Why Are There So Few Adult OT Private Practices?

Re-printed from the Advance POV blog

Published January 29, 2014 8:41 AM by Iris Kimberg

Thanks to everyone following my blog  I have already received many fantastic questions to answer for several weeks to come. This one really struck a chord:

Question:  Why do you think there are so few OT practices that treat adults, and so many that treat children??? Is there not a market for adult services in OT private practices???


I have often asked this myself – well over 60% of the OTs I consult with are pediatric private practitioners, and only a few work with adults. I think the answers lies in the cyclical nature  of therapy services. Like  everything else, there is a life cycle of therapy services – back in the 80’s healthcare, especially in rehabilitation  was adult driven. Private practices (mostly PT because very few OTs dabbled in private practice then outside of hand therapists) treated adults, there was no managed care, and very little was done in pediatrics.

Fast forward to the 90’s when 2 things happened:

1) Managed care rolled out across the country from West to East in part due to billing/therapy treatment abuses of the system by those providing  rehabilitation services
2) Parents of children with special needs woke up and began demanding the services their children were entitled to under Federal law PL 94-142, its expanded version, PL 99-457, and PL 105-17 (in 2004)

These two scenarios lead the cycle shift in therapy services from adult driven care to pediatric care. There was a significant increase in OTs developing private practices to serve the demands of the pediatric community nationwide starting in the 90’s and continuing fr the next 20 years. Guess what cycle watchers – it should come as not new news to pediatric practices, that the cycle is shifting again. Funding for pediatrics is declining and at the same time, baby boomers are living longer, and demanding to live better. This points to a very ripe opportunity for OTs to offer adult driven services. Right now, certified hand therapists who have always offered adult services will continue to do so, and there are some OT private practices who specialize in niche offering like low vision rehabilitation, drivers rehab, home modification services, vestibular rehab etc.

The time is  now for additional OTs to enter the world of private practice and succeed. The cycle is in your favor, the ACA is already addressing habilitative services in addition to rehabilitation services as an essential health benefit, more and more elderly want to stay and live in their homes, every day 10,000 people in the USA become baby boomers. Opportunity is definitely knocking – it is up to you to answer the call!

For the next few weeks, I will be opening this blog up for questions which may be answered in subsequent blogs.  My goal is to help therapists understand the business end of therapy provision through many lenses and achieve the success that they want for the mutual benefit of themselves and their patients.

Questions relating to the following topics can be submitted to me at infonytherapy@aol.com

  • Finances/ Billing
  • Legal  and Risk Management Considerations
  • Strategic Marketing and Business Communication
  • Day to Day Operational Issues
  • Ethical Considerations
  • Long Term Growth and Development

I look forward to hearing from many of you in the weeks to come!

Comments are closed.