Cash Based PT Practice as a New Mom | Dr. Bre Guettler
The short answer: Dr. Bre Guettler built her cash based PT practice in less than two years, hired her first physical therapist, and then used her maternity leave to rethink her business around her family. Today she works in focused blocks while her daughter naps, has condensed patient care to two days a week, and is searching for her own space, proving that motherhood and practice ownership can grow together.
Can you really build a practice while raising a newborn? For many physical therapists, becoming a parent feels like a reason to put business ownership on hold. Dr. Bre Guettler's story shows it can actually be the moment your business gets clearer.
I'm Morgan Meese, a physical therapist and business coach for healthcare providers starting and growing their own practices. Bre first joined DPT to CEO in June 2024, later joined our team, and is now one of our coaches. In this interview, she shared what it's really like to run a practice as a new mom, plus her best advice on hiring, finding a space, and marketing in your community.
Key Takeaways:
Pick a clear niche so your messaging speaks to the right people
In-person community outreach can grow a practice faster than online content alone
Maternity leave can become a powerful time to refine your business
Block scheduling helps you protect focused work time around your family
Know your business inside and out before you hire
Compare every rental option carefully before signing a contract
If you want help building a practice that fits your life, Join DPT to CEOÂ and let's map it out together.
How Did Bre Start Her Practice?
Bre was working at a small, family-owned clinic that started double booking patients. She'd worked in that environment before and knew how much it took a toll on her mental health. So in 2024, she quit her job, picked up several PRN positions, and started building her own practice.
Her goal was simple: step away from the revolving door of outpatient care and create a life with real time for her husband and children. You can read more about how she got started in her first interview with us.
Today, her practice, Rocket City Performance Therapy, serves barbell athletes, including CrossFitters, powerlifters, and Olympic lifters. She helps them overcome nagging, recurring injuries so they can keep training and performing.
Why Does Choosing a Niche Matter So Much?
As a coach, Bre regularly sees students arrive with dozens of ideas. Her advice is to choose one. As she puts it, "If you have five million things to focus on, then you're not going to make progress in five million things."
Niche marketing helps your messaging speak directly to the person you want to treat. Once Bre began speaking specifically to barbell athletes, those were the patients who started booking. Her very first patient was a powerlifter, even though the problem was TMJ pain.
How Can You Build Confidence Talking to Potential Patients?
Bre is a self-described introvert, so in-person outreach didn't come naturally at first, but once she practiced it consistently, community marketing became one of her strongest client sources.
With students, she role-plays real scenarios. Imagine you overhear someone at the gym saying their knee hurts. How would you start that conversation? It usually feels awkward initially, but it improves quickly with repetition.
Her reminder is reassuring: just be a person.
Most people are too focused on themselves to notice if you feel a little nervous. Even Bre has to rebuild that confidence after time away, including after her maternity leave.
How Did Bre Prepare for Maternity Leave?
Before her daughter arrived, Bre planned to hire a second therapist to cover a full caseload while she was away. She interviewed five candidates. Two were strong fits, but one decided she couldn't take on more without overcommitting, and the other was expecting a baby herself.
Instead of forcing the wrong hire, Bre paused some patients and discharged others who were doing well. That created an unexpected two-month window to work on her business.
Between feedings and naps, she updated her website, switched to a new EMR, batch-created Instagram content, and built marketing materials for a hybrid program she hadn't been promoting. "Maternity leave was kind of a blessing in disguise," Bre shared, because she finally had time for projects that were always pushed aside while she was treating patients.
When she came back, her momentum surprised her. Growth that took about four months the first time took her roughly two months the second time. Because she'd tracked her data, she knew exactly which channels worked. She quickly scheduled seven community events in two months and began testing new digital marketing, including Meta ads and a TV ad.
How Does a New Mom Manage Her Schedule?
Right now, Bre works in 90-minute to two-hour blocks while her daughter naps, usually about three blocks a day. One might be her CEO block, while another becomes her marketing block.
We teach block scheduling inside DPT to CEO, and Bre jokes that having a baby basically forces you to master it. Whether you're a new parent, an ADHD entrepreneur, or simply juggling a lot, protected time blocks make it easier to focus on what matters most. If you want to see how this works week to week, here's a closer look at how I structure my own PT business.
Flexibility matters too, since some days naps simply don't go as planned. That's exactly why Bre focused on cutting the fat from her business. When you know your highest priorities, it's much easier to adapt without falling behind.
What Does "Pick Your Hard" Really Mean?
Owning a business is hard, and so is working a 40-hour job where you see three patients at a time. As Bre puts it:
"You have to pick your hard."
The real question is which choice fulfills you. Are you actually living, or just functioning? I shared a similar question I heard recently: are you happy about the reason you're tired? Running a business will be tiring at times, but for many of us, it's a tiredness that feels worth it.
What Should You Know Before Hiring?
Bre hired a pelvic health physical therapist who's also a CrossFitter and loves working with barbell athletes. Before making it official, the two talked for about four hours about treatment style, expectations, pay, and boundaries.
Her biggest piece of advice is to fully understand your business before you hire, because if you don't know the heart of your practice, it's difficult to find someone who shares your vision.
She also prioritizes clear communication and respect. She sets boundaries around her team member's schedule, always asks before adding responsibilities, and reminds her that it's okay to say no. Of the five people she interviewed for her second role, three weren't the right fit, so she didn't hire just to fill a seat.
I always recommend wearing every hat yourself first, so you can learn what works, what you enjoy, and what you're ready to delegate.
How Do You Find the Right Space for Your Practice?
There are many ways to see patients. I've treated out of my garage gym, inside gyms, through mobile visits, and with telehealth physical therapy. Bre currently treats patients in their homes or at a local gym. Now that she's a mom with two days of childcare, she's condensed patient care into two treatment days, seeing 10 to 15 people in that time. Consistency matters more than ever, so she's searching for her own space and plans to offer mobile visits at a higher price.
She started by reaching out to her network, which led to three to five leads from gym owners and realtors. Her advice is to spread your net wide and compare location, size, flexibility, lease length, insurance requirements, and price before committing.
She also points out that working with a gym owner can feel very different from signing with a leasing agent. Gym owners may be more flexible, while leasing agents often present a standard contract with less room to negotiate. For more guidance on evaluating your options, check out how much it costs to rent a PT practice space.
What's Bre's Final Advice?
Just do something. Pick one thing and take action, because waiting for the perfect time can quietly turn into years. "There's always tomorrow, but today is the best day to start," Bre said.
Even if you can't finish a whole project today, choose the piece you can complete. One small step each day adds up to 365 steps forward in a year.
Bre's story shows that physical therapy entrepreneurship doesn't have to look one way. Whether you offer cash pay physical therapy in a gym, in homes, or eventually in your own clinic, you can build a practice around the life you want. Our coaching team is made up of women PTs, and as women entrepreneurs, we've all walked this path too.
You can find Bre on Instagram at @breethedpt, follow Rocket City Performance Therapy on Instagram and Facebook, or visit rocketcityperformancetherapy.com.
Ready to Build a Practice That Fits Your Life?
Whether you're starting from scratch or ready to grow, the right plan and support can make every step feel more manageable. When you're ready to start a cash based practice or grow one you already have, Join DPT to CEO. My team and I would love to help you build a cash based physical therapy practice around your family, your goals, and your life.
Listen to this episode on my podcast!
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