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From Healthcare Burnout to Racquet Sports Guru with Sam Ritz

Dr. Sam Ritz, PT, Owner of Functional Physical Therapy

Join us during our latest DPT to CEO interview where we chat with Dr. Samantha Ritz, PT and racquet sports expert. Sam is the owner and operator of Function Physical Therapy, a cash based physical therapy practice based out of Dallas, TX, servicing tennis and pickleball players.

Sam shares her path from healthcare burnout to the steps she took to build a thriving cash based practice. From quitting her job after speaking with Morgan about her practice aspirations to now living her dream life as a solo entrepreneur, Sam sheds light on what it takes to be a successful cash based practice owner.

What we're covering:

Tell us about you and your career and what led you to start your own practice.

Sam: Yeah, of course. So, I graduated in 2022 with my doctorate from the Health Science Center here in Fort Worth, Texas. Like most people, I took an outpatient job right out of school with a new grad salary and hours. Initially, I really loved it. I love being a physical therapist; that's never been the issue. But once my caseload started to grow, it became more difficult. About three months into working at the clinic, my clinic director went on paternity leave. There were zero plans in place, so I had to manage the clinic with a student for a month. It was chaotic, but we made it work, and I realized I could handle it.

At the end of the year, my clinic director left to open another clinic, and they were hiring for a new clinic director. Despite only starting in May, everyone encouraged me to go for the job. By November, I put my name out there and ended up getting the position. I was really excited. I started in January, but the person who was supposed to return from maternity leave didn't come back, and we couldn't find anyone willing to take the low pay. So, I managed by myself. There was one week I saw 101 patients alone, without any student assistance. It was just me and my tech. By the end of that week, I cried a little and then went to get a margarita.

I was becoming unhappy but still loved my job. I had signed a two-year contract with a signing bonus that I would have to repay if I quit early. I was trying to make it to the two-year mark. Meanwhile, I had been listening to Morgan's podcast and a few others, and I always wanted to open my own business. I aimed to get three years of experience before starting my own practice. In August, after a year and a half, I talked to Morgan, expressing how exhausted I was and unsure of how much longer I could continue. We discussed the pros and cons of staying or leaving, and I decided it was time to move on. Some patients had even asked when I was going to start my own thing, which validated my decision.

Though it was scary to transition from a salary to no income, I decided to go for it. I signed with Morgan, and we started building the business. I gave my four weeks' notice, took a week off after quitting, and then started my own business two weeks later. Excitingly, I had patients the very first week. We hit the ground running, building the business. Now, months later, I'm running my business full-time. I do a little PRN work on the side, but mostly focus on my own practice. It's been great.

Learn how to get past the fear of the unknown and take the leap into cash based practice ownership in the blog post here.

Tell us about your practice and what kind of patients you see.

Sam: My practice is Function Physical Therapy, specializing in tennis and pickleball injuries. I was a college tennis player and still play both tennis and pickleball, so it's a passion of mine. I love treating this patient population. My practice is mobile outpatient, so I go to people's homes and provide services such as dry needling, cupping, and soft tissue work. I absolutely love it. I wasn't sure how I'd feel about being in the car so much, but I'm a podcast enthusiast, so I just put on my podcasts while traveling to my patients. There's a bit of time freedom that I really missed when I worked in outpatient settings. I never thought I'd be the type of person who could just go play tennis in the middle of the day when I wanted to, but now I can.

Morgan: Yeah, I know. I catch myself a lot thinking about how I'm in the gym for several hours a day at all times of day or how I can take my dog for a walk at 11:00 a.m. in the middle of working and be outside. One of the worst things about working in outpatient was driving to work when it was still dark in the morning, spending ten hours in the clinic, and then leaving when it was dark outside. I realized I didn't want to live like that.

Tell us about your mindset on the journey of being a business owner including how it started, how it's changed over time, and where it is now.

Sam: My mindset when I first started was that I knew nothing, so it was really great to have a business coach. I would always recommend having a business coach because I'm not sure I could have done it without one. There's just so much going on, and sometimes you need a checklist or someone to help you prioritize tasks. It's easy to get overwhelmed, especially in healthcare, where you have to set up your NPI and handle liability issues. Once you get through that, things start rolling smoothly.

I had a really good first two months because I was new and well-known in my community. Then the end of the year came, everyone had met their deductibles, and it became slow. People preferred using their insurance over paying for cash therapy, so November and December were extremely hard. I was surprised at how difficult being slow was for me. I thought I would love the free time, knowing it would pick up again, but I struggled. I felt the need to fill my day with something and became frustrated when it wasn't happening.

At the end of the year, I had to sit down and set realistic goals. After that, things got better. The winter was slow, but spring became busy. Shifting my mindset was really hard. As a very type-A person, I valued myself based on how productive I was during the day. With this type of business, productivity doesn't always match up with immediate results. I had to come to terms with the fact that I was doing a lot of backend work that would pay off in the future, even if I wasn't seeing the benefits right away. This realization was particularly difficult from November through January, but now I feel more at peace with it.

Morgan: Yeah, it's hard because the way to get consistent, good results in your business is by putting in consistent, good work, but the results are always delayed. You don't see them at the same time. Especially with marketing, all the effort you put in now will show results two, three, or six months from now. Our current mindset wants to see results immediately and feel successful right away.

Regarding valuing yourself and your self-worth based on productivity, you have to find different ways to feel successful. For me, it's a very active decision process. I have to actively participate in deciding what makes a successful day. Sometimes it means sitting at the computer for eight hours until a project is done, and other times it's just having five appointments and getting nothing else done because I was exhausted. Both can be successful days, and this shift in perspective is quite interesting.

Learn how to keep a positive mindset around the work you're doing now that's going to pay off later in the blog post here.

How have you figured out ways to be accountable to yourself and maintain your boundaries?

Sam: It was hard for me at first, to be honest. I'm very type-A and checklist-oriented, so staying accountable to myself was actually harder than staying accountable to a boss. I felt like I could give myself too much grace because it was just me. I had to stop setting goals or checklist items with the mindset that I could get to them whenever, as I would always push them back. I was really surprised at myself for doing that, so I needed someone to check in with me. Working with you was great because I knew I had to get things done by our weekly check-ins.

Now, without that regular check-in, I make sure to set deadlines with someone else who holds me accountable, ensuring that projects happen within a set timeline. This has been really helpful. Setting my own checkpoints and being the one accountable was difficult at first, but now I make sure that my checkpoints are necessary for the next step to happen.

It's been beneficial for me to break down tasks. I used the 365-day calendar method, where you create a year-long plan. For example, if you want to write a book by the end of the year, you break it down into smaller, manageable tasks. In two months, you just need to write a certain number of chapters. I applied this philosophy to my smaller goals, which has been really helpful. Breaking tasks into bite-sized chunks, such as doing something in two days versus two weeks, has made it much easier to stay on track.

Morgan: I love that idea. It takes time to get to a place where you can look at the whole year, but even taking the time to look at the next three to six months and figure out the big goal, then break it down into smaller pieces and put it on your calendar, can eliminate so much decision fatigue when you're executing tasks. This approach makes it easier to get things done.

This year, I've also been meeting with a friend twice a quarter to go over our annual and quarterly goals together. It's like having an accountability buddy. This low-key accountability to someone else helps because three months ago, I said I would do something, and now we're having our meeting to see if I did it or not. That's been helpful too.

Tell us about your experience learning to sell physical therapy for cash.

Sam: I'm very grateful because my target audience is Country Club tennis and pickleball members. It's important to pick a niche where the client base is available. With cash-based therapy, especially in Texas where we don't have full direct access (we have 10 days or two weeks), patients still need a referral. Often, people ask why they should come to me when their doctor takes insurance and recommends clinics that take insurance. Niching down is crucial because I'm the tennis and pickleball specialist here—no one else does that in the Metroplex.

In my outpatient practice, I only got 10 or maybe 15 minutes with each patient, often sharing my time with three other people and a tech. I'm a big believer in manual therapy, which not everyone is, but I think my patients should get better faster. In my cash-based practice, I offer an hour of my time, my brain, and my hands. That's really what I went to school for. While I can show exercises and have a great personality, the real value is in my expertise and hands-on therapy.

I sell my packages on the basis that you can't get this level of personalized care anywhere else, and I come to you. What I charge is reasonable, and some patients even tell me I don't charge enough. When selling packages, I sometimes encounter people on the edge of deciding. I ask why they called me, and often, they’ve tried everything else and see me as a last resort. I then discuss the value of their health and how much it's worth to be able to play with their kids or join a league again. Physical health greatly affects mental health and overall well-being.

I struggled with feeling guilty for charging because I enjoy what I do, but the value is there. We went to school for seven years to learn this. In my first call with potential patients, I focus on direct and specific goals. We're not vague; we get right to the point. I use specific techniques like dry needling and soft tissue work, which are great supplements. This approach has been working out very well so far.

Morgan: I cannot emphasize enough the importance of niching down and picking a specific target market. You can't just say, "I'm selling physical therapy and I can help relieve pain," because who cares? You can get that anywhere. When you position yourself in such a way and have a specific offer where through physical therapy you can provide a specific result that helps people achieve the desired outcomes in their lives, it becomes worth paying for.

When you show potential clients how you've helped people like them in the past and demonstrate how those people now enjoy the dream life they're hoping for, such as getting back to playing tennis and pickleball with their friends, it becomes a no-brainer for them to make that purchase.

Learn more about the benefits of niching down and how it can impact sales in the blog post here.

What advice would you have for someone who is wanting to start their own practice but is nervous or worried about it? 

Sam: It sounds crazy, but just do it. I'm a doer, so when I was on the edge of making a decision, I called Morgan with the intention of saying, "This is what I'm going to do." When she asked if I was sure, I said yes. She then suggested, "Why don't you just quit?" and I decided to go for it. I think I had already subconsciously decided this was going to happen. I realized it's not so serious; we often take life too seriously. I'm a very serious and intense person, but I tried to take a step back.

If I have, on average, 80 years to live and want to do all these things, I asked myself if this job would allow me to do them. The answer was no. It was impossible to take PTO, I was exhausted by Thursday, and I was missing out on a lot. I thought, "I'm never going to be as young as I am now, whether that's 25, 35, or 45. I'm never going to know as little as I do right now."

When I looked at it that way, I thought, why not? If it goes south, I can always get another PT job; there are plenty out there. Why not try for a year? If I'm giving advice, I'd say give yourself a year, not just three or six months, as that's too little time. After a year, if it doesn't work out, you will have learned enough skills in other aspects of business building. You might not have to go back to outpatient or acute care; you can find other opportunities, like building a website for someone, which is something I learned while building my business.

It's not the end of the world, and you shouldn't take it so seriously. This might sound shallow, and I understand people have different circumstances and considerations. However, take a step back and ask yourself, "Will I be disappointed in 20 years if I didn't do it?" If the answer is yes, then do it.

Morgan: I love that that is the number one piece of advice that everyone gives.

How to contact Sam:

Listen to this episode on my podcast!

DPT to CEO: The Podcast


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