Kristin M. Anderson, David L. Nelson; Wanted: Entrepreneurs in Occupational Therapy. Am J Occup Ther 2011;65(2):221-228. doi: 10.5014/ajot.2011.001628.
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© 2019 American Occupational Therapy Association
The American Occupational Therapy Association (AOTA) has challenged occupational therapy practitioners to advance the profession so that we may become more “powerful” and “widely recognized” by the year 2017 (AOTA, 2007a). To fully achieve this vision, this article argues that the profession should encourage occupational therapy entrepreneurship. As Herz, Bondoc, Richmond, Richman, and Kroll (2005, p. 2) stated, “Entrepreneurship may provide us with the means to achieve the outcomes we need to succeed in the current health care environment.” This article also argues the urgency of seizing the many opportunities that entrepreneurship offers and recommends specific actions to be taken by AOTA and by therapists.
Most occupational therapists, like speech therapists, are young women . . . and at some point need to take care of their families and at some point need to switch their priorities. Physical therapists . . . a fair amount of them are male . . . but they have the freedom to have a practice and maybe have the support of a spouse at home taking care of their family. (personal communication, January 30, 2009)
Even the definition of private practice is disputed. There is the purely staff therapist and the purely independent therapist. And in-between there are uncounted occupational therapists who are designing lifestyles and professional practices to suit need, theirs and society’s, in varying degrees of risk. (p. 12)
We would have a patient with a problem, and [we] would devise some kind of way to solve the problem. Then I would find a way to make that product and put it in my little catalogue. I invented it and controlled the manufacturing, and then I took the money to the bank. (personal communication, February 27, 2009)
Overwhelmingly, interviewees agreed that occupational therapy entrepreneurs do not receive adequate business education. Glantz recommended that occupational therapy programs include general business concepts such as starting and operating a business, including the basics of marketing for all students (personal communication, February 24, 2009). The main problem is that occupational therapy curricula are already burdened with content (Cynthia Epstein, personal communication, March 9, 2009). The argument can be made, however, that business concepts are needed not only for future entrepreneurs but for all therapists. Most therapists will work for organizations using business strategies; understanding how to operate a successful business can make therapists better employees.
Several current standards of the Accreditation Council for Occupational Therapy Education (2007) speak to skills needed by entrepreneurs. These include content on service delivery systems; management and supervision; legislation, regulation, and reimbursement; program development; and social, economic, political, geographic, and demographic factors. But no standard specifies entrepreneurship, types of entrepreneurial opportunities in occupational therapy, the processes of capital formation, or business structures. Entrepreneurial terms could be integrated into current standards (e.g., Standard B.6.5.), or a new standard could be formed, with an especially challenging version for doctoral-level education.
Entry-level occupational therapy students desiring special training in business and entrepreneurship should have access to relevant electives or optional tracks. Teresa Nelson is currently developing such a venture (personal communication, February 27, 2009). In her proposal, a university would offer a certificate program in entrepreneurship, separate from the school of business. Enrollment in such a program would be open to students and alumni with no previous business training. Entry-level students would have the opportunity to interact with alumni therapists who share their interest in entrepreneurship.
An occupational therapist with a desire to develop a business idea and skill should have the opportunity to attend appropriate continuing education courses. Tara Glennon strongly recommends enrolling in business-related seminars; however, she also recognizes the challenge of doing so while spending time pursuing needed clinical continuing enrollment units (personal communication, March 2, 2009). Short business courses and workshops offered in the past have occasionally addressed business topics, yet, as Richman observed, “I think we’ve been lacking in conference presentations that attract managers and entrepreneurs” (personal communication, February 27, 2009). Business-related continuing education courses should target general business needs (e.g., sole proprietorships, partnerships, and corporations) as well as specialized topics (e.g., becoming a Medicare provider). Entrepreneurial courses should be offered at each national AOTA conference and as free-standing continuing education courses sponsored both by AOTA and entrepreneurs. The costs of producing such courses may be recovered through attendance fees.
AOTA should increase entrepreneurial resources and opportunities for its members. One of the goals of AOTA’s Administration and Management Special Interest Section (AMSIS) is to revise and update the online private practice resource, supplying readers with comprehensive information. This publication should also be offered at true cost to nonmembers of AOTA, thereby possibly reaching all potential entrepreneurs. Potential entrepreneurs need concrete evidence of support to encourage AOTA membership and participation in the professional association. Richman observed, “Not all entrepreneurs are members of AOTA, and [they] don’t see all of the support [available] for them” (personal communication, February 27, 2009).
AOTA should also execute marketing campaigns promoting entrepreneurship. As stated previously by Leslie (2005), many therapists lack the motivation to pursue entrepreneurship. A national marketing campaign, sponsored by AOTA, AMSIS, and practicing entrepreneurs would generate entrepreneurial discussion and interest. This effort could include regular columns in OT Practice or OT Advance featuring occupational therapy entrepreneurs as well as entrepreneurial conversations by means of AOTA’s networking Web site, OT Connections.
Our professional organizations and individual therapists should communicate the close links among entrepreneurship and participation in state and national associations. Many successful entrepreneurs interviewed for this article attributed business success in part to being actively involved in AOTA, either at the state or national levels. As Becky Austill-Clausen stated, “My best suggestion for an entrepreneur is to get involved in state and national associations because it keeps you in the groove; it keeps your name in front of people; it keeps you open to the cutting edge of what is happening” (personal communication, April 30, 3009). Successful business owner Cynthia Epstein has maintained an active role in the New Jersey Occupational Therapy Association since early in her career. “I became involved . . . at national and state levels because I was looking at the big picture, change, the impact of the political world onto the profession” (personal communication, March 9, 2009). Mary Foto, chief executive officer of two successful companies (the Foto Group and Treat-it.com) has served as AOTA president (1995–1998) and represents occupational therapy on several professional boards. Through her efforts as an advocate, leader, therapist, and entrepreneur, Foto exemplifies how these roles complement one another.
Our professional organizations and individual therapists should also encourage mentorship in the arts and practicalities of entrepreneurship. All the occupational therapy entrepreneurs interviewed for this article stressed the importance of mentorship. Still, more is needed, “I don’t think we have enough people out there to really be mentors. You need good mentors, people who are willing to sit down and take time, talk about how important [your business] is” (Gina Arroyo, personal communication, February 11, 2009). Potential entrepreneurs should seek out successful therapists in the specific areas of business. This is not as difficult as it might seem. All of those interviewed for this article generously offered their time and knowledge at the request of an occupational therapy student. A therapist seeking mentorship should not be deterred by the thought that most businesspeople, however busy, would not want to help. Paradoxically, people who devote much effort to the bottom financial line are often altruistic. Therapists desiring to enter the business world should become members of the AMSIS, sponsored by AOTA. This group supplies a quarterly newsletter and presents networking sessions at national AOTA conferences.
Take reasonable risks! Entrepreneurs are risk takers, and the business world is often unpredictable. One must not be afraid to take reasonable risks. The potential entrepreneur has to analyze each opportunity and choose the most appropriate business risk. Occupational therapy has great entrepreneurial potential, with relatively low risk for entry. Starting small and building gradually is the method used by many successful occupational therapy entrepreneurs (e.g., Epstein, Glennon, Glantz, Richman, Hassen, Arroyo, Alterio, and Dy). If one wants to remain a solo practitioner, this option is also available.
Successful occupational therapy entrepreneurs should be urged to spread the word. A culture of entrepreneurship requires nurturing to develop. For those who have succeeded in business, the next step is to tell others how to achieve the same results. Business owners could begin online or in-person networking events, publish articles, write books, or conduct continuing education courses regarding an area of expertise. Therapists also have the responsibility of educating the community about therapist-owned and -operated businesses.
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