Looking all the way back to my college graduation with a BS in PT, I was eager and enthusiastic about the amazing knowledge base that I was starting my career with. I went on to work in a rehab setting with adults with orthopedic, cardiac, and neurological conditions and diseases – with many diverse comorbidities. This was 1994. PTs were well paid and sought after in the job market and made a significant impact on people’s quality of life. Why would I ever do anything besides this?
The first cue may have been when Mike decided to change his plan from pre-law to PT. Thinking back, that may have been the impetus that set the wheels in motion in my head as I now had an ally. It wasn’t so much of a surprise that one of my siblings believed in the human body and all of its potential as much as I did, we were raised that way, but a validation of the potential in the desire to make it his life’s work. As I waited for Mike to finish his PT degree, I completely immersed myself in every PT related growth opportunity available: extra work, research, editorials, continuing education and anything else I could find to feed this growing passion.
At the same time, the US insurance industry was changing. “Managed care” was making its way into our area and there were new limits being imposed on PT practice patterns, mostly throttling back and cost containment efforts. Being sick was not only getting more common, it was getting more costly. While “sharing the responsibility” for health by the consumer seems reasonable, it certainly wasn’t simple. The result was frustration for everyone as outcomes suffered and costs continued to rise. Somehow there was BOTH over-utilization (of “what insurance covered”) and underutilization (of what the patient actually needed) - clinicians were becoming technicians and masters of counting the minutes of time spent; there had to be a better way.
Still a student, Mike was trying to graduate “with honors”, which meant a thesis. True to form his dig into the business of Physical Therapy led him to a different vantage as to the value of the clinical skills. Our treatment was not our greatest asset, our knowledge of the moving body was. PTs weren’t “fixing” injuries, they were helping people to take responsibility for a critical aspect of their health; they were helping people to be more effective and since according to Steven Covey habit 1 was “Be Proactive”, that’s what he decided to call his fictitious thesis company…only to forget about it until I brought it up a year or so later.
By Mike’s graduation the job market had reacted to the new “management” scheme for care. Jobs were harder to come by for PTs and they had many restrictions. Anyone who knew us, Mike especially, could surmise a rank-and-file role wouldn’t be a great fit. We found ourselves working “institutional care” for adults with severe disabilities. It was hard work, occasionally rewarding and afforded plenty of time to discuss the idea of opening a practice. A few too many moments of “excessive management” (a story for another day) made it clear, by September 1998, it was time.
To say we were under-capitalized (we had no money for start-up) and under-experienced (we had never done anything like this before) would have been an understatement. What could go wrong? We did however have energy, a strong belief in ourselves, an agreement to outwork and reinvest in the practice and the support of family. So we scratched together a few thousand dollars, registered an LLC, got a couple of pagers, a fax machine and a handful of business cards and put our stake in the ground. We’d call it Pro-Activity, and it would be our life’s work to help people find the highest potential in theirs.
-Amy W.
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