Seismic shift

Entrepreneur Jim Abrams entered the physical therapy business partially for personal reasons: Knee and hip injuries drained his quality of life.

Abrams, who founded Clockwork Home Services, which grew into one of the largest privately owned firms in Sarasota-Bradenton under his leadership, got some pain relief. He also discovered the physical therapy delivery model, in his mind, was out of touch with customers — like selling landline telephones to teenagers. In essence, says Abrams, the industry is insurance-based and reactive, when it should be cash-based and preventive.

Abrams' disruptive answer to what he experienced is Fyzical Therapy & Balance Centers. Founded in early 2013, the Sarasota-based firm aims to build a nationwide network of physical therapy centers under one franchised brand, a major departure from the fragmented $32 billion industry. Fyzical's approach combines therapy with body-balance techniques, in addition to a medically based physical fitness component. Executives eventually plan to add rejuvenation therapies through spa treatments.

It's all done in a customer-centric approach with a focus on process and systems. Fyzical is a unit of BizZoom, a private-equity firm Abrams launched in 2012. “This is a total paradigm shift” for physical therapists, says Abrams. “It's a different business model, unlike what they have been used to.”

Therein lies the biggest challenge Abrams and longtime business partner Terry Nicholson face at Fyzical: To help physical therapists embrace the changes and consider the Fyzical franchise model. “It's clear that this is the way medicine will be done,” says Abrams. “Our challenge is getting enough PTs to learn about it.”

Fyzical has so far signed up 37 franchise locations in 12 states, from Florida to Massachusetts to Nevada. It's a network that totals about $30 million a year in sales. The firm hopes to have 60 locations by 2015 and 460 by 2019.

Franchise owners include Dr. Daniel Deems, a prominent Sarasota neck surgeon and neuroscientist with University ENT Associates, and Mike Graves with Palm Beach-based Gold Coast Physical Therapy Associates. Graves, who partnered with the firm earlier this year, rebranded his six physical therapy clinics Fyzical Gold Coast.

Abrams and Nicholson seek more success stories like Graves. The firm has spent well into the six figures, says Abrams, to promote two Fyzical franchise discovery days scheduled for October. Fyzical has also invested more than $3 million to develop new diagnostic techniques and acquire related businesses, including a balance-focused practice in Las Vegas.

The goal behind the investments, says Nicholson, is to target physical therapists/entrepreneurs who struggle to grow their business against reimbursement cuts and other obstacles. “The industry is really beat down right now,” Nicholson says. “They are making less and less money. They find it hard to believe there is light at the end of the tunnel.”

Abrams, in one sense, has been here before. Clockwork, the firm he founded in 1998 that grew to $215 million in annual sales by 2008, grew its home services franchise model by teaming up with individual companies. Toronto-based Direct Energy bought Clockwork in July 2010 for $183 million.

This time, with Fyzical, Abrams isn't only the head of the company. He's also a franchise, along with his three sons. “We're not just selling this to others, but we are buying it ourselves,” Abrams says. “There is so much opportunity here it's unbelievable.”

Follow Mark Gordon on Twitter @markigordon