Putnam Physical Therapy expands with family
Tuesday, Apr 2, 2013
Rachel Grubb with Putnam Physical Therapy moved back to Cookeville with her husband Matt, also a physical therapist, to work with her father, Larry Burks at what is becoming more of a family business.
Burks’ Putnam Physical Therapy Services was a two-physical-therapist shop for the longest time. But six months ago, he got a surprise that expanded the number of therapists and broadened the type of therapy his office offers.
His business became more of a family affair when his daughter, Rachel, and her husband, Matt, both doctors of physical therapy, came home from Montana to join the practice, bringing skills and training in such areas as pediatrics, manual therapy, athletic training, and strength and conditioning.
Until then, direct family involvement had been smaller. Burks’ wife, Ruth, had been involved in the business aspect of the practice for a long time. And his son, Nathan, a physical therapist in Nashville, has worked one day a week for the past year and a half to help out his father and bring his daughter to see her grandparents.
Putnam Physical Therapy Services is like many small, family-owned businesses that begin the succession of ownership within a family to build on a legacy so it continues to flourish. And these businesses have a substantial economic impact in this country.
According to Family Enterprise USA, a non-profit devoted to extolling the positive contributions of family-owned businesses, it is estimated that there are 5.5 million family-owned businesses in the United States employing 63 percent of the workforce and making up 78 percent of all new job creation.
Rachel and Matt Grubb had spent a year in Montana rising up the management levels in a chain of physical therapy offices there but felt like they had gone as far as they could. So the prospect of eventual ownership was appealing, and they got to come back to family in Tennessee.
“Unless you are a chain, it’s very difficult to start a private practice,” Rachel said. Matt added, “It’s a pretty unique situation to walk into what Larry has created here, which is a great reputation as a great clinician. That takes time to build.”
Larry Burks had gone on his own after four years doing inpatient and outpatient physical therapy at Cookeville Regional Medical Center. He’s seen major changes since.
“When I got started, insurance was pretty liberal,” Burks said.
In recent years, reimbursement has seen a steady decline, however.
“They are going to start looking more at outcomes in the future,” he said of insurance companies. “It really places a premium on physical therapy as a service to be effective and deliver great results.”
He’s also seen more people coming in willing to pay cash rather than go through insurance companies. That’s partly because of high deductible health insurance plans a lot of people have gotten to lower their insurance costs.
Four years ago, the law changed to allow patients to directly access physical therapy instead of needing a referral from a doctor.
Physical therapists had sought this change. In 2011, the journal Health Services Research produced a study partly paid for by the American Physical Therapy Association that showed self-referred patients had 14 percent fewer therapy visits and healthcare costs were 13 percent lower than doctor-referred visits.
Burks has always spent time building relationships with doctors and continues to do so. “That’s still the most solid source of referrals,” he said.
Patients who come in directly often are treated with physical therapy but at times the therapist may refer the patient to their doctor.
For several years, physical therapists around the country have been pushing for “fair co-pay” legislation. Such legislation is in the Tennessee General Assembly now.
Currently, physical therapists are classified as specialists in the same category as the likes of neurologists or rheumatologists. Patients must pay much higher co-pays than they do when seeing a general practitioner.
It’s onerous on patient finances because physical therapy requires ongoing visits and the co-pays, which are sometimes as high as $50, add up.
Of course, a big change came when Matt and Rachel decided to join his office. Both brought different skills that complemented what Burks was already doing in the office. They have experience treating various orthopedic problems including spine, knee and shoulder injuries.
In addition to being a licensed physical therapist, Matt is certified in both athletic training and strength and conditioning, which is advantageous when working with athletes.
“I have worked in both sports medicine and sports performance, so that experience helps when returning athletes back to playing their sport,” Matt said.
Rachel specializes in pediatric patients and infants with torticollis, a condition characterized by shortened muscles in the neck and decreased range of motion.
“That’s one of my favorites to work with,” Rachel said. “I also love working with women who are having pregnancy-related spine pain.”
All three of the therapists have specialty certifications that required many hours of post-graduate education and testing in the area of spinal problems.
Although every patient coming to Putnam Physical Therapy Services has their primary therapist, all three may with a single patient at times with their different treatment techniques coming into play to bring about the best results.
That’s a lot of family time together. “We’re a really close-knit family,” Burks said.
They are so close-knit in fact, that Matt and Rachel lived with Larry and Ruth until they bought a house.
“I learned that Rachel is a really good cook,” Burks said.
There are family photos on the wall – Rachel as a cheerleader at Tennessee Tech, Nathan playing basketball at Tech, Burks playing basketball in high school and his wife as a cheerleader at Motlow State.
He also has photos on the wall of children of current and former employees.
“My dad is a great boss,” Rachel said. “If he wasn’t, we wouldn’t be here.”