PT in the House: 6 Benefits of Running a Home-Visit Therapy Practice

What if I told you there’s a physical therapy practice model that requires minimal investment, has a low operating cost, and is practically burnout-proof? What if I added that this model provides a steady flow of new clients and is well poised to meet the rehab needs of the Baby Boomer generation?

It would almost be too good to be true, right? Well, this model exists, and since 2009, my partners and I have enjoyed all of the above-listed benefits.

Our company, Beyond the Clinic, provides outpatient house calls throughout Portland, Oregon.

If you aren’t familiar with physical therapy house calls, here’s the lowdown: we bring the essential elements of an outpatient clinic to our clients’ homes. While we don’t deliver a fully stocked gym or a wide spectrum of modalities, we do bring the mentality and creative treatment approach typical of most outpatient therapists.

It’s important to note that we aren’t a home health business. Our clientele don’t have to be homebound. We treat and bill like a regular brick-and-mortar clinic, accepting Medicare, commercial insurance, and cash payment just like any other private practice.

If you’re thinking of launching your own business, the house-call model is an elegant solution for getting up and running quickly. Or, if you’re already an established private practice owner, offering house calls to your existing clients is an excellent way to add value.

There are numerous benefits to providing house calls. Here are a few examples:

1. Greater Patient Convenience

In a competitive marketplace, outcomes and costs tend to be fairly similar across the board. So, consumers tend to choose whichever option is the most convenient. We’ve already witnessed the rise of ride-hailing apps, food delivery services, and on-demand pet-sitting. The healthcare space is moving this way, too—and it’s time to get ahead of the wave. Telling a patient that he or she can have a therapist come directly to his or her house, place of work, or gym, is a much easier sell than asking him or her to get into the car and battle traffic. If you’ve been looking for a differentiator—something that will set you apart from the other PT options in your community—house calls are it.

2. Slower Pace

One feature of a house call practice is that it’s impossible to have a day that’s as busy as one in a standard orthopedic clinic. Unless you want a 16-hour workday, driving between clients naturally caps your number of patient interactions to five to seven visits per day. Our full-time therapists complete an average of 22 to 25 visits in a week. Can you imagine a life at that pace? Talk about catching your breath! Make no mistake: once you jump into the world of house calls, going back to 12 to 15 visits in a day seems ludicrous.

3. More Focus on the Basics

I could be wrong, but I’m guessing you don’t drive around in a work van. I don’t, either—and neither do our therapists. We all drive small vehicles, which means we can’t lug a ton of equipment between clients. Sometimes we bring a treatment table and resistance bands. Sometimes we just bring our hands and clinical expertise. By limiting your toolset to what can fit in your car, you are forced to emphasize the basics of patient care. What are the most important educational elements to address? What mobility and strength deficits can you tackle with the equipment laying around someone’s home? Ditching some of the bells and whistles of a fancy PT department can help you become a better therapist.

4. Increased Functionality

How many times have you questioned whether something you and a client went over in the clinic would actually make it home with them as intended? We all know that what happens in the clinic doesn’t always translate well to what your clients have at their disposal in a home environment. By providing therapy in someone’s house, you can be sure that your instructions have immediate relevance:

• “Let’s do that hamstring stretch near the doorway into your dining room.”
• “Come over to this narrow hallway and we’ll practice that balance drill.”                                                 

The New York Times recently ran a piece explaining how doing post-op total knee arthroplasty (TKA) and total hip arthroplasty (THA) rehab at home was as effective as the same treatment in an inpatient setting (e.g., a skilled nursing facility [SNF]). We’ve seen that borne out in person. In fact, a huge portion of our business involves helping people who have had joint replacements. And, guess what? Every single client comments on how wonderful it is to be doing it at home. You can’t deny it. The home is where it’s at.

5. Lower Cost

This one is obvious. Your clients save money on drive time, parking costs, and no-show fees. (The patient can’t be a no-show if the therapist comes to him or her, right?) Plus, you, as the therapist, save money on office overhead. Every brick-and-mortar business owner I know is beholden to the landlord raising the rent every few years. By focusing on house calls, though, you don’t need an expensive location with lots of foot traffic. You also don’t need to stock your clinic with nice furniture or high-end treatment tools. Your main expense ends up being payroll. And, if you do it right, you can’t lose.

6. Easier

Dipping your toes into the house calls space is much easier than you would imagine. We’ve been doing it full-time for more than eight years now, but you could easily start doing it as a side hustle. You also don’t need to worry about the extensive paperwork demands that come with home health PT; your charting is the same as it would be in an outpatient setting. Once you have yourself covered from a liability insurance perspective, the sky’s the limit.

These six bullets cover the most immediate benefits of offering physical therapy house calls, but they are by no means the only reasons to consider. Physical therapists are blessed to be in a profession that offers a variety of practice settings and business models. House calls are simply another point along that spectrum.

Now, house calls obviously aren’t a viable solution for every practitioner. If you’re someone who thrives in a busy workplace with tons of interdisciplinary interaction, then driving from one patient to another might not be for you.

But, if you dream of a slower pace with plenty of freedom, you owe it to yourself to learn more about house calls.

Over the years, our clinic has routinely fielded calls and emails from PTs inquiring about how they can bring house calls to their cities. We’ve done our best to help point people in the right direction, but managing a growing practice hasn’t always allowed us to devote much time to helping others get started. But, that ends this year. We’ve finally put together a startup manual to guide your effort to launch and operate a profitable house calls practice.

If you’d like to learn more, please sign up to participate in our upcoming webinar, “Physical Therapy House Calls Demystified.” In addition to covering the basic operations of our practice, we’ll answer the top 10 most common questions about PT house calls. Space is limited, so sign up soon.

Ben Musholt has been in practice as a physical therapist in Portland, Oregon since 2001. He and two other partners co-founded Beyond the Clinic in 2009. He also co-authored the book Parkour Strength Training in 2016, and his second edition of the Mad Skills Exercise Encyclopedia comes out this fall. Follow him on Instagram @benmusholt.