From Preparation to Purpose: Getting Started in Unique OT Niches

 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. 

Transcript

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Hi, this is Gina, your co-host at animals and aquatics and occupational therapy. We're getting started today with our getting started in a niche practice series. And I'm excited to get started with this. Because we have had a lot of questions about how we began working in either hippotherapy or aquatics as occupational therapy providers. How we started our private practice and with all of those questions, we wanted to give you some background from our own experiences, as well as those that we've worked with. And it's kinda nice to put it all together and a little mini series as we get started this year. So, again, this is our kind of kicking it off how to get started in your unique practice area series. And we're going to give you some insights into both how we got started and, some ideas if we had to do it over again. If we move to a new area, what were the things that we would do? What would the steps be that we would take? So, as we think about this, I want to extend that invitation again, that I talked about at the beginning of season two, with more opportunities to connect and work together. I am going to be at the American hippotherapy association conference coming up in March. So if you're also going to be there, make sure that we connect there. Uh, certainly welcome you to join us on an upcoming call. I'm going to be recording some trainings and I think it'd be a lot of fun. To invite some people along a lot of times it's more interactive if there's somebody on the call while I'm doing a training. And so I'll be opening that up soon. Certainly you can always reach out to us via email. We've had a lot of people who have either taken one of my courses on occupational therapy.com and then have reached out or from the podcast. And you can certainly follow me on social and see what we're doing in some of our treatment sessions and see. Some of the behind the scenes information there. So, if you want to know a little bit more about why we're doing this series based off of people's questions. And I would say it's also based off of my students' interests. So every cohort that I teach, every soda that I speak to, there are a number of students who are really interested in the unique practice areas that we work in that could be nature based services that could be using aquatics or incorporating hippotherapy into our occupational therapy services. And a lot of people have some really basic questions about getting started and we. We wanted to take some time, right at the beginning of season two, to answer those questions and make sure that we provided that as a resource out there. So we're going to try to keep these pretty short, give you some things to think about and a place to start. And you can always reach out with specific questions. If there's enough interest, then we can get together and do a live call to discuss some of these. And I am calling this first episode here the preparatory episode. So what is occupational therapy? When we're talking about preparatory, you may remember this back from school, but preparatory activities are really the warmups. The things that we do at the beginning of a treatment session, they're activities that are going to maybe stimulate different sensory systems or wake up different muscle groups. Help our clients prepare for a functional activity. Or an occupation based activity right there. Kind of what happens maybe at the beginning of the session to prepare. The person. So with preparatory activities, they really help get the client ready for that purposeful activity or occupation based activity. So I chose preparation specifically for occupational therapy providers, interested in venturing into a unique niche, such as hippotherapy or incorporating farm animals into their therapy sessions, aquatic therapy or nature-based therapy because it does require a little bit more oomph to get started than our traditional private practice. And I think that's a really fun way too. Take something that's maybe a little bit of the microcosm of a one treatment session. And really blow it up into a much bigger macro chasm of looking at your career. And maybe if you're making a change or you're expanding a little bit. And so we're going to look at. Three specific areas that I think are really important. When you're looking at getting started. And the, that is the work or skills side of things. That's the business side of things and then any legal concerns. So as I break it down into these three areas to prepare. I want you to think in those categories, right? So work. When we think about. The work or the skills side of things. Thinking about what is the work like? What is it going to entail? And it's often easy to think about the beautiful scene of being outside on a sunny day and we're walking beside the horses or being in a beautiful, warm pool and helping a client with something. But it's important to really think about what does it like when it's not a good day? What is it like when things are more challenging? And do you think that you'll like doing that work? So in the like skills development side of things. OTs that are transitioning into these unique niches. Are going to have to invest in specialized training and education to develop the skills and expertise. So in this preparatory phase, it's really. Starting to look at what skills do I have, what skills would I have to invest in growing? So that might include completing a certification program or an educational. Series, it might be attending workshops or conferences. And finding a mentor from somebody who is already working in this area. So those are all important components in some easy ways that you can get started with this. Would be to find someone that you can volunteer with, you can do job shadowing. You can do a short internship. We have interns with our private practice here in New Jersey. And they can do as little as a few hours a week coming one day a week. Just to see either a specific setting or a specific client population. You can find. A facility that will let you come and observe. And in some cases you might be thinking there are no occupational therapy providers in my county or state. That are using this particular treatment strategy or this particular tool. Or a setting. And what I would encourage you to do is think outside the box a little bit with that. And what's like the next closest thing. So is there a nature based school nearby? Is there an adaptive riding facility? Is there an adaptive swim program that you can go and shadow or volunteer with? And, you know, get in the water, walk beside the horse, be out at the nature school for six hours and see if you like it. See what you feel like at the end of the day after you've been in the pool for three or four hours? Like how wiped out are you when you do five miles walking beside a horse in a few hours? Like, how does your body handle that? Like, how do you hold up with all of that? So I think those are great areas when we're in that preparatory phase and thinking about getting started. And we look at the work and the skills portion. We really want to immerse ourself as much as possible in what that might be like. And. OTs that are preparing to specialize in one of these areas. You're really starting to cultivate adaptability. And resilience because as I like to say, whenever you combine animals and children, like you just never ever know what's going to happen when you're working in a nature based setting and you're working with the elements of weather you really need to be able to anticipate challenges that could be weather related or equipment or your partners that are horses or goats. Or other farm animals. As well as client's specific considerations. So starting to develop that flexibility and problem solving skills. And being able to kind of put on a smile and go about it will help you. As you move into the next phase. In this journey of getting started. And I would say lastly, in this area of work in the skills is networking. And relationship building and looking at again. Who is in your niche area that you're interested in because building those professional connections within a niche community, Is really important for OTs that are preparing to specialize, whether that's inhibitor therapy or quad X. You want to be able to start networking and there's two components to this, so one is local. So you might be looking at local facilities. You might be looking at equine specialists. You might be looking at other organizations that are doing something that would be complimentary. And then you also want to look at something that's broader, which is who else in the industry is doing, what you want to do. Right. So there are two components. In that networking and relationship building. Part that's really preparatory and OTs are really friendly, like approachable group. So I always recommend, reaching out to someone, asking them about. Their program or about their private practice. And that's often a good way just to get a conversation starter. When you say like, I'm really interested in this. I don't really know if it's right for me yet, or I don't know if it's gonna work in my area, but I'm just curious. How did you get started? What have you found has worked for you? Like those conversations really can end up. Being really good professional assets down the road. So. Whenever you can in the work and skills category when you're preparing is to start small. Even if it's an activity with a current client, That's a good way to see, is this something that you like. What skills do you already have? What skills do you need to work on? So in, in that area, thinking about what do you have access to doing some of that research? You know, creating for me, it's creating like a spreadsheet, marking everything down. Who's in my area for different types of connections who have I reached out to via email. And I usually just include. Like a little note about what my email said to them. So I can keep track of that. Make us all those things are really important. When we think about the preparatory phase. Now as we move towards Our next phase, right. That's going to be the purposeful phase and that's going to be in our next episode. So we'll be going through. A lot of the components of establishing collaborative relationships. That could lead to referrals or resource sharing. And supporting you in your practice. And that really is an important part 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 start preparing. And one of the first things is market research, right? We need to know what's going on in our local community. And we can look at who else is doing something similar? Right. Is there already. A number of occupational therapy providers that are providing nature based OT. Are there a number of occupational therapists who are specializing in incorporating hippotherapy horses and farm animals into their OT practice? And some of the things that I look for when I look at some of those similar businesses is are they full. Do they have a waiting list? And seeing are there other again, similar programs? So it might not be an occupational therapist, might be a physical therapist or a speech language pathologist. It might be a recreational program. If there's a lot of nature-based recreational or educational programs in a given area, often it tells me that the people in those areas value those types of programs. And so I'm looking to see what's going on with other programs that are like complimentary. To what I want to do for that area. So it's really important that if you're looking to specialize in aquatics or nature-based therapy, That you're conducting market research to understand what the demand would be for the service in your area. Right? How many occupational therapy providers are in your area? How many are traditional clinic based and how many are specialists? Then looking at demographics and with demographics. I'm looking at things like, are there a number of special needs schools or special autism programs in my area that will give me an idea. Of the number of kids that might be seeking services. I'm going to look at socioeconomics, right? What is the ability of the clients in my area to go a private pay route versus insurance-based. And so, as I'm looking up those things. That's a really important way to start preparing. For a business. Or. Adding an additional specialty area. In an occupational therapy. So when we start to think about that, you might want to be thinking about how far would people have to travel to get to you, and how far are they used to traveling? Because in some areas. Like traveling 15 or 20 minutes to get to an OT clinic is about as far as people are willing to go, because there's a number of clinics and they don't have to go particularly far. In a more rural area. People are used to driving an hour just to go to the grocery store. And so driving an hour or so to go to a therapy center. Isn't going to be as much of a big deal. So knowing what is usual for people as far as travel can be a component of that. Then in this market research phase, you're also going to look at. What other programs or facilities are in the area. And. Looking to see, are they. Private pay. Are they insurance based? What insurance companies are kind of king in your area. Because usually there are two or three that kind of dominate the market. And so knowing like which insurance companies, they, those are reviewing Medicaid, reimbursement rates is really important in this preparatory phase. That way you have an idea of what. Your reimbursement rates might look like if you're going to go the insurance route or what. Might be typical there. And that really starts to lead into that business planning strategy development. So developing a business plan is really essential for OTs that would be transitioning into these areas. You want to start to get an outline of what area you're going to specialize in? I always recommend. Really focusing on one area first. Because that way, you're concentrating your efforts in one direction, rather than being very scattered in many directions. What client Tel. Your ideal client, do you think you might be serving. What pricing structure. Are you planning to use, are you going to be fee for service package pricing? If you think that you are going to be private pay or insurance based. What marketing strategies might you be using? And so you're not actually doing these things yet. You're just kind of thinking them through. And this way also be where you start to identify suitable locations for your therapy services and thinking about. Who would be a potential collaborator in your area? Where might you be able to find a practice location if you're not providing services at your own facility? So those are all important parts of putting it together. And as you start to identify those things, that's going to lead you into financial planning. And so as occupational therapy providers, we're looking at assessing the financial implications of practicing in a niche area. And like hippotherapy aquatics or nature-based therapy. And certainly there are additional costs. When we are incorporating horses or we're incorporating aquatics into our therapy services, because we need to pay for access to the horses, a horse handler the facility, or access to the pool. And. Figuring out how that's going to be factored in. Is really important. So you're going to look at maybe startup costs, any ongoing expenses that you would have, and you can also start to look at some funding options such as grants. So that way you can have. Beginning idea of what a budget might look like. And. It's important to, again, just start to get an idea of those things. So you might be wondering. Oh, how do I get this information? So, of course you can Google it or 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's websites, find out if they're specializing in any of the areas you're thinking of specializing in, but often. Websites can be really misleading. I've certainly. Gone through websites and thought I had a pretty clear picture of what that business might look like. And when I went to the facility, it was not at all what I expected. So it's often good to follow up with. A field trip. And I love doing field trips. I love seeing how other people have their facilities set up and it's always kind of a fun way to do it. So before I had my kids and early on in my career, that was something that I really prioritize was going out to see and meet. As many local people as I could seeing what their setup was, chatting with them. And it just gave me such a great resource to see. So many different setups and I could easily be like, I like that. I don't like that. I'm taking a picture of that for later. And, cataloging that information. So that's a really, very much part of that preparatory phase, phone calls, emails. Those are really good ways to find out things like. Are you in network with insurance? What insurances are you in network with now? Remember most people who are contracted with insurance, they cannot discuss their rates, their reimbursement rates with you. So don't ask that question. But you can at least find out like who they're contracted with and do they see private pay clients? They might be willing to tell you what's the percentage of private pay clients that they see. So those are important things. To ask or to find out, as you are thinking about the business side of things. Now everybody's favorite part is the legal side. And honestly, I think the legal side scares a lot of occupational therapy providers. Before they even get started. And when we start to think about the legal side, We need to research what we need to do legally to provide services in our state. In our county in our city night, do we need a business license? For our practice location in our city. What type of business setup do we need? And that's one of the things that I include and my business barn raising is a way for everyone to find out for their state, what type of business entity do they need? Do they need to have an LLC, a PLLC? What type of business entity they need to set up. What. Resources or where can you find this information? You can look at your state's website, right? That will tell you a lot of this information. You can go to your occupational therapy association for your state. So for us, it's N J O T. But for your state. Ask, reaching out and asking them questions can be also a good way to find out some of that information. I've especially been researching this as far as direct access in because a New Jersey, we have direct access, meaning that if a client wants to receive occupational therapy services, they don't have to go to their pediatrician primary care physician and get. Prescription for occupational therapy, right? It means direct access. They can directly access the services. But in other states, that's not the case. So in Pennsylvania, I would need to have a prescription. If I was treating someone with a medical diagnosis and thinking about that's one more. Step in my business that I need to figure out cultivate, right. I need to cultivate those relationships with doctors and pediatricians. And what if there's not buy-in from those doctors and pediatricians, that could be a barrier. To access to clients who want to come to me, but also a barrier access for me growing my business. So I'm really interested in what states have direct access versus those that don't. So that would be something to research. For your area that has a pretty big legal implication, right? You need to know that. The small business associations can be really helpful with some legal background. Just remember. Not, you're not always going to get connected with somebody who understands the healthcare field. So I have found sometimes when I'm talking with someone from the small business association. They're really good business people, but they don't necessarily understand some of the constraints that I might have in operating under my licensure. So. That's an important thing to think about. The other thing that you might want to start doing in this preparatory phase is name, search and look up. If you have a private practice name in mind, you might want to go to your state's website and look up business names that have already been taken. That can give you an idea. And you're going to come back around to that expense. Piece right. That we had talked about with your business plan because you might want to track some of those. So what is the cost to file for an LLC PLLC? Is there a cost to open up a bank account? What is the credit card processor that you are going to use? What's their take on it. You can just gather some data on EMR costs. And how about an email service? How much is that going to cost your liability insurance? You're going to have your professional liability and your general liability insurance is a good time to make a phone call, start getting some quotes, right? Those are perfect preparatory activities. Getting quotes for professional liability and general liability. And making sure that you feel comfortable, that the company that you choose. Understands what it is that you do, and they're going to cover you if there was ever an incident and. I have been using H PSO for several years now. And they are expensive. And I thought, I'm going to go get some quotes and see if maybe I can cut this expense because it's a big expense for us. And I contacted a couple of their companies. And there. Responses to my questions did not satisfy me. And so I said, you know what? I am comfortable that HCSO knows what I do. They understand how I incorporate nature horses aquatics into my occupational therapy practice. And I feel comfortable with that. I do not feel comfortable with some of the other companies. One company actually asked me. How high off the ground. Where the tree forts that we build. Because they saw a picture on the website. Of like, some sticks leaning up against the tree and like that was a tree Fort and I was like, Hmm. I'm not thinking that you're getting what I'm doing. Workman's comp expenses. That's another area that you can get some quotes in. You want to start to investigate EIN NPI numbers and look at the process for those. Things like that really make my head hurt and I really need to block out time to do those things. So in this preparatory phase, it's a really good idea to look up those processes. Look up. Getting your EIN look up getting an MPI number. You probably already have an individual NPI number. So then the process for filing for a group NPI. When you're practicing in a niche area like hippotherapy or aquatics or nature-based therapy. You certainly have to adhere to specific legal and regulatory standards. Most of these are not specific to our niche. They are specific to occupational therapy and the practice under our licensure, but we want to familiarize ourselves with any relevant laws in our area and any of our licensing and supervision requirements. Again, this goes back to our occupational therapy license and practice, and then our liability considerations. So thinking. Thinking about. Are we going to have the safety protocols that we need in place? What risks might we need to come up with a risk management plan? So when we think about the legal side of things, it doesn't necessarily have to be. Frightening or overwhelming. But there are things that we want to consider in this preparatory phase and just start working through it like one step at a time. So to wrap it up today in the preparatory phase, we're getting the details in place to move to a purposeful phase in the getting started series. We're going to look at how we can conduct some market research. Sketch out a business plan. Like it's not going to be the finished business plan. That's definitely going to come more in the next phase. Looking at what legal and insurance compliance we need to take care of. We can start looking at. Professional relationships and the skills that we might need to work in our niche area. And if you start with this preparatory phase, you really can successfully transition into a unique niche and provide the valuable occupational therapy services to your clients that they need. So I hope this was helpful for you today. Remember, you can join me in the nail, your unique OT niche to learn more about the specialty area. That might be a really good fit for 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 the research on costs of certification challenges. Practice locations, things like that. So until next time, this is Gina at animals and aquatics and OT signing off.