February 13, 2024 • 27 mins
In this episode of Animals & Aquatics in OT, co-host Gina delves into the theme of "Getting Started" in unique OT niches like hippotherapy, aquatics therapy, or nature-based therapy. She emphasizes the importance of preparation in three key areas: work, business, and legal considerations. Preparatory activities in OT serve as warm-ups, stimulating sensory systems and muscle groups to prepare clients for functional activities. Gina breaks down the preparation process, discussing the significance of skill development, adaptability, networking, market research, business planning, financial considerations, and legal compliance. She highlights the need for specialized training, market analysis, and relationship building to successfully transition into these niches. Gina concludes by inviting listeners to join her in the "Nail Your Unique OT Niche" series for further exploration and guidance.
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(00:17):
Hi, this is Gina, your co-hostat animals and aquatics and
occupational therapy.
We're getting started today withour getting started in a niche
practice series.
And I'm excited to get startedwith this.
Because we have had a lot ofquestions about how we began
working in either hippotherapyor aquatics as occupational
(00:40):
therapy providers.
How we started our privatepractice and with all of those
questions, we wanted to give yousome background from our own
experiences, as well as thosethat we've worked with.
And it's kinda nice to put itall together and a little mini
series as we get started thisyear.
So, again, this is our kind ofkicking it off how to get
(01:01):
started in your unique practicearea series.
And we're going to give you someinsights into both how we got
started and, some ideas if wehad to do it over again.
If we move to a new area, whatwere the things that we would
do?
What would the steps be that wewould take?
So, as we think about this, Iwant to extend that invitation
(01:25):
again, that I talked about atthe beginning of season two,
with more opportunities toconnect and work together.
I am going to be at the Americanhippotherapy association
conference coming up in March.
So if you're also going to bethere, make sure that we connect
there.
Uh, certainly welcome you tojoin us on an upcoming call.
(01:46):
I'm going to be recording sometrainings and I think it'd be a
lot of fun.
To invite some people along alot of times it's more
interactive if there's somebodyon the call while I'm doing a
training.
And so I'll be opening that upsoon.
Certainly you can always reachout to us via email.
We've had a lot of people whohave either taken one of my
courses on occupationaltherapy.com and then have
(02:10):
reached out or from the podcast.
And you can certainly follow meon social and see what we're
doing in some of our treatmentsessions and see.
Some of the behind the scenesinformation there.
So, if you want to know a littlebit more about why we're doing
this series based off ofpeople's questions.
(02:31):
And I would say it's also basedoff of my students' interests.
So every cohort that I teach,every soda that I speak to,
there are a number of studentswho are really interested in the
unique practice areas that wework in that could be nature
based services that could beusing aquatics or incorporating
(02:51):
hippotherapy into ouroccupational therapy services.
And a lot of people have somereally basic questions about
getting started and we.
We wanted to take some time,right at the beginning of season
two, to answer those questionsand make sure that we provided
that as a resource out there.
So we're going to try to keepthese pretty short, give you
some things to think about and aplace to start.
(03:14):
And you can always reach outwith specific questions.
If there's enough interest, thenwe can get together and do a
live call to discuss some ofthese.
And I am calling this firstepisode here the preparatory
episode.
So what is occupational therapy?
When we're talking aboutpreparatory, you may remember
(03:35):
this back from school, butpreparatory activities are
really the warmups.
The things that we do at thebeginning of a treatment
session, they're activities thatare going to maybe stimulate
different sensory systems orwake up different muscle groups.
Help our clients prepare for afunctional activity.
Or an occupation based activityright there.
(03:55):
Kind of what happens maybe atthe beginning of the session to
prepare.
The person.
So with preparatory activities,they really help get the client
ready for that purposefulactivity or occupation based
activity.
So I chose preparationspecifically for occupational
therapy providers, interested inventuring into a unique niche,
(04:18):
such as hippotherapy orincorporating farm animals into
their therapy sessions, aquatictherapy or nature-based therapy
because it does require a littlebit more oomph to get started
than our traditional privatepractice.
And I think that's a really funway too.
Take something that's maybe alittle bit of the microcosm of a
(04:41):
one treatment session.
And really blow it up into amuch bigger macro chasm of
looking at your career.
And maybe if you're making achange or you're expanding a
little bit.
And so we're going to look at.
Three specific areas that Ithink are really important.
(05:01):
When you're looking at gettingstarted.
And the, that is the work orskills side of things.
That's the business side ofthings and then any legal
concerns.
So as I break it down into thesethree areas to prepare.
I want you to think in thosecategories, right?
So work.
(05:21):
When we think about.
The work or the skills side ofthings.
Thinking about what is the worklike?
What is it going to entail?
And it's often easy to thinkabout the beautiful scene of
being outside on a sunny day andwe're walking beside the horses
(05:42):
or being in a beautiful, warmpool and helping a client with
something.
But it's important to reallythink about what does it like
when it's not a good day?
What is it like when things aremore challenging?
And do you think that you'lllike doing that work?
So in the like skillsdevelopment side of things.
(06:05):
OTs that are transitioning intothese unique niches.
Are going to have to invest inspecialized training and
education to develop the skillsand expertise.
So in this preparatory phase,it's really.
Starting to look at what skillsdo I have, what skills would I
have to invest in growing?
(06:26):
So that might include completinga certification program or an
educational.
Series, it might be attendingworkshops or conferences.
And finding a mentor fromsomebody who is already working
in this area.
So those are all importantcomponents in some easy ways
that you can get started withthis.
(06:47):
Would be to find someone thatyou can volunteer with, you can
do job shadowing.
You can do a short internship.
We have interns with our privatepractice here in New Jersey.
And they can do as little as afew hours a week coming one day
a week.
Just to see either a specificsetting or a specific client
(07:08):
population.
You can find.
A facility that will let youcome and observe.
And in some cases you might bethinking there are no
occupational therapy providersin my county or state.
That are using this particulartreatment strategy or this
particular tool.
(07:28):
Or a setting.
And what I would encourage youto do is think outside the box a
little bit with that.
And what's like the next closestthing.
So is there a nature basedschool nearby?
Is there an adaptive ridingfacility?
Is there an adaptive swimprogram that you can go and
shadow or volunteer with?
And, you know, get in the water,walk beside the horse, be out at
(07:52):
the nature school for six hoursand see if you like it.
See what you feel like at theend of the day after you've been
in the pool for three or fourhours?
Like how wiped out are you whenyou do five miles walking beside
a horse in a few hours?
Like, how does your body handlethat?
Like, how do you hold up withall of that?
So I think those are great areaswhen we're in that preparatory
(08:15):
phase and thinking about gettingstarted.
And we look at the work and theskills portion.
We really want to immerseourself as much as possible in
what that might be like.
And.
OTs that are preparing tospecialize in one of these
areas.
You're really starting tocultivate adaptability.
(08:35):
And resilience because as I liketo say, whenever you combine
animals and children, like youjust never ever know what's
going to happen when you'reworking in a nature based
setting and you're working withthe elements of weather you
really need to be able toanticipate challenges that could
be weather related or equipmentor your partners that are horses
(08:58):
or goats.
Or other farm animals.
As well as client's specificconsiderations.
So starting to develop thatflexibility and problem solving
skills.
And being able to kind of put ona smile and go about it will
help you.
As you move into the next phase.
In this journey of gettingstarted.
(09:20):
And I would say lastly, in thisarea of work in the skills is
networking.
And relationship building andlooking at again.
Who is in your niche area thatyou're interested in because
building those professionalconnections within a niche
community, Is really importantfor OTs that are preparing to
(09:42):
specialize, whether that'sinhibitor therapy or quad X.
You want to be able to startnetworking and there's two
components to this, so one islocal.
So you might be looking at localfacilities.
You might be looking at equinespecialists.
You might be looking at otherorganizations that are doing
something that would becomplimentary.
And then you also want to lookat something that's broader,
(10:04):
which is who else in theindustry is doing, what you want
to do.
Right.
So there are two components.
In that networking andrelationship building.
Part that's really preparatoryand OTs are really friendly,
like approachable group.
So I always recommend, reachingout to someone, asking them
about.
Their program or about theirprivate practice.
(10:26):
And that's often a good way justto get a conversation starter.
When you say like, I'm reallyinterested in this.
I don't really know if it'sright for me yet, or I don't
know if it's gonna work in myarea, but I'm just curious.
How did you get started?
What have you found has workedfor you?
Like those conversations reallycan end up.
Being really good professionalassets down the road.
(10:49):
So.
Whenever you can in the work andskills category when you're
preparing is to start small.
Even if it's an activity with acurrent client, That's a good
way to see, is this somethingthat you like.
What skills do you already have?
What skills do you need to workon?
So in, in that area, thinkingabout what do you have access to
(11:09):
doing some of that research?
You know, creating for me, it'screating like a spreadsheet,
marking everything down.
Who's in my area for differenttypes of connections who have I
reached out to via email.
And I usually just include.
Like a little note about what myemail said to them.
So I can keep track of that.
Make us all those things arereally important.
(11:31):
When we think about thepreparatory phase.
Now as we move towards Our nextphase, right.
That's going to be thepurposeful phase and that's
going to be in our next episode.
So we'll be going through.
A lot of the components ofestablishing collaborative
relationships.
That could lead to referrals orresource sharing.
(11:53):
And supporting you in yourpractice.
And that really is an importantpart of that purposeful phase
that we're going to cover.
In our next episode.
In the business area of things,there's a number of different
areas where you can startpreparing.
And one of the first things ismarket research, right?
We need to know what's going onin our local community.
(12:16):
And we can look at who else isdoing something similar?
Right.
Is there already.
A number of occupational therapyproviders that are providing
nature based OT.
Are there a number ofoccupational therapists who are
specializing in incorporatinghippotherapy horses and farm
animals into their OT practice?
(12:38):
And some of the things that Ilook for when I look at some of
those similar businesses is arethey full.
Do they have a waiting list?
And seeing are there otheragain, similar programs?
So it might not be anoccupational therapist, might be
a physical therapist or a speechlanguage pathologist.
It might be a recreationalprogram.
If there's a lot of nature-basedrecreational or educational
(13:01):
programs in a given area, oftenit tells me that the people in
those areas value those types ofprograms.
And so I'm looking to see what'sgoing on with other programs
that are like complimentary.
To what I want to do for thatarea.
So it's really important that ifyou're looking to specialize in
(13:23):
aquatics or nature-basedtherapy, That you're conducting
market research to understandwhat the demand would be for the
service in your area.
Right?
How many occupational therapyproviders are in your area?
How many are traditional clinicbased and how many are
specialists?
Then looking at demographics andwith demographics.
(13:43):
I'm looking at things like, arethere a number of special needs
schools or special autismprograms in my area that will
give me an idea.
Of the number of kids that mightbe seeking services.
I'm going to look atsocioeconomics, right?
What is the ability of theclients in my area to go a
private pay route versusinsurance-based.
(14:06):
And so, as I'm looking up thosethings.
That's a really important way tostart preparing.
For a business.
Or.
Adding an additional specialtyarea.
In an occupational therapy.
So when we start to think aboutthat, you might want to be
thinking about how far wouldpeople have to travel to get to
(14:29):
you, and how far are they usedto traveling?
Because in some areas.
Like traveling 15 or 20 minutesto get to an OT clinic is about
as far as people are willing togo, because there's a number of
clinics and they don't have togo particularly far.
In a more rural area.
People are used to driving anhour just to go to the grocery
store.
And so driving an hour or so togo to a therapy center.
(14:52):
Isn't going to be as much of abig deal.
So knowing what is usual forpeople as far as travel can be a
component of that.
Then in this market researchphase, you're also going to look
at.
What other programs orfacilities are in the area.
And.
(15:13):
Looking to see, are they.
Private pay.
Are they insurance based?
What insurance companies arekind of king in your area.
Because usually there are two orthree that kind of dominate the
market.
And so knowing like whichinsurance companies, they, those
are reviewing Medicaid,reimbursement rates is really
(15:33):
important in this preparatoryphase.
That way you have an idea ofwhat.
Your reimbursement rates mightlook like if you're going to go
the insurance route or what.
Might be typical there.
And that really starts to leadinto that business planning
strategy development.
So developing a business plan isreally essential for OTs that
(15:56):
would be transitioning intothese areas.
You want to start to get anoutline of what area you're
going to specialize in?
I always recommend.
Really focusing on one areafirst.
Because that way, you'reconcentrating your efforts in
one direction, rather than beingvery scattered in many
directions.
(16:17):
What client Tel.
Your ideal client, do you thinkyou might be serving.
What pricing structure.
Are you planning to use, are yougoing to be fee for service
package pricing?
If you think that you are goingto be private pay or insurance
based.
What marketing strategies mightyou be using?
And so you're not actually doingthese things yet.
(16:37):
You're just kind of thinkingthem through.
And this way also be where youstart to identify suitable
locations for your therapyservices and thinking about.
Who would be a potentialcollaborator in your area?
Where might you be able to finda practice location if you're
(16:58):
not providing services at yourown facility?
So those are all important partsof putting it together.
And as you start to identifythose things, that's going to
lead you into financialplanning.
And so as occupational therapyproviders, we're looking at
assessing the financialimplications of practicing in a
niche area.
And like hippotherapy aquaticsor nature-based therapy.
(17:22):
And certainly there areadditional costs.
When we are incorporating horsesor we're incorporating aquatics
into our therapy services,because we need to pay for
access to the horses, a horsehandler the facility, or access
to the pool.
And.
Figuring out how that's going tobe factored in.
(17:42):
Is really important.
So you're going to look at maybestartup costs, any ongoing
expenses that you would have,and you can also start to look
at some funding options such asgrants.
So that way you can have.
Beginning idea of what a budgetmight look like.
And.
It's important to, again, juststart to get an idea of those
(18:04):
things.
So you might be wondering.
Oh, how do I get thisinformation?
So, of course you can Google itor do online research.
To find out like what's near me.
Right.
Those are really useful ways to.
I get an idea.
You can look at people'swebsites, find out if they're
specializing in any of the areasyou're thinking of specializing
in, but often.
(18:26):
Websites can be reallymisleading.
I've certainly.
Gone through websites andthought I had a pretty clear
picture of what that businessmight look like.
And when I went to the facility,it was not at all what I
expected.
So it's often good to follow upwith.
A field trip.
And I love doing field trips.
(18:46):
I love seeing how other peoplehave their facilities set up and
it's always kind of a fun way todo it.
So before I had my kids andearly on in my career, that was
something that I reallyprioritize was going out to see
and meet.
As many local people as I couldseeing what their setup was,
chatting with them.
And it just gave me such a greatresource to see.
(19:09):
So many different setups and Icould easily be like, I like
that.
I don't like that.
I'm taking a picture of that forlater.
And, cataloging thatinformation.
So that's a really, very muchpart of that preparatory phase,
phone calls, emails.
Those are really good ways tofind out things like.
Are you in network withinsurance?
What insurances are you innetwork with now?
Remember most people who arecontracted with insurance, they
(19:31):
cannot discuss their rates,their reimbursement rates with
you.
So don't ask that question.
But you can at least find outlike who they're contracted with
and do they see private payclients?
They might be willing to tellyou what's the percentage of
private pay clients that theysee.
So those are important things.
To ask or to find out, as youare thinking about the business
(19:52):
side of things.
Now everybody's favorite part isthe legal side.
And honestly, I think the legalside scares a lot of
occupational therapy providers.
Before they even get started.
And when we start to think aboutthe legal side, We need to
research what we need to dolegally to provide services in
(20:13):
our state.
In our county in our city night,do we need a business license?
For our practice location in ourcity.
What type of business setup dowe need?
And that's one of the thingsthat I include and my business
barn raising is a way foreveryone to find out for their
(20:33):
state, what type of businessentity do they need?
Do they need to have an LLC, aPLLC?
What type of business entitythey need to set up.
What.
Resources or where can you findthis information?
You can look at your state'swebsite, right?
That will tell you a lot of thisinformation.
(20:54):
You can go to your occupationaltherapy association for your
state.
So for us, it's N J O T.
But for your state.
Ask, reaching out and askingthem questions can be also a
good way to find out some ofthat information.
I've especially been researchingthis as far as direct access in
because a New Jersey, we havedirect access, meaning that if a
(21:15):
client wants to receiveoccupational therapy services,
they don't have to go to theirpediatrician primary care
physician and get.
Prescription for occupationaltherapy, right?
It means direct access.
They can directly access theservices.
But in other states, that's notthe case.
So in Pennsylvania, I would needto have a prescription.
(21:36):
If I was treating someone with amedical diagnosis and thinking
about that's one more.
Step in my business that I needto figure out cultivate, right.
I need to cultivate thoserelationships with doctors and
pediatricians.
And what if there's not buy-infrom those doctors and
pediatricians, that could be abarrier.
(21:58):
To access to clients who want tocome to me, but also a barrier
access for me growing mybusiness.
So I'm really interested in whatstates have direct access versus
those that don't.
So that would be something toresearch.
For your area that has a prettybig legal implication, right?
You need to know that.
The small business associationscan be really helpful with some
(22:19):
legal background.
Just remember.
Not, you're not always going toget connected with somebody who
understands the healthcarefield.
So I have found sometimes whenI'm talking with someone from
the small business association.
They're really good businesspeople, but they don't
necessarily understand some ofthe constraints that I might
have in operating under mylicensure.
(22:41):
So.
That's an important thing tothink about.
The other thing that you mightwant to start doing in this
preparatory phase is name,search and look up.
If you have a private practicename in mind, you might want to
go to your state's website andlook up business names that have
already been taken.
That can give you an idea.
And you're going to come backaround to that expense.
(23:05):
Piece right.
That we had talked about withyour business plan because you
might want to track some ofthose.
So what is the cost to file foran LLC PLLC?
Is there a cost to open up abank account?
What is the credit cardprocessor that you are going to
use?
What's their take on it.
You can just gather some data onEMR costs.
(23:27):
And how about an email service?
How much is that going to costyour liability insurance?
You're going to have yourprofessional liability and your
general liability insurance is agood time to make a phone call,
start getting some quotes,right?
Those are perfect preparatoryactivities.
Getting quotes for professionalliability and general liability.
And making sure that you feelcomfortable, that the company
(23:51):
that you choose.
Understands what it is that youdo, and they're going to cover
you if there was ever anincident and.
I have been using H PSO forseveral years now.
And they are expensive.
And I thought, I'm going to goget some quotes and see if maybe
I can cut this expense becauseit's a big expense for us.
(24:12):
And I contacted a couple oftheir companies.
And there.
Responses to my questions didnot satisfy me.
And so I said, you know what?
I am comfortable that HCSO knowswhat I do.
They understand how Iincorporate nature horses
aquatics into my occupationaltherapy practice.
(24:34):
And I feel comfortable withthat.
I do not feel comfortable withsome of the other companies.
One company actually asked me.
How high off the ground.
Where the tree forts that webuild.
Because they saw a picture onthe website.
Of like, some sticks leaning upagainst the tree and like that
was a tree Fort and I was like,Hmm.
(24:55):
I'm not thinking that you'regetting what I'm doing.
Workman's comp expenses.
That's another area that you canget some quotes in.
You want to start to investigateEIN NPI numbers and look at the
process for those.
Things like that really make myhead hurt and I really need to
block out time to do thosethings.
So in this preparatory phase,it's a really good idea to look
(25:17):
up those processes.
Look up.
Getting your EIN look up gettingan MPI number.
You probably already have anindividual NPI number.
So then the process for filingfor a group NPI.
When you're practicing in aniche area like hippotherapy or
aquatics or nature-basedtherapy.
You certainly have to adhere tospecific legal and regulatory
(25:40):
standards.
Most of these are not specificto our niche.
They are specific tooccupational therapy and the
practice under our licensure,but we want to familiarize
ourselves with any relevant lawsin our area and any of our
licensing and supervisionrequirements.
Again, this goes back to ouroccupational therapy license and
(26:02):
practice, and then our liabilityconsiderations.
So thinking.
Thinking about.
Are we going to have the safetyprotocols that we need in place?
What risks might we need to comeup with a risk management plan?
So when we think about the legalside of things, it doesn't
necessarily have to be.
Frightening or overwhelming.
(26:22):
But there are things that wewant to consider in this
preparatory phase and just startworking through it like one step
at a time.
So to wrap it up today in thepreparatory phase, we're getting
the details in place to move toa purposeful phase in the
getting started series.
We're going to look at how wecan conduct some market
(26:44):
research.
Sketch out a business plan.
Like it's not going to be thefinished business plan.
That's definitely going to comemore in the next phase.
Looking at what legal andinsurance compliance we need to
take care of.
We can start looking at.
Professional relationships andthe skills that we might need to
(27:05):
work in our niche area.
And if you start with thispreparatory phase, you really
can successfully transition intoa unique niche and provide the
valuable occupational therapyservices to your clients that
they need.
So I hope this was helpful foryou today.
Remember, you can join me in thenail, your unique OT niche to
(27:26):
learn more about the specialtyarea.
That might be a really good fitfor you.
And you can think of it like a,choose your own adventure
learning lesson.
That is really specific to OTs.
And I've done a lot of theresearch on costs of
certification challenges.
Practice locations, things likethat.
So until next time, this is Ginaat animals and aquatics and OT
(27:48):
signing off.
Hi, this is Gina, your co-hostat animals and aquatics and
occupational therapy.
We're getting started today withour getting started in a niche
practice series.
And I'm excited to get startedwith this.
Because we have had a lot ofquestions about how we began
working in either hippotherapyor aquatics as occupational
(00:40):
therapy providers.
How we started our privatepractice and with all of those
questions, we wanted to give yousome background from our own
experiences, as well as thosethat we've worked with.
And it's kinda nice to put itall together and a little mini
series as we get started thisyear.
So, again, this is our kind ofkicking it off how to get
(01:01):
started in your unique practicearea series.
And we're going to give you someinsights into both how we got
started and, some ideas if wehad to do it over again.
If we move to a new area, whatwere the things that we would
do?
What would the steps be that wewould take?
So, as we think about this, Iwant to extend that invitation
(01:25):
again, that I talked about atthe beginning of season two,
with more opportunities toconnect and work together.
I am going to be at the Americanhippotherapy association
conference coming up in March.
So if you're also going to bethere, make sure that we connect
there.
Uh, certainly welcome you tojoin us on an upcoming call.
(01:46):
I'm going to be recording sometrainings and I think it'd be a
lot of fun.
To invite some people along alot of times it's more
interactive if there's somebodyon the call while I'm doing a
training.
And so I'll be opening that upsoon.
Certainly you can always reachout to us via email.
We've had a lot of people whohave either taken one of my
courses on occupationaltherapy.com and then have
(02:10):
reached out or from the podcast.
And you can certainly follow meon social and see what we're
doing in some of our treatmentsessions and see.
Some of the behind the scenesinformation there.
So, if you want to know a littlebit more about why we're doing
this series based off ofpeople's questions.
(02:31):
And I would say it's also basedoff of my students' interests.
So every cohort that I teach,every soda that I speak to,
there are a number of studentswho are really interested in the
unique practice areas that wework in that could be nature
based services that could beusing aquatics or incorporating
(02:51):
hippotherapy into ouroccupational therapy services.
And a lot of people have somereally basic questions about
getting started and we.
We wanted to take some time,right at the beginning of season
two, to answer those questionsand make sure that we provided
that as a resource out there.
So we're going to try to keepthese pretty short, give you
some things to think about and aplace to start.
(03:14):
And you can always reach outwith specific questions.
If there's enough interest, thenwe can get together and do a
live call to discuss some ofthese.
And I am calling this firstepisode here the preparatory
episode.
So what is occupational therapy?
When we're talking aboutpreparatory, you may remember
(03:35):
this back from school, butpreparatory activities are
really the warmups.
The things that we do at thebeginning of a treatment
session, they're activities thatare going to maybe stimulate
different sensory systems orwake up different muscle groups.
Help our clients prepare for afunctional activity.
Or an occupation based activityright there.
(03:55):
Kind of what happens maybe atthe beginning of the session to
prepare.
The person.
So with preparatory activities,they really help get the client
ready for that purposefulactivity or occupation based
activity.
So I chose preparationspecifically for occupational
therapy providers, interested inventuring into a unique niche,
(04:18):
such as hippotherapy orincorporating farm animals into
their therapy sessions, aquatictherapy or nature-based therapy
because it does require a littlebit more oomph to get started
than our traditional privatepractice.
And I think that's a really funway too.
Take something that's maybe alittle bit of the microcosm of a
(04:41):
one treatment session.
And really blow it up into amuch bigger macro chasm of
looking at your career.
And maybe if you're making achange or you're expanding a
little bit.
And so we're going to look at.
Three specific areas that Ithink are really important.
(05:01):
When you're looking at gettingstarted.
And the, that is the work orskills side of things.
That's the business side ofthings and then any legal
concerns.
So as I break it down into thesethree areas to prepare.
I want you to think in thosecategories, right?
So work.
(05:21):
When we think about.
The work or the skills side ofthings.
Thinking about what is the worklike?
What is it going to entail?
And it's often easy to thinkabout the beautiful scene of
being outside on a sunny day andwe're walking beside the horses
(05:42):
or being in a beautiful, warmpool and helping a client with
something.
But it's important to reallythink about what does it like
when it's not a good day?
What is it like when things aremore challenging?
And do you think that you'lllike doing that work?
So in the like skillsdevelopment side of things.
(06:05):
OTs that are transitioning intothese unique niches.
Are going to have to invest inspecialized training and
education to develop the skillsand expertise.
So in this preparatory phase,it's really.
Starting to look at what skillsdo I have, what skills would I
have to invest in growing?
(06:26):
So that might include completinga certification program or an
educational.
Series, it might be attendingworkshops or conferences.
And finding a mentor fromsomebody who is already working
in this area.
So those are all importantcomponents in some easy ways
that you can get started withthis.
(06:47):
Would be to find someone thatyou can volunteer with, you can
do job shadowing.
You can do a short internship.
We have interns with our privatepractice here in New Jersey.
And they can do as little as afew hours a week coming one day
a week.
Just to see either a specificsetting or a specific client
(07:08):
population.
You can find.
A facility that will let youcome and observe.
And in some cases you might bethinking there are no
occupational therapy providersin my county or state.
That are using this particulartreatment strategy or this
particular tool.
(07:28):
Or a setting.
And what I would encourage youto do is think outside the box a
little bit with that.
And what's like the next closestthing.
So is there a nature basedschool nearby?
Is there an adaptive ridingfacility?
Is there an adaptive swimprogram that you can go and
shadow or volunteer with?
And, you know, get in the water,walk beside the horse, be out at
(07:52):
the nature school for six hoursand see if you like it.
See what you feel like at theend of the day after you've been
in the pool for three or fourhours?
Like how wiped out are you whenyou do five miles walking beside
a horse in a few hours?
Like, how does your body handlethat?
Like, how do you hold up withall of that?
So I think those are great areaswhen we're in that preparatory
(08:15):
phase and thinking about gettingstarted.
And we look at the work and theskills portion.
We really want to immerseourself as much as possible in
what that might be like.
And.
OTs that are preparing tospecialize in one of these
areas.
You're really starting tocultivate adaptability.
(08:35):
And resilience because as I liketo say, whenever you combine
animals and children, like youjust never ever know what's
going to happen when you'reworking in a nature based
setting and you're working withthe elements of weather you
really need to be able toanticipate challenges that could
be weather related or equipmentor your partners that are horses
(08:58):
or goats.
Or other farm animals.
As well as client's specificconsiderations.
So starting to develop thatflexibility and problem solving
skills.
And being able to kind of put ona smile and go about it will
help you.
As you move into the next phase.
In this journey of gettingstarted.
(09:20):
And I would say lastly, in thisarea of work in the skills is
networking.
And relationship building andlooking at again.
Who is in your niche area thatyou're interested in because
building those professionalconnections within a niche
community, Is really importantfor OTs that are preparing to
(09:42):
specialize, whether that'sinhibitor therapy or quad X.
You want to be able to startnetworking and there's two
components to this, so one islocal.
So you might be looking at localfacilities.
You might be looking at equinespecialists.
You might be looking at otherorganizations that are doing
something that would becomplimentary.
And then you also want to lookat something that's broader,
(10:04):
which is who else in theindustry is doing, what you want
to do.
Right.
So there are two components.
In that networking andrelationship building.
Part that's really preparatoryand OTs are really friendly,
like approachable group.
So I always recommend, reachingout to someone, asking them
about.
Their program or about theirprivate practice.
(10:26):
And that's often a good way justto get a conversation starter.
When you say like, I'm reallyinterested in this.
I don't really know if it'sright for me yet, or I don't
know if it's gonna work in myarea, but I'm just curious.
How did you get started?
What have you found has workedfor you?
Like those conversations reallycan end up.
Being really good professionalassets down the road.
(10:49):
So.
Whenever you can in the work andskills category when you're
preparing is to start small.
Even if it's an activity with acurrent client, That's a good
way to see, is this somethingthat you like.
What skills do you already have?
What skills do you need to workon?
So in, in that area, thinkingabout what do you have access to
(11:09):
doing some of that research?
You know, creating for me, it'screating like a spreadsheet,
marking everything down.
Who's in my area for differenttypes of connections who have I
reached out to via email.
And I usually just include.
Like a little note about what myemail said to them.
So I can keep track of that.
Make us all those things arereally important.
(11:31):
When we think about thepreparatory phase.
Now as we move towards Our nextphase, right.
That's going to be thepurposeful phase and that's
going to be in our next episode.
So we'll be going through.
A lot of the components ofestablishing collaborative
relationships.
That could lead to referrals orresource sharing.
(11:53):
And supporting you in yourpractice.
And that really is an importantpart of that purposeful phase
that we're going to cover.
In our next episode.
In the business area of things,there's a number of different
areas where you can startpreparing.
And one of the first things ismarket research, right?
We need to know what's going onin our local community.
(12:16):
And we can look at who else isdoing something similar?
Right.
Is there already.
A number of occupational therapyproviders that are providing
nature based OT.
Are there a number ofoccupational therapists who are
specializing in incorporatinghippotherapy horses and farm
animals into their OT practice?
(12:38):
And some of the things that Ilook for when I look at some of
those similar businesses is arethey full.
Do they have a waiting list?
And seeing are there otheragain, similar programs?
So it might not be anoccupational therapist, might be
a physical therapist or a speechlanguage pathologist.
It might be a recreationalprogram.
If there's a lot of nature-basedrecreational or educational
(13:01):
programs in a given area, oftenit tells me that the people in
those areas value those types ofprograms.
And so I'm looking to see what'sgoing on with other programs
that are like complimentary.
To what I want to do for thatarea.
So it's really important that ifyou're looking to specialize in
(13:23):
aquatics or nature-basedtherapy, That you're conducting
market research to understandwhat the demand would be for the
service in your area.
Right?
How many occupational therapyproviders are in your area?
How many are traditional clinicbased and how many are
specialists?
Then looking at demographics andwith demographics.
(13:43):
I'm looking at things like, arethere a number of special needs
schools or special autismprograms in my area that will
give me an idea.
Of the number of kids that mightbe seeking services.
I'm going to look atsocioeconomics, right?
What is the ability of theclients in my area to go a
private pay route versusinsurance-based.
(14:06):
And so, as I'm looking up thosethings.
That's a really important way tostart preparing.
For a business.
Or.
Adding an additional specialtyarea.
In an occupational therapy.
So when we start to think aboutthat, you might want to be
thinking about how far wouldpeople have to travel to get to
(14:29):
you, and how far are they usedto traveling?
Because in some areas.
Like traveling 15 or 20 minutesto get to an OT clinic is about
as far as people are willing togo, because there's a number of
clinics and they don't have togo particularly far.
In a more rural area.
People are used to driving anhour just to go to the grocery
store.
And so driving an hour or so togo to a therapy center.
(14:52):
Isn't going to be as much of abig deal.
So knowing what is usual forpeople as far as travel can be a
component of that.
Then in this market researchphase, you're also going to look
at.
What other programs orfacilities are in the area.
And.
(15:13):
Looking to see, are they.
Private pay.
Are they insurance based?
What insurance companies arekind of king in your area.
Because usually there are two orthree that kind of dominate the
market.
And so knowing like whichinsurance companies, they, those
are reviewing Medicaid,reimbursement rates is really
(15:33):
important in this preparatoryphase.
That way you have an idea ofwhat.
Your reimbursement rates mightlook like if you're going to go
the insurance route or what.
Might be typical there.
And that really starts to leadinto that business planning
strategy development.
So developing a business plan isreally essential for OTs that
(15:56):
would be transitioning intothese areas.
You want to start to get anoutline of what area you're
going to specialize in?
I always recommend.
Really focusing on one areafirst.
Because that way, you'reconcentrating your efforts in
one direction, rather than beingvery scattered in many
directions.
(16:17):
What client Tel.
Your ideal client, do you thinkyou might be serving.
What pricing structure.
Are you planning to use, are yougoing to be fee for service
package pricing?
If you think that you are goingto be private pay or insurance
based.
What marketing strategies mightyou be using?
And so you're not actually doingthese things yet.
(16:37):
You're just kind of thinkingthem through.
And this way also be where youstart to identify suitable
locations for your therapyservices and thinking about.
Who would be a potentialcollaborator in your area?
Where might you be able to finda practice location if you're
(16:58):
not providing services at yourown facility?
So those are all important partsof putting it together.
And as you start to identifythose things, that's going to
lead you into financialplanning.
And so as occupational therapyproviders, we're looking at
assessing the financialimplications of practicing in a
niche area.
And like hippotherapy aquaticsor nature-based therapy.
(17:22):
And certainly there areadditional costs.
When we are incorporating horsesor we're incorporating aquatics
into our therapy services,because we need to pay for
access to the horses, a horsehandler the facility, or access
to the pool.
And.
Figuring out how that's going tobe factored in.
(17:42):
Is really important.
So you're going to look at maybestartup costs, any ongoing
expenses that you would have,and you can also start to look
at some funding options such asgrants.
So that way you can have.
Beginning idea of what a budgetmight look like.
And.
It's important to, again, juststart to get an idea of those
(18:04):
things.
So you might be wondering.
Oh, how do I get thisinformation?
So, of course you can Google itor do online research.
To find out like what's near me.
Right.
Those are really useful ways to.
I get an idea.
You can look at people'swebsites, find out if they're
specializing in any of the areasyou're thinking of specializing
in, but often.
(18:26):
Websites can be reallymisleading.
I've certainly.
Gone through websites andthought I had a pretty clear
picture of what that businessmight look like.
And when I went to the facility,it was not at all what I
expected.
So it's often good to follow upwith.
A field trip.
And I love doing field trips.
(18:46):
I love seeing how other peoplehave their facilities set up and
it's always kind of a fun way todo it.
So before I had my kids andearly on in my career, that was
something that I reallyprioritize was going out to see
and meet.
As many local people as I couldseeing what their setup was,
chatting with them.
And it just gave me such a greatresource to see.
(19:09):
So many different setups and Icould easily be like, I like
that.
I don't like that.
I'm taking a picture of that forlater.
And, cataloging thatinformation.
So that's a really, very muchpart of that preparatory phase,
phone calls, emails.
Those are really good ways tofind out things like.
Are you in network withinsurance?
What insurances are you innetwork with now?
Remember most people who arecontracted with insurance, they
(19:31):
cannot discuss their rates,their reimbursement rates with
you.
So don't ask that question.
But you can at least find outlike who they're contracted with
and do they see private payclients?
They might be willing to tellyou what's the percentage of
private pay clients that theysee.
So those are important things.
To ask or to find out, as youare thinking about the business
(19:52):
side of things.
Now everybody's favorite part isthe legal side.
And honestly, I think the legalside scares a lot of
occupational therapy providers.
Before they even get started.
And when we start to think aboutthe legal side, We need to
research what we need to dolegally to provide services in
(20:13):
our state.
In our county in our city night,do we need a business license?
For our practice location in ourcity.
What type of business setup dowe need?
And that's one of the thingsthat I include and my business
barn raising is a way foreveryone to find out for their
(20:33):
state, what type of businessentity do they need?
Do they need to have an LLC, aPLLC?
What type of business entitythey need to set up.
What.
Resources or where can you findthis information?
You can look at your state'swebsite, right?
That will tell you a lot of thisinformation.
(20:54):
You can go to your occupationaltherapy association for your
state.
So for us, it's N J O T.
But for your state.
Ask, reaching out and askingthem questions can be also a
good way to find out some ofthat information.
I've especially been researchingthis as far as direct access in
because a New Jersey, we havedirect access, meaning that if a
(21:15):
client wants to receiveoccupational therapy services,
they don't have to go to theirpediatrician primary care
physician and get.
Prescription for occupationaltherapy, right?
It means direct access.
They can directly access theservices.
But in other states, that's notthe case.
So in Pennsylvania, I would needto have a prescription.
(21:36):
If I was treating someone with amedical diagnosis and thinking
about that's one more.
Step in my business that I needto figure out cultivate, right.
I need to cultivate thoserelationships with doctors and
pediatricians.
And what if there's not buy-infrom those doctors and
pediatricians, that could be abarrier.
(21:58):
To access to clients who want tocome to me, but also a barrier
access for me growing mybusiness.
So I'm really interested in whatstates have direct access versus
those that don't.
So that would be something toresearch.
For your area that has a prettybig legal implication, right?
You need to know that.
The small business associationscan be really helpful with some
(22:19):
legal background.
Just remember.
Not, you're not always going toget connected with somebody who
understands the healthcarefield.
So I have found sometimes whenI'm talking with someone from
the small business association.
They're really good businesspeople, but they don't
necessarily understand some ofthe constraints that I might
have in operating under mylicensure.
(22:41):
So.
That's an important thing tothink about.
The other thing that you mightwant to start doing in this
preparatory phase is name,search and look up.
If you have a private practicename in mind, you might want to
go to your state's website andlook up business names that have
already been taken.
That can give you an idea.
And you're going to come backaround to that expense.
(23:05):
Piece right.
That we had talked about withyour business plan because you
might want to track some ofthose.
So what is the cost to file foran LLC PLLC?
Is there a cost to open up abank account?
What is the credit cardprocessor that you are going to
use?
What's their take on it.
You can just gather some data onEMR costs.
(23:27):
And how about an email service?
How much is that going to costyour liability insurance?
You're going to have yourprofessional liability and your
general liability insurance is agood time to make a phone call,
start getting some quotes,right?
Those are perfect preparatoryactivities.
Getting quotes for professionalliability and general liability.
And making sure that you feelcomfortable, that the company
(23:51):
that you choose.
Understands what it is that youdo, and they're going to cover
you if there was ever anincident and.
I have been using H PSO forseveral years now.
And they are expensive.
And I thought, I'm going to goget some quotes and see if maybe
I can cut this expense becauseit's a big expense for us.
(24:12):
And I contacted a couple oftheir companies.
And there.
Responses to my questions didnot satisfy me.
And so I said, you know what?
I am comfortable that HCSO knowswhat I do.
They understand how Iincorporate nature horses
aquatics into my occupationaltherapy practice.
(24:34):
And I feel comfortable withthat.
I do not feel comfortable withsome of the other companies.
One company actually asked me.
How high off the ground.
Where the tree forts that webuild.
Because they saw a picture onthe website.
Of like, some sticks leaning upagainst the tree and like that
was a tree Fort and I was like,Hmm.
(24:55):
I'm not thinking that you'regetting what I'm doing.
Workman's comp expenses.
That's another area that you canget some quotes in.
You want to start to investigateEIN NPI numbers and look at the
process for those.
Things like that really make myhead hurt and I really need to
block out time to do thosethings.
So in this preparatory phase,it's a really good idea to look
(25:17):
up those processes.
Look up.
Getting your EIN look up gettingan MPI number.
You probably already have anindividual NPI number.
So then the process for filingfor a group NPI.
When you're practicing in aniche area like hippotherapy or
aquatics or nature-basedtherapy.
You certainly have to adhere tospecific legal and regulatory
(25:40):
standards.
Most of these are not specificto our niche.
They are specific tooccupational therapy and the
practice under our licensure,but we want to familiarize
ourselves with any relevant lawsin our area and any of our
licensing and supervisionrequirements.
Again, this goes back to ouroccupational therapy license and
(26:02):
practice, and then our liabilityconsiderations.
So thinking.
Thinking about.
Are we going to have the safetyprotocols that we need in place?
What risks might we need to comeup with a risk management plan?
So when we think about the legalside of things, it doesn't
necessarily have to be.
Frightening or overwhelming.
(26:22):
But there are things that wewant to consider in this
preparatory phase and just startworking through it like one step
at a time.
So to wrap it up today in thepreparatory phase, we're getting
the details in place to move toa purposeful phase in the
getting started series.
We're going to look at how wecan conduct some market
(26:44):
research.
Sketch out a business plan.
Like it's not going to be thefinished business plan.
That's definitely going to comemore in the next phase.
Looking at what legal andinsurance compliance we need to
take care of.
We can start looking at.
Professional relationships andthe skills that we might need to
(27:05):
work in our niche area.
And if you start with thispreparatory phase, you really
can successfully transition intoa unique niche and provide the
valuable occupational therapyservices to your clients that
they need.
So I hope this was helpful foryou today.
Remember, you can join me in thenail, your unique OT niche to
(27:26):
learn more about the specialtyarea.
That might be a really good fitfor you.
And you can think of it like a,choose your own adventure
learning lesson.
That is really specific to OTs.
And I've done a lot of theresearch on costs of
certification challenges.
Practice locations, things likethat.
So until next time, this is Ginaat animals and aquatics and OT
(27:48):
signing off.
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