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The Journey to EPTG; Finding Morality Amongst Corrupt Competition

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As I look back into my journey of becoming a physical therapy clinic owner, I can say I have learned numerous lessons the hard way.  Physical therapy facilities in the NJ/NY area are known for being crowded, almost mill-like factories where patients are moved through an assembly line and too often treated poorly.  Coming out of PT school we were all taught to be idealist medical practioners with the treatment revolving around the patient's needs.  We were encouraged to provide the best possible physical therapy experience while keeping our code of ethics in mind at all times.  Coming to New Jersey as a traveling physical therapist in 2010 I was excited.  I moved here from Rhode Island where I had worked for a great PT clinic where 1-on-1 for sessions for 30 minutes was the norm.  At this clinic I was really able to develop and master my skills to embody the principals of genuine physical therapy reflecting what I had been taught in school.

Little did I know, when moving to NJ, I was in for a rude awakening. I found that the physical therapy / chiropractic clinics that employed me were unethical and violated the codes of conduct I had sworn to follow when given my diploma.  Each job I took seemed to get worse and worse.  In some instances, busloads of Medicare patients would get dropped off for the same appointment time.  I had worked in rehab centers prior and have developed a particular fondness for the generic population. Because of the degeneration, progression of arthritis, comorbidities and medical problems they require uninterrupted attention.  Overwhelmed is an understatement of what I felt my first day of work when 10-12 seniors were in a room in the hands of myself, one other PT and a physical therapy aide.  How was I suppose to treat six seniors during the same hour? Legally Medicare requires direct 1-on -1 attention in order too bill. I was cornered and told that if I bill a group code (which was correct ethically), it will significantly lower the office collections and I could possibly be fired.  My mind would wander to how was I suppose to pay my rent and other expenses in Hoboken?  Over the course of 2 years I worked at 5 clinics with the same result.  I would be told to bill aqua therapy in a pool of 10 Medicare patients for individualized treatment plans.  When I refused, again my job was threatened.  I even found my billing was adjusted and my charges inflated by the owner of the business after hours against my knowledge!  I found that my boss was doing this so the struggling company would become more profitable.  So I did what seemed to be the theme, quit and looked for another job.  As luck would have it I was hired the next day with the highest salary offer of my career!  It seemed almost too good to be true, and if fact it was.  On the first day the owner told me he would pay me to stay at home as he didn’t want me to meet the other PT who was on her way out the door.  Seemed like a red flag but I was hopeful. I mean this salary would allow me to live the life I always dreamed!  However this was déjà vu all over again and I learned when things seem too good to be true, they probably are.  During the first week the owner gave me a list of exercises, three to four for each body part.  I was told to not deviate from the sheet of paper.  If someone had a back problem, do these 3 exercises.  If someone had a neck problem, then these 3 would be the exercise plan.  The owner told me to not pay attention to the patients because he did not want them getting too dependant on me.  I was told to do 2 minutes of manual therapy with each patient and after that they would get a mandatory routine adjustment from the chiropractor (billing inflation).  For these who aren’t familiar with PT billing, 8 minutes of manual therapy is the minimal requirement for billing.  Of course I started asking questions and remained doing the full allotted time for proper unit billing. After 2 weeks the owner called me before work and told me he thought the clinic was “too busy” for me and he would have to let me go.  This was the best thing that had ever happened to me.  Of course it was a blessing in disguise as I did not see it this way immediately.  I was able to pick myself up and make a promise that this would not happen again! I had one option….open my own clinic and do it the right way.  If not I would be fighting a losing battle for the remainder of my career.  So in 2012 my best friend Dr. Drew Nussbaum and I found the perfect space on the 4th floor of 31 Montgomery and we opened my dream clinic.  Unsure of exactly how to run a PT clinic we rented the space and learned through trial and error.  Everyday I go to work excited without that pit in the bottom of my stomach.  Over the course of 5 years we have hired 3 other physical therapists, a physical therapy assistant, 2 PT aides and 2 office managers.  We have hands on manual therapy every treatment for a minimum of 10 minutes emphasizing direct contact throughout each appointment.  We offer 60 minute 1-on-1 sessions with our senior citizen Medicare patients to ensure they are getting the attention they need.  We offer 401K, health insurance, and competitive salaries for our staff.  We pride ourselves on DOING THE RIGHT THING.  I am thrilled to announce the opening of our second Weehawken office opening April 1st at the Ferry and Light rail Terminals in Port Imperial.

Though it was a difficult and often challenging road to get where I am, I feel at peace knowing I followed my heart and took the leap of faith going off on my own.  Being an entrepreneur comes with challenges but looking back I wouldn’t change a thing.

-Jaclyn Fulop

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