Technical paper

Business plans in physiotherapy: a practical guide to writing a business plan for the non specialist
Katie Wassinger, G. David Baxter
School of Physiotherapy, University of Otago, Dunedin, New Zealand

Introduction
Business plans are commonly used within the eld of commerce as an essential element of the planning process for starting a new business venture. In physiotherapy, and in healthcare more generally, business planning is often considered the preserve of those working in the private sector (i.e. for developing plans for establishment of private practice clinics), rather than those working in other practice settings such as hospitals or community clinics, or in education. However the principles underpinning the development of business plans have relevance beyond cases of new business start up, including but not limited to, activities such as: starting a new service or facility within a hospital physiotherapy department, expanding a community-based service targeting womens health, organizing an annual professional or scientic conference for a society, branch or chapter, or planning the introduction of a new academic course offering. However, and despite the potential relevance of business planning skills to a wide range of activities within physiotherapy, these are not commonly covered in the curricula of pre-registration training for new professionals, and are generally only incorporated into continuing professional development activities for relevant specialist interest groups or chapters, i.e. private practitioner associations. Given the importance of this topic, and the current lack of sources and resources currently available in the physiotherapy literature, this paper provides a simple introduction to business planning for physiotherapists, focusing on the practical aspects of the task of developing a formal business plan.* For more detailed discussion of the principles of business planning, the reader is directed elsewhere. Formulating a business plan is a vital part of starting or running a successful business, and should also
Correspondence to: David Baxter, School of Physiotherapy, University of Otago, 325 Great King Street, PO Box 56, Dunedin 9056 New Zealand. Email: [email protected] * This paper is based upon materials developed by the authors for teaching in management for physiotherapy students at the School of Physiotherapy, University of Otago.

be developed when beginning a new venture.1 It is the most important document to be prepared for a new physiotherapy practice.2 A business plan needs to be t for purpose: it may be long and detailed, e.g. for a planned new franchising arrangement, short and simple, e.g. for the development of a new service for an existing successful practice, or anywhere in between, in order to best meet the business or organizational needs.3,4 The plan should be comprehensive and should describe, in the required detail, all aspects of your idea.2

Business Concepts and Issues for Physiotherapy

At the simplest of levels, a business is based upon providing a product (e.g. lumbar roll) or service (e.g. physiotherapy treatment) with the aim of making a prot (in private practice), or generating a surplus (non-prot sector). A private physiotherapy clinic or practice is clearly a business, and thus business plans are self-evidently relevant; however, within the public or non-prot sectors, a business approach, including a plan for a new project or service which ensures staying within a predened budget allocation, is certainly also important. The underpinning concept for business planning may appear relatively straightforward, however new businesses and projects regularly fail despite the enthusiasm and hard work of the individuals involved. Often, the issues which lead to failure are linked to overoptimism, and a failure to address and plan for key aspects of starting any new venture, for example:

(i) Offering the right product or service

This may appear straightforward, i.e. physiotherapy, but is there a particular focus or approach that the market requires? Physiotherapy practices are not all the same: does there need to be a specic focus to a new practice in the area of sports medicine, or paediatrics; are these the right services in terms of what the target population wants or needs (and will pay for?). Simply establishing another outpatient physiotherapy

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practice in a given area, which may already be well served with practices, is no guarantee of business success. In planning the new venture or business, it is useful to consider what added value it will bring above what is already available or offered. This might include: providing solutions to current problems, e.g. providing accessible services where none are currently available, offering a unique service that provides a point of difference with existing services, e.g. offering specialist services such as home-based therapy and rehabilitation, or specic talent, e.g. a sports medicine business based upon postgraduate trained sports physiotherapists working alongside a consultant physician in sports medicine.

(ii) Insufficient funding to get started

Whether a new physiotherapy private practice or the introduction of a new service through a hospital physiotherapy department, it is important to consider, and adequately plan for, accessing the funds and resources required to sustain the new venture from launch until it becomes protable or sustainable. Often, novice planners will focus on the initial capital or overhead outlay, without giving adequate attention to resource needs beyond the rst several months or year. Equally, the need for annual budgeting in the public sector will sometimes override the need to consider the sustainability of activities in the medium to longer term.

manager, for the purposes of considering a business loan, or a non-physiotherapist investor. If the plan contains too much technical language, such as medical terminology, the reader may not understand some of the key points to be conveyed in the document. Beyond this, it also important to ensure that people think of the business plan in a positive light by making the proposal balanced, realistic, and honest, while conveying condence that the plan will work. When writing each section, it is important to start with the most critical information and then move on to the rest.5 If someone is skimming the document rather than thoroughly reading the detail in each section, they are most likely to read the rst parts of each section, which should contain the most pertinent information to get across to the reader. In order to ensure the business plan is accurate and as well-informed as possible, it will usually be necessary to enlist the assistance of experts in certain areas. These may include other experienced private practice owners, consultants, small business experts, lawyers, real estate agents, and nancial planners.2 These professionals will, in most instances, possess a much better understanding and knowledge of topics such as tax and healthcare insurance, and licensure laws and regulations, and can ensure that the practice will be operating within all relevant regulations and legislation.6

(iii) Finding the right location

This is an important consideration at several levels, including location relative to existing (i.e. competitor) practices and services, and accessibility and convenience for the target client group. Setting up a practice or clinic in an area where there are currently no practices might give a competitive advantage, but if the practice is situated on a second oor of a building with difcult access and parking, this might limit the potential of the business to grow.

Case Study: Business Planning for a New Physiotherapy Practice

There are a variety of resources available to assist with the writing of business plans, e.g. on the internet and simple how to guides, and while all of these are different, the key aspects are essentially the same. The purpose of the following case study is to give a simple explanation of what a basic business plan should include, related in this instance to the start-up of a new physiotherapy practice. It should not be regarded as prescriptive, and does not need to be strictly followed; rather, it should be used as a starting point and guideline template. While all of the sections presented below may be considered minimum requirements, the sections can be rearranged and relevant content shifted based upon the needs of the particular business or venture. Additional other important information pertaining to the business or project that is not specically mentioned here can be added as necessary.

(iv) Planning
The need for planning for a new physiotherapy business or venture is no different to most other endeavours in life. For the new venture, this will include careful consideration of plans to market and promote the services provided, and detailed work on the nancial projections for the new venture.

Writing the Plan: Getting Started

A Business Plan should be written in a concise, realistic, positive, and honest manner, and depending upon the intended audience without using too much technical jargon.2,5 It should be stressed that the plan will likely be read by at least a few people with little or no knowledge of the physiotherapy profession: for example, this might include a bank

The Business Plan: Relevant Sections and Content

The sample business plan for Physio Kids (a hypothetical new paediatric physiotherapy clinic service) is presented in the Appendix: the following provides a guide to writing the various sections of this type of plan.

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Executive Summary
The Executive Summary is the rst section of the business plan, following a cover sheet and table of contents. Although in the nished document it is read rst, it is written last during preparation of the document.1,4 This section is like a summary or abstract of a journal article, and contains a summary and overview of the entire business plan. Topics covered include, but are certainly not limited to, reasons for the business choice, its potential, its uniqueness, and basic nances. This section should be used to provide the reader with brief but informative selections of information from the business plan. It is essential here to emphasize the ventures strengths, but potential limitations and weaknesses should usually be excluded,5 as these will be discussed later in the plan. Because it is the rst section read, it is important that the Executive Summary is written to grab the readers attention with a brief and interesting synopsis.2 If this section is poorly written and does not manage get across the basics of the proposed business venture, the reader may choose not to continue with the remainder of the plan.

Logistics
This section may also contain details on the logistics of the business. Location, geographical area, hours, and facility details (size, setup, etc.) can all be vital parts of business, and represent points of difference with existing clinics or services.2 Advantageous locations for a clinic may be in a gym, near a hospital, or close to the main trafc route in and out of the area, and if so these should be emphasized. Provision of services out of hours during evening or weekend hours may help increase patient ow and provide a business advantage. If so, the plan should articulate for the reader what these advantages are, and how they will benet the proposed new practice.

Management
This section needs to present, in detail, the structure of the business, all members of the practices management team, and their ability to run the new venture.2 The relationship between this group needs to be clear: i.e. sole proprietor, or a partnership or limited company?7 All members of the management team should be described, including details about the skills, experience, background, and expected duties of each member of the team need to be clearly presented.1 Some internal members of the management team may be owners, partners, or business managers; additionally any external members of the team should be listed, including accountants, lawyers, IT consultants, business consultants, or professional associations such as Chamber of Commerce or Physiotherapy Association.2 Basically, anyone assisting with the advising or actual running of the practice should be mentioned here.2 These descriptions can be brief, or quite lengthy, as the situation demands. If the new venture benets from having a particularly strong management team, and this represents a signicant factor for the success of the business, all the relevant information should be provided.8 One option is to include a CV for each member of the team, usually as an appendix.7 Alternatively, for those members of the team who may be less involved in the day to day operation of the venture, a brief paragraph regarding their skills and duties may be sufcient. For example, for a part owner of a new outpatient orthopedic clinic, with 15 years of experience as a physiotherapist in outpatient orthopedics, detailing that experience in the plan can help to convince people that the team has the high level clinical skills necessary to make the new practice a success. Likewise, if there is a partner who has experience with the management or business aspects of running a physiotherapy practice, this should be highlighted to the reader in this section.

Business Description Idea

This section should include key details about the business idea or proposal. In essence, this is a good place to communicate to the reader exactly what the physiotherapy business is all about. This section can include the proposal, its mission, uniqueness, and growth potential. It is the place to begin to highlight why this particular physiotherapy practice or venture will be a success. The description should include details of all the things that make this physiotherapy clinic or service different from all of the others currently available in the area. Often, this uniqueness is the key aspect of the business, and the thing about which the partners or proposers are personally most excited about when thinking about the venture: this should be clearly conveyed.5 A strong mission statement can also be a great tool to convey the central focus of the plan in one or two simple sentences. The mission statement should be a clear, precise statement of the purpose of your business or rehab business idea:6 it is a statement explaining what the practice is, and what it stands for.1

Future
Planning for future growth and how the clinic or venture will improve or change with time is important.5 This section should outline and discuss any possible future additions to the practice, such as recruitment plans for additional physiotherapists, other professional disciplines, e.g. occupational or massage therapists, or the introduction of new or unique therapeutic interventions, e.g. addition of a hydrotherapy pool or running Pilates classes.

Competition and Market Competition

Competition is a signicant issue when planning to launch any new physiotherapy business or venture,

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and the business plan needs to provide details on the nature of the competition. This is an area that needs to be carefully researched and considered; notwithstanding the needs of the business plan document, the better the competition is understood, the better prepared the business will be to achieve success in spite of such competition. Essential information includes who the main competitors are, and how many will directly impact your business. The business plan should report accurately the number of physiotherapy practices or related services (e.g. chiropractic clinic, massage therapists) there are situated in the local area. This information can be obtained in a number of ways, ranging from driving around the neighborhood and counting practices, reviewing telephone and internet listings, checking local business directories, or enquiring with the local chamber of commerce. Other sources of information include the local physiotherapy association, branch or chapter, reviewing local newspapers, advertisements, and local broadcasts (television and radio), and by simply listening to people in the community.2 It is also important to understand and give due consideration to the competitions strengths and weaknesses. This information will provide a better idea of what needs to do be done to address or overcome the strengths of existing practices, and also what might be usefully done through the new practice to address existing weaknesses. One of the best means of collecting this information is simply to observe, and to communicate with relevant individuals or groups. If they are agreeable, it might be possible to speak with the owners/managers of competing clinics, or the therapists that work there. Alternatively, past and present patients of competing practices represent great sources of information. Another possibility is to read the business plans of other area physiotherapy practices, where these are available, bearing in mind they may read yours.5 In countering the competition in the business plan, it is important to stress the new ventures strengths, taking care not to overlook any personal strengths of the business team, such as good leadership skills or an ability to motivate others (patients or employees).5 There are different kinds of strengths which can be emphasized, but these broadly fall into two areas. Common strengths are things that the new venture will do well, and competitive strengths are those things which the venture will do better than others, say, in the physiotherapy profession, or the local area.5 Some common strengths may include high skills levels, and experience in clinical practice. A competitive strength may be that the venture will charge lower co- payments than the competition, or that the new clinic has some specialized equipment that is not available at any other clinic in the area.

When planning the new business or venture, it is essential to acknowledge adequately the new practices weaknesses. In such cases, it is important to address any foreseeable problems where this is possible, and to explain within the business plan document how the new business will eliminate or work around the rest. As with strengths, there are two types of weaknesses, common and catastrophic.5 A common weakness is one that is shared with other clinics, such as low patient ow upon initial launch. A catastrophic weakness is a problem that the practice will not be able to overcome without signicant external support, such as lack of nancing for start up, or a treatment space not large enough for all of the necessary equipment.5 Catastrophic weaknesses should be identied early and should be carefully considered to determine whether or not the new business can be successful.

Market
The details on market should identify several key factors: the geographical area of relevance, who exactly represents the target population or market, i.e. who the business plans to serve, and the size of that population.2 This includes relevant information regarding the primary area from which the majority of patients will be recruited, and also what specic target population will be served.1 The target population is essentially a description of the people to whom the new services will be marketed; for a specialized clinic this might be only adults with spinal pain, females for a womens health clinic, or children with a physical disability. The business plan needs to dene the specic patient needs the new practice will address.1 Usually, the geographical area is the surrounding city/town/suburbs of the new business. However, the business plan may also discuss demand for the proposed venture, and how the needs of the target population are not currently being met in that area. In particular, if there are already large numbers of existing physiotherapy practices within a 10 mile radius of the planned clinic, the business plans needs to explain explicitly how the area will benet from the new venture.

Business Strategy Marketing

Marketing is one of the key elements of a successful business, and the business plan should include relevant information on how the new venture is to be marketed. A key aspect of this is the marketing angle, which is a tool to draw people to your business: it is a means to communicate to the public, and in particular the target population, why they should utilize the services provided by the new business. Therefore, the marketing angle should distinguish or set the practice apart from existing practices or services. The

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marketing of the business may usefully include its mission statement. As part of this, potential patients or clients should be reminded of your clinics competitive advantage to gain their trust in the value of your services.2 For example, marketing for the new venture should highlight how the practice is unique, and what special facilities or equipment it provides. Additionally, since the key component of a specialist business or venture is the staff, marketing should also demonstrate how its clinicians have superior or specialist knowledge and expertise in the practice area of interest, and how this results in better quality of care.

Promotions
Promotional plans should also be specied in the business plan. Advertising by mail, press, and internet are all good ways to publicize a new practice: all of the relevant details of these plans should be provided, including duration and location of advertising, cost, and description of advertisements. This section should include information about planned public relations activities (clinic launch event, open house, community activities, etc.) and how they will help your business. The promotional strategy may also usefully include a questionnaire survey (distributed by phone, email, or post) to your target population to gain valuable feedback regarding their needs and wants, and also serve to raise awareness of the new business.2 In addition, it is important to detail any plans to meet with medical doctors or other relevant professionals to promote the new clinic and thus gain referrals. Other important aspects of business strategy which can be included in this section are product/service pricing policies and strategic location. Most likely, pricing will be based on a governing bodys guidelines for reimbursement fees set by a body such as Accident Compensation Corporation (ACC), the professional body, or private insurance companies. Any rates for copayments and for private fee rates should be competitive with surrounding practices. This information can be easily obtained online, or with a few simple phone calls to existing practices. One way to increase revenue for a clinic or practice is to sell a retail product, such as lumbar rolls, joint bracing, or informational books. If this is to be part of the plan for the new venture, it should be detailed in this section.

requirements for these staff (e.g. registration), and information on any training plan. If there are plans to recruit ancillary staff or assistants, the plan should make clear what their role will be, and who will be responsible for overseeing their work. Inclusion of details regarding responsibilities for physiotherapists supervising such staff is essential, including initial assessments, treatment planning and implementation, and documentation. Requirements for employees should also be clearly detailed. This might include a requirement that all employees will have at least 3 years of post-graduate experience in the area of physiotherapy addressed by your practice. Also, all therapists will be required to be registered with the relevant registration body (e.g. Physiotherapy Board of New Zealand) and possess a current annual practicing certicate. If it is planned to promote professional development through inservices or other training tools, this should also be described in the plan. Details on support staff should also be provided (including receptionist, practice manager, assistants, aides, etc), and the relevant responsibilities for these staff: e.g. who is responsible for billing, scheduling appointments, and record keeping? The plan should give the reader a picture of who will be involved in the business operation every day, and in what capacity. This is also an important section if the business plan is to be used to attract potential employees (for example a practice manager).

Facility
Details regarding any equipment and a description of the facility can be included here, although it may also be listed previously under business description. This section can be used to describe what specialized equipment, such as plinths, ultrasound, traction units, parallel bars, etc. the practice will offer. The layout and setup of the facility can be important considerations for a new clinics operation. For example, are there individual treatment rooms for initial assessments or treatments requiring privacy? Is there a large, open space in which dynamic activities such as group sessions or plyometric training are possible and gym equipment will t? Is there room for a reception or ofce area?

Legal requirements
The plan should specify any legal requirements such as licensing, permits, insurance, and regulations required for your business to run;2 it is important to take expert advice on these issues at an early stage in the development of the Business Plan. The practice will need liability insurance in case of patient or staff injury, and all therapists must be covered by liability insurance, whether funded by the practice, or by the therapist. It may be benecial to seek professional

Operations Staff
This section of the business plan should describe how the venture will run on a day-to-day basis, and how the services will be delivered,7 including details on stafng. Details should be provided on how many staff will be hired, salaries, full time or part time, what the titles and duties will entail, any relevant

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legal advice related to healthcare law to ensure compliance with relevant requirements in this area. If there are any planned renovations to a building which is to be used as a clinic, proper permits must be secured and, most likely, the building will need to be inspected by building or health and safety inspectors. The Business Plan document should demonstrate to readers that all legal requirements have been appropriately researched and considered, and that the new business is well prepared to deal with them.

Financial
This section will explain all of the nancial aspects of the new business or venture, including funding position, start-up costs, source of funds (sales, loans, nancial backing), and estimates of the businesss projected prots or losses for at least the rst three years. All relevant funding details should be provided, including how much is needed, when it is needed, what it is to be used for, and where it is coming from.2 A considerable amount of research may be required to compile this information and consultation with an accountant or business advisor may prove invaluable.2 This is often the most daunting aspect of business planning for physiotherapists and other healthcare professionals, particularly for those who have had little previous experience in this area. Financial estimates must be based on actual data whenever possible,4 and can be a sobering experience for the business planner. The nancial projections should include plans for both regular (rent, utilities, salaries) and non-regular (yearly malpractice insurance) bills,2 and should also include provision for any applicable taxes.

predict what will happen after year one, so it is important when planning to be cautious and realistic (prudent) when formulating the 3 year forecast.7 The nancial projections should take into consideration wage increases, ination, changing tax rates, and changing utility charges,2 and provide supporting data and other information available to back up the assumptions underpinning the projections.7 Projected monthly revenue should be based upon estimating the number of therapy sessions provided each month, multiplied by the expected reimbursement per session (including co-payment if applicable and any insurance/ACC reimbursement).2 Any anticipated retail sales (lumbar rolls, informational books) should also be included in the projections. The clinics monthly expenses should be detailed, including employee wages, utilities, lease, and loan payments, and all other costs. As part of the projection, such expenses should be subtracted from the projected revenue to end up with the practices net prot or loss.1

Sources
The nancial section of the Business Plan should also specify the source of funding, or how it is planned to pay for everything listed above: is it planned to pay initial costs with the personal savings of the partners, is there an investor/nancial backer, or will costs be covered by a bank loan, and the details of these sources.4 This section should provide details of all the aspects of the businesss nances, to prove that, if things go as planned, the clinic will be a success, and if things do not go as planned, there are strategies in place to deal with the issues nancially. It is important to stress that Business Plans do not have to show a prot in the rst year (indeed this is unusual).9 However, it is generally accepted that a new practice should begin making money within the three year nancial forecast. The important thing is that the plan is realistic in terms of budgets and nances, and provides an accurate, realistic picture of the nancial future for the venture.2

Start up cost
When estimating start-up cost, actual prices should be used whenever possible (rst months rent, deposit, furniture, equipment, supplies, advertising). The starting point for this is putting together a comprehensive list of all equipment required, from goniometers and reex hammers to free weights and plinths, and researching their actual prices. This section should also include details on costs for furniture (reception desk and chairs) and consumable supplies (pens, pencils, clipboards, paperwork, tape, ultrasound gel, Thera-BandH, hand soap, etc.). Plans may also need to include requirements for laundry or cleaning services. Utilities should be estimated based on actual gures from other similar practices in the area. The source of all of these gures should be revealed in this section. This information may be best presented on an organized spreadsheet, with only the major points discussed here.

Appendices
Spreadsheets, tables, and graphs are a great way to illustrate the key features of the plan, and to effectively portray information in a more organized fashion. These save space, are more easily understood, and are visually pleasing.5 Appendices will most likely include spreadsheets with nancial projections, estimates, and assumptions. Also included here can be maps/photos of the proposed clinic site, lease agreement, copies of any relevant contracts and CVs, licenses, demographic studies, letters of support from area doctors or people otherwise involved in the areas physiotherapy community, lists of therapy equipment, and advertising

Income statement
A monthly income statement should be projected through at least the rst three years. It is difcult to

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material.1,4 Appendices should provide a collection of any relevant information that will help to support and explain the Business Plan.

Acknowledgements
This paper arose from a teaching exercise undertaken for student physiotherapists at the School of Physiotherapy, University of Otago, New Zealand. The Business Plan (Appendix) is, as far as is possible at the time, accurate, but assumes a case for a new service: it should not be considered a criticism of current clinical provision or providers within the Dunedin or Otago region. A number of colleagues provided useful feedback on the content including: Alice Baxter FCA, Bursar, Knox College; Sinead Lodge, Director of School of Physiotherapy Clinics, University of Otago; Cheryl Hefford, Clinic Coordinator, Victoria Clinic, School of Physiotherapy, Otago; Lynda McCutcheon, Tracy Hogarty and Pip Stewart, Dunedin Hospital.

References
A list of references should be attached to the Business Plan; this should include information that may be helpful for a reader who is not knowledgeable about the area of business. For a new physiotherapy clinic or service, a prospective nancial backer or bank manager who is reading the Business Plan may not even be clear on what physiotherapy entails, and will want to nd out before making decisions on investing money in the project. Other information provided may be in regard to ACC/insurance reimbursement policies, the clinics specialist area of practice or expertise (orthopedic, cardiopulmonary, pediatric), evidence (research) proving positive effects of the proposed services, and relevant statutory and other requirements affecting physiotherapy (licensing, direct access). References should be included so that the reader can nd information easily regarding any area of the plan that is not general knowledge.

References
1 Small Business Planner. Write a business plan. [cited 2010 Oct 1]; Available from: http://www.sba.gov/smallbusinessplanner/ plan/writeabusinessplan/index.html. 2 Planning for success. 20042005 [cited 2010 Oct 1] Available from: http://www.nzte.govt.nz/common/files/biz-planning-forsuccess-2005.pdf. 3 An introduction to business plans. 2008 [cited 2010, Oct 1]; Available from: http://www.entrepreneur.com/startingabusiness/ businessplans/article38290.html. 4 (SCORE), S.C.O.R.E. Business plan for a startup business. 2003 [2010 Oct 1] Available from: http://office.microsoft.com/ en-us/templates/TC010175201033.aspx?pid5CT101172331033. 5 Sutton G. The ABCs of writing winning business plans. New York: Warner Books; 2005. 6 Richmond, T. Business plan. In: Richmond T, Powers D. Business fundamentals for the rehabilitation professional. New York: SLACK Incorporated; 2004. p. 4980. 7 Setting up your own business. 2003 [cited 2010 Oct 1]; Available from: http://www.enterprisingcommunities.com/Own_Business_ Guidelines.pdf. 8 Enterprising communities preparing a business plan. [cited 2010 Oct 1]; Available from: http://www.workandincome.govt. nz/documents/business-plan-template.rtf. 9 Blackwell E. How to prepare a business plan. 5th ed. Sunday Times Business Enterprise series. London: Philadelphia: Kogan Page; 2008

Summary
In summary, the production of a simple business plan is important, not only to get the concept of the new business across to others, but because preparing the plan can be benecial in highlighting to prospective partners what is involved in starting a new physiotherapy practice. Putting plans and ideas down on paper helps to organize thoughts, and often leads to the realization of the complexity of starting a new venture. A good Business Plan can help to reassure the team and others that there has been the necessary consideration of all the relevant details, and that the new venture has the best chance of success.

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I. Table of Contents
I. II. III. IV. V. VI. VII. IX. Table of Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Business Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Markets and Competitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Business Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Monthly Operating Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Start-up Costs Year 1 Overhead, Income, Net Gains/Losses . . . . . . . . . . . . . . . . . . 11 Year 2 Overhead, Income, Net Gains/Losses . . . . . . . . . . . . . . . . . . 11 Year 3 Overhead, Income, Net Gains/Losses . . . . . . . . . . . . . . . . . . 12 Income and Overhead Assumptions . . . . . . . . . . . . . . . . . . . . . . . . . 13 X. References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Appendix: Sample Business Plan

Physio Kids

VIII. Financial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Business Plan October 2009

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Great King Street Dunedin New Zealand

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II. Executive Summary Business Choice Mission Statement

III. Business Description The Proposal

The current proposal is to develop a physiotherapy clinic in Central Dunedin specializing in paediatric rehabilitation. This proposal stems from a lack of such services in the area. The clinic will provide high levels of specialized physiotherapy services to paediatric clientele in an outpatient clinic setting in order to meet the needs of the paediatric population in Dunedin and adjacent areas.

The idea is to develop a Physiotherapy Clinic in Central Dunedin, specializing in Paediatric Physiotherapy services to meet the needs of a growing demand for these services.

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Target Population Uniqueness

Physio Kids will serve children aged up to 15 years who demonstrate a permanent or temporary physical disability.

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Uniqueness and Evidence for Success

The Physio Kids clinic will be the only one of its kind in the area, and will be able to provide a high level of care to Dunedins paediatric population by utilizing the expertise of experienced clinicians and specialized paediatric equipment.

The clinic will be the only outpatient paediatric rehabilitation facility located outside of a hospital in Dunedin. It will also be the only such practice with specialized paediatric equipment, and staff with a high level of paediatric physiotherapy expertise.

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Skills and Experience

Clinic Success
As the only other paediatric services provided in Dunedin are in hospital, the likelihood of success of an independent clinic is high. This Physio Kids clinic will help meet the needs and demands of the local paediatric population. It is expected that the clinic will have a good relationship with the hospitals physiotherapy department, and with the nearby University of Otagos Physiotherapy School and its Clinics, resulting in client referrals.

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There are two lead partners in the Physio Kids team, one with extensive clinical experience with the paediatric population, and the other with rst hand knowledge of managing a physiotherapy practice. Clinicians experienced in paediatric physiotherapy will be the primary service providers. Future recruitment of graduates of the nearby University of Otago and other staff with paediatric expertise will be completed on an as needed basis to meet growth in demand.

Growth Potential

Geographical Area
The primary geographical area serviced will be Dunedin City. It is also expected that clients will travel from outlying areas, principally Otago and Southland and South Canterbury, to be able to access the specialist level of care that will be provided.

Throughout the South Island of New Zealand, demand for paediatric therapy services continues to grow. There is potential for additional staff, and possible expansion to other sites to meet these needs in the future; as part of this, there is the possibility of extending our services into schools, home, and community settings. There is also the potential for recruitment of additional staff from other areas and disciples, such as Occupational Therapy or Speech Language Therapy, to meet the rehabilitation needs of this population.

Facilities

Start-up Costs

The estimated start-up cost, including space lease, equipment, and advertising is $59,513.

Source of Funds

The proposed clinic site is located in Central Dunedin, on an easily accessible ground oor, with car parks for visitors conveniently located nearby. The main clinic area will have a 396 m2 open oor plan, allowing enough space for equipment and active treatments. This location is near hospital, university, and State Highway 1, the major route in and out of the city of Dunedin. The area is also serviced by regular and affordable bus and taxi services.

Growth Potential
Throughout the South Island of New Zealand, demand for paediatric therapy services continues to grow. There is potential for recruitment of additional, suitably qualied staff, and possible expansion to other sites to meet these needs in the future. Further research into the need for such practices throughout the South Island of New Zealand may reveal opportunities for future expansion to other areas. There is the possibility of extending our services into schools, home, and community settings. In keeping with experience elsewhere, it is anticipated that as awareness of the need for more paediatric services increases, so will the demand for services in alternate settings. Beyond this, there is also the potential for recruitment of staff from other professional areas such as Occupational Therapy or Speech Language Therapy. Our experience is that these different disciplines work well together within the paediatric area, and serve to complement each other in terms of services and skills provided. It is anticipated that such a development would better serve the wider rehabilitation needs of our target client population, and in turn by the offering of these related services will provide a basis for increase in patient numbers in the future.

A bank loan in the amount of $100,000 over 5 years will cover start-up costs and rst months overhead. The Accident Compensation Corporation (ACC) as one of the major funders of health services in New Zealand will reimburse for approved patients where appropriate, and non-ACC patients will pay privately. Retail sales of informational books and sensory/motor equipment will be available to clients. The clinic will also host regular classes for a fee, including tness for children, parent education, dance classes such as Zumba, etc.

IV. Management The Management Team

V. Markets and Competitors Geographic Scope

The primary geographic scope of the proposed physiotherapy clinic is Dunedin City and its outlying areas. There is also potential, due to the specialist nature of the clinic, that patients will travel from further aeld (including Otago, Southland and South Canterbury) to access these expert services.

Customer Description
Patients will be children, ages up to 15 years with physical disabilities, injuries, or conditions for which physiotherapy services are indicated. These may be children with congenital abnormalities, or children who have suffered a trauma such as a car accident, resulting in physical impairment.

The two major players on the Physio Kids team are the businesss two founding partners. The rst is Jane Smith, a 37 year-old physiotherapist with 12 years of clinical experience in paediatrics. Jane graduated with her bachelors degree with a certicate in physiotherapy from the State University of New York at Buffalo in 1992. She worked in neurological rehabilitation for 4 years, during which time she completed several continuing education courses related to paediatric physiotherapy. Jane became Neurodevelopmental Therapy (NDT) certied in 1996, and at this time began working primarily with the paediatric population. Since that time, she has gained extensive experience working as a paediatric physiotherapist in several different settings, including hospitals, schools, and community. Janes clinical expertise will be an invaluable asset to the proposed practice.

Main Competitors
Existing physiotherapy clinics providing paediatric care (n52) in the Dunedin area are limited and are solely located in the hospital setting. Many of the physiotherapists involved in these existing clinics have demonstrated support of the current plan, including the potential for future referrals, given the lack of specialist services in the area, and its potential to better meet the demand and need for paediatric physiotherapy services.

>The second partner is John Doe, a 42 year-old physiotherapists, who is the current manager of a physiotherapy practice in Queenstown, New Zealand. John has been the practices primary business manager for 6 years, and is also a part-time clinician for the practice. John graduated from the University of Otago with his certicate in physiotherapy in 1991, and, after practicing for 6 years, decided to pursue his MBA. He earned his MBA in 2001, at which time he began his role as business manager of a physiotherapy clinic. As part of this, John helped turn the struggling physiotherapy practice in Queenstown into a one of the most protable businesses in the region. John now plans to relocate to Dunedin, and will be an integral part of this start-up physiotherapy clinic.

Strengths and Weaknesses of Competitors

Strengths: Current clinics have a loyal client base, and are located in a convenient space within hospital. This location allows convenient interaction with medical staff, and its familiarity to prior hospital inpatients makes the clinic a comfortable choice for outpatient therapy upon discharge from the hospital. It also can facilitate good continuity of care when transitioning between inpatient and outpatient services. Weaknesses: Low numbers of available clinicians specializing primarily in paediatric rehabilitation result in demand for these services being higher than that able to be provided through existing services to the paediatric population in need. This unmet demand can also result in longer waiting times for initiation of therapy services in some cases.
Wassinger and Baxter

Other important members of the proposed management team include a nancial advisor, accountant, and business consultant. These professionals will be consulted as needed to ensure sound decision making, and that all relevant requirements are met from a business and nancial standpoint. The accountant will be responsible for all tax-related issues, including ling of annual tax returns. All these professionals have been intimately involved with the development of this plan, including the proposed budget and nancial projections.

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VI. Business Strategy Pricing Policy

VII. Operations Staffing

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Clinic fees will be charged based on services provided and within ACC guidelines where relevant. There will be no co-payment fee for patients covered under ACC. Patients who pay privately will be charged $75 for initial assessment, and $50 per visit thereafter.

Promotional Plans Staff Training

One full time (working partner) and part-time physiotherapy clinicians (one full time equivalent) will be appointed in the rst instance to provide services at the clinic. Other clinicians will be hired on a casual contract basis on an as needed basis to meet demand. All treating staff will be required to hold and maintain a current Annual Practicing Certicate from the Physiotherapy Board of New Zealand, and to have at least 2 years of post-qualication clinical experience with paediatric physiotherapy. Regular mandatory in-service training will be scheduled to promote continued professional development, use of up-to-date techniques and treatment ideas, and to ensure delivery of best possible patient treatment.

Business plans in physiotherapy: a practical guide

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The clinic will be advertised in print and online editions of the Otago Daily Times, and in the print edition of The Press. Also a programme of promotional activities including, mailings, iers, and visits to local hospitals, other physiotherapy clinics, and medical practices will help to publicize the Physio Kids clinic. The practice will have a large sign prominently displayed on the front of showing its name, address, and phone number. Total advertising cost is estimated to be $10,480 for the rst year.

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Support Staff

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Current evidence demonstrates that physiotherapy can provide signicant benet to children with a wide range of disabilities, such as congenital or acquired musculoskeletal, neurological, and cardiopulmonary impairments, conditions, or injuries. It can help to signicantly improve a childs quality of life, and increase their involvement in daily life activities by minimizing or compensating for their impairment.

Direct Mail Patient Numbers

Support staff for the clinic will include one full-time receptionist, responsible to cover the reception area, answer telephones, schedule appointments, and le/maintain clinical records. One full-time Practice Manager/Working Partner will be appointed to take on a management role within the clinic, and to oversee all marketing, nance, and purchasing activities. This person will also be responsible to ensure the safe, efcient, and effective running of the clinic (i.e. in keeping with relevant statutory and legal requirements).

We will mail descriptions of our services to private insurance and healthcare providers, schools for children with special needs, CCS Disability Action, and other relevant entities in the area. Total cost for these mailings including stamps, paper, and envelopes is estimated at $1500.

Press Advertising Equipment and Facility

It is expected that the clinic will initially serve four patients per day. These numbers are expected to grow steadily with increased referrals: details of these projections are found in the appendices section to this Business Plan.

The opening of the Physio Kids clinic and client recruitment will be advertised in community and local newspapers, including the Otago Daily Times and The Press. An advertisement in the Otago Daily Times will run Monday through Saturday for one month for a total of $6780, and for one month in The Press for $600.

Internet

The clinic will be publicized through banner ads in the Otago Daily Times online edition. This banner will contain a link to the Physio Kids clinic website, which will provide details of services provided, clinic location, hours, and phone numbers. This banner will be good for 40,000 views for $600.

A variety of specialized equipment including parallel bars, mats, staircase, positioning devices, and various treatment tools will be purchased for an estimated total of $28,000. As previously stated (see page 4, Facilities), the clinic will have a large, open oor plan with room for equipment and dynamic activities, as well as three separate patient rooms for initial assessments and privacy. This clinic setup will be ideal to allow effective treatment through functional activities such as play.

Legal Requirements
All physiotherapists providing clinical services within the clinic will be registered with the New Zealand Physiotherapy Board, and will have an unrestricted annual practicing certicate. All clinicians will also have adequate professional liability insurance cover, through the New Zealand Society of Physiotherapists. The clinic will operate within terms of the ACC master agreement, and will be appropriately certied to provide clinical services.

Public Relations

Physio Kids will hold an open house upon clinic launch, and will provide or participate in regular community activities, such as holding community education courses open to the public regarding health and rehabilitation-related issues. The open house will be open to the public, and medical professionals will be invited for nger foods, beverages, and tours of the clinic.

VIII. Financial Sources of Figures

IX. Appendices Monthly Income and Expenditure

The appendices include details of start-up costs, projected rst 3 years expenditure and income, and assumptions regarding data provided, and CVs of the management team.

The gures provided are based on consultation with other health care providers and physiotherapy professionals in Dunedin, and also on research related to services in Dunedin.

Funding Position
Physio Kids Clinic: Monthly Operating Costs and Start Up Costs Monthly Operating Costs (Fixed Costs), Year 1

Costs have been calculated on a conservative scale (principle of prudence), utilizing estimates at the high end of data available in relation to salaries, equipment costs, services, etc. Income, also based on a conservative scale, uses estimates on the low end of reimbursement and revenue.

Cost

The estimated start-up cost, including space lease, equipment, and advertising is $59,513. These are the funds required before clinic opening. First year monthly overhead, with the exception of the rst month, has been calculated at $21,900 per month, including salaries, rent, utilities, insurance, and loan payment. These gures are based on actual costs (rent, salaries, insurance, loan) and an estimate of utility cost based on average cost reports for other similar businesses in the area.

Source of Funds

ACC cover will be sought for approved patients, and private payment will be required for other patients. A bank loan in the amount of $100,000 over 5 years will cover start up costs and rst months costs. Client purchase of informational books, sensory/motor equipment will be available and help to generate alternative sources of income. The clinic will also hold regular classes for a fee, including tness for children, and parent education, dance classes etc. Start-up Costs

Rent Utilities Insurance (x2 physio) Physio-part time Physio-full time Practice Manager Receptionist Loan Payment (NB: only interest is revenue; assume 7% for 4 years) Miscellaneous Total

6333 350 117 2500 4167 4167 2500 1666 500 22,300

Changes in Projections

Wassinger and Baxter

The estimated costs, income, and net gain of the clinic will change with differences in patient numbers, recruitment, and fee levels. These variations are accounted for in the assumptions table in the appendix provided.

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Retail Product Space Remodel Office Furniture Office Supplies Computer Software Advertising Microwave/Refrigerator Water Cooler Linens Equipment Parallel Bars Staircase Hi-Lo Mat Table Miscellaneous Security Deposit Total

1000 10,000 5000 500 2000 200 10,480 500 200 500 10,000 3500 2500 7000 1000 6333 $59,513

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Physio Kids Clinic: Financial Projections Feb March April May June July Aug Sept Oct Nov Dec Total

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Year 1

Jan

Overhead Rent Utilities Insurance Loan Salaries 6333 350 117 1666 4167 2500 2500 4167 100 21,900 21,900 21,900 21,900 21,900 21,900 21,900 21,900 21,900 6333 350 117 1666 4167 2500 2500 4167 100 6333 350 117 1666 4167 2500 2500 4167 100 6333 350 117 1666 4167 2500 2500 4167 100 6333 350 117 1666 4167 2500 2500 4167 100 6333 350 117 1666 4167 2500 2500 4167 100 6333 350 117 1666 4167 2500 2500 4167 100 6333 350 117 1666 4167 2500 2500 4167 100 6333 350 117 1666 4167 2500 2500 4167 100

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1 1 1 1

FTE PT PTE PT FTE receptionist Practice Manager

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Retail Product Advertising Total Expenditure

6333 350 117 1666 4167 2500 2500 4167 1000 7336 30,136

6333 350 117 1666 4167 2500 2500 4167 100 1572 23,472

6333 350 117 1666 4167 2500 2500 4167 100 1572 23,472

75,996 4200 1404 19,992 50,004 30,000 30,000 50,004 2100 10,480 274,180

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NO .

Income No. of treatments Fees collected Retail Sales (Net) Gross Income 96 7344 275 7619 214,281 Feb March April May June July Aug 212,799 211,011 28,682 27,769 24,627 23,053 21,168 Sept 115 8798 303 9101 138 10,557 332 10,889 166 12,852 366 13,218 199 15,300 403 15,703 219 16,830 443 17,273 241 18,360 487 18,847 265 20,196 536 20,732

80 6120 250 6370

291 22,185 590 22,775 875 Oct

321 24,480 649 25,129 3,229 Nov

353 26,928 713 27,641 4,169 Dec

2484 18,9950 5347 19,5297 278,883 Total

Net Gain/Loss

223,766

Year 2

Jan

Overhead Rent Utilities Insurance Loan Salaries 6650 350 117 1666 4375 2625 2625 4375 250 23,033 23,033 23,033 23,033 23,033 6650 350 117 1666 4375 2625 2625 4375 250 6650 350 117 1666 4375 2625 2625 4375 250 6650 350 117 1666 4375 2625 2625 4375 250 6650 350 117 1666 4375 2625 2625 4375 250

1 1 1 1

FTE PT PTE PT FTE receptionist Practice Manager

Retail Product Advertising Total Expenditure

6650 350 117 1666 4375 2625 2625 4375 250 1000 24,033

6650 350 117 1666 4375 2625 2625 4375 250 250 23,283

6650 350 117 1666 4375 2625 2625 4375 250 23,033

6650 350 117 1666 4375 2625 2625 4375 250 23,033

6650 350 117 1666 4375 2625 2625 4375 250 23,033

6650 350 117 1666 4375 2625 2625 4375 250 23,033

6650 350 117 1666 4375 2625 2625 4375 250 250 23,283

79,800 4200 1404 19,992 52,500 31,500 31,500 52,500 3000 1500 277,896

Income No. of treatments Fees collected Retail Sales (Net) Gross Income 353 29,621 713 30,334 7,301 7,301 7,301 353 29,621 713 30,334 353 29,621 713 30,334

353 29,621 713 303,34

353 29,621 713 30,334 7,301

353 29,621 713 30,334 7,051

353 29,621 713 30,334 7,301

353 29,621 713 30,334 7,301

353 29,621 713 30,334 7,301

353 29,621 713 30,334 7,301

353 29,621 713 30,334 7,301

353 29,621 713 30,334 7,051

4236 355,452 8556 364,008 86,112

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Net Gain/Loss

6,301

Year 3

Jan

Feb

March

April

May

June

July

Aug

Sept

Oct

Nov

Dec

Total

Overhead Rent Utilities Insurance Loan Salaries 7332 350 117 1666 4292 2575 2575 4292 250 23,449 23,449 23,449 23,449 23,449 23,449 23,449 23,449 7332 350 117 1666 4292 2575 2575 4292 250 7332 350 117 1666 4292 2575 2575 4292 250 7332 350 117 1666 4292 2575 2575 4292 250 7332 350 117 1666 4292 2575 2575 4292 250 7332 350 117 1666 4292 2575 2575 4292 250 7332 350 117 1666 4292 2575 2575 4292 250 7332 350 117 1666 4292 2575 2575 4292 250

1 1 1 1

FTE PT PTE PT FTE receptionist Practice Manager

Retail Product Advertising Total Expenditure

7332 350 117 1666 4292 2575 2575 4292 250 1000 24,449

7332 350 117 1666 4292 2575 2575 4292 250 250 23,699

7332 350 117 1666 4292 2575 2575 4292 250 23,449

7332 350 117 1666 4292 2575 2575 4292 250 250 23,699

87,984 4200 1404 19,992 51,504 30,900 30,900 51,504 3000 1500 282,888

Income No. of treatments Fees collected Retail Sales (Net) Gross Income 388 32,583 713 33,296 9,847 9,847 9,847 9,847 9,597 9,847 388 32,583 713 33,296 388 32,583 713 33,296 388 32,583 713 33,296 388 32,583 713 33,296 388 32,583 713 33,296

388 32,583 713 33,296

388 32,583 713 33,296 9,847

388 32,583 713 33,296 9,847

388 32,583 713 33,296 9,847

388 32,583 713 33,296 9,847

388 32,583 713 33,296 9,597

4656 390,996 8556 399,552 116,664

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Net Gain/Loss

8,847

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Physio Kids Clinic: Assumptions Table for Financial Projections

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Income

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Physio Services

This figure is based upon treatment sessions x actual fee Assume price per session for ACC patients is $103 Assume price per session for non-ACC patients is $50 Assume these prices will rise by 10% per year

2011

Number of Treatments Assume Assume Assume Assume Assume

there will be an average of 80 treatment sessions in the first month. this number will increase by 20% for the first 6 months and by10% per month thereafter for the first year. number of treatments plateaus after the first year. 50% of patients are covered by ACC, and 50% will private pay. maximum of 12 treatments per day per physiotherapist

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Retail Sales

Assume there will be an average of $250 of sales in the first month and an increase of 10% in the following months Assume the amount of retail sales plateaus after the first year.

NO .

Overhead Lease

Assume rent will not change in the first year of lease. Assume rent increases by 5% each year.

Utilities

These estimates are based upon reported utility charges for similar businesses of comparable size in the area Assume utility fees will be the same each month for the first 3 years.

Insurance

Salaries

This figure is based upon pricing information to cover 2 therapists Assume that insurance premiums will not change in the first 3 years. These salaries are based upon average salaries of like employees of other area businesses, and include relevant contributions e.g. Kiwisaver, and statutory holidays Assume employees accept these offered salaries Assume salaries increase by 5% the 2nd year, and 3% in following years.

Retail products

Assume $1000 will be spent initially to stock retail product for sale, and $100 per month for the first year to maintain stock. Assume $250 per month will be spent to stock product after the first year. Assume retail product cost/sales plateau after the first year, with consistent mark up on all sales

Advertising

Initial cost will be high in order to promote new business Costs during the first year will focus on launch and include: Ads in the Otago Daily Times print edition x 1 month, M-Sa Ads in the Otago Daily Times online edition 40,000 views Ads in The Press x 1 month Mailings and Fliers Clinic Sign Total These costs will be spread across the first year. Assume after the first year, costs will be 1500 per year, spread out throughout the year.

6780 600 600 1500 1000 10,480

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Physio Kids Clinic: Assumptions Table for Financial Projections Notes and Explanation of Financial Tables $ Start-up Costs $ 1000 10,000 5000 500 2000 200 10,480 500 200 500 10,000 3500 2500 7000 1000 6333 6333 59,513 Retail Product Space Remodel Office Furniture Office Supplies Computer Software Advertising Microwave/Refrigerator Water Cooler Linens Equipment Parallel Bars Staircase Hi-Lo Mat Table Miscellaneous Security Deposit 1st Month Rent Total Space Remodel: Estimate/quote from contractor for building renovations. All prices for furniture, supplies, and equipment are actual prices. Security Deposit and First Month Rent required per property manager. Total: Sum of all costs. Year 2 Overhead Projections. 6333 350 117 2500 4167 4167 2500 1666 500 22,300

Monthly Operating Costs (Fixed Costs), year 1

Rent Utilities Insurance (x 2 physio) Physio-part time Physio-full time Practice Manager Receptionist Loan Payment Miscellaneous Total

Rent: ($76,000 per year)/(12 months)5$6333 per month. Utilities: Based on average monthly costs for power, water, phone, and internet reported by other area clinics. Insurance: Quotes include NZSP membership ($596.50), Paediatric Special Interest Group subscription ($25.00), and liability insurance ($22.50) for 2 full time Physiotherapists. Salaries: Based on average salaries for similar positions in the area. Loan Payment: $100,000 over 5 years. Miscellaneous: Small cushion for unexpected costs, repairs, etc. Total: Sum of all costs.

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Year 2 Overhead Projections $ 6333 350 117 1666 Net Gains/Losses 223,766 214,281 No. of treatments Fees collected Retail Sales (Net) Gross Income 80 6120 250 6370 96 7344 275 7619 Income $

Year 2 Income Projections

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Rent Utilities Insurance Loan Salaries 1 FTE PT 1 PTE PT 1 FTE receptionist 1 Practice Manager Retail Product Advertising Total Expenditure 4167 2500 2500 4167 1000 7336 30,136

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Rent: ($76,000 per year)/(12 months)5$6333 per month. Utilities: Based on average monthly costs for power, water, phone, and internet reported by other area clinics. Insurance: Quotes include NZSP membership ($596.50), Paediatric Special Interest Group subscription ($25.00), and liability insurance ($22.50) for 2 full time Physiotherapists. ($644 per PT, per year)/(12 months)5$116.08 per month, rounded up to $117. Loan: Bank loan in the amount of $100,000 over 5 years is $20,000 per year. ($20,000 per year)/(12 months)5$1666 per month. Salaries: Full time PT: ($50,000 per year)/(12 months)5$4167 per month. Retail Product: $1000 worth of products to originally stock for sales. Then, $100 per month after the first month to maintain stock. Advertising: $10,480 total based on quotes for press ads, internet ads, mailings, and clinic sign. ($10,480 for first year)6(75% for the first month)5$7336. 50% of the remaining $3144 will be spent in June ($1572) and the rest ($1572) in December. Total Monthly Expenditure: Sum of rent, utilities, insurance, loan, salaries, and advertising.

No. of treatments: Based on reported first month patient flow of other area start-up clinics. Expected to increase by 20% per month for the first 6 months. 20% of 80516. 80z16596 patients for the second month. Fees collected: 50% of patients are covered by ACC, 50% will pay privately. ACC currently reimburses $103 per session. Other area clinics charge, on average, $50 per session for private pay patients. (40 ACC patients)6($103 per session)5$4120. (40 private pay patients)6($50 per session)5$2000. $2000z$41205$6120. Retail sales: $250 in net sales estimated for the first month and is expected to increase by 10% each month. 10% of $2505$25. $250z255$275 for the second month. Gross Income: Sum of fees collected and retail sales. Net Gain/Loss: (Gross Income) (Total Expenditure)5Gain/Loss.

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Year 2 Overhead Projections $ 6650 350 117 1666 4375 2625 2625 4375 250 1000 24,033

X. References N http://www.physicaltherapy.com/pt_dened.php

Overhead

Rent Utilities Insurance Loan Salaries 1 FTE PT 1 PTE PT 1 FTE receptionist 1 Practice Manager Retail Product Advertising Total Expenditure

Rent: Rent is expected to increase by 5% from $6333 per month in 2009 to $6650 per month in 2010. Utilities, Insurance, Loan costs are expected to remain the same from 2009 to 2010. Salaries will increase by 5% from 2009 to 2010. Full-time PT will increase from $4167 to $4375 per month. Advertising: $1500 total for the second year, 50% in first month, 25% in June, 25% in December.

Year 2 Income Projections $ 353 29,621 713 30,334 6,301

Income

Wassinger and Baxter

No. of treatments Fees collected Retail Sales (Net) Gross Income

Net Gain/Loss

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No. of treatments: Patient load stabilizes so fees and retail sales level out.

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What is Physical Therapy? N http://en.wikipedia.org/wiki/Physical_Therapy What is Physical Therapy? N http://physicaltherapy.about.com/ PT Basics N http://www.physioboard.org.nz/pracdef.asp The Practice of Physiotherapy N http://www.nzsp.org.nz/ Click on Physiotherapy in NZ All about Physiotherapy in New Zealand N http://www.nzsp.org.nz/ Click on Special Interests Info regarding Paediatric PT in NZ N http://physicaltherapy.about.com/od/pediatricphysicaltherapy/Pediatric_Physical_Therapy.htm Paediatric PT, conditions treated N http://kidshealth.org/parent/system/ill/phys_therapy.html Paediatric PT: When is it needed? What is involved? N http://www.pedpt.com/pt/re/pedpt/abstract.00001577-20080191000003.htm;jsessionid5LxXV6ZLhrysp11wGnQ03H1GShLdvrnGKT6M1hq7Gtvnm1019nzX T!526656812!181195628!8091!-1 Study: Effect of NDT (Physio technique) on children with Cerebral Palsy N http://www.pedpt.com/pt/re/pedpt/abstract.00001577-20060182000007.htm;jsessionid5LxYNKLJlyMZnTHsLjjPsKvWjLJckQcnpHLpPyGD5M0nJ1l3WZdF b!526656812!181195628!8091!-1 Study: Physiotherapists run group tness programs for children in the community, resulting in improved functional mobility. N http://www.acc.co.nz/about-acc/index.htm About ACC N http://www.moh.govt.nz/moh.nsf/pagesmh/5238/$File/disability-service-spec-child-development-services.doc Child Development Services: Outlines services that children with disabilities are eligible for, and their details N http://www.dol.govt.nz/consultation/physiotherapy/draft-report-23July2007.pdf Information regarding funding of Physiotherapy services in NZ See especially pages 25 N http://www.acc.co.nz/Search_Results/ index.htm?sSID52DFEDE6E202CFB6E&fragment2_NextRow511 See Endorsed Provider Network (EPN) - Operational Guidelines For guidelines for participation And Physiotherapy Endorsed Provider Network Service Specications For explanation of EPN in regard to Physiotherapy services N http://www.acc.co.nz/for-providers/index.htm Working with ACC, as a provider of services N http://www.physioboard.org.nz/annual_practice.asp Explanation of Annual Practicing Certicate N http://www.physioboard.org.nz/registration.asp Explanation of Registration process
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