We’re excited to introduce you to the always interesting and insightful Kristie Mulder. We hope you’ll enjoy our conversation with Kristie below.

Kristie, looking forward to hearing all of your stories today. We’d love to hear about how you went about setting up your own practice and if you have any advice for professionals who might be considering starting their own?

I decided to start my own practice when I got to a point in an insurance based practice where I felt I wasn’t able to provide the type of care I felt each person deserved. Most of the limitations to the quality of care provided come from insurance reimbursement rates so I decided to look at different options. Many physical therapists around the country are turning to a cash-based model for care so I decided to look into it more. To work in healthcare and be free from the constraints of insurance sounded amazing. No more business person telling me what treatments my patient needs, no limitations on number of visits for patients who really need more treatment, and no more shaping my treatment plans to appease insurance requirements.

After looking into it more, and talking to a friend who also has a cash based practice, I decided to head that direction. I quit my job and spent a lot of time at a local tea lounge getting things set up. The hardest part was finding information! When you have only the internet (not a person) to ask questions of you get a lot of opinions and not a lot of official information.

I really enjoyed the process of thinking through how I wanted to set up my business. I don’t have much business knowledge and I wanted to set up my practice as a place to provide high quality care, not as a business to make as much money as possible. I was able to structure my appointment types/times and my pricing to create an environment that is truly patient-centered. So while I was staying away from “business for PTs” type of books, I still had to learn how to run a business. I have always heard from business owners how many hats they wear, but I didn’t realize how un-equipped I would feel for many of those roles. Things like accounting, marketing, social media, networking, and graphic design were not anything I had encountered before so I have had to work with that learning curve.

My advice to young professionals looking to open their own practice would be to step back and think about what you really want to do. As the owner, you get the chance to totally shape what things look like. There are a lot of things “everyone” does the same way, but when you are designing the practice, you get the opportunity to do them differently. So take the time to critically look at how you want to set things up before you make any moves.

Great, appreciate you sharing that with us. Before we ask you to share more of your insights, can you take a moment to introduce yourself and how you got to where you are today to our readers.

I’m Kristie Mulder, an orthopedic and pelvic health physical therapist who decided to open my own, cash-based PT practice. Orthopedic physical therapists treat most typical injuries you may think of: back pain, neck pain, shoulder pain, running injuries and provide post-operative rehabilitation. In pelvic health I have the opportunity to help women dealing with pelvic floor dysfunction, or who are pregnant and postpartum. Pelvic floor dysfunction includes things like incontinence (leaking) urine with coughing/laughing/jumping, pelvic organ prolapse, and pain with intercourse. With my pregnant and postpartum clients I have the chance to help address the aches and pains that come with these stages, help return to exercise, and do some birth prep work as well.

I opened a cash-based clinic about a year ago and offer 60 and 90 minute sessions for patients to come and get the care they need. I get to spend all of the appointment time one on one with the patient doing whatever it is that they need. I love the chance to talk with my patients and share information with them about their condition. Sitting and providing education is so effective both for helping someone heal, and for showing the person in front of me how valuable they are to me. This model truly sets me apart from most clinics where patients share their providers attention with other patients at the same time.

A lot of my patients have been to see other PTs before without getting relief because they haven’t gotten the attention they need. By getting so much more, focused, time with my patients, I am able to look much more closely at what is going on and design more specific treatment plans for patients. I love the challenge of looking thoroughly at a case and thinking through different ways to approach it if something doesn’t work as expected. I get to go back to my anatomy knowledge and try some alternative techniques from time to time which is really fun.

It is challenging for patients to think about not using their medical insurance for a service, but often using a cash-based PT can save a patient money. If someone is not going to hit their insurance deductible for the year, they can often save quite a bit. Per session my appointments are much cheaper than insurance based clinics AND I tend to see patients for fewer session overall meaning even more savings. It is also a unique setting that works well for those with more complex cases because of the amount of attention they are able to receive.

Can you open up about how you managed the initial funding?

I actually have a very small side business where I make handmade kids clothing. I started that business to essentially just fund my sewing hobby. Well, I had a year where I did several shows and had built up quite a bit in my sewing fund. So I set aside a good chunk for my fabric budget and was able to start Firm Foundation with what was left. Well, actually I was $500 short, but there was a market coming up about 3 days from when I realized I needed a little more. So I took what inventory I had left (it didn’t feel like much compared to what I had had for other markets) and entered the market. I made almost exactly $500 at that market! This strategy earned me the label of “serial entrepreneur” from a good friend.

If you could go back, would you choose the same profession, specialty, etc.?

I absolutely would choose the same profession over again. I absolutely love learning about the body and how to help it work better. PT has been a place that has opened so many opportunities to connect with people on a personal level as well. I didn’t start treating pelvic health until almost 5 years into my career and while I would love to have more experience in that area, I am so thankful for the orthopedic knowledge I do have. It plays such an important role in how I treat my pelvic floor patients and gives me a strong base for how to progress patients toward their goals. I hear a lot of PTs say not to go into the profession for a lot of reasons, but I absolutely love it.

Contact Info:

• Website: https://Firmfoundationpt.com
• Instagram: @firmfoundationpt
• Facebook: Firm Foundation Physical Therapy