Respiratory therapists generally don’t get into the field thinking they’ll one day run a business of their own. But it happens — and more frequently than you might think. What does it take to become an RT entrepreneur? We talked to several AARC members who have taken that path.
Alex Saint-Amand, MBA, RRT, RRT-ACCS, and his wife Beverly, RRT, NP-C, entered the profession in the 1980s, and, like the vast majority of their peers, went to work as staff therapists in local hospitals. It wasn’t long, though, before Saint-Amand saw a need for a company that could supply not only home oxygen to patients in need but also the expertise of a respiratory therapist to help them get the most out of the therapy.
CSW Medical Corp was born as a DME provider, but soon thereafter, the DRGs came into being, leading many hospitals to look for long-term care settings where they could place patients with tracheostomies and other pulmonary complications who could no longer be cost-effectively cared for in the acute care facility.
“A very historical, state-owned rehabilitation hospital in Warm Springs, GA, called the Roosevelt Warm Springs Institute for Rehabilitation was in need of a respiratory therapy department to help them with the new type of referrals they were beginning to receive,” Saint-Amand said. “To make a long story short, I went up to Warm Springs, met with the administration, and put in a proposal to start their respiratory therapy department as well as staff it under a contract.”
They got the contract, bought out their partners in CSW Medical, sold off the DME part of the business, and started the RT department at Warm Springs. Thirty-two years later, the business is still going strong.
Although Roosevelt Warm Springs Hospital is now independent of the vocational campus and is operated by Augusta University Health System, CSW Medical provides respiratory therapy and lab services to long-term acute care units and an inpatient rehabilitation unit. They also operate a successful ventilator weaning program.
Filling an unmet need
Amyotrophic lateral sclerosis (ALS) is a devastating disease requiring highly specialized treatment. Keith Sanborn, RRT, first encountered ALS patients at Methodist Hospital in Houston, TX, and after working closely with a pulmonologist there to treat these patients saw the need for a DME company that could provide them with the equipment and services they need at home.
Respiratory Quality Services (RQS) was launched in October of 2008 and Sanborn spent the next three years working hard to build a reputation for outstanding customer service and patient care.
“I knew firsthand what ALS patients and their loved ones go through and strongly believed that they shouldn’t have to worry about their respiratory care and how they were going to get the medical equipment they need,” Sanborn said.
Today, he and his 37 employees work with pulmonologists, neurologists, and other members of the ALS treatment team throughout Texas and even into Louisiana to find the best treatments for people living with ALS.
“The success of RQS is not a big business secret,” says Sanborn, “it’s actually pretty simple — put the patient first, and everything else will follow.”
Not ready for retirement yet
For Todd Tyson, BS, RRT, his road to entrepreneurship began out of necessity.
“I fell into entrepreneurship myself when, after many years in hospital RT, I was passed over for lateral promotion and quit,” Tyson said. He went to work for a large home care company and from there was recruited to join a smaller home care company jointly owned and operated by an RT and a pharmacist.
“They drove Cadillacs and lived in the country club so I decided to start my own business,” Tyson said. He founded Hi-Tech Homecare, Inc., in 1990, growing the business to include eight locations employing 150 people in Georgia, Tennessee, and Alabama.
Tyson sold the company to a national provider in March of 2015, and, after working for them for 14 months, decided it was time to retire. That didn’t last long.
“I joined a manufacturer in February this year to promote a portable volume vent throughout Georgia and Alabama, primarily for chronic respiratory failure/COPD with NIV,” he said. “Life is fun again.”
Future looks bright
A growing frustration with the Medicare system led Steve DeGenaro, RRT, and his partners to start Fresh Air Medical Oxygen.
“Wonderful portable oxygen technology exists that can vastly improve the quality of life for oxygen-dependent patients,” DeGenaro said. “This lightweight equipment can be taken on cruise ships, in and out of hotels, and even on airplanes.”
Unfortunately, insurance often won’t pay for portable technology, tethering people to their homes and decreasing their quality of life.
“We started our business to give these patients an affordable alternative and make their travel goals and plans a reality,” DeGenaro said.
The company began five years ago and is now expanding into CPAP equipment and supplies. According to DeGenaro, profits are slowly increasing and he’s growing his marketing skills by learning more about everything from Google advertising to social media.
“Our future looks extremely bright with the graying population, retiring baby boomers, and a vibrant economy,” he said.
He’s never looked back
Bill Baker, RRT, opened his first DME business in 1991 with a credit card worth $5,000 and has never looked back. Desert Air Respiratory Care began with some used equipment, and the then single father worked night and day to nurture both the business and his daughter at the same time.
In 2000 he opened another company called RxO2 Oxygen & Medical Equipment and Supply, and recently acquired another DME called Dependable Home Medical. He is operating a CART DME business called Desert Air Medical as well, along with a hospice contracting business serving the medical equipment and services needs of several local hospice companies.
Baker has 17 employees overall and says that despite being retirement age he has no plans to hang up his entrepreneurial skills.
“Today I’m on Social Security — bought another DME to accompany the one we had on the same day I signed up for Medicare,” Baker said.
Growing family spurred her decision
The decision to adopt led Ronda Bradley, MS, RRT, FAARC, into a life of entrepreneurship.
“I had been working in an industry in a job I loved, but traveled 200 nights a year,” she said. ”When my husband and I decided to grow our family through adoption, I decided that a career change would be best for our growing family.”
A friend of hers who happened to be an attending physician at a pediatric skilled nursing facility in St. Louis, MO, asked her to lend a hand as the facility transitioned to a pediatric subacute hospital in a new building, and that experience led to a contract to do the same at another facility in Iowa.
“In the same week, I was approached by what was then Pulmonetic systems about serving as an independent manufacturer’s representative for sales and clinical support of the LTV series of ventilators,” Bradley said. ”I will never forget the regional manager for Pulmonetic saying to me, ‘You have everyone in town using and seeing the value of the LTV, don’t you want to get paid for it?’”
The week after leaving the hospital she was busy with her new contracts and her company, Spiritus Consultants, LLC, was born. Today she contracts with other companies as well and says she’s always seeking new ways to use her RT background and experience to help bring new products to market.
Business is booming
After working three years in the acute care setting, Howard Ingham, RRT, decided he could put his skills to better use by practicing in the subacute world. “The business that I started in 1997 and still own is Premier Pulmonary Service,” says Ingham, “It’s a DME company in the Daytona Beach area.”
The company does much more than sell equipment, though. Ingham says he consults for several other companies, takes care of the RT equipment and supply needs of several nursing homes, and specializes in the care of trach patients.
He also speaks at area colleges and has RT students come and shadow him three times a week to show them the potential that exists in running an RT-related business.
“Today my business is doing 60% better than it was in 2010,” Ingham said. “I attribute that to gaining the mindset of an entrepreneur and studying how to market my business instead of relying on sales.” He also has a book coming out soon, about how to start your own RT business.
Just do it!
Of course, not every entrepreneurial story ends the way the therapist would like it to end. Dawn Fielding, BS, RRT, AE-C, started and ran two pulmonary rehabilitation clinics in Utah for five and a half years, but ultimately had to close the clinics due to reimbursement issues.
“I couldn’t survive the reimbursement cuts as well as the implementation of ACA audits,” Fielding said, noting that during audits, which could go on for months at a time, all reimbursement to the company was withheld.
“I did pass my Medicare certification and audit flawlessly, but by that time I was too far gone to recover and had to close my doors,” she said.
But the entrepreneurial bug is still biting. Fielding has now written a book on COPD that is being used by some pharmaceutical companies and she has created COPD home care management programs as well.
Fielding’s advice for other RTs who see themselves becoming RT entrepreneurs: “Do it! The world needs your knowledge, skill set, and wonderful ideas!”