My Hiring Strategy For My Cash-Based Practice

“If you replace the ‘I’ in illness with ‘we,’ you get Wellness” 

This is the sentence that Dr. Eric Abramowitz posted years ago, which confirmed to me that he and I shared values that would foster an incredible professional relationship and that he was the right choice for my first hire in my cash-based practice model.

Within five years after opening my CBP, my waitlist had gotten so long that my fear was actually that I wasn’t going to be able to give my patients what they needed sheerly because I didn’t have any time left on my schedule to see them quickly enough when they needed it.

But I knew I couldn’t just hire anyone. It had to be someone who shared my values, vision, and mission for not only my business but also patient care. It had to be someone who demanded excellence from themselves, prioritized results for their patients over anything else and knew the importance of working together as a team.

Images of Dr. JJ Thomas performing different kinds of physical therapy

How My Journey to Cash-Based Practice Began

My whole story is that I became interested in physical therapy at the age of 14 when I was working at a gym that had a physical therapy office attached to it.  Every day as I walked through the PT space to go work out, I tended to linger longer and longer to see what they were up to.

Eventually, I volunteered time to learn more and see if it really was something I wanted to pursue.  As a hard worker and someone with genuine interest, the owner of the clinic (my soon-to-be mentor) took me under his wing, hired me as an aid, and (almost) taught me everything he knew.

I worked with Paul and his team throughout my entire high school, college, and graduate school career, and even stayed working with him for his practice as it grew into a much larger entity for over a decade.

Now, anyone knows that the insurance-based industry has made things harder and harder to survive as a business. That struggle was palpable to me, my colleagues, and my patients.

Fast forward time to the middle of 2013: I’d hit my limit. I was fried in the insurance-based world, and I was so frustrated with the inability to treat patients the way they deserve to be treated due to the many constraints that are inevitable in that world.

I left the insurance-based clinic I was working at (on good terms) and opened my own practice.

I opened my practice in phases.

I started by renting space 2 days a week, where I built my cash-based practice presence, and the other 3 days a week, I did contract work with a company that I had great respect for in regards to their standards of treatment and time management (they were a mixed insurance and cash-based practice which allowed some leeway for this).

As my schedule became more and more full, I was able to open my brick and mortar studio in 2015. From then on, it was as if rocket fuel had been dumped on my practice, and I just seemed to get busier and busier.

Around 2017/2018, I started having a hard time fitting my patients in. I was working on the weekends and seeing patients at 5 am in order to fit them all in. The funny thing is I didn’t really mind doing this because working with my patients in my cash-based environment is SO rewarding.  But I knew if I continued on this path I would burn out, and that wouldn’t be good for anyone.

As I searched through my mental Rolodex of potential candidates I could hire, Eric popped into my head.


Let me take you back to the time Eric and I first met somewhere around 2010

Eric and I both worked for a large insurance-based company at different offices. I was the only therapist in the state using dry needling at the time, and my PT Mentor sent Eric to consult with me regarding a patient that he had plateaued in progress with.

During that session, I was struck by the way he held himself, the values that he portrayed in the conversation working with this patient, and the sheer fact that he was going above and beyond to get results for this patient – by taking the time to trek up to my office to listen, learn and grow from this consult.

I remember the distinct moment when we were recapping after the patient left, and I thought, ‘Wow, this guy is awesome. I’m going to remember him.’ When I had that thought, I wasn’t even intending to open my own practice. I’m sure I had dreams of it, but I wasn’t anywhere close to making that jump. But something in my gut told me to remember this special therapist who was clearly going to make a difference in the world through his passion for excellence and helping people.

The best thing about this interaction with Eric and I was that, at the time, I had no idea what I meant when I thought, “I’m going to remember him.” But I KNEW his passion for learning, his humble but respectful questions, and his genuine interest that told me right away that our values were aligned AND we would somehow work together one day.

LESSON: It’s important as professionals to self-reflect and ask what impression we’re portraying to those around us. You never know who you might be locking your name in their memory bank to fulfill a future need. 


Returning back to 2017 when my book was PACKED and I NEEDED HELP:

I found him on social media, and as I scrolled through his posts, I reconfirmed that we had shared values that would work well together. So I reached out.

Unfortunately, at that time, when I reached out, I just asked how he was, and his reply was an excited, “I’m great, I just got hired as clinic director at _____ office.” He was genuinely excited that he’d earned his spot up the ladder, and I was not about to kill that momentum for him.

Timing is everything in life. So I politely congratulated him and decided to keep looking for another person to fill this role.

The thing was, I wasn’t going to fill this role with just anyone. It had to be someone who fit my brand, values, and mission for both the business and our patients. So although I had a few temporary therapists fill in for the next few years, no one in that time really fit the mold the way I wanted. So I kept looking for the right “fit.”

By 2020, my schedule was bursting at the seams. Even through the pandemic, the need for help was very apparent. And then I saw it: a post Eric put on social media that said,


“If you replace the ‘I’ in illness with ‘we,’ you get wellness.”

This reconfirmed my initial thought years ago that he was the best fit for Primal. I looked back at when our last communication was, and when I saw it was two+ years prior, I remember thinking, “OH YEAH, two years running a busy insurance-based practice?  He’ll be ready to make the jump, haha.”

So I texted Eric, and all I said was, “Hey! How are you doing? Are you ready to come work at Primal now?”

Turns out I was right. I caught Eric right at the time when he was starting to burn out at his role as clinic director at the insurance-based clinic. He, of course, was nervous about making the jump to all cash-based practice at first. But his passion for helping patients, and his desire to restore the dignity of what we do for our patients beat out his fear of not succeeding in the cash-based world.

Why do I tell you this whole story?

Because it perfectly reflects all of the things that I look for when hiring someone, and maybe it will help you land a job at a cash-based practice OR help you instill the core qualities needed to make your cash-based practice a success.


If someone wants to work at Primal, they must exude these things:

  • Deep values rooted in helping others
  • A passion for learning
  • A continual quest for excellence
  • Confidence in themselves that comes from putting in the work
  • Humility that stems from being confident.
  • A drive to make a difference in the world.

It sure looks pretty simple when it’s bulleted out in a list like that. I can tell you, it’s simple but not easy.

It’s simple because it’s rooted in a core value system that jives with many physical therapists and why we originally got into the business in the first place.

It’s not easy because sticking to these standards consistently day in and day out takes hard work, dedication, and an unwavering commitment to growth and excellence in yourselves and your patients.

About the Author
Dr. JJ Thomas, DPT, MPT, CMTPT
JJ Thomas is the owner and founder of Primal Physical Therapy and Primal University, located in Bryn Mawr, PA. She is an instructor for Evidence in Motion, and lectures and speaks nationally on the topics of Dry Needling, Functional Movement Analysis, and Functional Anatomy. She has been published in IJSPT for her contribution to a commentary on dry needling and consults as a content expert for organizations such as the APTA and FSBPT. In this role, she played a large part in the addition of a CPT code for dry needling through the AMA and was on the task force that helped identify competency standards for dry needling education nationally. JJ works with US Field Hockey teams, and individuals from US Lacrosse, US Polo, USA Track and Field, NFL, NBA, PLL, MLB, and more.
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