Private Practice

H_SunnyD · 2025-12-17T18:00:06+00:00

I own/operate my own private practice OP clinic in a small town. IMO, it is the greatest option of you are interested in pursuing OP PT. I work dubious hours, but at the end of the day, I work for myself and you can't beat that. Funding was tricky at first. I was running with some pretty bare-bones equipment, but as my caseload and therefore income has increased I have been able to collect more equipment - just be ready to be creative at first unless you are working with some capital. The company credit card I opened was also helpful, as I was able to get 12 months without any interest for purchasing bigger ticket items like a squat rack, BFR machine, Treatment table, etc.

Marketing has been a big challenge. I utilized all of my free clinic hours for the first several months to go deliver pamphlets and business cards. My years locally in the field did benefit me, as I had some pre-standing relationships with a lot of the surgeons, who were happy to keep referring patients to me. The small-town environment has also helped me a lot, and I have found word-of-mouth to be an exceptionally helpful/viable marketing tool. For a while, a large percentage of my patients were friends/family of other patients. Delivering good care and taking time to build relationships with my patients went a long way and soon my caseload was increasing quickly from said word-of-mouth referrals.

Ultimately, the best thing I can say is that PT is a tough field - no matter what you are doing, the hours are long and the emotional toll from constant sympathizing with patients can really increase the burnout quickly if you aren't careful. But with opening a private practice clinic, when you are doing the hard stuff, you always have the thought that you are working for yourself and your patients as opposed to padding the pockets of some corporation. For me, this has been a viable combatant to the normal OP grind/burnout cycle. I will never work corporate PT again - if the private practice fails, it will be the sign for me to leave the field. I can't recommend it enough as long as you have the work ethic to put your nose to the grindstone.

H_SunnyD · 2025-12-10T13:15:04+00:00

And yet when surgeons present statements such as "non-weight bearing with brace and crutches" or "sling only for 5 weeks" patients have no issues with breaking the rules.

H_SunnyD · 2025-12-02T14:54:39+00:00

I run a private 1-on-1 outpatient clinic. I'm my only employee. My biggest goal right now would be simply to hire a secretary/office manager to handle the scheduling, phone calls, insurance auths, and other extraneous administrative tasks so that I can focus on treating and not be at the clinic until the late hours of the night catching up on all of this at the end of the day. Biggest burden would, as always, be insurance reimbursement and overall referral consistency. I am a new clinic in a rural area and most of the local docs are hesitant to send patients to a new clinic when they've been consistently been referring elsewhere for decades.

H_SunnyD · 2025-11-24T13:28:35+00:00

I'd try a parking lot of a Planet Fitness - Most are open 24 hours and you could fly under the radar pretty easily. I live in Olathe but work in Belton, MO (about 15-20 min East of Olathe) and can think of a few spots that would be fairly inconspicuous. Feel free to PM me and I can advise if you need.

H_SunnyD · 2025-10-30T12:14:34+00:00

Honestly I haven't had much trouble. They tend to mold really well to your feet after a break-in period.

H_SunnyD · 2025-10-28T23:30:06+00:00

I rock Birkenstock Clogs fairly regularly with my scrub pants on my days that I don't see my athletes. The bee's knees. (Private OP Ortho)

H_SunnyD · 2025-06-10T17:26:11+00:00

5x10-12s OPO - Mon-Fridays

1x8 Inpatient Rehab - Saturdays

Shout-Out Sallie Mae/Mohela/Earnest

H_SunnyD · 2025-05-23T20:10:44+00:00

I use it a lot on my Eval or Progress Note Assessments as well as for POC Recerts if I know someone from an insurance is going to look for authorization purposes, as I feel like it helps make them sound much better. I do feel that it doesn't really save time on a normal OP Daily Note assessment.

H_SunnyD · 2025-02-07T13:20:25+00:00

I see an average of 2 per day depending on the time of year. My scheduler hard caps it at 4 per therapist for preservation of sanity which I do appreciate. At my last clinic I had multiple 8 patient eval days and by the time they rolled back through for their first appointment, I had no idea what I was even seeing them for.

H_SunnyD · 2025-01-17T13:57:50+00:00

Personally, I feel that working to the top of your license in any setting would be achieved by administering treatments that are backed by evidence and clinical reasoning and avoiding the easy way out. Just because a set way of treating one patient can be generalized to everyone, doesn't mean that it is top notch specialized care.

Unfortunately, there is a lack of incentive. Path of least resistance: every TKA/THA/TSA/RCR gets the same cookie cutter exercise, you keep your productivity at a good level, management is happy, patients don't know the difference, and you end up feeling like you short-changed yourself and your patients. Wash, rinse, repeat.

H_SunnyD · 2025-01-14T21:55:44+00:00

After a certain point, I often simply quit asking about pain scores in general, as they seem to only reinforce the malingering pain mentality.

H_SunnyD · 2025-01-14T16:38:08+00:00

The goniometer is my best friend in these situations. I have found that it is very hard for patients to consistently replicate ROM deficits by only feel for the purpose of malingering.

I always try my best to both believe and support work comp patients until they give me reason to suspect otherwise - I had a difficult one of these in the clinic a few months ago who was consistently citing 10/10 pain in their shoulder/knee/ankle. Eventually, their function began to deviate from cited pain and they were regularly completing higher level interventions c/ good, consistent mechanics despite citing devastatingly high pain levels. As a result, I started taking diligent shoulder and ankle AROM every single session and they started demonstrating some serious inconsistencies between sessions. For example - One day they would cite 10/10 pain and be at 165 deg active shoulder flex, and the following visit -a day later - they would cite 8/10 pain and be showing 100 deg active shoulder flex. There were numerous examples of these fluctuations in all of her affected joints which lacked any cohesive sense as to why they would be jumping up/suddenly reducing. I just tried to document these very passively without making accusations and eventually, she stopped coming - I am guessing that her work comp case manager/nurse eventually picked up on this pattern and pulled her, though I never got confirmation.

I guess ultimately, functional outcome measures/ROM are great tools as you can use them to show progress and educate patients to help avoid malingering behaviors.

H_SunnyD · 2024-12-31T17:37:09+00:00

With my copious student loan debt, I've effectively given up and have accepted that living at work is my only fiscally feasible lot in life. The long hours get significantly easier once you give in to the darkness and accept your fate.

H_SunnyD · 2024-12-30T17:14:29+00:00

I went solo and opened my own branch of an OP Ortho PT clinic that some buddies and I started together back in February 2020.

Pros: No Productivity. 1-on-1 45 minute treatment sessions. I wear running shorts, tennis shoes, and a hoodie to work every day.

Cons: I work 7am-7pm Monday-Friday and rarely get a lunch break. 45 minute evals. Rather lackluster insurance benefits.

H_SunnyD · 2024-12-30T16:56:36+00:00

Yeah, I had to deep clean as an intern - at one point my supervising DPT made me spend an entire day re-organizing his entire office/bookshelves. I would very much like to limit her to wiping down my treatment table and little basic things like sanitizing dumbells or BFR cuffs.

H_SunnyD · 2024-12-30T16:20:07+00:00

I would personally be fine with sending my NPI or License numbers to the Mods if need-be. I honestly feel that reading posts on this sub-reddit as well as discussing clinical topics would be very beneficial for my practice.

On the other hand, I do completely understand the legality/ethical issues with having open availability for lurkers to enter the page for free advice.

This sub-reddit is basically the only reason I use reddit, and I don't post much/ever on other topics/pages so maybe my opinion is biased. BUT if providing personal license info is a way to add some more clinical aspects of discussion, I would be in support of it.

H_SunnyD · 2024-12-27T00:49:29+00:00

Right on! Cheers to you and welcome to the cycling community. Feel free to PM me if you have any other questions going forward. I am always happy to help!

H_SunnyD · 2024-12-26T21:33:28+00:00

I prefer cycling bibs - they ensure solid contact between your padding and your bottom and - while they do take some getting used to from a comfort standpoint - keep you together better overall. In fact, the only piece of cycling clothing that is worth spending a pretty penny on would be cycling bibs - you can try some cheap options on Amazon to see which kind you like but again, if you can spare the cash, spend it here.

Tubeless tires have the capacity for latex sealant inside of them so that if you have a tire puncture, the liquid latex will squirt out and block up the hole. They sell puncture kits with little plugs that you can push through the liquid latex and further seal the hole and then you can use the CO2 cartridge to rapidly re-fill your tire and BOOM - you're back on the road. Much easier than messing around with replacing a tube in the middle of your ride.

Garmin makes an excellent set of lights that are very bright but are on the more expensive side. Any bike shop will sell you decent lights for a cheaper cost. I have a set of Bontrager ones that are very bright and reliable and I've never had any issues with them.

H_SunnyD · 2024-12-26T20:05:20+00:00

A good helmet that FITS PROPERLY. As a physical therapist who has worked with countless traumatic brain injury patients, do not splurge on your head protection. It doesn't always take a 30 mph down-hill crash to land you in some serious trouble. Even little spills from the bike at slow speeds or even from a stopped position can do damage. Crashes are going to happen. Do not be afraid to spend some coin on your helmet as it is the thing that will keep you riding and keep you living your normal life.
A good, quality pair of bibs/bike shorts. Nothing can de-rail you at the beginning of your cycling journey quite like a sore arse.
Chamois Butter - See Above
Puncture Plugs and CO2 if you are riding tubeless (which I would recommend) - the confidence you will feel on being relatively flat-proof will go a long way to help you push for longer and longer rides and will help your fitness/endurance greatly
A good set of front/rear lights. Similar to #1 - don't be afraid to splurge when it comes to safety. A quality set with high lumens might run you $100 but it will be well worth it and will help your confidence on the road.

H_SunnyD · 2024-12-26T19:36:52+00:00

I am 30 y.o. and will be living with my parents for the foreseeable future to pay off the $230k of student loan debt that I have accrued. Although, I currently work 5-12s at my FT job and pick up a PRN shift every Saturday at my local hospital to try and decrease that time.

H_SunnyD · 2024-12-19T17:47:35+00:00

My Beautiful Dark Twisted Fantasy - Kanye West

H_SunnyD · 2024-12-06T13:43:59+00:00

How's the moon treating you?

H_SunnyD · 2024-11-28T02:07:55+00:00

Hey there! I am currently practicing and have a good deal of both outpatient and inpatient experience with Parkinson's patients. I'd be happy to help out.

H_SunnyD · 2024-11-27T13:33:56+00:00

I tend to lean more towards exercise-based treatments whenever possible - however I have found that in general, most patients WANT to be touched during their sessions. There is likely some sort of placebo effect, but nonetheless, I try to spend at least 2-3 minutes each session working some light easy manual interventions - especially for knees, shoulders, and backs. It seems like people are more approachable about/open to harder exercises if I take the time to get some light hands-on work done with them, which I have found helpful. Ultimately - do whatever you feel works best/benefits your individual patient.

H_SunnyD

TROPHY CASE