The New Look of Competition

Posted on: November 21, 2011

I applaud AOTA President Florence Clark’s 2011 Presidential address (see in which she discussed competition as it related to the practice of occupational therapy. Clark stressed that it is to our credit that we are compassionate, kind, and honest, but added that these values do not have to preclude competition. “Competition is not mean. But we can’t continue to let others define occupational therapy. That’s not playing nice-it’s playing dead,” she said.

Clark compared OTs to sleeping giants who must stop letting others muscle in. We need to be worthy collaborators rather than support personnel. As she noted, “victories are sometimes won through teamwork but always through competition.” Clark pointed out that in its best form, we compete with, not against others; the stronger the occupational therapy team members are, the better the outcomes.

Competition vs. Service Substitution

An old adage is “to compare is to despair.” That does not have to hold true. Good can come out of looking around at other practitioners. Heidi Grant Halvorson, author of Succeed: How We Can Reach Our Goals, writes that upward comparison can be punishing and make you feel terrible . but also states that you can look upward to learn.

Downward comparison may make you feel superior, may remind you of your good fortune, but could also help you avoid the challenge to do better. To be competitive in today’s environment, you first have to have a good handle on who your competition is and what it has to offer.

I have found from consulting with therapists that they may not realize how competition in health care has changed over the years, most notably in the last five. Traditional, or direct, competition is typically what we are used to. A pediatric OT practice is in competition with another one in town, a physical therapy practice specializing in ortho competes head to head with another. But that condition is not very stable. For many years, Pepsi and Coke were direct competitors for the cola market, and they loved it! Why? Because they each had a 50-percent share of the cola market, they knew and understood each other, and had made peace (and profits) with each having half the market. Then something happened to rock their world. Along came water. The consumer began drinking water instead of soda, and act that we would call service substitution. Pepsi and Coke were blindsided; they knew how to compete with each other, but not with another product. Sound familiar?

Therapists need to realize the extent to which there is service substitution encroaching in health care. Many consumers are looking to other services much like the consumer turned to water. There are personal trainers, athletic trainers, life and wellness coaches, behavioral therapists, even posture coaches to name a few.

Clark shared her confidence that this is OT’s time, based on the rising incidence of polytrauma and TBI; and I would add that the fact that baby boomers now survive and live with many diseases, including cancer, can give our field momentum to be acknowledged and embraced by consumers. She suggested promoting areas where OT is already well recognized, including hand therapy, autism and “wounded warriors.” We can take a competitive edge by sharing published studies emphasizing OT’s effectiveness, increasing grant proposals to NIH, using our experience in home health for falls prevention and energy conservation, and “owning” the appropriate words in documentation to reflect OT intervention.

As holistic as our frame of reference is, we need to look at the whole picture. Make sure you know with whom you are competing so you can better strategically position yourself for long term success and recognition in this increasingly crowded market place.

Pepsi and Coke found a way – they started bottling water. I know we can do better than that!





Did Your Doctor Disappear Without a Word? A Noncompete Clause Could Be the Reason

Reprinted from the NY Times March 15th 2019 –

When Don Cue developed a bladder infection last fall, he called his longtime urologist’s office for a urine culture and antibiotics. It was a familiar routine for the two-time prostate cancer survivor; infections were not uncommon since he began using a catheter that connects to his bladder through an incision in his abdomen.

When Mr. Cue called this time, a receptionist told him that his physician, Dr. Mark Kellerman, no longer worked at the Iowa Clinic in Des Moines, a large multi-specialty group. She refused to divulge where he had gone.

“As a patient, ‘scared’ is too strong a word, but my feeling is, ‘What do I do now?’” said Mr. Cue, 58.

Flummoxed, he solved his immediate problem by taking leftover antibiotics he had in his medicine cabinet.

It was only later that he learned his doctor had been fired by the Iowa Clinic and planned to start a urology practice with clinic colleagues. And, under the terms of their contract with their former employer, the doctors were banned for a year from practicing within 35 miles of the clinic, and from recruiting former patients to follow them.

Contracts with so-called restrictive covenants are now common in medicine, although some states limit their use. Noncompete clauses — common in many commercial sectors — aim to stop physicians and other health care professionals from taking patients with them if they move to a competing practice nearby or start their own. But what may be good for business can be bad for patient care — and certainly disquieting for those whose doctors seem to simply disappear.

One survey of nearly 2,000 primary care physicians in five states found that roughly 45 percent were bound by such clauses.

Continuity of care is important, doctors say, especially for patients with ongoing medical issues. Cutting off access to a doctor is different from disrupting someone’s relationship with a favorite hairstylist or money manager, they say.

“When doctors want to move from one practice to another, if they’ve got good therapeutic relationships with their patients, you’d think that public policy would want them to continue to treat these patients that trust them,” said Judy Conti, government affairs director at the National Employment Law Project.



Are you interested in working in a great environment where patient care is primary and your physical therapist skills can be utilized to help people reach their optimum potential? PT-owned outpatient physical therapy clinic in Asheville, NC serving a diverse caseload including orthopedics, neuro, chronic pain, gait and balance disorders seeks an experienced outpatient physical therapist who is a team player to join our quality team.  Must have excellent training and skills in manual therapies. One to one 45 minute treatments in a great working environment surrounded by the beautiful Blue Ridge mountains and all the outdoor recreation and cultural opportunities the area offers!  Part time/ Full time is possible, with competitive benefits available with at least 30 hours/ week including PTO, paid holidays, CEU reimbursement and health stipend.  If interested, please reply with Cover Letter, Resume and References to


New Jersey Adult Physical Therapy Practice for Sale

Located in Middlesex County,New Jersey,  this well established and highly regarded  PT owned  general physical therapy practice is coming up for sale due to the upcoming retirement of the owner after 36 years.

The practice is in a great family friendly community conveniently located with ample parking. The 2520 square foot facility is fully built out and equipped, with a  main gym,semi private gym,3 closed door private treatment rooms,billing office,laundry room,and reception area.Bathroom areas  is just outside of  the office space and is meticulously maintained by the landlord. Therapy equipment and office equipment included in the sale are   2 cable columns,recumbent upper and lower body cycles,recumbent elliptical,treadmill,stationary bicycle,vibration machine,total gym,traction machine,5 interferential machines(2 with ultrasound) 2 high volt machines,parrafin,cold pac freezer,3 hydrocollator machines,1 low mat table,3 treatment tables,3 computers,3 printer,scanner copier machines,refrigerator, and a washer and dryer.

The practice sees a mix of patients including chronic pain and general orthopedics and has  very well established local referral sources and is in network with a large number of insurance contracts.   The staff consists of Physical therapist/Owner, a part time physical therapist assistant and support staff of 3. At the present time, the practice, by choice, operates on a part time basis, consistently grossing over $250,000. Under new ownership the practice can easily ramp up to full time.  The owner is willing to stay on for a reasonable transition period and other staff is eager to stay on with new owner.  The existing lease is very favorable, renewable  and transferable.

Full financial information and practice statistics are available upon request.  Asking price will be discussed with qualified interested parties

Serious inquiries only:  Please contact the practice owner directly at



Manhattan based highly regarded Medicare Part B Home Care Physical Therapy Practice is available for sale

 This is a GREAT opportunity for an existing PT practice looking to establish a home care division, an experienced therapist looking for a firm foundation upon which to move to home care, or an expanding PT group wanting to increase market share.

  • Current case load in Manhattan, with a very strong presence on the Upper West Side,  with opportunities to expand to other boroughs,other disciplines and assistive living facilities.
  • Emphasis on PT services for seniors including fall prevention, balance, strength and ADL training.
  • Sale includes database of patients and referring physicians and highly regarded part time contractor.
  • Averaging  30-40 visits per week with very high retention of former patients.
  • Streamlined business model with very little overhead, low risk.
  • Easy segue way to also include cash based concierge service.
  • 2018 revenue over $118,000 with very positive projections for 2019.
  • Opportunity for a practice with OT services to increase current yearly revenue by at least 50%.

Full financial information including profit and loss statements, practice statistics and tax returns are available for inspection.
The practice is being offered at $89,000.00.  The practice owner is flexible and will consider an asset sale with terms available, as well as structuring a mutually beneficial structured buy in opportunity for the right therapist.  The practice owner is willing to be very active in the transition process to ensure patient retention, for a reasonable period of time.

Serious inquiries only:  Please contact Iris Kimberg, MS PT OTR on behalf of the practice owner at or

Help save the Early Childhood Direction Centers! They need our help RIGHT NOW

  NY State has terminated the contract with the Early Childhood Direction Centers, and all of them will close as of June 30, 2019.
As many of you know ECDC  as been an amazing resource for families and professionals helping to navigate the systems of EI, transitioning to CPSE etc. for the past 30 years.
It has been said that the NYS Board of Regents is very concerned about the ECDC closure and the lack of transparency in the process. The Regents are meeting this coming Monday, January 14th which means there’s a very short window to make our feelings known! We need to tell them what the ECDC has done for us and what the lack of that support will mean for families of young children.
Here is the contact info to let your concerns be known:
Betty A. Rosa
12th Judicial District
Regents Office, State Education Building, 89 Washington Avenue, Albany, N.Y. 12234
(518) 474-5889
T. Andrew Brown
Vice Chancellor
7th Judicial District
925 Crossroads Building, Two State Street, Rochester, NY 14614
(585) 454-3667

Commissioner of Education and
President of the University of the State of New York
MaryEllen Elia
(518) 474-5844

P-12 Instructional Support
Deputy Commissioner
Angelica Infante-Green
(518) 474-5915

Christopher Soriano
Assistant Commissioner Special Education

PT and OT  Receives Significant Payment Increase from NYS Worker Compensation Board for 2019

On December 26th, the New York State Workers’ Compensation Board adopted regulations which substantially increase payment for PT and OT therapy services provided to injured workers effective April 1, 2019.

The conversion factor for PT and OT services increased from 21 to 30 percent across the 4 regions of the state. The average conversion factor increase across all 4 regions was 25.4%

Initial evaluations are capped at 18 RVUs, revaluations are capped at 15 RVUs and follow up visits are capped at 12 RVUs, all of which allow for a greater intensity/duration of medically necessary treatment to be provided per session.

The changes in the fee schedule will take effect April 1, 2019.

There is NO  hard cap of 12 visits/180 days.
I will post additional information as I find it out.

2019- Long Standing and Well Established Physical Therapy Practice for Sale in Central Long Island (Nassau County) NY

This is a very well established and highly regarded physical therapy practice in Central Nassau County.  It is known for its quality care and individualized treatment and has earned an excellent reputation amongst physicians and patients in the community.  The practice currently employs 2 physical therapists (full and part-time), 1 physical therapist assistant (part-time) and is fortunate to have a capable office staff including an administrator and biller, all  interested in staying on with the new owner.

The practice treats a diverse caseload including orthopedic, neurologic, chronic pain, balance and wellness and generates $400,000-$500,000 annually with an excellent and enviable net profit margin.  The clinic participates in most major insurance networks including Medicare.  It is located in an office building and a lease with highly favorable terms and is transferable and renewable.  The 3000 plus square foot office has good parking and enjoys convenient parkway access.  It includes  state of the art equipment, separate patient and staff bathroom,  a waiting room, private treatment rooms,a main gym and balance/plyometrics room, whirlpool room, private owners and administrators offices, as well as a  separate front office.

Full financial information including profit and loss statements, practice statistics and tax returns are available for inspection.
The practice is being offered at $325,000.00.  The practice owner is willing to remain with the clinic as clinician and/ or clinic director

Serious inquiries only:  Please contact Iris Kimberg, MS PT OTR on behalf of the practice owner at or

Fabulous Opportunity to Work in a Premier Pediatric Practice in Bergen County New Jersey

Pediatric Occupational Therapy Services, LLC  (POTS)  is a cutting edge private private practice in Teaneck NJ seeking dynamic, experienced pediatric occupational therapists who loves children and families, to work in our sensory gyms and in private schools 20 hours per week and full time (must include 1-2 days after school and/or Sunday hours). We have a dedicated highly experienced staff that provides cutting edge OT, PT and Speech therapy in state of the art sensory gyms. Our clients range from birth through 21. Primary therapeutic approaches include sensory integration treatment, Floortime, Handwriting Without Tears, listening therapies, NDT, motor learning, biomechanical approaches and SOS feeding. Among the areas we address are sensory processing, praxis, self-regulation, self-care, handwriting, gross and fine motor development, visual perception, and feeding. We are unique in our commitment to evaluate and treat the whole child and partner with the important people in a child’s life.

Job Description

We are looking for therapists who has strong treatment and evaluation skills, and is able to effectively work with children in a sensory gym and in private schools.

  • Evaluate new patients.
  • Provide occupational therapy services to children in a sensory gym using the therapeutic approaches that best meet the child’s unique needs.
  • Design and monitor effective home programs, sensory diets, and school and home strategies, as needed that meet the child’s needs and family’s capacity for follow through.
  • Provide occupational therapy services within a classroom or school that enable the child to better function and thrive in that environment.
  • Collaborate with the teacher and school, and provide strategies for the individual child or class that will benefit the client.
  • Collaborate with parents and teachers to set functional goals
  • Provide ongoing guidance, support and education to parents
  • Participate in team meetings and workshops
  • Participate in program development, such as summer camp programs and after-school groups

Required Skills

  • Master’s Degree in Occupational Therapy
  • 3+ years’ experience providing occupational therapy to children in a sensory gym and in schools. Experience in treating children with a wide range of challenges, including Sensory Processing Disorder and Autism
  • NJ Occupational Therapy License
  • NJ school certification, a plus
  • Willingness to work in the clinic and in schools
  • Compassionate, caring, collaborative, willing to go the extra mile for your families
  • Excellent problem solving skills and analytic abilities
  • Ability to meet the child where they are and build a warm therapeutic relationship with the child and family
  • Ability to conduct assessments and evaluations using standardized evaluation tools and clinical observations to determine the child’s strengths and challenges, collaborate on goal setting with caregivers, and generate a comprehensive report of findings
  • Sensory gym experience
  • Provide effective treatment sessions to meet the child’s functional goals
  • Experience treating clients within the classroom and collaborating with teachers
  • Excellent communication skills with parents, children and co-workers
  • Demonstrated commitment to continuing education, such as sensory processing, Floortime, Handwriting Without Tears, Brain Gym, Reflex integration, etc.
  • Feeding coursework and experience a plus. SOS preferred
  • Desire to work long term in a warm supportive environment

Job Type: Part Time and Full Time

Salary: Part time: 38,480.00-46,600.00 commensurate with experience

Full time with benefits: commensurate with experience
Please email your resume or questions to Dr. Chaye Lamm Warburg, DPS, OTR, Director:

Physical and Occupational Therapists – Want a Better Answer to the Age Old Question – Where Do You See Yourself in 5 Years??????

NYC ORTHO AND SPORTS PRACTICE looking to expand and open new locations in
the Greater NY area.

If you read this and nod your head, we want to talk to you!

  • Are you  working for years for someone else  without building equity of your own?
  • Have you thought about opening your own  practice but fear failing, or having  too many headaches and that is just too risky?
  • Are you building someone else’s brand just to receive a small end of year bonus each year?
  • Are you  frustrated that you never pulled the trigger on your own practice?
  • Do you have referral sources that send patients to the practice you are employed at to see you specifically  and all you see from it is a small “referral bonus”?
  • Are you ready to join a team that will provide you support and confidence to succeed in a challenging private practice environment?

Evolve Physical Therapy and Sports Rehabilitation is looking for PTs and orthopedic/CHT Occupational Therapists to become practice partners in strategic areas of NYC and surrounding counties.  The chosen candidates will join the Evolve Team  with total  support for all things practice related.   Start up capital, management duties, advertising, billing, etc.  will be assisted and structured by our highly experienced group.   Each practice will follow the “Evolve Model” that has continued to grow our practice into one of the top Orthopedic and Sports PT practices in NYC.  Together, let’s  go  into private practice  with no fear of failing and a much greater likelihood to succeed.

Co-owners Greg Babiec, MSPT, SCS, MTC, CMP, CSCS, and Jason Roth, PT, SCS, MCMT, TPI CERTIFIED  welcome the chance to discuss this opportunity  with you. Contact us today in confidence  to start the process to your Private Practice.
Evolve Physical Therapy & Sports Rehabilitation

159 East 74 st
1st floor
New York, NY 10021
Please email us  your resume and cover letter to get the conversation started!