As they approach graduation, students starting their careers in rehabilitation face a number of daunting questions, including How am I going to get my practice started? As one RMT put it, “It’s not like graduating as a teacher or an X-ray technician where you know pretty well what your working environment will be – and how much you will be making…although that’s another story!”

For most regulated health professionals such as chiropractors, physiotherapists, naturopaths, psychologists, physiatrists, OTs, osteopaths or massage therapists, there are three basic choices: buy a practice, join a practice or start your own practice.For chiropractor Dr. Luke Winegard of In Motion in Sarnia, it was all about having clear values, a strong vision and considerable self-awareness. As an athlete, he wanted to live in a friendly small city with opportunities for outdoor activities, and Sarnia, where he also has extensive family connections, certainly fit that bill. Winegard knows himself well enough to realize that he wouldn’t be content for long playing on the second line in an established practice. “After a few months with someone else calling the shots, I would have had to find a way to do things my way, buy the practice and take over, or leave and start again somewhere else.”

"Like other regulated health professionals, physiotherapists are in high demand"

During his final year at CMCC Winegard developed a detailed business plan for a multidisciplinary clinic that could offer a wide range of services to his clientele. He was not content to just “hang a shingle” and operate a single-discipline practice working as a sole chiropractor. Instead, he wanted to offer both fitness and health care services under one roof.So began In Motion, opening in a Sarnia plaza after months of business development and down-and-dirty renovations that created a bright, welcoming multi-use clinic. From the day it opened, the business had a staff of eight – chiropractors, physiotherapists, personal trainers, massage therapists and nutritionists – which presented significant financial challenges for these young professionals at the beginning of their careers. But they never lost sight of the vision, and three years later, all eight practitioners have full appointment books, In Motion is a thriving practice, and Winegard’s thoughts are turning to possibilities of expansion.

"For most regulated health professionals, there are three basic choices: buy a practice, join a practice or start your own practice."

Dr. Carney Carney-Kilian wanted to be quite sure he would be heading in the right direction after graduating as a chiropractor in 2007, so he spent a year in a marketing job while he investigated his options. When a friend mentioned some good prospects in Red Lake, Ontario, Carney-Kilian took a trip up there to check it out. He was pleasantly surprised to find a prosperous community with a busy part-time chiropractic clinic available for purchase. He bought the practice, extended it to full time, and hasn’t looked back since. Both his professional and personal life have turned out just as he hoped: he has already bought his own building and expanded the practice to include a full-time massage therapist and a holistic health practitioner. As the only chiropractor within 3½ hours, his clinic is booked solid, and his work is highly rewarding. He does little advertising or marketing because word of mouth brings in most of his patients. Carney-Kilian also enjoys the lifestyle in northwestern Ontario, including the two-minute walk to the office from his downtown lakeside home, “Where I can fish right off my back deck,” he boasted cheerfully.In her final year of schooling, exams and licensing, naturopath Dr. Laura Gilpin considered a number of communities before settling on Guelph as the right place to start her practice. “It just feels like home,” she said. There she joined a like-minded group of chiropractors and massage therapists and was on the way to building a solid client base only a couple of weeks after she started practising. For Gilpin, qualitative considerations such as the right “feel” of the situation and compatibility with the rest of the team were paramount, and these days she couldn’t be happier in her comfortable Guelph office.

Given her focus on neurological/stroke rehabilitation, Dana Vanderaa graduated with a Masters in Physiotherapy in 2004 knowing she would likely work in a hospital setting. Like other regulated health professionals, physiotherapists are in high demand and according to Vanderaa, “You can find any kind of work you want in a large city.” She quickly landed a challenging and satisfying position in a Toronto hospital right after graduation. Since then she has started a family and has recently returned to her hospital job after maternity leave. Vanderaa also has a part-time position in a community clinic where she enjoys working with a broad variety of patients, most of whom need physiotherapy for orthopaedic conditions.After earning his diploma and membership in the UK Chartered Society of Physiotherapists in London, England, physiotherapist Ron Jolicoeur also practised in a hospital setting, first in his home country of Mauritius and later in Montreal and Toronto. After several years of developing his physiotherapy skills and rising through ever-more-responsible positions, Jolicoeur felt well prepared to launch his own clinic in Brampton, where he is the sole practitioner. That was almost 20 years ago, when only a few physiotherapists were in private practice and when there wasn’t a physiotherapy clinic “on every corner, as there seems to be now in Brampton,” Jolicoeur quipped. He believes it would be more difficult to start out his way these days, with so many private practitioners for clients to choose from.

"Massage On Wheels features mobile massage therapists who are hired for events, trade shows and workplaces in major cities across the country."

Massage therapist Kristy Cipolla always wanted to work for herself, but when she graduated with a diploma in massage therapy and completed her certification exams in 2004, she had to look for a job to pay the bills. After a couple of short-term positions – in chiropractic and athletic therapy clinics, as well as on-site for corporations and movie and television sets – Cipolla settled on a situation that suits her working style and lifestyle for the longer term. She did some advertising and marketing in her local area (“Because you don’t have your clientele handed to you,”) and has established a flourishing massage therapy practice in a multifaceted chiropractic clinic. She also has some corporate clients for whom she treats employees right in their workplace. This part of her practice is growing and has become very popular with employees. During her recent maternity leave, Cipolla had another RMT take over her practice temporarily, and now the two of them continue to job share and balance their work and home life.Ten years ago when the specialized service she wanted to provide didn’t exist anywhere, Carrie Rubel developed her own unique business model and founded what quickly became a very successful company. Billed as “Canada’s On Site Massage Specialists,” Massage On Wheels features mobile massage therapists who are hired for events, trade shows and workplaces in major cities across the country. The relaxing or energizing (depending on the purpose, the venue and the client’s needs) chair massages are extremely popular. At trade shows, the booth that has hired the Massage On Wheels specialists attracts line-ups and enthusiastic crowds – excellent traffic for the booth’s products or services. With the business going so well, Rubel is always looking for more RMTs to provide the superior customer service – consistency, quality and reliability – her company has come to be known for.

If there is one lesson to be learned from these practitioners, it is that although their training and skills prepare them for a variety of different practice models, graduates need to do some soul searching and have a clear idea of the kind of work they want to do. The ideal scenario is slightly different for everyone, and one’s sense of the ideal can change with experience over time. Starting out with defined values and a clear vision helps to ensure that each step along the way is the right one for the right reasons.