Resilience, ingenuity and adaptability are key characteristics of companies that managed to weather the economic turmoil of the COVID-19 pandemic. But these principles have guided Summit Physical Therapy’s business model from day one.
In this Q&A, we chat with PT Summit co-founder Jay Cherok, PT, DPT, Cert. MSKUS, on what it takes to build a physiotherapy clinic in a rural Alaskan town of 6,000 – and how the lessons he and his team learned early on helped them navigate the rapid and furious changes resulting of COVID-19. Jay also shares:
- significant challenges that Summit PT overcame during the pandemic,
- how he was able to maintain a full complement and offer them bonuses after the lockdown,
- how they are doing now compared to before COVID-19, and
- his advice for other therapists who are completely reopening their practices.
How long have you been PT?
I have been a physiotherapist since 2011 and loved every minute of it. My wife and I started out as traveling PTs until we found a home in Alaska in 2013.
Can you tell us a bit about your journey up to the co-founding of Summit PT?
I have always enjoyed problem-solving, being creative and working with people, so pursue a career in physiotherapy felt like a natural fit. After graduation I became a travel specialist – along with my wife / co-founder – and we moved across the country for about two and a half years. I was placed as director of the PT in several clinics during these years, which allowed me to see different management structures and Business plans. My wife and I moved to Alaska in the spring of 2013 on a travel contract which became a salaried position for the next five years. During this time, I ran a small three PT clinic, which I helped grow up to twice its size and expand to another location offering aquatic PTs. Ultimately, the growth model I employed – along with our goal of providing services to growing Medicare and Medicaid populations – did not match the clinic owner’s goals. So, in May 2018, I made the decision to split up and fend for myself.
Summit Physical Therapy was conceptualized late at night with the help of colleagues with whom I had worked and managed for a few years. This group was young and talented, and they had clinical chemistry that I’ve never experienced elsewhere. They also shared my ambition for growth and support for the underprivileged. We decided it was time to take the risk and be our own bosses. Summit PT opened on June 4, 2018 and it was a major turning point in my career, one that I couldn’t imagine doing differently.
What inspired you to start a physiotherapy clinic in a remote Alaskan town of 6,000 people?
Physical therapy is something I love to do, so I thought, why not do it in a place that I love too? Homer, Alaska is a dream place that many people from all over the world visit for a week or two. So having the opportunity to call this place home while pursuing my passion has been an easy sale for me. As I mentioned, I love problem-solving and being creative – and being adaptive is a prerequisite for living in rural Alaska.
What were some of the unique challenges of setting up a boutique in such a remote location?
Logistics is the first thing that comes to mind. Whenever we have tried to order something we have encountered high fees, delays, or outright refusal. I couldn’t count the number of times we’ve been told, “We don’t ship to Alaska.” It took a few details – and a lot of price negotiation – but we were able to find an alternate shipping method. We would order our supplies sent to Washington, then put them on a barge to be picked up at a local store in Homer. We also ended up making a lot of our own gear or hiring local friends and builders to build some of it. We brought in some friends to help us paint the clinic, install the flooring and assemble the furniture so everything was ready in time for our opening.
We also had to adapt our marketing strategies to adapt to our target population. We have found that one of the best ways to spread awareness of Summit PT was to be in public, volunteer, and attend a variety of events. It has helped our community to partner with this new company and brand. We also used digital media, newspaper articles and direct contacts to raise awareness.
How have you used these challenges to the benefit of your practice?
These challenges have taught us to be adaptable and not be afraid to deviate from the norm. For example, instead of buying some of the supplies we needed, we used our resources to craft these things instead. We have also learned that we cannot be passive in our marketing – we have to go out and get the attention of our patients. These lessons are reflected in our economic model. We don’t always have the ability to simply buy solutions to our operational problems. Rather, we need to create solutions and actively adapt processes to make them work for us. This mindset has not only helped us save money, but also gave our people a sense of accomplishment knowing that they helped create what we have today.
Do you think the business model you created before COVID-19 helped you weather the pandemic storm? If so, how?
Absolutely! We were constantly facing unforeseen challenges and last minute changes leading up to COVID-19, so we felt like one more day in the office when we started planning for the inevitable arrival of the virus. We had myself and my wife, our office manager and a few others in the war room laying out the closure policies and telehealth procedures, verify telehealth reimbursement and coverage, create public statements, refine marketing strategies and review our risk mitigation plans. We have often collaborated in this way: first to gather the spirits, then to divide to conquer.
How has the pandemic affected Summit PT’s business operations (i.e. patient volume, workforce and services offered)?
Being in rural Alaska, we initially had an advantage as cases were slow to increase in our area, that is, until the tourist season and spring break arrived. During this time, we have closed our doors to inpatient visits for six weeks out of care for our patients, our community and our staff. Throughout the lockdown, we continued to pay our employees while they worked from home, and I’m happy to say we didn’t have to fire or fire a single person. We also used telehealth with all patients who were suitable for virtual care and interested in the service.
When we first opened our doors there was a slight decrease in patient volume, but we staggered appointments and only had two PTs working per day – one in the morning and one in the evening – so it all worked out. conducted in accordance with our mitigation plan. As we built therapist schedules up to 40 hours per week over the next few weeks, we kept the staggered appointment schedule to minimize the number of patients in common areas at the same time. We continue to use this tactic, with make everyone wear a mask, wash their hands before and after their appointment, answer screening questions before each appointment, have their temperature taken before appointments, among other social distancing and cleanliness protocols. Our patient volume continued to grow steadily after the lockdown, so much so that we had to hire an additional PT to meet demand.
How were you able to maintain a full workforce and offer every employee a bonus once Summit PT reopens?
We are keeping a minimum amount of cash available to cover operational costs during events like this pandemic. We were also able to apply and demonstrate the inclusion criteria for the Paycheque Protection Program (PPP) loan, which allowed us to pay our staff transparently while the practice closed and until cash flow resumed. Bonuses were paid to administrative and clinical staff for their continued efforts and the increased risk they took in continuing to provide care to our patients. Having a close eye on your numbers and planning for a rainy day has really turned out to be helpful for us here.
What was the biggest challenge you had to overcome during the pandemic?
Misinformation and no information about COVID-19 has been our most difficult challenge. As the pandemic evolved and the internet became inundated with shifting views on masking, social distancing, vaccines supposedly containing computer chips, and other fake news, it was getting harder and harder to tell. make clear and objective decisions for the health and safety of our patients and staff. It is not often that we are faced with a new virus in which decisions are made based on information that is quickly discovered. That said, each of our protocols had to be carefully researched and considered to ensure that we were doing our best for our patients.
What has this pandemic taught you about business continuity planning and how will you adjust your long-term strategy accordingly?
This event taught us that things can go wrong in an instant. It is relatively easy to plan for the ebb and flow of seasons in the rehabilitation industry once this pattern is recognized and can be predicted. The pandemic, however, was not on our radar. We have learned that planning for a setback and keeping a close eye on our finances has allowed us to retain staff and continue operations in a newly adapted model. As rare as anything of this magnitude is, there are other events that could compromise the health of our business, and we must prepare for the worst. Increasing our minimum cash flow, having a very low debt-to-income ratio and respecting the budgets set for purchases and commitments will not only keep us afloat, but also thrive when the next storm hits.
How is Summit PT doing now?
Summit PT is doing very well. We are proud to have new clinicians joining our team and we have even started thinking about expanding to another satellite location (we already have one located in the even more remote town of Seldovia, Alaska). Best of all, our patients have confidence that our precautions and protocols are working, which has brought our September visit count for this year to last year.
What would you say to other therapists who reopen their practices and navigate the world of PT after lockdown?
When you reopen your clinics, make sure your decisions are made objectively and put the health of your patients, staff and yourself first. Ultimately, people – and their livelihoods – are everything that matters. These are stressful and difficult times, but there are many hidden opportunities. And while we can’t choose which cards are dealt to us, we can choose what to do with them.
You have all faced adversity before and you have won. Now, more than ever, it’s time to win again.