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Principles of Practice Development

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Title: Principles of Practice Development


1
Principles of Practice Development Marketing
  • Rocky Mountain University Of Health Professions
  • CC 562.3 T-DPT Class 10 (Oct 2006)
  • Dr. Ed Ramsey, PT Business Consultant

2
A Little about Dr. Ramsey
  • Almost 39, married 1 year this week
  • Expecting our 1st child December 21
  • Graduated from SC 1990 BS, 1991 MSPT
  • RMUofHP 2004 DPT
  • Worked in every PT setting between 1991-1996

3
Opening of Ramsey Rehab
  • Opened Ramsey Rehab 1997 with 3 employees
    counting myself
  • Turned down from 3 banks
  • Finally approved for 68K business, 122K
    mortgage, 30K equipment lease
  • 2,200 sq ft between 2 basement office condos
  • Added 1st PTA in 2 months, PT in 6 months
  • 100 visits/week in 3 months
  • Story about Tufts, 100 visit mark

4
Continued Growth
  • Opened satellite in 2000
  • Leased 400 sq ft, 1,000 capital outlay
  • Dr. Jones moves out
  • Increased space to 1,200 sq ft
  • Added more employees
  • 2004Decided to build new 10,000 sq ft clinic
  • 1.7 million

5
9 Years Later
  • Took 49 employees/family on Cruise
  • Employ 28 employees
  • Need 4 more PTs, 3 PTAs
  • Bill out 2.3 million Jan-June 2006
  • Collect 1.1 million Jan-June 2006
  • Profit per Visit of 6.2
  • Schedule 710 patients/week

6
Consultant, Speaker Author
  • National Speaker
  • PPS 2003, 2004, 2005, 2006
  • CSM 2004, 2005, 2006
  • Pre-conference PPS CSM 2006
  • Co-writing a book 2006, ? Published 2007
  • National Consultant 2004-current

7
Why Do I Tell You This?
  • Even today you can succeed in private practice if
    you develop and use a plan
  • Vinod S clinic
  • Tommy M clinic
  • NH clinic (location matters)
  • Opportunities

8
Class Information
  • CREDIT HOURS One (1)
  • INSTRUCTOR Ed Ramsey DPT
  • Ed_at_RamseyRehab.com
  • CLOCK HOURS Based on 50 minutes per hour, 9
    hours of class time is 450 minutes. The
    following schedule provides for 225 minutes in
    the morning and 225 minutes in the afternoon.
  • 800am - 1000am Class
  • 1000am - 1015am Break
  • 1015am - 1200pm Class
  • 1200pm - 130pm Lunch
  • 130pm - 330pm Class
  • 330pm - 345pm Break
  • 345pm - 530pm Class

9
COURSE OBJECTIVES
  • Upon successful completion of this course, the
    student will be able to
  • 1. Describe the basic personal qualities
    necessary to be a successful business owner and
    how to strengthen weak areas through education
    and professional help.
  • 2. Understand common clinic designs and the flow
    principle.
  • 3. Complete an adequately detailed and tailored
    business and marketing plan.
  • 4. Complete an accurate SWOT analysis.
  • 5. Articulate the importance of pre-marketing,
    branding, a company mission statement and staying
    on message.
  • 6. Describe marketing tips and ideas for the
    start-up and early years to include common
    mistakes and areas to target based on your own
    SWOT analysis.
  • 7. Understand the necessity of credentialing
  • 8. Identify the essential qualities of support
    staff
  • PREREQUISITES None

10
TEACHING METHODS AND LEARNING ACTIVITIES
  • Through extensive self-study, dynamic group
    discussion and focused practical projects, the
    experienced clinician/student will be given the
    framework to complete a detailed business and
    marketing plan that can be successfully utilized
    to open a private practice. 
  • The focus will be on development of a business
    plan and creating a dynamic comprehensive
    marketing plan that will allow the experienced
    clinician to move from working for others to
    working for themselves.
  • Students will be responsible for answering the
    questions in the pre-class assignment (as
    described in attachment A) and bringing two
    copies of it to class. Instructor will keep one
    copy.
  • Grading for the pre-class assignment will be as
    described in attachment A.

11
METHODS OF EVALUATION
  • METHODS OF EVALUATION
  • Completion and submission of pre-class assignment
    at class 40
  • Final project-grading of a business marketing
    plan
  • Or final written exam 60
  • GRADING SCALE
  • Letter Grade Value Letter Grade Descriptor
  • A 100 93 I Incomplete
  • A- 92 90 IP In Progress
  • B 89 87 W Withdrawal
  • B 86 83 TC Transfer credit
  • B- 82 80 NS Grade not submitted
  • C 79 77 R Repeat Course
  • C 76 73 AC Audit Course
  • F 72 and below
  • LATE ASSIGNMENTS Assessments submitted by
    students, which are postmarked one to thirteen
    days past the due date, in a course without an
    approved Incomplete status, may be subject to
    grade deductions ranging from 5-15. Faculty
    will determine the appropriate grade deduction.
  • If assessments are not received postmarked within
    14 days after the due date, in a course without
    an approved Incomplete status, then the
    University will assume that the student has
    withdrawn from the course.

12
Attachment A Pre-Class Assignment Grading Sheet
  • Please pull out attachment A from the syllabus.
  • Please hand me your pre-class assignment

13
Mandatory Pre-Class Assignment
  • Attachment A
  • Mandatory Pre-class Assignment
  • You must bring with you to class a minimum of 4
    of the following 5 items
  • 1)   1 business plan (with marketing info)
    preferably from the medical field to use as
    samples.
  • 2)   Demographics for your local area or the area
    you want to open a practice. Bring information on
    a minimum of 4 of the 8 listed below
  • a.       Population (mention if varies by season,
    etc)
  • b.      Socioeconomic breakdown
  • c.       Disposable income
  • d.      Work force data
  • e.       Education
  • f.        Medical Access
  • g.       Competition
  • h.       Reimbursement Rates
  • 3)   A rough executive summary for your clinic or
    future clinic or new program
  • 4)   A list of all potential competitors
  • 5)   Rough draft of a SWOT analysis for your
    management team, your clinic, future clinic or
    new program

14
Pre-Class Optional Bonus
  • Optional Bonus (20 points towards pre-class
    assignment grade)
  • Provide 3-4 entire journal articles of Evidence
    Based Research or published case studies for a
    main selling point or techniques of your company.
  • For example-below are research articles
    validating the use of exercise to improve the
    outcome of patients with knee OA. You could
    find more support-build a protocol around this
    and market it to the local community and referral
    sources. To successfully complete this bonus
    provide high quality research articles or
    published studies that you could use in the same
    method and write 2 paragraphs as to why you
    choose them and how you would use them in
    developing and marketing your clinic. (You can
    not use the articles I referenced below to
    receive this bonus).
  • Deyle GD, Allison SC, Matekel RL, Ryder MG, Stang
    JM, Gohdes DD, Hutton JP, Henderson NE, Garber
    MB.
  • Physical therapy treatment effectiveness for
    osteoarthritis of the knee a randomized
    comparison of supervised clinical exercise and
    manual therapy procedures versus a home exercise
    program. Phys Ther. 2005 Dec85(12)1301-17.
    PMID 16305269 PubMed - indexed for MEDLINE
  • McCarthy CJ, Mills PM, Pullen R, Roberts C,
    Silman A, Oldham JA.
  • Supplementing a home exercise programme with a
    class-based exercise programme is more effective
    than home exercise alone in the treatment of knee
    osteoarthritis. Rheumatology (Oxford). 2004
    Jul43(7)880-6. Epub 2004 Apr 27. PMID
    15113993 PubMed - indexed for MEDLINE

15
Questions to Ask-Refer to handout
  • Yourself
  • Do I want to do this?
  • Am I committed?
  • What am I willing to risk?
  • Can I put my life/relationships/family on hold to
    do this?
  • Your Family
  • Spouse
  • To do this you need to be 100 in synch with the
    family
  • Missing family functions, birthdays, vacations
  • Long nights, weekends, not enough money
  • Kids
  • Missing family events
  • Missing sporting and school events
  • Being tired or not around as much
  • Extended Family
  • Support to help in your absence
  • Potential financial support for your family or
    business

16
Questions to Ask cont.
  • Experts
  • Legal
  • Corporate status
  • Ownership structures and Federal/State laws
  • Leases and Contracts
  • Accounting
  • Method (cash vs. accrual)
  • Out-source or not
  • Projections
  • Financial
  • Business Plan creation, development, modification
  • Projections (patient volume, PL, debt to equity
    ratio)
  • Cash-flow
  • Bank Relationship
  • Mortgage Brokers

17
Questions to Ask cont.
  • Best friend/personal confident/spiritual advisor
  • What do they think of your idea
  • Why
  • Are they supportive or not
  • Why or Why not
  • Are their comments valid
  • If yes-Thank them for taking the time to listen
    and analyze, then answer them and put the answers
    in the business plan
  • If not-was your explanation clear, concise,
    accurate?

18
Additional Questions to Ask
  • Other Successful PT clinic owners (Retired and
    Current-same state and other states)
  • Other Business Owners
  • All Feedback is worth listening to-but may not be
    worth acting upon. If someone is willing to
    listen-give them your spiel. Its good practice
    for you and repetition will help you focus and
    develop your plan.

19
Refer to Handout
  • Questions to Ask
  • Please spend 5 minutes and complete

20
Personal Skill Inventory
  • What are you good at?
  • What are you horrible at?
  • What would you need to hire HELP for?
  • Personality
  • High strung, low key
  • Energy Level
  • Big Picture or Small Picture Person

21
Skill Inventory cont.
  • Previously could you sleep at night
  • Are you the type of person that can deal with
    on-going long term problems
  • Can you live with a bad decision
  • Can you forgive yourself of your mistakes if you
    learned from them
  • Can you learn from your mistakes/or others
  • Can you take constructive criticism
  • Are you a leader? Team player? Both?
  • Can you make the hard decision/tough call

22
Best Teacher
  • Experience is the Best teacher
  • Do you have experience in the exact business you
    plan to open?
  • If not-can you get some before opening?

23
Business Experience
  • Business Experience
  • Managing a business in any field
  • In PT
  • Supervisory experience
  • Customer Service experience
  • Creating and working within a budget
  • Hiring/Firing/Interviewing/H.R.
  • Reading PL, making projections, looking for
    trends and making management decisions based on
    them
  • Has your business judgment proved trustworthy
  • Have you learned from your mistakes

24
Family/Friend Skill Inventory
  • What are their talents
  • Legal
  • Financial
  • IT
  • Maintenance
  • Keep this list for an emergency
  • Experience has taught many of us never to hire
    family or friends
  • It may cause friction by not hiring them but
    nothing compared to what happens to the
    relationship if it doesnt work out you fire
    them. (Example)

25
Refer to Handout
  • Skill Inventory
  • Please spend 5 minutes and complete

26
Establish Relationships
  • Established Relationships with the Pros
  • Legal
  • Financial (Personal and Professional)
  • IT
  • Maintenance
  • Construction
  • Printing

27
Personal Resources
  • Financial
  • Do you need your salary to survive?
  • How many months total expenses do you have in the
    bank?
  • How is your credit score, line and credit
    worthiness?
  • What is your current debt to equity ratio?
  • Have you ever used a budget successfully?

28
Personal Resources Cont.
  • Time
  • What time commitments do you currently have other
    than this adventure?
  • Child care
  • Elder care
  • Volunteer
  • Associations/groups/religion/charities

29
You decided Yes-Now What?
  • After completing the skill inventories, looking
    at you and your support system-What is next?
  • Identify the Holes and their fixes with a …

30
Develop a Business Plan
  • A great business plan will force you to ask
    yourself and your support staff (paid
    professionals, family and friends) to answer many
    difficult questions that are important to your
    businesses future.
  • They can be 20 pages or over 400 pages
  • My last 3 took between 150-400 hrs to write
  • It is a road map for your corporate success and
    will allow other professionals to see your
    potential in a multidimensional sense

31
Business Plan
  • What is a business plan and why do I need to
    write one?
  • Cant I just wing it?
  • What if its in my head-good enough?
  • All good business people have a business plan-you
    should too.

32
Business Marketing Plan
  • It will also include a detailed Marketing Plan
    with an in depth market analysis
  • SWOT (strength, weakness, opportunity, threats)
  • HOW DO I DO IT?
  • You can pay a professional to write it
  • Accountant, Consultant
  • You can use free resources to assist you
  • SBA, Local business college, library book, PPS
  • You can write it yourself, or any combo

33
Help is Available
  • See Impact (April and May 2005)
  • Refer to web site
  • www.ppsapta.org
  • www.SBA.gov
  • www.RamseyRehab.com (sample)
  • www.score.org
  • www.cweboston.org
  • Library, bookstore, community college

34
Business Plan Help cont
  • Best plans are written by someone with PT and
    Business Plan writing experience
  • Same holds true for Marketing Plans
  • If you have someone else write it
  • Interview them, check other plans they have
    written
  • Have they been accurate, well received, funded
  • How do their prices compare to other
    professionals
  • How much input do you have
  • Make sure you know everything in it, the hows
    and whys
  • Make sure you are comfortable with all sections,
    projections, etc… It represents YOU! You are
    Liable for errors, omissions, false statements,
    etc…

35
Review samples provided by the class
  • Any commonalities between all of these plans?

36
Business Plan Outline
  • Name of Company
  • Executive Summary
  • Vision Statement Section
  • Objectives
  • Mission
  • Keys to Success
  • Start-up Summary
  • Company Ownership
  • Company Location and Facilities
  • Services
  • Competitive Comparison
  • Sales Information (Sell)
  • Sourcing (Info)
  • Future Products (Services, Expansion)
  • Market Analysis Summary (What, Who, Where)
  • Market Segmentation (Services Provided)
  • Industry Analysis (Who else is doing it? Their
    success)
  • Distribution Patterns
  • Competition and Buying Patterns

37
Business Plan Outline cont.
  • Strategy and Implementation Summary (Computer
    Back-up)
  • Marketing Strategy (Payer Mix)
  • Sales Strategy (Information Management)
  • Sales Forecast
  • Milestones
  • Management Summary
  • Organizational Structure
  • Management Team
  • Management Team Gaps
  • Personnel Plan
  • Other Management Considerations
  • Financial Plan
  • Important Assumptions
  • Key Financial Indicators
  • Breakeven Analysis
  • Projected Profit and Loss
  • Projected Cash Flow
  • Projected Balance Sheet
  • Business Ratios

38
Refer to Handout
  • WALK-IN WELLNESS CENTERS, INC.
  • Name of Company
  • Executive Summary
  • Brief 1-2 page summary
  • Recognize the funder interest
  • (SWOT) Situation Weapons Objectives Tactics
  • Do you know who your customers are?
  • Do you know the economic and physical demands
    required to
  • service the customers?
  • Do I know what to offer to relieve those
    demands? (point of service, location, personnel,
    equipment)
  • Pinpoint request and ROI expectations
  • How do we mutually benefit from the risks
  • Recognize challenges
  • Review and link elements
  • Demonstrate confidence in you and the plan
  • SWORT
  • Strengths
  • Weaknesses- in other providers not mine
  • Opportunities

39
From Tom Little
  • Smart Objectives
  • Specific
  • Measurable
  • Achievable, Applicable
  • Realistic
  • Timely
  • This section is very important- gives the funder
    the reason to fund your plan.
  • Make sure it includes all the elements above.

40
Your Exec Summary
  • Pull out the one you completed for the pre-class
    assignment
  • Or if you didnt do it for pre-class-lets start
    one now

41
2.0 Vision Statement Section
  • 2.0 Vision Statement Section
  • 2.2 Objectives
  • 2.3 Mission
  • 2.4 Keys to Success
  • To provide the public with a multiple of Health
    Screening Tests and immediate results with
    in-depth information concerning their actual
    results. This valuable health related
    information will be used to address health
    concerns, injurious behaviors and nutritional
    problems with the intent to modify behavior or
    attitudes that lead to these problems. It is
    then the employees job to instruct the testee in
    ways that Walk-In Wellness Centers, Inc.s (WIWC)
    services can assist them in living a healthier
    lifestyle.
  • To achieve these goals will require a
    knowledgeable, friendly well educated staff with
    an out-going, extroverted personality and a
    wiliness to engage the public while selling
    products. They must have the ability to see the
    big picture concerning each testees health and
    factor that into their personalized educational
    discussions and the product WIWC offers.
  • WIWC will be successful because of the long
    established support structure and time tested
    methodology that has been a value added assets to
    over 350 communities that it already services.
    The employees hired locally are some of the most
    highly trained in the field and have a proven
    tract record in the health promotions and
    Physical Therapy field.

42
3.1 Start-up Summary
  • 3.1 Start-up Summary
  • All Materials (Equipment, Sales Literature,
    Marketing Literature, Training Manuals, Training,
    Free Standing Inserts, etc…) for opening and
    continued operation are being purchased through
    US Wellness. (www.USWellness.com) US Wellness is
    the leader in Public Health testing (onsite and
    through store-front locations) for the last 5
    years. They have 10 corporate owned and operated
    locations expanding to 40 by 2004 and 350
    locations throughout the United States and 2
    Internationally. USWellness is currently adding
    2-4 new sites per month.
  • 3.2 Company Ownership
  • The company (WIWC) is a Sub Chapter S Corporation
    owned by Edward Ramsey MSPT, president and owner
    of Ramsey Rehab, Inc. (www.RamseyRehab.com)
    Ramsey Rehab is an out-patient Physical Therapy
    clinic specializing in Orthopaedics and Sports
    Medicine. Ramsey Rehab is THE recognized
    leader in Sports Rehabilitation having provided
    services to the Northern Worcester County Region
    for over 6 years. Ramsey Rehabs strong
    management team and proven track record as well
    as all company resources will support WIWC in all
    forms of HR and operations through consultation,
    including capitol outlay and establishing a line
    of credit.
  • Charity is a large part of the owners and
    management teams philosophy. It is our intent
    to donate a portion of the profits to St.
    Josephs Catholic Church, Charlton, MA. For the
    establishment of a Catholic school and free
    medical clinic as is currently being done with
    donations from the owner, Ed Ramsey. Support is
    also to be provided to 12 community organizations
    through Ramsey Rehab and Ed Ramsey, personally.

43
4.1 Company Location
  • 4.1 Company Location and Facilities
  • Ramsey Rehab has two locations
  • Main Office Satellite
  • 33 Electric Avenue Suite B-10 100 Erdman Way
  • Fitchburg, MA 01420-7954 Leominster, MA
    01450-1841
  • Walk-In Wellness Centers, Inc. (WIWC)
  • Main Office Satellite
  • 33 Electric Avenue Suite B-10 111 King Phillip
    Road
  • Fitchburg, MA 01420-7954 Worcester, MA 01450
  • Primary service area for WIWC and one of it best
    assets will be its mobility. WIWC will have the
    ability to service a different location each day.
    (Health clubs, health stores, alternative
    medicine locations, YMCA or YWCAs, Pharmacies,
    Physician offices, Wal-Mart/K-Mart or Grocery
    stores like USWellness models). Management will
    contract with specific target locations to
    rent/lease space 1 day per week. Marketing
    literature will support each service location.
    As volume grows at that location it will be
    determined by management whether to add
    additional days at that location and eventually a
    permanent storefront there.
  • Expansion into Health Fairs, Local and State
    Fairs, Agricultural or Art Fairs, Corporate or
    Business Conventions and Corporate on-site
    services.

44
5.1 Services
  • 5.1 Services
  • High quality standardized, objective, reliable,
    reproducible and public friendly health tests and
    health related counseling available immediately
    and at a fair value. Tests will include Bone
    density (assess actual risk of breaking a bone),
    Body Fat Analysis (Measures your percentage of
    muscle mass to fat mass and compares it to the
    healthy normal), Arterial Stiffness (reliable
    indicator for risk of heart attack), Skin
    Hydration and damage (Illustrates the damage
    already done to your skin by sun exposure and
    chance of cancerous cells), Peripheral Vision
    Testing (measures and quantifies your peripheral
    visual field and detect potential visual
    problems), VO2 Max (tests your ability to breathe
    and potential for lung disease), Metabolic Rate
    (Measures the efficiency of your body, a good
    measure of a persons overall health). Equipment
    can be view at www.USHealth.com/Business/services_
    equip.asp
  • Many additional testing equipment and tests are
    available to expand into depending on local needs
    and regulations (Cholesterol, allergy, Hormone,
    drug, and over 80 additional blood derivered
    tests).
  • Two other areas of expansion include utilizing
    the test results and biomarkers for weight
    management classes and selling of
    biopharmaceuticals/supplements. These two areas
    will become significant for surpassing the 30
    profit mark. The success of these offerings will
    be dependent on the skills of WIWC employees in
    up-selling.
  • USWellness has been strong in their support of
    these areas through weekly womans newsletter and
    monthly wellness newsletter, monthly conference
    calls on topical continuing education issues and
    high quality glossy inserts and 4 color pamphlets
    for lay public education.

45
6.1 Competitive Comparison
  • 6.1 Competitive Comparison
  • Currently there is no Independent competition in
    the Northern MA, Central MA or Southern CT.
    There are 4 Urgent Care centers (within 30 miles)
    that provide a few of these tests but typically
    require physician authorization, insurance
    approval, long waiting period and clinic
    appointments. Occasionally justification to any
    of these check points could delay or prevent the
    testing to occur. A co-payment is usually also
    paid. Local hospitals also offer some of these
    tests but the above restrictions still apply.
  • No similar weighty management program combined
    with objective testing, nutritional education and
    scientifically supported targeted
    biopharmaceuticals/supplements.
  • None of these services are currently provided at
    local fairs, state fairs or conventions at
    present.
  • 6.2 Sales Information (Sell)
  • 6.3 Sourcing (Info)
  • 6.4 Future Products (Services, Expansion)
  • Expansion into additional areas for permanent
    storefronts and addition of other tests can
    include drug testing, allergy testing, hormone
    testing, vaccination program for flu, pneumonia,
    etc.
  • USWellness provides over 110 tests for a myriad
    of health issues and has the documentation for
    instruction of employee/tester and testee
    handouts. All tests and literature as well as
    the health monitoring programs are designed by
    renowned experts in the health field and the
    company is overseen by a medical oversight board.

46
7.1-2 Market Analysis
  • 7.1 Market Analysis Summary (What, Who, Where)
  • 7.2 Market Segmentation (Services Provided)
  • 8.1 Industry Analysis (Who else is doing it?
    Their success)
  • Currently there is no Independent competition.
    There are 4 Urgent Care centers (within 30 miles)
    that provide a few of these tests but typically
    require physician authorization, insurance
    approval, long waiting period and clinic
    appointments. Occasionally justification to any
    of these check points could delay or prevent the
    testing to occur. A co-payment is usually also
    paid. Local hospitals also offer some of these
    tests but the above restrictions still apply.
    Equipment we utilize is state-of-art with
    literature to back up its claim of reliability
    and accuracy within 4 of the Gold Standard,
    very acceptable for mobile equipment. This
    literature will be marketed and available for
    public review and education.
  • No similar weight management program combined
    with objective testing, nutritional education and
    scientifically supported targeted
    biopharmaceuticals/supplements.
  • None of these services are currently provided at
    local fairs, state fairs or conventions at
    present.
  • As mentioned earlier (www.USWellness.com) US
    Wellness is the leader in Public Health testing
    (onsite and through store-front locations) for
    the last 5 years. They have 10 corporate owned
    and operated locations expanding to 40 by 2004
    and 350 locations throughout the United States
    and 2 Internationally.
  • Financial numbers available for review as well as
    volume reports show this field and technique to
    be a highly successful turn-key operation.

47
9.1 9.5
  • 9.1 Distribution Patterns
  • 9.2 Competition and Buying Patterns
  • Savvy consumers will continue to look towards
    their insurance to provide these ancillary
    testing but if insurance trends of managed care
    continue- these tests will not be covered in the
    future or a larger sharing of the cost will be
    passed on to the consumer. We will offer the
    same high quality, reliable services for less
    because the over head and paperwork will be much
    less. Convience will also be a major selling
    point. In addition, as the public becomes more
    health conscious and looking for healthy
    alternative- the solutions we provide will be
    ideal to answer their questions and fill their
    needs.
  • Implementation now will allow us complete market
    dominance and the ability to educate the public
    for improved branding and market loyalty.
  • 9.3 Strategy and Implementation Summary (Computer
    Back-up)
  • 9.4 Marketing Strategy (Payer Mix)
  • 9.5 Sales Strategy (Information Management)
  • All computer systems will have a daily removable
    back-up as well as a copy to a second hard-drive.
  • As mentioned the Management of WIWC is
    experienced in the Health Field, Health Care
    management and in marketing. To further our
    success each employee will go through training by
    USWellness on the proper use of the equipment,
    program implementation and customer service.
  • Initial training will be provided by USWellness
    at their corporate office in Gaithersburg, MD
    with follow-up through monthly phone conference
    calls, monthly newsletter and phone follow-ups as
    needed to the medical directors.

48
9.5 cont
  • Contracts will be signed with the sites prior to
    equipment purchase. Marketing material will be
    presented to local newspapers, health facilities
    and medical offices in addition to the actual
    provider sites. This pre-roll out marketing will
    provide for a fast start. Additional income will
    be derived from providing services at fairs as
    mentioned in earlier sections and lastly through
    providing testing for Pharmaceutical Companys.
    Pharmaceutical companys through their local drug
    representatives request health screenings/tests
    at local physician offices. Those requests are
    paid by their respective companys and requested
    through USWellness. USWellness through contract
    will pass these screening/testing opportunities
    to their local facilities. We will be the only
    site in Central-Northern MA and Metro-Boston.
    The only other site in MA is in Springfield.
    (Shoppers Drug Assist Compounding Pharmacy)
    Last year the money generated through
    Pharmaceutical contracts in MA was 42,000.00.
    It is expected to triple this year and we expect
    to get a large portion of that revenue due to our
    location and mobility.
  • (Pharmaceutical revenue USWellness Yr 2000 600K,
    Yr 2001 2.2mil, Yr 2002 3.5mil projected to
    reach 4.5 mil, Yr 2003 Projected 6.5mil)

49
9.6 Sales Forecast
  • 9.6 Sales Forecast
  • See attached spreadsheet in your handout  

50
10.1 Milestones
  • 10.1 Milestones
  • Opening Day
  • Breaking even
  • Paying off start-up Debt
  • Hiring third employee
  • Establishing permanent storefront
  • Purchasing additional equipment
  • Each site sales surpassing 300,000.00
  • Sales of Biopharmaceuticals equal 25 site sales
  • Recognized as the Leader in Public Health Testing

51
11.1 Management Summary
  • 11.1 Management Summary
  • 11.2 Organizational Structure
  • 11.3 Management Team
  • Management
  • Ed Ramsey MSPT. Owner of Ramsey Rehab, Ramsey
    Reality Trust and a Board of Director of St.
    Josephs Catholic Radio Station and North Central
    MA Red Cross. Ed has over 24 years of management
    experience from retail to Health Care. From
    oversight of one location to 6 locations in
    several states. Ed has been on several National
    and state boards, participates in community
    activities and religious organizations. Ed
    advises friends on financial matters and
    investing and has lectured locally and at State
    conferences of topics from Physical Therapy,
    health care, starting a new business, tithing,
    and disaster services to name a few.
  • Manager
  • Joseph Magdis, BS (Management with concentration
    in Marketing) AS PTA, CSCS, ACE. Joe has over 16
    years experience in the Health Field and has had
    8 years of management experience.
  • Ed Ramsey will oversee company operations. Joe
    will attend to all daily decisions of the
    company. Additional employees will be hired as
    needed.

52
Management/Personnel
  • 11.4 Management Team Gaps
  • Minimal experience in contract negotiation for
    facility leases in union and non-unionized
    companies. This deficit will be reduced by
    awareness of this, establishment of short-term
    contracts in unfavorable conditions and use of
    USWellness information on typical rates and
    contracts for its other 350 facilities. A
    partnership will also be cultivated with local
    business owners to elicit advice in this area to
    prevent egregious errors.
  • 11.5 Personnel Plan
  • Hiring only highly qualified personnel with
    health care/promotions/marketing experience.
    Then an extensive training program initiated at
    USWellness then continued onsite by management
    staff.
  • Training will be on-going through monthly phone
    conference calls by USWellness medical
    directors, newsletters, on-line courses and
    direct phone calls or e-mails to the medical
    directors as needed.
  • 11.6 Other Management Considerations
  • One strategy to maintaining respect will be by
    surrounding our company with experienced leaders
    in the health and business world to act as
    mentors and advisors. Also establishment of a
    local Medical Board of Directors to assist with
    local decisions.

53
12.1 Financial Plan
  • Please refer to your handout

54
13.1 Important Assumptions
  • 13.1 Important Assumptions
  • Success with this program at the existing 100
    sites in the US can be reproduced in MA
  • Contracts/lease agreements can be arranged at a
    reasonable rate for each site
  • Openings available at the designated fairs and no
    other similar testing already present
  • Costs to have a booth at the fairs are affordable
  • Coverage and well trained staff are available
  • Pharmaceutical open house revenue will continue
    to grow 2-3 times annually
  • We will be able to service the Pharmaceutical
    open houses as requested

55
Equipment
  • BILL TO/SHIP TO
  • Walk- In Wellness Centers Inc.144 Hammond Hill Rd
    Charlton MA. 01507Phone 508-769-6116
  • QUANTITY
  • DESCRIPTION
  • 1 Bone Sonometer
  • 1 Resting Metabolic Rate Analyzer
  • 1 Body Composition Analyzer
  • 1 Arterial Stiffness Analyzer
  • 1 Skin Damage Analyzer
  • 1 Spirometer Lung Function Analyzer
  • 1 One Year Licensing Agreement
  • Includes Lap Top Shipping
  • TOTAL43,295.00

56
Current Operations
  • Current Operations September to current
  • September 1, 2002 Company opened
  • September 1, 2002 Signed contract with
    USWellness to cover 10-12
  • Independent Pharmacies between MA and CT
  • (September and November, potential for 18
    months/alternating months) Potential 68,000
    contract if fully realized.
  • September 1, 2002 Ed Ramsey Purchased equipment
    (turned down bank lease) Terms were not
    favorable to allow future unrestricted expansion
  • September 11, 2002 Provided first of 11 Bone
    Density scans (480/ 6 hr day)
  • September 18, 2002 Proposal and presentation
    for 1st permanent site (Global Fitness)
  • September 27, 2002 Global Fitness accepts
    proposal without modifications (Attached)
  • October 3, 2002 Completed September Bone
    Density Contract
  • October 8, 2002 Open House for 1st permanent
    Wellness site (Global Fitness)
  • October 11-12, 2002 Covered Tufts Womens Fun Run
  • October 15, 2002 First day at permanent site.
    (Next week start 3 day/wk coverage)
  • October 15, 2002 Global requests second permanent
    site at Stowe location (on hold
  • until current site has proven
    profitable.
  • October 23, 2002 Coverage for Exec. Womens
    Network
  • November 1, 2002 Start first of 11 Body Fat
    coverage sites (480/ 6 hr/day)
  • December 2002 Grand Opening- to be scheduled.
    (Elected officials, media, public)

57
Global Fitness Proposal
  • Global Proposal
  • Walk-In Wellness Centers, Inc.
  • Proposal to Global Fitness
  • 9/18/02
  • Submitted by
  • Ed Ramsey MSPT, Pres
  • Joe Magdis PTA, BS, CSCS
  • Manager and Site Coordinator
  • 508-438-0487 Business
  • 508-864-4033 Cell Phone

58
Global cont
  • Company History
  • Ramsey Rehab
  • Walk-In Wellness Centers, Inc.
  • Walk-In Wellness Centers, Inc. (WIWC) is owned by
    Edward Ramsey MSPT, president and owner of Ramsey
    Rehab, Inc. (www.RamseyRehab.com) Ramsey Rehab is
    an out-patient Physical Therapy clinic
    specializing in Orthopaedics and Sports Medicine.
    Ramsey Rehab is THE recognized leader in
    Sports Rehabilitation having provided services to
    the Northern Worcester County Region for over 6
    years. Ramsey Rehabs strong management team and
    proven track record as well as all company
    resources will support WIWC in all forms.
  • WIWC is a new company opened in 2002 to perform
    health testing initially through mobile sites and
    eventually from permanent sites that cross-refer
    and support each other. Joe Magdis PTA, BS, CSCS
    is the manager of WIWC and will be responsible
    for providing all services to Global Fitness. He
    will be your primary contact and can be reached
    at 508-864-4033 Cell, 508-438-0487 Business.
  • Wellness Concept
  • To provide the public with a multitude of Health
    Screening Tests and immediate results with
    in-depth information concerning their actual
    results. This valuable health related
    information will be used to address health
    concerns, injurious behaviors and nutritional
    problems with the intent to modify behavior or
    attitudes that lead to these problems. It is
    then the employees job to instruct the tested in
    ways that WIWCs services can assist them in
    living a healthier lifestyle.
  • To achieve these goals will require a
    knowledgeable, friendly well educated staff with
    an out-going, extroverted personality and a
    wiliness to engage the public while selling
    products. They must have the ability to see the
    big picture concerning each testeds health and
    factor that into their personalized educational
    discussions and the product WIWC offers. Joe is
    the embodiment of these talents and will work
    with your staff as needed to assist them in your
    own product up-sales.
  • WIWC will be successful because of the long
    established support structure and time tested
    methodology that has been a value added assets to
    over 350 communities that it already services.
    The employees hired locally are some of the most
    highly trained in the field and have a proven
    tract record in the health promotions and
    Physical Therapy field.
  • (www.USWellness.com) US Wellness is the leader
    in Public Health testing (onsite and through
    store-front locations) for the last 5 years.
    They have 14 corporate owned and operated
    locations expanding to 40 by 2004 and 350
    locations throughout the United States and 2
    internationally. USWellness is currently adding
    2-4 new sites per month.
  • WIWC purchased all equipment and received staff
    education and training through them.

59
Marketing Plan Outline
  • Start your Marketing Plan
  • Table of Contents
  • 1.0 Executive Summary………………………………………............ 3
  • 2.0 Market Audit…………………….………………………………. 5
  • 2.1 Market Research………………………………………… 5
  • 2.1.1 Customer Survey………………………….......... 5
  • 2.1.2 Data Base Mining………………………………. 6
  • 2.1.3 Competition Analysis…………………………... 8
  • 2.1.4 Demographic Analysis…………………………. 8
  • 2.2 Market Needs…………………………………………… 9
  • 2.3 Environmental Data…………………………………….. 9
  • 2.3.1 Strategic Plan/Goal………………………........... 9
  • 2.3.2 Service Area……………………………………. 9
  • 2.3.3 WIWC Facility Location/Hours/Access………...
    10
  • 2.3.4 Medical Staff/Provider Structure……………….. 1
    0
  • 2.3.5 Referral Sources/Volume………………………. 11
  • 2.3.6 Historical Activity Levels………………………. 11
  • 2.3.7 Payer Mix………………………………………. 11
  • 2.3.8 Pricing Arrangements…………………………... 12

60
Marketing Plan Outline cont
  • 2.5 Market Trends…………………………………………... 15
  • 2.6 Market Growth………………………………………….. 15
  • 2.7 SWOT Analysis…………………………………………. 15
  • 2.7.1 Strengths………………………………………... 15
  • 2.7.2 Weaknesses…………………………………….. 16
  • 2.7.3 Opportunities…………………………………… 17
  • 2.7.4 Threats………………………………………….. 18
  • 2.8 Competitive Analysis…………………………………… 18
  • 2.9 Keys to Success…………………………………………. 19
  • 2.10 Critical Issues…………………………………………… 20
  • Marketing Position………………………………………………. 20
  • 4.0A Marketing Strategies……………………………………………... 21
  • 4.1A Marketing Mission Statement…………………………… 21
  • 5.0A Marketing Objectives and Action
    Plans…………………………. 21
  • 4.0B Marketing Strategies……………………………………………... 32
  • 5.0B Marketing Objectives and Action
    Plans…………………………. 32
  • 4.0C Marketing Strategies…………………………………………….. 37
  • 5.0C Marketing Objectives and Action
    Plans………………………… 37
  • 4.0D Marketing Strategies…………………………………………….. 43

61
Refer to Handout
  • Sample Marketing Outline and sections from a
    marketing plan I created.

62
From Tom Little
  • Smart Objectives
  • Specific
  • Measurable
  • Achievable, Applicable
  • Realistic
  • Timely
  • This section is very important- gives the funder
    the reason to fund your plan.
  • Make sure it includes all the elements above.

63
Whats the Next Step
  • Type of Clinic and Design

64
Deciding the type of Clinic
  • What are your interests?
  • What did your market study tell you about the
    area you are considering?
  • Competition
  • Any, how many, proximity
  • Same patient population
  • Similar patient populations or treatments
  • Do your strengths work well in this area, pt
    population
  • Patient population-demographics (age, education,
    income, disposable income, community support)

65
Clinic Type cont.
  • Reimbursement for your services
  • Cash vs. Insurance or mix
  • Will the mix work with the projections you ran
  • Is it higher or lower than projected
  • Are all insurance plans in the area taking new
    providers
  • Enrollment delays?
  • Do they pay for PTAs? No one pays for aides!
  • Can you survive if you DO NOT get into some of
    the plans
  • Do you need to join a PT network?

66
Consider all options Think outside of the box!
  • Can you buy someone else out
  • Can you open a clinic within a clinic
  • Can you add services to other local clinics
    without being their competitor
  • Can you run your clinic without a bldg-a virtual
    office

67
Financing your Dream
  • Upon completion and refinement of the business
    plan-DECIDE how to finance
  • Business bank loan
  • Personally fund through
  • 2nd mortgage
  • Home equity loan
  • Cash in your retirement plan
  • Borrow money from friends/family
  • Take on a partner

68
My Opinion
  • Personally-I would take a business loan from the
    bank and/or use your available cash (and did)
    before I would ever consider any of the other
    options. Especially borrowing on my home or
    removing my retirement or borrowing from a
    friend. The risk is too HIGH that you could lose
    everything.
  • A Mortgage broker may be an alternative, if the
    banks are not directly willing but interested.
  • Same thing about borrowing from Family/friends.
    It changes your relationships permanently.
  • Taking on a Partner is possible but is a much
    longer discussion with many, many variables.

69
Working 2 Jobs or more…
  • I recommend that you work on your dream, develop
    your business plan, sales pitch, marketing plan,
    scouting a location all while still working at
    least 1 job.
  • Never cheat your current employer-but in your off
    hours, weekends get this out of the way while
    banking as much as possible.
  • Some employers will assist you others may see if
    you want to open up another location for them,
    others may be hostile. Be honest in any
    direction you choose to go.
  • Plan to work per diem initially even when you
    open your own place to allow some cash flow to
    pay bills.
  • Banks historically will not finance close to what
    is needed and will not bankroll your payroll.
  • Consider opening part-time while continuing to
    work for someone else (your previous job, or per
    diem, self-contracting, etc).

70
Picking a Location
  • As in all real estate deals- CONSIDER
  • Location, location, location
  • Drive-by traffic count (weekday, weekend, hourly,
    holiday)
  • Accessibility (car, bus, taxi, metro, shuttle, on
    foot…)
  • Future area of growth or decline and effects
  • Proximity to current/future referral sources, ?
    Too close?
  • More than adequate parking-or else
  • Drive-by visibility, day or night, safety of area
  • Run the numbers- do they fit the budget?
  • Does it fit into the business and marketing plan?

71
Buying/Building versus Leasing
  • Things to consider
  • Which option are you comfortable with
  • What do you think the area will be like in the
    next 10, 20, 30 years
  • What are your plans for retirement
  • Will the cash flow support a mortgage
  • Pros and Cons of each

72
Clinic design/flow
  • Typical or Unique
  • Rectangle- RX rooms, offices on outside
  • Gym space in the center
  • Design only one path for pts in/out flow
  • Single vs. Multiple use space
  • Think patient and staff flow
  • Plan for future expansion
  • Patients
  • Programs
  • Physical Plant

73
Insurance-Fire, Liability,…
  • Too Much is almost as Bad as TOO little!
  • Make sure you have a good representative
  • Make sure you get the correct type

74
Insurance cont.
  • Make sure your venture is insurable
  • Business location, patient population, etc
  • Example-Wellness Center, Rock climbing wall
  • Speak to your agent prior to funding
  • State and National APTA, PPS can help

75
Incentive Policies
  • Depends on your Corporate Philosophy
  • I find it beneficial but it took some convincing
    for me to buy into it.
  • Determine which stat most reflects what that
    persons jobs is or what you want to focus on
    (most use arrival, productivity)
  • Be objective and consistent in enforcement
  • Retroactively apply prior to roll-out to test
    impact
  • Adjust every 6 months
  • Dont GIVE away the Farm, or under-incentivize
  • Incentives must be motivating to work
  • Excellent presentation at last years PPS conf

76
Stats Some of the many to check
  • Some should be monitored
  • Daily
  • arrival, co-pays collected vs. owed
  • Weekly
  • arrival, productivity
  • Monthly
  • arrival, productivity, total billed,
    collected, w/o, aging
  • new referrals, charges/visit, collected/visit,
    cost/visit, insc mix
  • Annually
  • volume, trends, pl, insc mix, after tax profit,
    taxes vs. projections
  • Look for trends, anticipate and adjust slowly-do
    not make quick and frequent changes-its
    unhealthy for everyone.

77
Marketing
  • Every interaction (physical, verbal, non-verbal,
    by phone, letter…) is a Marketing Opportunity
    seize it!!!!!
  • Develop a logo, a tag line and branding
  • All marketing literature, company literature and
    staff conversations must stay on the company
    message
  • Have a 30 sec, 1 min and 3 min spiel
  • Complete a SWOT, marketing plan
  • Know your abilities (Corporate/Personal) and
    capitalize on strengths, downplay weaknesses
  • Cultivate relationships, monitor quality
  • Effectively deal with all problems now/cool head
    only

78
More on Marketing
  • Attend as many community events as possible.
  • Encourage your staff to attend as well
  • This is part of my staff merit raise system
  • Give staff company coats, etc to raise your
    company visibility and branding
  • Try donating sports screens, and your services
    instead of the 10-20 ad in books and events-do
    that too if possible
  • Potentially assign staff to each area team or
    community program to act as a reference. They
    dont necessarily have to attend all functions
    but its a point person

79
Contact Information
  • Private Practice Section, APTA
  • 1-800-517-1167
  • 1055 North Fairfax St, Suite 100
  • Alexandria, VA 22314
  • www.ppsapta.org
  • Or contact your state chapter

80
www.ppsapta.org
81
www.ppsapta.org
82
PPS 20 step Plan-Opening Up a Private Practice
83
PPS Member Mentor Program
84
www.SBA.gov
85
www.score.org
86
Center for Women and Enterprise
87
Contact Information
  • Ed Ramsey DPT
  • Owner
  • Ramsey Rehab Inc (www.RamseyRehab.com)
  • Walk-In Wellness Centers (www.WalkInWellness.com)
  • 978-353-0030
  • Ed_at_RamseyRehab.com
  • Additional articles and reference materials at
    www.RamseyRehab.com

88
www.RamseyRehab.com
89
Previous Web casts
  • Consider purchasing previous web casts for your
    reference library
  • HIPAA
  • Billing
  • Employment policies
  • Contacting/Joining your state PPS
  • Becoming active on a National/State level
  • Attending State and National PPS
    meetings/conferences
  • Join PT-PAC (Political Action Committee)

90
(No Transcript)
91
Your Future!
92
(No Transcript)
93
Final Assignment
  • Option 1 Written Exam
  • Option 2 Complete a comprehensive Business and
    Marketing Plan using the format and examples from
    class.
  • Grading and Requirements
  • Refer to syllabus
  • Make sure you have handed in your pre-class
    assignment or you will get a zero.

94
METHODS OF EVALUATION
  • METHODS OF EVALUATION
  • Completion and submission of pre-class assignment
    at class 40
  • Final project-grading of a business marketing
    plan
  • Or final written exam 60
  • GRADING SCALE
  • Letter Grade Value Letter Grade Descriptor
  • A 100 93 I Incomplete
  • A- 92 90 IP In Progress
  • B 89 87 W Withdrawal
  • B 86 83 TC Transfer credit
  • B- 82 80 NS Grade not submitted
  • C 79 77 R Repeat Course
  • C 76 73 AC Audit Course
  • F 72 and below
  • LATE ASSIGNMENTS Assessments submitted by
    students, which are postmarked one to thirteen
    days past the due date, in a course without an
    approved Incomplete status, may be subject to
    grade deductions ranging from 5-15. Faculty
    will determine the appropriate grade deduction.
  • If assessments are not received postmarked within
    14 days after the due date, in a course without
    an approved Incomplete status, then the
    University will assume that the student has
    withdrawn from the course.

95
Attachment B
  • Please take out attachment B from the syllabus
  • Written Final Exam grading sheet OR
  • Business Marketing grading sheet
  • Please remember the following
  • Each Spelling Error -1 Point
  • Each Grammatical Error -1 Point
  • Late submissions will lose points per RMU grading
    policy
  • Comments Additional points will be awarded for
    novel marketing ideas that are plausible and for
    evidence based practices/techniques as
    demonstrated in class and on the pre-class
    assignment bonus.
  • Document Guidelines
  • MS Word format (.doc)
  • double spaced-use example referred in class as a
    guideline
  • 1 Margins
  • length should be between 10 and 25 pages maximum.
    Be brief and concise-papers that do not clearly
    cover the topic within the page allotment will
    have 2 points deducted for each additional page.

96
Additional References
  • I have some previous presentations on my
    website-free (www.RamseyRehab.com) but can also
    recommend the following resources
  • PPS-How To Open a Private Practice Manual (for
    sale on the PPS website)
  • PPS "How To" 1.5 day classes, next one is in the
    North West but after that it's scheduled for
    Philadelphia in April 2006 (at the moment). It
    covers what is in the book as well as additional
    information.
  • The PPS website has a list of mentors.
  • There are paid consultants with PT
    experience-like me. APTA and PPS has a list also.
  • There are excellent classes at PPS National
    Conference as well as CSM each year
  • Your state may have a local PPS chapter that
    could help you, also.

97
Additional optional reading. Not required but if
YOU want more information this is a good place to
start looking.
  • http//www.ramseyrehab.com/business_consulting.htm
    l Ed Ramseys consulting page with many good
    articles and samples from previous National
    presentations on starting a private practice.
  • Barrera R. Over Promise and Over Deliver. The
    secret of unshakable customer loyalty. New York,
    NY. Penguin 10014 2005 ISBN 1-59184-061-9.
  • Nosse L J, Friberg D G, and Kovacek P R.
    Managerial and supervisory principles for
    physical therapists. Philadelphia Lippincott
    Williams Wilkins 1999. ISBN 0-7817-4264-1.
  • McCormack G L, Jaffe E G, Goodman-Lavey M. The
    Occupational Therapy Manager. Bethesda American
    Occupational Therapy Association 2003. ISBN
    1569001782.
  • Schaefer, K. Marketing techniques for physical
    therapists. Gaithersburg MD Aspen
    Publications 1991. ISBN 0834202085.
  • Glinn J E and Crankhorn A. Marketing techniques
    for physical therapists Independent study
    course 14.3.2. La Crosse WI Orthopedic
    Section, American Physical Therapy Association
    2004. Can be ordered from the Ortho Section
    website at https//www.orthopt.org/143.php.
  • Richmond T, Powers D. Business Fundamentals for
    the Rehabilitation Professional. Slack Inc. 2004.
    ISBN 13-978-1-55642-593-6.
  • Articles and Web sites
  • Roth MS, Amoroso WP. Linking core competencies
    to customer needs strategic marketing of health
    care services. J Healthcare Marketing. 1993
    49-54.
  • Weiss R. Dont forget about the office staff.
    Marketing Health Services. 2003 10-11.
  • Jacobs K. Innovation to action marketing
    occupational therapy. Am J Occup Ther 1998 Sep
    52(8)618-20 http//www.ncbi.nlm.nih.gov/entrez/q
    uery.fcgi?cmdRetrievedbPubMedlist_uids9739393
    doptAbstract
  • http//www.knowthis.com/tutorials/marketing/market
    ingplan1.htm
  • http//sbinfocanada.about.com/cs/businessplans/a/b
    izplanmarkplan
  • Palacio M. 25 secrets of profitability of private
    practice. Online Advance for Occupational Therapy
    Practitioners serial online. 2000. Available
    at http//www.advanceforot.com/common/editorial/e
    ditorial.aspx?SECCCCC14. Accessed October 9,
    2000.

98
Legal
  • This information is the property of Dr. Ed
    Ramsey and should not be copied or otherwise used
    without the express written permission of the
    authors.

99
Contact Information
  • Ed Ramsey DPT
  • Ramsey Rehab Inc.
  • 978-466-6677 Phone
  • 978-466-1133 Fax
  • Ed_at_RamseyRehab.com
  • www.RamseyRehab.com

100
Questions?????
  • I will be happy to take your questions now.
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