Burnout to Balance: How one OT Built a Sustainable Practice (RTS Newsletter #6)

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From Burnout to Balance: How One Occupational Therapist Built a Sustainable Practice

For Marlene Handler, the path to entrepreneurship began with burnout. Working in an insurance-based clinic as a pelvic floor therapist, she found herself seeing up to 17 patients a day, missing time with her children, and struggling with her own health. The demanding schedule wasn't just affecting her well-being—it was compromising her ability to provide the specialized care her patients needed.

Today, Handler runs The Lifted Lotus, a successful cash-based practice in Williamsburg, Brooklyn. She sees a maximum of five clients per day and works just three days a week. Her journey from overwhelmed clinician to thriving business owner offers valuable lessons for healthcare providers considering the entrepreneurial path.

Starting with Strategy

Despite having no business background, Handler approached her venture methodically. She created a slide deck—a comprehensive Google Slides document containing everything from financial projections to brand colors. This living document helped her visualize her business and served as a roadmap for launch.

A key early decision was hiring a business coach. Though the coach had no healthcare experience, her expertise in systems and prioritization proved invaluable. "From the time I started working with her until I had my first client, everything was on target. Every goal was hit," Handler recalls.

Embracing Technology

While Handler describes herself as "not super comfortable with technology," she recognized early that the right digital tools would be crucial for creating an efficient practice. She invested in IntakeQ, a practice management platform that automates scheduling, documentation, and payments.

"The best use of my time early on was to create a system for all of my documentation and invoicing," Handler explains. "I do not want to get bogged down with all the administrative tasks." This early investment in technology—including 20-30 hours learning the software—has paid dividends in time saved and improved client experience.

Lessons for Aspiring Entrepreneurs

Handler's experience offers several key insights for healthcare providers considering independent practice:

1. Be intentional about your vision: Handler designed her practice around her desired lifestyle, prioritizing work-life balance from the start.

2. Invest in systems early: While the upfront time investment in learning new technology may feel daunting, it pays off in long-term efficiency.

3. Research your market: Handler called other practices to understand pricing, waiting lists, and service gaps in her area.

4. Focus on your niche: Understanding and serving a specific demographic—in Handler's case, postpartum clients and young women—can help establish a sustainable practice.

Most importantly, Handler emphasizes the value of being deliberate about your business model. "I was so intentional about what I wanted to create," she says. "This is the life that I want."

For healthcare providers feeling trapped in traditional practice models, Handler's story demonstrates that with careful planning, strategic use of technology, and a clear vision, it's possible to build a practice that serves both practitioners and patients better.

World of Rehab 🌐

• [Speech] A UK study reveals significant pandemic-related developmental challenges among children born during lockdowns, with one school reporting a rise in speech and language needs from 25% to 34% among pre-schoolers, while NHS England data shows over 28,000 children waiting months to years for speech therapy appointments.

• [Physical + Occupational] Starting January 2025, CMS will relax Medicare supervision requirements for physical and occupational therapy assistants from "direct" to "general" supervision, allowing supervising therapists to be available remotely rather than on-site—a change expected to save $242 million over 10 years while improving care access, particularly in rural areas.

• [General Rehab] WebPT's 2024 State of Rehab Therapy report, based on a survey of over 5,000 therapy professionals, reveals persistent industry challenges, including high burnout rates (85% of clinicians documenting at home) and declining insurance reimbursements. It also highlights opportunities in cash-pay models, advocacy efforts, and emerging technologies like AI to shape the field's future.

Indie’s Insights: The Promise of Predictive Analytics 💡

While hospitals race to implement AI for surgical outcomes, we in rehab therapy are sitting on a gold mine of untapped potential. The Cleveland Clinic's recent move to predict spine surgery outcomes got me thinking - what if we could bring this same predictive power to rehabilitation?

Let's be honest: we've all had those moments. A patient walks in, and based on experience, we make educated guesses about their likely progress, potential barriers, and optimal treatment frequency. But what if we could move beyond intuition to data-driven certainty?

The Current State: Why We Need Better Predictions

Right now, our prediction "tools" are primarily clinical experience and standardized outcome measures…

See you in two weeks,

Eddie

P.S. Have thoughts about predictive analytics in rehab? I'd love to hear them - reply to this email!

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