< = > Less Equals More: Why a Low Overhead Is Ideal for Your Cash Based Physical Therapy Practice

physical therapy cash based practice less is more

Less is More

< = >

or Less Equals More

This is the logo for the New Balance Minimus Line of shoes. I just started running again and the shoes I purchased have this < = > logo on the sock liner and it has inspired me to share some thoughts.

A low overhead and small footprint is the way to maximize profits for almost any company, business, entity or corporation.  The less you spend and the more you collect, the larger your profits.  As a start up private practice there are many ways you can leverage your dollars to get quality services in the creation and operation of your practice.

To start, consider your practice philosophy.  An aspect of mine is to be able to treat anyone almost anywhere using only my hands.  This and my belief in the amazing power of human touch is one of the reasons I do not use any modality or exercise equipment (expensive or not) in my office.

  • You could spend $1000-$1,600 to form your corporation, LLC, s-Corp, PLLC, etc or you could use Legal Zoom and spend a couple hundred.
  • You can spend hundreds to design a logo and business cards created and printed out or you can get 250 free business cards from Vista Print and your logo created for $5 at Fiverr.
  • You can buy a paper calendar, pay for a fancy online scheduling and EMR system or you can use Google Calendar for free and handwritten notes.

A low cost option for office space is to sub-let a room from another physical therapist, massage therapist, occupational therapist, gym or fitness professional.  Inquire about renting per hour or per treatment you provide vs. weekly/monthly.  This way you only pay when you provide a service and earn and income.  It may not be the least expensive agreement once you become busy, so work a transition to favorable monthly fee into your rental agreement.  This will still be less than renting and furnishing a space of your own.

Be sure to visit my Resources page for more time and money leveraging services that I have used successfully in my practice.

As a start up practice you are likely to have time on your hands and the ability to put in some sweat equity to your practice.  Get to work, hustle and consider this a long term investment.  Be patient and you will begin to see the fruits of your labor. Once your schedule begins to fill it will be time to start to leverage your time and not just your dollars.

Now, these solutions may not be ideal or the exact system of your dreams, but they certainly can provide a low cost or free option until your cash flow becomes consistent and you can afford to spend a bit more to create an even higher value service.


About The Author

Aaron LeBauer

Aaron LeBauer PT, DPT, LMBT started a 100% cash based physical therapy practice right after graduation. He's on a mission to save 100 million people from unnecessary surgery & enjoys helping passionate therapists build successful businesses without relying on insurance.


  • Steve Cuddy

    Reply Reply February 3, 2014

    Thanks Aaron. As usual, great ideas.

  • Richard Symister

    Reply Reply February 3, 2014

    Once again, great information.

    I was wondering, with your toolkit, are the forms “fillable” or are you typing text directly into a MS Word document? Are you converting to a PDF to save the template or are you using this converted PDF form to write upon. Currently, I convert my MS word forms to fillable PDF forms using Nuance (but am looking into Adobe for creating more compatible forms).

    I am very interested in your product, but knowing how you apply text and info to your forms will help with my decision.

    Thanks, again.

    Richard Symister, MSPT, CSCS, CKTP
    MovEvolution Physical Therapy
    Brooklyn, NY 11217

    • Aaron LeBauer

      Reply Reply February 3, 2014

      Thanks for your compliment. I currently convert the word files to pdf for printing. I print them, fill them out by hand (I circle and underline common areas that I have listed) and store them in a double punch manila folder for each patient in a file drawer. I’m sure the files I have can be converted to be used as you described. I’m happy to email you a sample to see if it works for you. just contact me directly using the contact form or my email address if you have it.

  • Greg Cecere

    Reply Reply February 5, 2014

    Thanks for sharing this, Aaron! I couldn’t agree more. I just opened my cash practice about 6 months ago (thanks in part to some of the information I have gathered here) and have already implemented many of the things you suggest here. Besides the obvious cost benefit from maintaining a low overhead, I also find it makes my life much easier as it allows me to work smarter, not harder.

    Thanks again,
    Greg Cecere PT, DPT
    Momentum Physical Therapy of New Paltz

    • Aaron LeBauer

      Reply Reply February 5, 2014

      Thanks for your comment and kind words. You have a great looking website and blog. Congratulations on starting your practice!

  • Tom

    Reply Reply March 31, 2015

    Thanks for the helpful article, Aaron! Question for you: my friend is starting up his own PT practice and wants to do as you describe and “rent” space from a fitness center. I want to make sure he doesn’t run afoul of the fee-splitting rules in NY.

    Do you know where I could find a good sample independent contractor agreement that’s specific to physical therapists?

    Thanks again for the great article. This is a great resource for the more entrepreneurial members of the profession!

    • Aaron LeBauer

      Reply Reply April 1, 2015

      Thank you very much!
      To answer your question, if his sublease is set up as a monthly rent that is reasonable within the margin of the going rate locally, then I don’t believe there should be a problem with viewing it as “fee splitting.” It would be closer to a “fee splitting” arrangement if the subleasee were to pay a percentage fee for each person the training center referred or scheduled for them. This is different than a fee for each person treated, however, I would double check the local statutes to be certain it is worded correctly.

  • Cathy

    Reply Reply June 13, 2017

    Hi Aaron – What are your thoughts on an appropriate percentage to pay per person seen if I’ll be leasing space from an existing clinic?


    • Aaron LeBauer

      Reply Reply June 13, 2017

      Hi Cathy,
      great question.
      Probably something like $20 up to 10 people a week, then transition to a monthly rent. 10 patients per week at $20 each is $800/month. So start with $20 maybe up to $30 per hour you use the space with an understanding that you’ll begin paying $500-800 (or what ever you negotiate) per month at a specific time or beyond a specific number of patients.
      two points, my numbers are not exact. you should always negotiate the lowest rate possible. Ask the other person what their best rate it that they want and always ask for lower or something else out of the deal, like help marketing, with utilities, or similar.
      Also, don’t pay per patient but per time unit that you use the space.
      good luck!

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