighting his status as the only board-certified orthopedic physical therapist in the region with an advanced doctoral degree. Insurance companies, doctors and patients gave him a chance and Dr. Rafeei and his staff delivered successful treatment outcomes. In time, word spread that the Center for Physical Therapy & Sports Medicine, PC, was an ideal physical therapy setting.

One referring physician, Geoffrey B. Higgs, MD, established a relationship with Dr. Rafeei in 2001 and continues to send him a high volume of patients. "I trust Dr. Rafeei implicitly in caring for my patients for a variety of complex problems associated with patients recovering from sports injury," says Dr. Higgs, an orthopedic surgeon specializing in sports medicine at Advanced Orthopaedic Centers in Richmond, Va. "Overall, the patient satisfaction has been outstanding and without comparison to any other practice with which I have contact."

Dr. Higgs cites excellent quality of care, patient education and communication at Dr. Rafeei's practice as reasons for his loyalty.

The Center for Physical Therapy & Sports Medicine, PC, makes sure referral sources and patients are happy by delivering the following services:

• Physicians and treating clinicians receive typed evaluations, reports and discharge summaries promptly.

• Clinicians make follow-up calls to patients with complex conditions after the first visit.

• Patient calls are returned on the same day. And new patients are seen within 24 hours of referral when required.

• Patients receive a quarterly newsletter with educational materials and health-related updates.

• Patients receive written instructions for home exercise programs.

Other notable services include: extending hours past 6 p.m. to accommodate work schedules; holding open houses; giving all patients t-shirts with the center's logo on it; awarding compliant patients with a sports bag; and sponsoring community events and youth teams.

Dr. Rafeei is also proud of the staff and team he's put together. The 11-member clinical staff doesn't hesitate to ask each other for help if they can't figure out a tough case, he says. "We learn from each other," he adds. "It's a real team effort."

In addition, several staff members speak fluent Spanish, Russian and Persian. "Language can create a huge barrier for providing quality patient care," says Dr. Rafeei. Speaking clients' native tongue eliminates communication obstacles and allows for better quality care, he adds.

But he didn't build the team by himself. Dr. Rafeei credits the contributions of clinic administrator Olga Wilkins, who was hired three years ago when business began to flourish. "She takes care of the business side of things, allowing clinicians to concentrate on providing patients with the most efficient quality care," he says.

They've developed a list of career development opportunities for the staff, such as paying annual dues at professional organizations such as the American Physical Therapy Association, and covering orthopedic/sports specialty board exams and tuition assistance for DPT programs. The center provides unlimited continuing education assistance and allows employees to contribute 20 percent to 25 percent SEP (IRA) of gross income. Employees also receive bonuses and a percentage of the clinic's annual income. Other perks include team-building seminars and a benefits package with paid health/dental insurance, paid vacations and major holidays.

But Dr. Rafeei's practice is always looking to improve operations. As the business administrator, Wilkins is attempting to increase the practice's efficiency by establishing an electronic in-house billing system, which can be more cost-effective than outsourcing. Staying abreast of billing and coding criteria has also resulted in more efficient patient care, notes Dr. Rafeei. Some insurance companies require pre-approval and deny coverage if you don't use the right terminology, he says. By becoming savvy in insurance language, the Center for Physical Therapy & Sports Medicine, PC, didn't have a single insurance denial in 2004, says Dr. Rafeei.

Dr. Rafeei notes that if he learns an insurance company interferes too much with patient care due to complex coverage criteria, he isn't afraid to drop them. For instance, the clinic treated one patient with an anterior cruciate ligament tear that required at least three months of rehabilitation. The patients' insurance carrier, however, only approved six to eight visits before the company needed more information for further coverage. "Every time you have to go through this process it takes a week, which disrupts treatment," says Dr. Rafeei.

In denying certain insurance companies, Dr. Rafeei has noticed that patients are willing to pay out-of-pocket for quality care. "One patient drove 80 miles to come see us," he recalls.

In 2005, the clinic expanded by opening another location that's overseen by Richard Linkonis, MS, PT, OCS. Linkonis has worked side-by-side with Dr. Rafeei and helped with the growth at the first location.

It seems Dr. Rafeei's vision of providing quality patient care has paid off. While owning your own practice involves long, stressful hours, the end result will be positive if you pay attention to your customers, he says.

"If you take care of patients," he says, "other aspects of the business will fall into place easier."

Tisha Nickenig is a free-lance writer in the Philadelphia area.

ADVANCE for Directors in Rehabilitation would like to thank the sponsors and judges of this year's 2005 Best PT Practice contest.

Sponsors

HCR•ManorCare

Toledo, Ohio

Health Providers Service Organization (HPSO)

Hatboro, Pa.

Measurable Solutions

Clearwater, Fla.

NuStep

Ann Arbor, Mich.

ReDoc

Nashville, Tenn.

Judges

T.J. Antich, MS, RPT

Newtown Square Sports PT

Newtown Square, Pa.

Ed Ramsey, DPT

Ramsey Rehab Inc.

Fitchburg, Mass.

Kevin McGovern, PT, CSCS

McGovern Physical Therapy Associates

Revere, Mass.

Previous Winners of the Best PT Practice

2004 McGovern Physical Therapy Associates, Revere, Mass.

2003 Mettler Center LLC, Champaign, Ill.

2002 Jack D. Close and Associates Rehabilitation Center, Las Vegas, Nev.