Weathering the Storm: How One O&P Partnership Has Flourished

In an industry that has seen many solo practices close over the last decade, Progressive Orthotics and Prosthetics, Albertson, New York, has marked a milestone: 20 years in business. Progressive O&P is a business partnership between Sal Martella, CPO, and Dan Bastian, CP. The practitioners met early in their careers as coworkers at an O&P practice. They had similar ideas about how they would run their own practice, and after three years decided to take the plunge and open a practice together. Their first business plan was on a small piece of paper that hangs framed in their office today.

A private business partnership that has lasted 20 years is rare in and out of healthcare. Martella and Bastian share a belief that a need exists for more heartfelt, technically skilled, and smart O&P practitioners to enter the profession and care for people living with limb loss and limb difference. Martella and Bastian share the advantages of a business partnership and how it has helped them navigate a profession that has seen its share of change, give advice to readers on five things to know about a potential business partner, and offer their best tips for enjoying a healthy partnership.

Advantages to Business Partnerships in O&P Martella and Bastian believe the partnership structure helped their business flourish and avoid acquisition. Over the past ten years, they have been approached several times from potential buyers, but the partners believed their vision would best be fulfilled without outside involvement. They share five key advantages for anyone considering an O&P business partnership:

Divide and conquer. It may seem obvious that having two people to divide the work is an advantage, but if one looks beyond the day-to-day and considers marketing strategies, including clinical education, the benefits of a partner are apparent. If one partner is presenting an in-service or continuing education program or other non-revenue-generating activity, then the other can be in the office conducting revenue-generating activities. Both activities are important, but when you are an owner/practitioner, the former may be considered a luxury, regardless of how important it is for the long-term growth of the business.

Financial flexibility. A common reason for entering a partnership is to share the financial risk and burden. Starting a business, expanding staff, or investing in real estate takes a large amount of capital. The opportunity to leverage the financial muscle of two people from different households creates less personal risk for each person and allows the potential for twice the access to capital.

Strategic growth. Two practitioners can grow the business strategically. Early on at Progressive O&P, the business grew, but not enough to support the addition of full-time staff, especially when that would include salary and benefits. Instead Martella and Bastian worked extra hours and documented their time until they were able to justify the need for a full-time team member.

Weather the storm of uncertainty. Healthcare has seen seismic shifts in the last ten years. O&P has had its own share of trying times, including the Dear Physician letter in 2011 that changed the requirements for documentation of the medical necessity of orthotic and prosthetic services provided to Medicare beneficiaries.

Martella and Bastian not only weathered the storm but became part of the solution. Martella focused on the day-to-day business while Bastian worked with the American Orthotic & Prosthetic Association (AOPA) and lawmakers to help change the requirement, even though it meant time away from the office and revenue-generating activities. The Dear Physician letter was replaced in 2018, directing Medicare to consider the medical notes from orthotists and prosthetists as a legitimate part of the medical records for purposes of claims payment and medical necessity.

Peer coaching and professional development. With two people keeping an eye out for industry trends, changes, and opportunities for professional development, there is double the focus on staying ahead of the competition. Martella and Bastian find that they push each other professionally to continue to grow and share their knowledge with each other and their staff.

Tips for a Successful Business Partnership Respect. Respect the decisions made by your partner and don't override them without a discussion. Communication. Set ground rules about how you will manage conflict and think through all scenarios. What if one partner is sick for a period of time and can't work? What if a partner wants to leave the business? How will differences of opinion about staff be resolved? Never keep score. Be clear on your individual and business goals and focus on the big picture. If you made ten limbs this week and your partner made four, the imbalance shouldn't matter if all the goals were met. Stay out of the weeds. If you and your partner divide areas of responsibility, don't worry about the details of the other's work. Accept that your partner may not do things as you would have, and that's okay. Decision-making stays with partners. Martella and Bastian agree it's best to keep third parties out of the decision-making process. The decisions are between the partners. Opinions of an employee, family, friend, etc., can be voiced in private but are not an active part of the decision-making process. Protect the partnership. As your team grows, it's imperative to remember the most important relationship is between you and your partner. You need to support each other first and never allow a third party to come between you; that goes for staff and vendors. Yesterday cannot be changed. Dwelling on what went wrong yesterday will not change what happened. Leave your ego at the door. Accept that mistakes will happen and you will need help. Don't hesitate to ask for and offer help. Honor the friendship. Never forget why you went into business with your partner. If you were friends prior to starting the business, make sure that the friendship remains the foundation of your business. Welcome the differences. Respect that your partner may have a different style, but if it is in parallel with your style, it will work. For example, if your idea of being at the office early is 5 a.m., and your partner's is 8 a.m., accept you are both early. And if it bothers you, see tip three for success. Linda Williams is a partner for The Brand Counselors, a marketing firm in Long Island, New York, that manages the marketing for Progressive Orthotics and Prosthetics.

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