How to start a hand therapy practice

How to start a hand therapy business?

Starting a business may seem stressful and challenging, but taking risks can help you become more passionate about your career.

When I started my hand therapy business, I had literally no experience or guidance but it was a great learning experience, and it made my job more meaningful after years of feeling burned out.

For me, starting a business was like doing OT for myself.

In this post, I’ll discuss how to quickly start a business in hand therapy, how to avoid the problems, and how to do it without going completely broke.

Make a business plan

I’ve never created a business plan, but I can see why this is such an important step.  Having a business plan will help you have a vision for your business.

In the plan, you should include how you will start your business, market your business, and grow your business. 

A business plan should include something that is unique to your business.  In other words, what services will you offer that will be different from other businesses?

Below are some tips to include in your business plan. 

Do a market analysis

The best way to start a hand therapy business is by doing a market analysis.  This will help you know if there’s a need for your hand therapy business in your area.

An easy way to do this is by doing a simple Google search or look up all the hand clinics in your area on Google maps.

You may want to compare the number of clinics with the population in your city. Next, see how many hand surgeons are in your city. 

Compare these numbers with other cities that have similar demographics. 

You might also look up the type of people in your area who may become your future clients. This may include 

  • Construction workers
  • Older adults
  • Industrial workers

In my experience, most work related injuries happen with construction jobs. 

If you find that the competition is too high in your area, think about partnering with a physical therapist who has already done the hard work of opening a business. 

Get to know the Hand surgeons in your area

The best way to set yourself up for success is to have client’s before you start your business. Network with physicians in your area and see if they’re willing to refer them to your clinic. Share services you can provide that other clinics may not offer.

Give them your direct number, so they don’t have to go through a gatekeeper when making referrals. Find other ways that will make you stand out against your competition.

Decide on what services to offer

Do you want to offer hand therapy and physical therapy services? You may also consider other outpatient services like speech therapy or work hardening programs to help clients return to work.

Offering more services means more time spent developing relationships with the medical community to increase referrals.  

Decide on the size of your business?

You may decide you want to work on your own and rent a small office to see patients one-on-one. This can be an easy way to get started and much less stressful. It’s also a lower risk investment with your biggest cost being office space.

If you’re up for the risk, and you have a lot of potential clients in your area, you may want to rent a larger space. You may also want to hire other therapists for outpatient services like physical therapy.

Start a website

You might think it’s odd to start a website early, but I would recommend starting a website at least 6 months before your business opens.  The reason for this is because it takes about 6 months to a year to be indexed on google.

The least expensive way to do this is by purchasing a domain, hosting plan, and installing WordPress. 

Download a theme, create a simple website, and start writing blog posts to market your business in your area.  At this point, don’t even worry about how the site looks.

I would make a goal to write 10-20 posts in a question format for your local area.  For example, “Where can I find an occupational therapist in (your area)”

This will make your website discoverable on google, so you can get more traffic to your business. After a year, make your site look a little more professional.

Decide on a location

One way to choose a business location is by renting out a location at a medical park or plaza.  You can also find a medical building that will sublease an office.

An easier way to do this is to partner with a physical therapy clinic that is already successful.  They’ve already done the difficult task of setting up the business, renting the location, and setting up billing.  

All you have to do is become their business partner and offer opportunities for growth. 

Purchase equipment

Starting out, you don’t have to spend a lot. You can save by making some of your equipment or purchasing it used on ebay or finding it at a thrift store.

The most expensive item in hand therapy is a splinting pan. If you don’t already have one, use an electric skillet. It may not be as good as splinting pan, but you can set the temperature and get by with it. Just make sure you keep an eye on it and monitor the temperature.

Dynamometers can be expensive, but you might consider buying one used. If it’s not accurate, you can take it in to have it adjusted.

Apply for a business license

Most therapists starting their own clinic will apply for a state business license, register for a DBA (doing business as), and start an LLC.  

After approval, you’ll receive a tax ID number.

Every state has different requirements, so you will need to look up your state and country requirements.  

You can also apply for a business license as a sole proprietor.  For someone getting started, this might be a valuable option if you don’t have a lot to lose.  Instead of a tax ID number, you’ll use your EID number for tax purposes.

A sole proprietorship is a low cost solution but as your business grows you eventually will need more protection for your assets. An LLC can provide additional protection to your business to avoid potential malpractice issues.

Open a business account 

Now that you have a business license, you can open a business account at your bank.  There are plenty of free checking accounts.  I’ve used US bank in the past because they’re everywhere.

You can also apply for a business credit card. I recommend getting one that offers business rewards or cash back. If used correctly, this will help you save on every business purchase.  

Having a good business account will also help you avoid issues of malpractice.  For example, if you use a personal bank account for business transactions you may not be protected in a court of law. 

Keep good accounting records

Starting early with good accounting practices should not be disregarded.  You need good records for tax purposes, malpractice, and it’s a good way to see your business growth.

You can get by with your own accounting records by starting small, but eventually you will need an accountant. 

Setup Billing

Decide if you want to do your own billing or hire an offsight company to do your billing for you. 

If you do your own billing, you might consider hiring someone who has experience.  You will also need to be credentialed for each insurance provider, and that can take time. 

Become a Medicare provider

Becoming a Medicare provider is one of the reasons many therapists become discouraged when starting a business. 

The application alone is a journey, and it can take some time before you’re approved. To get started you’ll need to provide

  • An active NPI
  • Pecos number
  • State business license
  • EIN or Tax ID number
  • Practice location
  • Billing agency information
  • Completed application

To see the full checklist required by Medicare click here

Becoming approved can be challenging, because you almost need the business up and running before you apply.  That’s a lot of upfront costs while you wait for approval.

Continue Marketing your business

After your business is up and running, market your business by doing local SEO for your website, or share what you’re doing on social media. Promote your business locally by going to local events, provide free screenings at your local gym, pay for ads locally and become more social with medical professionals in your community.

Some other ways to market your business may include

  • Use after office hours to provide a gym or yoga class.
  • Provide a free inservice to construction workers on accident prevention
  • Offer an outpatient driver rehab clinic
  • Get involved with community activities

Top resources to start a business

Here are my top 3 resources for starting a business. Learn medical billing has some great resources that can help you get started and find unique ways to build your business.


As you can see, starting a business can be a lot of work, but it can also be extremely fulfilling. It may just be the risk you need to take to make your job more meaningful. I hope this information was helpful. Subscribe below to learn more ways to grow your career as an OT. Also don’t forget to check me out on youtube and instagram.