An interview with Mike Mulrenan, PT, OMT, FAAOMPT, President and founder of ProEx was featured in the April 2010 issue of the nationally circulated Impact Magazine, Private Practice Section of the APTA (American Physical Therapy Association).The comprehensive "Member Spotlight" interview covered a wide range of industry topics, including Mulrenan’s business philosophy, marketing strategy and goals for the future."It was a privilege to have the opportunity to share my views on our industry and my vision for ProEx Physical Therapy," said Mulrenan, adding "At ProEx, we have great passion for the profession of Physical Therapy and with Healthcare Reform in its infancy stages, our profession is in a wonderful position to play a role in the process of reform so having the opportunity to share our viewpoints with such a large national audience through Impact Magazine was truly an honor."
Part 1: Personal Data
Practice, Location: Woburn, MA President, co-owner, and founder: Michael J. Mulrenan, PT, OMT, FAAOMPT Size of practice (# of locations, employees): A corporate headquarters, ten clinics, and 100 employees Years in practice: Sixteen years as a physical therapist, nine years as private practice owner. Most influential book: The 4-Hour Workweek: Escape 9-5, Live Anywhere, and Join the Rich by Timothy Ferriss. Although not 100 percent practical for a service industry, his insight on how to value time, whether spent at work or at pleasure, is brilliant. Favorite vacation spot: York Beach, ME Favorite movie: Top Gun How do you like to spend your free time? With my wife and three children. Like most about your job: Creating ideas that enable our company to get closer to achieving its mission. Like least about your job: The fact that I do not actively treat patients any more. This was always a passion of mine and there are many times that I miss patient care, but I always find comfort in knowing that our business is now able to affect the lives of many more patients with good-quality treatment since I have assumed a more administrative role to help grow the business. Most important lesson you’ve learned: That it’s okay to be wrong. You will need to fail at some things in order to succeed. It is important to try something bold or think big because that is what makes great companies.
Part 2: Business Philosophy
Describe your essential business philosophy: Our core value is to be “people focused.” This means that we treat everyone our business comes in contact with as a person first, whether he or she is a patient, employee, referring practitioner, client, or vendor. We work hard to understand the needs of these people and deliver a service that addresses these needs. The relationships we build feed into the strength and stability of our company. Describe your management style: I am a big proponent of setting up systems of accountability, as this allows you to monitor and manage your business efficiently and ultimately allows your employees the freedom to do their jobs without feeling micromanaged. Accountability systems will set clear expectations, drive performance, and give you the opportunity to work on other aspects of your business. Best way you keep a competitive edge: Be a forward thinker and don’t always accept the norm. How do you measure your success? Through the amount of compliments from patients about their experiences at ProEx. I always feel that you can get the best read on how well your clinics are running by talking with the people in the communities you serve and listening to their feedback. Organic growth is almost guaranteed if you are making a good impression on your patients. Goal yet to be achieved: Our mission: to be leaders in clinical care, education, and research, ultimately having a positive impact on the profession. Best decision: Changing my practice name to a more scalable name. My first practice was Mulrenan Physical Therapy and my second was Stratham Physical Therapy. Both had local meaning, but neither was appropriate to scale to a larger region. In 2008, we changed our name to ProEx Physical Therapy. Worst decision: Offering too many services and spreading myself and my employees too thin. At one point, in addition to our outpatient orthopedic physical therapy practice, we had a full-service wellness center with a membership and various programs such as fitness classes, nutrition, and massage. This overworked environment was leading to poor job satisfaction and employee burnout. Toughest decision: Closing down our wellness center, which we had open for five years. We had done a lot of good work and had helped many people in the community with their health and wellness needs, but the time had come to choose one aspect of our business to focus more on. We decided to focus on our physical therapy practice and close the wellness center. This required laying off some great employees and some pretty difficult public relations work to make sure we took care of all of our wellness clients during the transition. How do you motivate your employees? Make sure they all have a sense of purpose, that they understand their role in the company mission, and that they are recognized and rewarded for exceptional performance.
Part 3: Your Practice
If you could start over, what would you do differently? In hindsight, I would have built better infrastructure earlier to allow for growth. I would have had better systems in place to handle the growth more easily and I would have set aside more time earlier to work on the business instead of trying to do everything in the business. Describe your competitive advantage: Our organizationwide commitment to education and a learning culture. Most physical therapists are driven to become better clinicians and are looking for a place to work that provides them with a supportive learning environment. ProEx is establishing a reputation as the place to work, and therefore we not only have an advantage with recruitment but we are also attracting the best talent to our organization. This will in turn allow us to continue to improve our service, which will make patients and referring practitioners happier and ultimately fuel our growth. Describe your marketing strategy and highlight your most successful action: The most stable physical therapy practices are the ones that don’t rely solely on direct referrals from physicians. The best way to achieve stability is to build a reputation within your community so that patients ask to go to your clinic. This strategy of grassroots community relationship-building has been one that we have adopted from Day One. Our strategy is to “get patients before they become patients,” which requires a lot of time and hard work to be active and have a presence in the community. In our experience, it can take up to three years to begin to see the returns of this type of effort. What unique programs do you offer that set you apart from the competition? We offer minimal products so that we can be the best at one, and that is delivering outpatient orthopedic physical therapy. Yes, we do offer subproducts like spine treatment, sports medicine, and work injury management, but they all have the core focus of treating the orthopedic condition in the most effective and efficient manner. We feel that by sticking to our commitment to clinical excellence and our customer service model of being people focused, we will have a competitive advantage. What are the benefits of PPS membership to your practice? PPS is always instrumental in providing private practitioners information and resources to succeed. I have used many ideas from Impact articles and PPS Annual Conference seminars to springboard projects within my practice.
Part 4: The Future
What worries you about the future of private practice? I believe private practice owners need to focus more attention on clinical care and the patient. Being a member of PPS and attending many PPS annual meetings, I have noticed that private practice owners are very interested in business systems, which are very important, but we need to begin to incorporate strong clinical care systems into private practice. We need to remember that our profession begins and ends with the patient, so this should be where we focus our attention the most. The quality of the delivery of our service is what matters most, as this is what will create credibility and autonomy for us in the health care system, ultimately securing the longevity of private practice in our constantly evolving profession. What are you optimistic about? I believe that health care reform will ultimately create an opportunity for our profession to elevate its status and take a more autonomous role. The byproduct of reform will be a focus on cost reduction, not in the form of the old managed-care model but more in reducing the cost of delivering the service. I speak from an orthopedic cost viewpoint, but I believe that with proper evaluation and patient management skills, physical therapists will have an opportunity to be first providers. We will be able to manage nonsurgical conditions in a more cost-effective manner than the traditional medical model of multiple physician visits and overutilization of diagnostic imaging and medicine. We will be a resource for the primary care physician and an asset to orthopedic surgeons if we do a good job at screening strong surgical candidates for referrals to the surgeons. What are your goals for the next year? Add five more clinics and launch our Teaching and Research Institute. Currently we have a continuing education arm to our company and we intend to develop a full teaching institute that offers not only continuing education courses but also a Fellowship Training program in Manual and Exercise Therapy. In addition, this institute will conduct research both independently and in conjunction with universities. We are aiming to have this program credentialed by the APTA and AAOMPT. Where do you see the best opportunities for your practice in the future? Education, in the form of fellowship training programs to be done on site at our clinics, to help better prepare our new physical therapists coming into the profession. I believe private practices that are the strongest clinically will benefit most from a substantially larger amount of insured people seeking our services, including the baby boomer population. Having your business set up to train your clinicians efficiently and to have your business systems in place to be able to scale will give you an advantage in the future. What do private practitioners need to do to thrive in today’s health care environment? As a whole, we need to be committed to clinical care. This means raising the bar on the evaluative, treatment, and patient management skills of physical therapists. We need to move toward specialty fellowship training after entry-level degrees are obtained. We need to value evidence-based practice but recognize that there is so much more evidence we can produce, so we should be innovative and proactive in the field of research. Our research agendas need to be well thought out and have strong clinical relevance in order to be successful in changing practice patterns and what is being taught to our students. We need to make sure that researchers and clinicians are working closely together so that we can focus on what is best for patients. Private practice is the heart of our profession, and I believe we can provide the vehicle to make a difference in our profession. Michael J. Mulrenan, PT, OMT, FAAOMPT, of ProEx Physical Therapy in Kittery, ME, can be reached at firstname.lastname@example.org.