“If you can’t beat ’em, join ’em.”

For the owners of newly formed Peak Sport and Spine Rehab, that old adage proved to be good business advice. Athletic trainer Mark Dempsey and physical therapists Shaon Fry and Todd Ankenman are the former owners of Peak Performance Physical Therapy & Sports Medicine. Physical therapist Phillip Smith is the former owner of Sport and Spine Rehab. The quartet merged the two companies to create Peak Sport and Spine Rehab last November.

“We’ve always had a mutual respect for each other,” Smith says. “But as former competitors, it was challenging at first to admit that we could do better working together than we could working against each other. As we learned more about each other’s values and belief systems, it was clear that we had the same goals and objectives.”

The merger took 1½ years to complete. Dempsey and Smith say the most difficult part of the process was dealing with all of the paperwork. They had to integrate their employee and patient records, and revamp their billing system. Despite the often-tedious process, the company has seen many advantages in the months since the merger. The partners have hired 12 new staff members and opened three more clinics.

“We’ve become more efficient since the merger,” explains Dempsey. “Bundling costs and sharing expenses have allowed the business to grow. We also have the ability to leverage more contracts than we could before.”

Smith says the merger also allows Peak Sport and Spine Rehab to better handle changes in the health care industry. One example is the move toward accountable care organizations, which are networks of doctors and hospitals that share responsibility for patient care. Their goal is to deliver high-quality care without unnecessary spending.

“We saw changes coming three years ago, and we took steps to get out in front of them,” Smith says. “We wanted to be able to compete and make it more viable for us to participate in ACOs. Many ACOs are forming in St. Louis and Kansas City. We’ve set ourselves up regionally to be able to accept patients from all areas.”

Collaboration is critical to Peak Sport and Spine’s success. Unlike most businesses, the company doesn’t advertise its services to potential clients. Each patient comes from a referral. The company generates the majority of its business through relationships with physicians. Referrals also come from employers and personal-injury lawyers. The partners note, though, that they sometimes come up against closed hospital systems that don’t allow referrals to outside health care providers.

            “We have to earn every patient,” Smith says. “It’s a constant struggle to develop new relationships. People have the choice to choose their caregivers, but it’s very seldom that a patient will choose someone different if the physician recommends someone inside their own system. Our only avenue is to get in front of physicians and earn their respect. Sometimes, the biggest challenge is just getting in front of the physician to start with.”

Ankenman says that maintaining professional relationships is an ongoing process that doesn’t always end with the initial patient referral.

“The most important way to develop relationships is through providing great service,” he says. “If it needs to be done, we strive to do it. We try to anticipate what our referral sources need, and we try to facilitate those needs, even if we don’t provide it ourselves. If a physician or patient has a need, we make it happen.”

Hospitals present the main competition for Peak Sport and Spine Rehab. Smith says that many private practices are struggling to stay in business because hospital-based clinics often get more favorable contracts from insurance carriers. He is a vocal proponent of equal pay for equal services legislation that would require health insurance companies to provide the same reimbursement to private-practice providers as to hospital-run physical therapy clinics.

Whatever It Takes
In a challenging marketplace, the owners of Peak Sport and Spine Rehab do everything they can to get a competitive edge. They attend conferences and do research to stay up-to-date on the latest technology that might help their patients. They are members of professional organizations, such as the Missouri Athletic Trainers’ Association and the American Physical Therapy Association. They use resources from the U.S. Small Business Administration and Regional Economic Development Inc. Above all, they strive to maintain a high level of patient care. And quality work is always good for business.

“The patient is always right and the patient always comes first,” says Smith. “When a patient leaves our clinic happy, they will often send their relatives or friends to us.”

Peak Sport and Spine Rehab is the largest privately owned physical therapy company in Missouri. It has 25 locations throughout central Missouri and the St. Louis area. Columbia is home to five of the clinics and serves as the firm’s headquarters. Peak Sport and Spine Rehab has contracts with 23 schools in the state, including all four of Columbia’s high schools. The company’s certified athletic trainers provide sport injury management services, such as sporting event coverage, educational talks and consultations.

Let’s Talk
With so many moving parts, the partners have learned that constant communication is a priority. When they can’t be in the same room, text messages, emails and tools such as shared Google documents and synced calendars keep them all on the same page.

“We meet at least two times every week,” Smith says. “We all work 60 to 80 hours a week, but we find the time to get together, whether it is at 6 in the morning or 7:30 at night. We talk through everything as a group, and we make decisions as a group. If anything, we might overcommunicate.”

The four partners have equal input into every business decision, but Smith and Dempsey say they handle 90 percent of the daily administration of the company. The pair has stopped seeing patients for now.

“There are sacrifices that go into taking care of multiple clinics and 100-plus employees,” says Smith. “Every decision that we make affects not only us, but also our staff and their families.”

Ankenman and Fry are still full-time practicing physical therapists, in addition to their duties as owners. Ankenman says they have to work as a team and back up each other to keep the business running smoothly.

“Balancing clinical practice and duties as an owner has always been a challenge,” Ankenman says. “The clinical schedule is very rigid, but many of the tasks for the business require flexibility and immediate attention. Being familiar with each other’s thinking and having trust allows us to get things done.”

Peak Sport and Spine’s 175 employees are a critical part of the business. The partners support their staff in pursuing continuing education. Since the merger, they also have increased their employees’ benefits.

“We try to foster independence and empowerment among employees,” says Dempsey. “We believe in investing in our people. Our employees are very motivated. One of our biggest struggles has been to create opportunities as fast as our employees are asking for them.”

Another important piece of the business is community involvement. Peak Sport and Spine Rehab sponsors several local golf tournaments each year. The partners are also members of the Columbia Chamber of Commerce. In April, Peak Sport and Spine Rehab hosted a 5K fundraiser for Kids’ Chance of Missouri, a not-for-profit organization that provides post-high school scholarships to children of Missouri workers killed or catastrophically injured on the job. In May, Columbia Public Schools honored the company for its 15 years of participation in the school district’s Partners in Education program.

“I’m proud of my partners and employees,” Smith says. “We feel lucky to be in a position to help our patients every day, and also be active in giving back to the community.”

Growth Mode
Smith, Dempsey, Ankenman and Fry have big plans for the future of Peak Sport and Spine Rehab. By fall, they hope to hire 30 more employees. They are currently making plans to open more clinics in the St. Louis area, and they have regional expansion plans throughout central Missouri as well. Smith says other private practitioners in the state have reached out to them about the possibility of working together.

“We want our clinics to be where the patients are, so they don’t have to drive out of their way to get to us,” Smith says. “We like to create win-win and no-brainer situations. The merger fit that criteria, and we want to keep making those types of decisions as we move forward.”