Interview with Mike Mulrenan, President of ProEx, featured in APTA's Impact Magazine


An interview with Mike Mulrenan, PT, OMT, FAAOMPT, President and founder of ProEx was featured in the April 2010 issue of the nationally circulated Impact Magazine, Private Practice Section of the APTA (American Physical Therapy Association).

The comprehensive "Member Spotlight" interview covered a wide range of industry topics, including Mulrenan’s business philosophy, marketing strategy and goals for the future.

"It was a privilege to have the opportunity to share my views on our industry and my vision for ProEx Physical Therapy," said Mulrenan, adding "At ProEx, we have great passion for the profession of Physical Therapy and with Healthcare Reform in its infancy stages, our profession is in a wonderful position to play a role in the process of reform so having the opportunity to share our viewpoints with such a large national audience through Impact Magazine was truly an honor."

Part 1: Personal Data

Practice, Location: Woburn, MA
President, co-owner, and founder: Michael J. Mulrenan,
Size of practice (# of locations, employees): A corporate
headquarters, ten clinics, and 100 employees
Years in practice: Sixteen years as a physical therapist, nine
years as private practice owner.
Most influential book: The 4-Hour Workweek: Escape 9-5,
Live Anywhere, and Join the Rich by Timothy Ferriss. Although
not 100 percent practical for a service industry, his insight on how
to value time, whether spent at work or at pleasure, is brilliant.
Favorite vacation spot: York Beach, ME
Favorite movie: Top Gun
How do you like to spend your free time? With my wife and
three children.
Like most about your job: Creating ideas that enable our
company to get closer to achieving its mission.
Like least about your job: The fact that I do not actively treat
patients any more. This was always a passion of mine and there
are many times that I miss patient care, but I always find comfort
in knowing that our business is now able to affect the lives
of many more patients with good-quality treatment since I have
assumed a more administrative role to help grow the business.
Most important lesson you’ve learned: That it’s okay to be
wrong. You will need to fail at some things in order to succeed.
It is important to try something bold or think big because that
is what makes great companies.

Part 2: Business Philosophy

Describe your essential business philosophy: Our core value is
to be “people focused.” This means that we treat everyone our
business comes in contact with as a person first, whether he or
she is a patient, employee, referring practitioner, client, or vendor.
We work hard to understand the needs of these people and
deliver a service that addresses these needs. The relationships
we build feed into the strength and stability of our company.
Describe your management style: I am a big proponent of
setting up systems of accountability, as this allows you to monitor
and manage your business efficiently and ultimately allows
your employees the freedom to do their jobs without feeling
micromanaged. Accountability systems will set clear expectations,
drive performance, and give you the opportunity to work
on other aspects of your business.
Best way you keep a competitive edge: Be a forward thinker
and don’t always accept the norm.
How do you measure your success? Through the amount
of compliments from patients about their experiences at ProEx.
I always feel that you can get the best read on how well your
clinics are running by talking with the people in the communities
you serve and listening to their feedback. Organic growth
is almost guaranteed if you are making a good impression on
your patients.
Goal yet to be achieved: Our mission: to be leaders in clinical
care, education, and research, ultimately having a positive
impact on the profession.
Best decision: Changing my practice name to a more scalable
name. My first practice was Mulrenan Physical Therapy
and my second was Stratham Physical Therapy. Both had local
meaning, but neither was appropriate to scale to a larger region.
In 2008, we changed our name to ProEx Physical Therapy.
Worst decision: Offering too many services and spreading
myself and my employees too thin. At one point, in addition
to our outpatient orthopedic physical therapy practice, we had
a full-service wellness center with a membership and various
programs such as fitness classes, nutrition, and massage. This
overworked environment was leading to poor job satisfaction
and employee burnout.
Toughest decision: Closing down our wellness center, which
we had open for five years. We had done a lot of good work and
had helped many people in the community with their health
and wellness needs, but the time had come to choose one aspect
of our business to focus more on. We decided to focus on our
physical therapy practice and close the wellness center. This
required laying off some great employees and some pretty difficult
public relations work to make sure we took care of all of
our wellness clients during the transition.
How do you motivate your employees? Make sure they all
have a sense of purpose, that they understand their role in the
company mission, and that they are recognized and rewarded
for exceptional performance.

Part 3: Your Practice

If you could start over, what would you do differently? In
hindsight, I would have built better infrastructure earlier
to allow for growth. I would have had better systems in place to
handle the growth more easily and I would have set aside more
time earlier to work on the business instead of trying to do
everything in the business.
Describe your competitive advantage: Our organizationwide
commitment to education and a learning culture. Most
physical therapists are driven to become better clinicians and
are looking for a place to work that provides them with a supportive
learning environment. ProEx is establishing a reputation
as the place to work, and therefore we not only have an
advantage with recruitment but we are also attracting the best
talent to our organization. This will in turn allow us to continue
to improve our service, which will make patients and referring
practitioners happier and ultimately fuel our growth.
Describe your marketing strategy and highlight your most
successful action:
The most stable physical therapy practices
are the ones that don’t rely solely on direct referrals from physicians.
The best way to achieve stability is to build a reputation
within your community so that patients ask to go to your clinic.
This strategy of grassroots community relationship-building
has been one that we have adopted from Day One. Our strategy
is to “get patients before they become patients,” which requires
a lot of time and hard work to be active and have a presence in
the community. In our experience, it can take up to three years
to begin to see the returns of this type of effort.
What unique programs do you offer that set you apart
from the competition?
We offer minimal products so that we
can be the best at one, and that is delivering outpatient orthopedic
physical therapy. Yes, we do offer subproducts like spine
treatment, sports medicine, and work injury management, but
they all have the core focus of treating the orthopedic condition
in the most effective and efficient manner. We feel that by sticking
to our commitment to clinical excellence and our customer
service model of being people focused, we will have a competitive
What are the benefits of PPS membership to your practice?
PPS is always instrumental in providing private practitioners
information and resources to succeed. I have used many
ideas from Impact articles and PPS Annual Conference seminars
to springboard projects within my practice.

Part 4: The Future

What worries you about the future of private practice? I
believe private practice owners need to focus more attention on
clinical care and the patient. Being a member of PPS and attending
many PPS annual meetings, I have noticed that private
practice owners are very interested in business systems, which
are very important, but we need to begin to incorporate strong
clinical care systems into private practice. We need to remember
that our profession begins and ends with the patient, so this
should be where we focus our attention the most. The quality of
the delivery of our service is what matters most, as this is what
will create credibility and autonomy for us in the health care
system, ultimately securing the longevity of private practice in
our constantly evolving profession.
What are you optimistic about? I believe that health care
reform will ultimately create an opportunity for our profession
to elevate its status and take a more autonomous role. The byproduct
of reform will be a focus on cost reduction, not in the
form of the old managed-care model but more in reducing the
cost of delivering the service. I speak from an orthopedic cost
viewpoint, but I believe that with proper evaluation and patient
management skills, physical therapists will have an opportunity
to be first providers. We will be able to manage nonsurgical
conditions in a more cost-effective manner than the traditional
medical model of multiple physician visits and overutilization
of diagnostic imaging and medicine. We will be a resource for
the primary care physician and an asset to orthopedic surgeons
if we do a good job at screening strong surgical candidates for
referrals to the surgeons.
What are your goals for the next year? Add five more clinics
and launch our Teaching and Research Institute. Currently we
have a continuing education arm to our company and we intend
to develop a full teaching institute that offers not only continuing
education courses but also a Fellowship Training program
in Manual and Exercise Therapy. In addition, this institute will
conduct research both independently and in conjunction with
universities. We are aiming to have this program credentialed
by the APTA and AAOMPT.
Where do you see the best opportunities for your practice
in the future?
Education, in the form of fellowship training
programs to be done on site at our clinics, to help better prepare
our new physical therapists coming into the profession. I believe
private practices that are the strongest clinically will benefit
most from a substantially larger amount of insured people seeking
our services, including the baby boomer population. Having
your business set up to train your clinicians efficiently and
to have your business systems in place to be able to scale will
give you an advantage in the future.
What do private practitioners need to do to thrive in
today’s health care environment?
As a whole, we need to be
committed to clinical care. This means raising the bar on the
evaluative, treatment, and patient management skills of physical
therapists. We need to move toward specialty fellowship
training after entry-level degrees are obtained. We need to value
evidence-based practice but recognize that there is so much
more evidence we can produce, so we should be innovative and
proactive in the field of research. Our research agendas need to
be well thought out and have strong clinical relevance in order
to be successful in changing practice patterns and what is being
taught to our students. We need to make sure that researchers
and clinicians are working closely together so that we can focus
on what is best for patients. Private practice is the heart of our
profession, and I believe we can provide the vehicle to make a
difference in our profession.
Michael J. Mulrenan, PT, OMT, FAAOMPT, of ProEx Physical
Therapy in Kittery, ME, can be reached at