Summit Physio: The Journey

What happens when a physical therapist realizes the healthcare system is holding her patients back? She builds the kind of clinic she always wished existed. Summit Physio came to be in a very roundabout way. I was feeling a bit stuck and limited at my physical therapy (PT) job in a busy outpatient orthopedic clinic, Colorado Springs Orthopaedic Group (CSOG). I had been taking quite a few physical therapy continuing education classes through the Institute of Clinical Excellence (ICE) and was feeling restricted in my ability to implement the things I was learning. ICE played a fundamental role in my education and continues to shape my current practice. Many of the Physical Therapists (PTs) I met at these courses were treating in a cash-based model. At the time, this was very foreign to me as CSOG was an insurance based clinic. At CSOG I saw up to 15 patients a day with a new client walking in the door every 40 minutes. Thankfully, most of the time I would see my clients one-on-one, but the volume was very high. Occasionally, we were even double booked, meaning we treated two patients at once.

A Physical Therapy Assistant (PTA) and a Physical Therapy Tech were assigned to me, creating my team. The techs made it possible to see this high of volume, as they would bring the patient in, warm them up on a bike or treadmill and help wrap up patient sessions. I was very cautious with what I would allow my tech to do, as they did not hold a degree. I wanted to treat patients in a way that was fitness forward and psychologically informed, while also demonstrating to the patient their progress during the session. This was harder to do while managing a large caseload with a PTA and having less touch points with my patients. Hands-on care was often less than 10-15 minutes, and rarely performed on the first visit. I knew this limitation was affecting patient outcomes. One client, who had lumbar fusion surgery needed an extensive amount of physical therapy. This patient was only getting approval for two to three PT sessions at a time through their insurance company. Each time we had to resubmit for additional, necessary visits which required a tremendous amount of paperwork and limited my ability to schedule the patient  consistently. The insurance company did not have the patient’s best interest in mind.

The year of 2023 felt like a year of exploration. I worked four, ten hour days at CSOG and also occasionally picked up some hours for a Parkinson’s based clinic. CrossFit Decimate, the gym I had been a member at for many years, discussed building an adaptive crossfit program which intrigued me. I considered heading this project as in my past I had a lot of experience working with individuals with disabilities in undergrad. CrossFit coaching was also something I was interested in pursuing. In the end, I did not pursue the adaptive crossfit program, but did complete my CF-L1 certification so I could pursue CrossFit coaching. My thoughts regarding my career goals were beginning to change. While I did enjoy my job at CSOG, my coworkers, the team environment, and the learning experiences I had, I knew I was ready for something more fulfilling and aligned with what I valued as a PT.

Mid 2023 I scheduled a career strategy call with Dr. Megan Daley to help me sort out my direction moving forward. Megan was a PT I had met at an ICE course who owned her own private practice clinic and was also helping to mentor PTs who were considering a career change. At the end of this planning session, I came to the realization that taking the leap and opening my own out-of-network, cash-based physical therapy practice was the next step in my career. The only way to treat patients with the time, attention, and expertise they deserve is to build something different. Something aligned. Something mine. I knew excluding insurance was the only way I could treat my clients without constraints. The owner of CrossFit Decimate had a room available for rent. It was a small room, with no windows, and only a sliding barn door, but it was a perfect starting point for $300 a month, a lobby, and access to the gym.

I started working with Megan on a more regular basis to help me sort out the ins and outs of starting my own clinic. I hadn’t learned a thing about business in PT school, nor had I ever taken a business class during undergrad. I knew this would be an undertaking, but worth it in the long run. I wanted quality time with my clients, the ability to treat my patients without the constraints of insurance, and a flexible schedule.

A local mentor company called SCORE also helped. They offered free small business mentoring. This is where I met a nice older  man named Ken who helped set up my LLC. I met him at his art gallery with my laptop and paid the state of Colorado $50 to create Summit Physio & Performance. I kind of jumped right into it without much planning. I left CSOG to join Altru Integrated Health, starting with 30 hours per week with the flexibility to eventually cut to 20 as my private practice grew. The plan was to work at Altru Monday, Wednesday, Thursday and continue at the Parkinson’s job on a very limited basis which allowed me to work my business two days per week.

After consulting several PT friends who operated their own out-of-network (cash-based) PT practice to gain insight on how to set everything up. I bought the book, the book Cash PT Blueprint for $10 and read it cover to cover in one day. Most of my plans were based off of this book, the advice from my PT friends, and my mentor Megan.  

Summit Physio & Performance took off very quickly. On July 17, 2023 my business was officially an LLC and my first patient was scheduled on August 1st, 2025. My first week I saw one client. The next week I saw seven clients, and the next week ten. By the middle of September I was seeing about 16 of my own cash-PT clients per week and also trying to juggle 30 hrs at Altru. I was feeling overwhelmed by all the newness of business and the clinic getting busy so quickly. Within a month, I put my notice in at both Altru and at the as needed Parkinson’s job. 

My last days of work at Altru were the first week of October 2023. The following week, I transitioned to my private PT practice and had 20 clients on the books. It blew my mind how quickly my practice grew. The only marketing I was really doing was networking, working out at crossfit gyms, and hosting a few free seminars. Having been a PT in Colorado Springs for a few years, really helped me to be well known. My previous patients followed me and were happy with the care they received. I was finally able to give my clients the care they deserved. They told their families and friends and the business continued to grow. Summit Physio operated off of Instagram and a Google Voice phone number for six months before I was finally able to put together a website.

Summit Physio grew at such a rapid rate I realized there wasn’t enough time to manage the number of new clients and a new business. I knew I needed help! Early in February of  2024 I hired Dr. Cat Cui one day per week. We had worked together at my previous job at CSOG and had a similar treatment model and had taken many similar continuing education courses, so she was a perfect fit. We happily shared my little 100 sq foot room and made sure we didn’t schedule clients at the same time. This opened up time for me to work on the business end of things.

Originally I was seeing clients randomly and this made for long days. Creating a new schedule allowed me to have a better work life balance and also CrossFit coach one day per week. I quickly learned it became much harder to stop working when there were always a million little things to do. Megan taught me a lot about having boundaries within my business.

Somewhere along the way, my friend Dr. Loren Wooldridge, whom I had met at an ICE course and who also owned his own PT business The Health Lab in Carson City, Nevada, agreed to mentor me as well. He had quite a bit of business experience with his own practice and helped me put a lot of things into perspective. We met monthly via Google Meet. Dr. Matt Sullivan was also extremely helpful as he too owned a very successful out-of-network PT business in Santa Fe called Pure Movement. I could not be more thankful for these mentors that I found along the way who helped guide me and shape my business.

By April of 2024, a larger room at CrossFit Decimate became available and I jumped on the opportunity. It was refreshing to finally have windows and space inside my treatment room. By August of 2024, Cat Cui made the jump and came on to work at Summit Physio full time. At first, we shared our single room and offset our schedules. Shortly after, another room became available which I rented so we could have schedule flexibility. It was amazing to have another PT around. I loved having a colleague to collaborate with. We were able to play to each other's strengths and between the two of us we were able to expand the types of conditions we could treat.

In the fall of 2024, Crossfit Decimate was purchased by new owners and became CrossFit Tava. This crossfit community grew as did we. We continue to have a very collaborative and close relationship with CrossFit Tava. Summit Physio has now been open for 2.5 years and it’s wild to think back at how quickly it grew. I was very fortunate to be this successful so fast.

At Summit Physio, our mission is to always provide one on one high quality care targeted to a clients needs, maintaining continuity of care, and to meet or exceed their goals. We offer advanced dry needling with electrical stimulation and targeted circuits, and many other high quality manual interventions. Our foundation in strength training principles and exercise prescription in order to support our clients, ensuring proper dosage and loading. With no insurance constraints, we treat the whole person. It is very rare for a client to come in with a single issue, as most clients have many contributing factors to their complaint.

For example, a client originally came in with acute hip impingement symptoms with squatting and running. We were able to fully resolve their  hip pain with heavy squatting and running. We then moved on to treating the neck and back which were originally a low priority. With our current model, we are not limited to one body part. We prioritize the client’s most pressing issue, treat the whole person, and assess contributing factors to their condition. We consider their movement mechanics, strength, mobility, and day to day habits and training to guide our care.  Our goal is to empower the client, so they feel confident with tools to help manage their symptoms and to build strength, making them often stronger and more resilient.

With direct access to care, we can see people the day of, or the day after an injury. We are fully using our knowledge as it was designed to be used in a doctoring profession, with the ability to see clients through direct access, and to refer out when we see the need. We can order x-rays and MRIs and treat complex cases. We see clients who had previously tried or experienced physical therapy which hadn’t helped them, but the real problem was they didn’t have a PT which aligned with them or had the time to truly listen and manage their case appropriately. 

As Summit Physio & Performance continues to grow, I am thankful for the practice model that I have built. I am able to purchase the equipment necessary to get optimal results and to take continuing education courses to continually improve my skillset and clinical reasoning. These courses have helped create a thorough, thoughtful clinical exam, appropriate treatment interventions, and an appropriate exercise and load prescription for our clients which directly shapes their outcomes. And every step of the journey reminds me that when you remove the red tape and return physical therapy to what it was meant to be, people thrive.

This business has been a lot of work, but so fulfilling, allowing me to continue to evolve my practice. I enjoy the networking and business side of things, the relationships I have with my clients, and ongoing learning this profession requires. I am thankful for every client, my husband, my family, my mentors, and my friends and truly love what I do.

-Tessa Kothe PT, DPT, Cert. DN, CF-L1

Summit Physio Founder