Practices in the Pandemic: Dr. Theresa Marko, PT, DPT, MS

Throughout the month of October, we’ll be exploring how the COVID-19 pandemic has affected healthcare practices around the U.S. through interviews with real practice owners and managers. The first interview we have for you is with Dr. Theresa Marko, PT, DPT, MS. 

 Dr. Theresa Marko, PT, DPT, MS is a Board-Certified Orthopaedic physical therapist & Certified Early Intervention Specialist with over 20 years of experience. She is the owner of Marko Physical Therapy, a private practice in New York City, specializing in orthopedics, adolescents, and pediatrics. She has helped thousands of people to overcome injuries, optimize their movement, and return them to work and sports pain free and better than ever.

When she is not caring for patients, Dr. Marko can be found in legislative offices in Washington, D.C. or Albany, New York. She is passionate about making a change in healthcare and has made advocacy a cornerstone of her practice. For over five years, and hundreds of hours, she has lobbied on behalf of her patients and her profession on topics such as repealing the Medicare cap, reducing student loan debt burden, and lowering copays. She forms public policy priorities as part of the American Physical Therapy Association’s Public Policy & Advocacy Committee, the advisory council for the board of directors of the association. In 2020, she was awarded the prestigious Doreen Frank Legislative Award, given to only one person a year, by the New York Physical Therapy Association for her outstanding advocacy work.

Dr. Marko’s expertise is featured in PopSugar Fitness, Self, Cosmopolitan, Muscle and Fitness, Business Insider, LiveStrong, and Healthline. She has spoken at Columbia University and Touro College about patient and physical therapy advocacy. She was recently appointed to the editorial board of SpineUniverse as the first and only physical therapist on the board.

She lives in Brooklyn, NY, with her husband of 13 years and her French Bulldog, Rondo.   

Q: How has the Coronavirus impacted your practice financially? 

A: COVID negatively impacted my in person practice in New York City as most clinics made the decision it was best to stop seeing in person patients at that time.  I had not previously had telehealth in my practice, but quickly pivoted and became educated in the subject and set it up. 

However, not everyone felt Telerehab was the right fit for them and declined services.  My solopreneur business lost up to 75% revenue. I remained close from mid March until July for in person, only doing telehealth sessions.

Q: Did your practice take advantage of any government stimulus programs? 

A: After much frustration, research, and webinar informational sessions I was able to successfully receive the PPP loan.  It was frustrating because my bank did not allow me to apply because I previously had no loan or business credit card with them, even though I have several personal credit cards, multiple personal accounts, multiple business accounts, and preferred platinum status.  The PPP procurement process was straining as the program ran out of money quickly that first week.

Q: Will you make any changes to the way you handle your practice finances going forward? 

A: I think I will be more conservative on expenses due to the fact that we have no idea if there will be a second wave in NY.  We are seeing a second wave in Europe.

Q: In what ways do you think your industry will change going forward, even after the pandemic is over? 

A: Great question! Well, the genie is out of the bottle! Almost every Physical Therapist I know has telehealth set up now! The profession has gone mobile and digital! However, there are some stumbling blocks. 

CMS, the center for medicare services, granted the PT profession a special waiver about June, finally, allowing us to do telehealth sessions with Medicare patients.  The commercial insurances followed suit and also allowed us to perform telehealth. 

Unfortunately, PT’s are not on the approved list of telehealth providers.  Even when it was March and April in the height of the NYC pandemic, it was still not allowed.  CMS would not grant authority.  They finally did, and it was a lifesaver to my business and to my poor patients at home, suffering in pain, but too afraid to go into an office to deal with it. 

When the COVID19 pandemic is over, the waiver will expire, and my profession would go back to not being allowed to do telehealth.  This is a major concern.  Patients like it.  They appreciate the option. 

My business appreciates the option, especially with winter and bad weather coming up. 

Making Telehealth permanent is something my professional association, the American Physical Therapy Association, has been fiercely advocating for.

Q: Have you experienced a “silver lining” either personally or professionally due to the pandemic?

A: March and April were hard, and the stress was so high.  However, as we got use to this now normal, I embraced all the time I got to spend at home with my husband and dog and all the projects I got to finally embark on that I had been putting off. 

Has anything positive come about for you or your business? Definitely that I finally set up telehealth.  It was on my to do list for 3 years but seemed so daunting to figure out.  Now I am working to advocate for the payment side of it to remain permanent with CMS and the commercial insurers.

Q: Finally, this isn’t related to the pandemic, but the majority of our education base is young healthcare professionals. Do you have any financial advice for someone just getting started in your field? 

A: Ha. Yes.  Funny you should ask this.  Google the word “Capitalization of interest”  Really understand what this means. 

Understand that every time you go into voluntary forebearance or deferment, they will then add that interest to the base (principal of your loan) and that larger base loan will now be the amount that the interest accrues on. 

This is not something I understood for a very long time.  Had I known, I would have considered my options more carefully. 

Also, with the creation of the Income Driven Repayment Plans for student loans, you now have many options to pay that are affordable.  Sadly when I was out of college and earning very little money at first, these programs were not around.  If you can avoid forebearance or deferment, do so or else your loan will grow larger faster.

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