Physical therapy business grows, transitions with help of Washington SBDC

By Hope Belli Tinney, Washington Small Business Development Center

PUYALLUP, Wash. – When Kim Bisson and Susan Hays started Rainier Family Physical Therapy in 2008, their goal was to share one full‑time patient load, leaving each of them more time to care for their growing families.

In 2018, with their children much older, their goal now is to create a business of value that eventually will provide a retirement nest egg.

Closeup of Bisson and Hays.
Bisson, Hays, l‑r, pursue growth of Rainier Family Physical Therapy business with help from Washington SBDC.

With the help of the Washington Small Business Development Center, Bisson and Hays achieved their first goal and are working on their second.

Bisson and Hays first discussed the idea of quitting their jobs as physical therapists with a large practice and opening a small practice of their own in February 2007. Within a month, they’d made an appointment to talk with John Rodenberg, a business advisor with the Washington Small Business Development Center (SBDC) in Tacoma.

The Washington SBDC is a network of more than two dozen small business advisors who work in communities across the state and work one‑on‑one with entrepreneurs who want start, grow or transition a business. The Washington SBDC is hosted by Washington State University and receives funding from the U.S. Small Business Administration (SBA), WSU and other institutions of economic development and higher education. SBDC advising services are provided at no cost to the client.

When Bisson and Hays first met with Rodenberg a decade ago, he started the discussion by asking, “What do you want out of your business? What are your goals?” He then helped them create a business plan and financial checks and balances to achieve those goals.

“His help was immense,” Bisson said. “He helped us look at things we didn’t want to look at, or didn’t know to look at.” Rodenberg constantly pushed them to question their assumptions and look at the evidence, she said.

“He always says, ‘Let’s look at the facts, let’s look at the numbers,” Hays said.

Over the years, the practice has now grown to one additional full‑time therapist in addition to Hays and Bisson, who spend about half their time working with patients. In addition to two full‑time assistant physical therapists, one part‑time assistant physical therapist and five physical therapy aides, they also have two employees at the front desk and another to handle insurance claims and billing.

The challenge they face now is how to grow from here. Does it make sense to expand their current office or open a second location? Again, they have been meeting with Rodenberg to discuss options, gather more information and then look at the data.

Whichever way they go, Hays and Bisson say, it’s of paramount importance that they are able to provide the same level of care that has distinguished their practice from the beginning. One reason they feel ready to expand, they say, is that they’ve gotten better at finding employees with the requisite skills, temperament and attitude to be a good fit in their practice.

“We have been through many employees, good and bad,” Hays said, and in hindsight she wishes they had been slower to hire and quicker to fire. Rather than hiring the best of the applicants available in the moment, she wishes they had waited until the “right” person showed up. “They always do,” she said. Similarly, they sometimes kept poor performing employees longer than they should have.

Bisson seconded that advice. By being “reasonable” in our expectations early on, we accepted a lot of low production years when staff members were not doing their jobs,” she said.

Too often, she said, being “reasonable” really means lowering your expectations. Instead, she said, she and Hays have embraced the mantra “observe, decide, act.” Rodenberg’s advice to look at the evidence before making a decision has become an engrained part of their strategic planning.

“We keep statistics on many different aspects of our business and track them on graphs,” Bisson said. “These matrixes have really helped us know for certain when something is not working as well as we think it is.” For example, she said, sometimes it can “feel” like they are busy, but until they look at the data they don’t know if they’ve hit their goals. Because they have data, instead of just assumptions, they can bring the information to their staff and make a plan for how to improve performance.

It’s not that different from how they work with patients. Evaluate the problem, make a plan, monitor for progress. Helping patients make progress — build strength, improve mobility, decrease pain — brings tremendous satisfaction. “You see a higher and greater purpose to your dream,” Hays said.

But, they also heed Rodenberg’s advice that they devote at least 20 percent of their time to working on their business — improving business systems, reviewing financial spreadsheets, creating and implementing a strategic plan.

Being able to talk through decisions with Rodenberg has helped them develop confidence as business owners, Hays said. And, she said, she appreciates that the SBDC has been helping small business owners in Washington state for more than 35 years. “It’s really nice that we can go back even 10 years later and say, ‘Okay, here we are’” and get assistance.

“It started out as, ‘Hey, I wonder if we can do this?’ to then, ‘Wow! We can,’” Hays said. “This little two‑person dream has become a 10‑ or 12‑person dream.”

And with the help of Rodenberg and the Washington SBDC, that dream is continuing to grow.

Find out more about Rainier Family Physical Therapy.


Media Contact:

  • Hope Belli Tinney, director of communications, Washington Small Business Development Center, 509‑432‑8254,

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