Novlinda Susy Anrianawati Manurung¹, Lucky Anggiat²

Corresponding Author:

¹Lecturer, Faculty of Vocational Studies, Physiotherapy Program, Universitas Kristen Indonesia, Jakarta, Indonesia, Email: novlinda.manurung@uki.ac.id

Co-Author:

²Lecturer, Faculty of Vocational Studies, Physiotherapy Program, Universitas Kristen Indonesia, Jakarta, Indonesia

ABSTRACT

Background: The development of entrepreneurial activities in society is the basis of the progress and prosperity of a nation. Currently the development of the age of the community is at a productive age which requires a prime or fit body condition and at an elderly age with a history of decreased movement activity which results in a decrease in quality of life. These existing problems are business opportunities that can be solved by physiotherapists by creating, building or opening a creative and innovative form of physiotherapy service business or physiotherapy entrepreneurship. This study aims to observe entrepreneurial activities carried out by physiotherapists.

Methods: this study uses a type of description taken from observations on 3 forms or models of business entities or physiotherapy entrepreneurship, in the form of: 1. independent clinics, 2. independent fitness training centers and 3. clinics in collaboration with doctors. Results: Based on the results of data searches and observations on the three physiotherapy entrepreneurial models, it can be seen the success of each entrepreneurial model. The independent clinic has a higher and higher level of difficulty, responsibility, creativity and innovation, while the clinical model that collaborates with doctors has a low level of difficulty with the division of responsibilities and has easier access to patients or clients compared to independent clinics.

Conclusion: The model for implementing physiotherapy entrepreneurial activities can be carried out independently in the form of clinics, fitness centers or in collaboration with doctors. Physiotherapy entrepreneurial activities have a contribution in creating job vacancies, solving health problems, and improving the welfare of society and the country’s economy.

Keywords: Physiotherapy; Entrepreneurship; Clinic

Received on 16^th August  2021, Revised on 26^th August 2021, Accepted on 30^th August  2021, DOI:10.36678/IJMAES.2021.V07I03.007

INTRODUCTION

The driving factor for the progress of a country lies in the number of entrepreneurs who stayed¹. Indonesia in improving the welfare and progress of the nation, is currently leading the goals of economic development which is focused on empowering the community to develop the economy through independent business as an entrepreneur in various forms of entrepreneurial activities².

According to Zimmerer, entrepreneurship is a process of applying creativity and innovation in solving problems and finding opportunities to improve lives³. Broadly speaking, it can be concluded that entrepreneurship is an effort to make an improvement by combining resources through new and different ways to win the competition⁴. This improvement can be made by developing new technologies, discovering new knowledge, finding new ways to produce brand-new goods and services that are more efficient, improving existing products and services, and finding new ways to provide satisfaction to consumers⁵.

Entrepreneurship in the health sector is a common phenomenon⁶. Since before the second world war nurses (health workers) have become entrepreneurs. Health entrepreneurship has increased in many countries in recent decades and there is evidence that entrepreneurs also play a role in public health⁷. Therefore, health professionals need to be educated to have entrepreneurial skills. Education in the health sector is still based on traditional forms of teaching and pays little attention to entrepreneurial issues⁸. In the health sector, there are several forms or models of entrepreneurship that are often implemented, such as the business activities of doctors, nurses, and physiotherapists who treat patients independently by coming to their homes, and this is a form or model of entrepreneurship called home care or home visit⁷. Furthermore, practice specialist doctors independently or jointly in the form of a health consulting service center clinic. Then, a physiotherapy service for fitness in the form of a fitness center working independently⁹. The physiotherapistworking with fitness training center in sports clubs for the improvement of achievement and hobbies. Moreover, a physiotherapy training service center in the form of a health sports club for movement recovery in specific conditions, such as stroke, heart disease, diabetes mellitus, asthma, and for pediatric patients with movement disorders during growth and development, as well as for patients with geriatric conditions¹⁰.

 Physiotherapy according to the Indonesian Regulation of the Minister of Health No. 65 of 2015 is a form of health service aimed at individuals and/or groups to develop, maintain, and restore body movement and function throughout the life span by using manual handling, movement improvement, equipment (physics, electrotherapeutic, and mechanical), functional exercise, and communication¹¹.

Currently, physiotherapy services in Indonesia are not only accessible at the referral level health care facilities, but also can already be found in several primary level health care facilities including independent practice⁹. Thus, arrangements and adjustments are needed so that the accessibility and quality of physiotherapy services can be accountable, meet the needs of the community while meeting the demands of the development of health services, including the development of accreditation of health care facilities¹². In addition, according to Regulation of Indonesian Ministry of Health Number 80 year 2013 that physiotherapists can practice independently or work in Health care Facilities¹³.

The entrepreneurial practice model in physiotherapy includes home visit, which is an independent physiotherapy service business activity by coming to the patient’s house¹⁰. Moreover, physiotherapy with fitness center is a physiotherapy service business activity in the form of specific physiotherapy training or exercises¹⁴.

Training centers or health sports clubs, achievement sports and hobbies, which are physiotherapy service businesses in the form of consultation, training or sports instructors both in the case of recovery and care of health conditions, improving sports performance and hobby sports activities carried out in a sports club. Independent Practice, is a physiotherapy service business activity that is carried out in a clinic independently. Furthermore, collaborative practice with doctors, is a physiotherapy service business activity carried out in a clinic in collaboration with a doctor and is a type of joint clinical business¹⁵. This study aims to observe what strategies and challenges are faced by entrepreneurs with a physiotherapy background in implementing their business in the field of physiotherapy services.

METHODS

This research is descriptive of the observation results on three entrepreneurial models in physiotherapy. The researcher interviewed three entrepreneurs in physiotherapy practice. The three resource person is physiotherapists who work and own the business. The spectrum of physiotherapy entrepreneurial services obtained is independent physiotherapy clinics for sports injury specific services, physiotherapy services at Pilate’s studios/centers and physiotherapy services at clinics in collaboration with general practitioners and specialists. The three resource persons were interviewed and the results of the interviews were collected and described in detail related to the strategy for implementing entrepreneurial activities. Then, conclusions are drawn which are the results of the research.

RESULTS AND DISCUSSION

Researchers obtained three types of entrepreneurial activities in physiotherapy services. The details of these types of activities can be seen in table 1. Through the results of the analysis and observation of three entrepreneurial models in physiotherapy, the following is a description of the form of entrepreneurship and its implementation.

Entrepreneur with Independent Clinic Model

Independent Sport Physiotherapy Clinic: The first resource person was the entrepreneurial activity of an independent clinic at a clinic called Physiopreuner Sport Physiotherapy, which has a specialty in sports and was founded in 2012, Jakarta. This clinic was built with a vision to become a physiotherapy clinic that can free Indonesia from injuries, specifically those caused by sports and injuries in general. Based on this vision, Physiopreuner Sport Physiotherapy clinic carried out a self-development mission by opening clinics in Surabaya and Makassar, then in 2017 a physiotherapy clinic named Quick Rehab & Performance was also opened in Jakarta and then in 2019 it was redeveloped by opening a clinic called Functional Prehab in Jakarta, Tangerang, Bogor, Bandung, Bali, and Makassar.

The initial strategy taken in opening an independent clinical business, which is carried out by the founder or entrepreneur, is to look at the various opportunities that exist in the sports field in the form of a high level of need for injury handlers. In addition, with capital preparation in the form of abilities and expertise in the field of physiotherapy in general and specifically in the field of sports, especially football. Second, the founder has the ability to observe and learn about the situation in the community as well as the need for physiotherapy services that are able to adapt to all situations and conditions. Third, the founder has the ability to respond to existing situations with creative ideas according to the field of physiotherapy.

Fourth, the founder has a relationship or network that supports and provides various assistance in the form of input, as well as leads and support regarding strategies in building a business. Fifth, founders have communication skills that become a marketing tool in business development and sustainability. The founder in carrying out business activities with independent clinical models has a significant vision, namely; “Indonesia BebasCidera” (Indonesia Incident & Injury Free), and has a specialty in the field of sports. During the establishment, they face enormous challenges and also bearing responsibilities and risks.

All of the management activities starting from preparation, selection, and determination as well as recruitment of human resources in the form of more experts and must have the same capabilities and qualities since they have very rapid business development, the provision of the same infrastructure in all branches, a very accurate financial system from each branch, quality of service, then supervision and quality control from all branches that must be the same and promotion and marketing for business development and sustainability are carried out independently. Entrepreneurs must have a scientific background in the field of sports physiotherapy, managerial skills, and courage as well as mental struggle and integrity.

Physiotherapy and Pilates Center: The second type of entrepreneurial activity is the model of combining physiotherapy service activities (clinical) with Pilates exercise training (gymnasium) in a business entity known as Cardea Physiotherapy and Pilates, and was established in 2016 as a physiotherapy clinic which continues to develop as a form of creative efforts and innovations in improving services by building specific physiotherapy training centers, pilates gymnastics in the form of a gymnasium. This business activity is an example of a physiotherapy business model which in its implementation provides comprehensive physiotherapy handling services in the form of a collaborative effort between clinical business activities with specific therapy services and business activities in the gymnasium and pilates exercise training. The type of physiotherapy services provided at the physiotherapy clinic is in the form of specific and up-to-date physiotherapy treatments or interventions that have great potential in providing various forms of quality services in overcoming physical problems and improving service quality. The type of service provided at the gym in the form of pilates training has great potential which creates the characteristics and advantages as well as triggers selling points in the community in this company.

The initial strategy taken in opening an independent clinic business with gymnasium collaboration by the founder or entrepreneur is as follows. First, seeing the existence of business opportunities through various types of specific and up-to-date interventions in the field of physiotherapy as superior products that are competitive and not owned by other companies that run similar businesses (Physiotherapy clinics). Moreover, conduct scientific learning and training on specific therapeutic techniques and up-to-date for human resources (physiotherapists) to improve the quality of services. Furthermore, carry out creative and innovative business development activities through the establishment of a physiotherapy training center using the Pilates method in the form of a gymnasium. Second, entrepreneurs have the ability to observe and learn about the situation that exists in the community for the need for physiotherapy services that are able to adapt to all situations and conditions. Third, entrepreneurs have the ability to respond to existing situations with creative ideas according to their field of physiotherapy and decide as well as implement these ideas.

Entrepreneurs in carrying out business activities with the model of merging two types of services in the form of clinics and gymnasiums face enormous challenges, responsibilities and risks seen from the management activities or management of companies that have two forms or models of business activities. In carrying out business management activities by combining the two forms of business models, entrepreneurs require the recruitment of human resources in the form of experts with different specifications according to the type of client-specific handling required in the two business models. Then, the provision of infrastructure for two business models, finance, service quality with two business models. In addition, promotion and marketing in maintaining business continuity are carried out for two business models. Entrepreneurs who carry out business activities with diversified products or services must have expertise in producing services or products of the same quality in maintaining business continuity, therefore more ability is needed in managing time and energy, devotion to work and integrity in carrying out business activities (professionalism at work).

Physiotherapy Clinic with Medical Doctor: The next type of entrepreneurial activity is a physiotherapy clinic business model that collaborates with doctors and was founded in 2018 and has a business entity named “Apotik Jaya Bekasi Clinic”. The form of business that is created as an example at this time has a form of cooperation service between physiotherapy and a doctor’s clinic as the owner who is also the executor of clinical governance in terms of financial administration management as well as a provider of facilities in the form of a place of practice needed in the implementation of physiotherapy service business activities.

The initial strategy in opening a clinical business with collaboration was to see the potential and opportunities for additional types or diversification of health service businesses at the KlinikApotik Jaya Bekasi, as well as the need for physiotherapy services in the community around Bekasi which was then followed up by submitting a collaboration proposal. The contents of the proposal are various forms of agreements between parties that work together regarding the profit sharing system and business governance activities in the form of administration, service implementation, and financial governance issues as well as business results sharing agreements in terms of payroll, payment of electricity costs, provision, maintenance, and addition of equipment. Furthermore, in this collaboration, entrepreneurs have capital in the form of expertise in the field of physiotherapy, therapeutic equipment and physiotherapy service personnel, who will work in physiotherapy clinics and are recruited by physiotherapy entrepreneurs. Patients or clients come with promotional management that has been carried out by the manager, while the owner of the physiotherapist clinic is responsible for providing services according to what has been promoted by the manager. Doctors who work closely with physiotherapists can also directly send patients so that physiotherapists do not have difficulty getting patients or clients. Physiotherapists do not have to face significant challenges in promoting their business so that business activities can last for a long time in the sense that the business is running stably, as long as the practice of doctors and pharmacies is still ongoing with the meaning that the sustainable value is high, however, this still prioritizes the quality of services provided for business continuity and success.

Entrepreneurs in carrying out business activities with a model of cooperation with several types of businesses such as doctors’ practices, pharmacies and physiotherapy, have challenges in terms of providing tools that require capital in the form of large amounts of funds. However, currently in terms of providing tools, entrepreneurs have a way to provide these facilities through cooperation with tool providers or equipment manufacturers in the form of a payment system that is given a payment settlement period and the tools have been provided to entrepreneurs in advance. In this case, the maintenance of the condition of the equipment is an important part in order to provide business results as expected and fulfill payments in accordance with the equipment purchase agreement. Business activities in the form of cooperation, Entrepreneurs face challenges in terms of preparing business capital, such as: providing tools, care, and providing physiotherapists, and having responsibilities for cooperation agreements both to owners of large facilities and equipment providers. However, the risk in the implementation of the service is not significant because it will be shared together, and for management activities or company management with a cooperative system, it will be divided between the owners and the members who cooperate. (Entrepreneurs must have expertise, capital in terms of funding tools through cooperation with tool providers, love for the field of work and integrity).

CONCLUSION

Based on the three models of physiotherapy entrepreneurship, it can be seen that the opportunities and business potential in the field of physiotherapy in Indonesia are widely opened. The crucial community need for health services related to human body movement activities has potential and is an opportunity to build a physiotherapy business or entrepren-eurship. The model for implementing physiotherapy entrepreneurial activities can be carried out independently in the form of clinics, fitness centers or in collaboration with doctors. Physiotherapy entrepreneurial activities have a contribution in creating job vacancies, solving health problems, and improving the welfare of society and the country’s economy.

Ethical clearance: Ethical clearance obtained from Faculty of Vocational Studies, Physiotherapy Program, Universitas Kristen Indonesia, Jakarta, Indonesia

Fund of Study: This study is self-funded study

Conflict of Interest: Author has no conflict of interest to declare.

Acknowledgement: We would to thanks Clinic Physiopreneur Sports Physiotherapy, Cardea Physiotherapy and Pilates, and Apotik Jaya Bekasi Clinic as resource persons in this research.

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