What does it take to build a successful cash-based physical therapy practice when owning a clinic was never part of your original plan? In this episode of the PT Entrepreneur Podcast, host Courtney Morse sits down with Michele Mannino, owner of Summit PT and Performance in Stowe, Vermont, to discuss her unconventional journey from business school and bookkeeping to building a thriving cash-based PT clinic. Michele started her practice with mobile visits and a folding treatment table before moving into a spin studio, then a small gym space, and eventually expanding into a multi-clinician practice. She shares how Summit grew by hiring clinicians with different specialties, building strong community relationships, and introducing small group training as a recurring revenue opportunity. With two full training groups and a third launching, Summit has created a way for patients to continue progressing beyond traditional rehabilitation. Michele also explains how her bookkeeping background helped her understand KPIs, identify seasonal trends, and make better business decisions. She discusses delegating discovery calls, empowering her clinicians, and creating a schedule that gives her more freedom to enjoy skiing, mountain biking, and time with friends and family. From exceeding an ambitious revenue goal to celebrating Summit's fifth anniversary, Michele's story demonstrates how a cash-based PT practice can grow without requiring the owner to personally handle every part of the business. In This Episode, You'll Learn How Michele went from bookkeeping to cash-based PT ownership Starting a practice with mobile visits and minimal overhead Hiring specialized clinicians and building a strong team culture Creating recurring revenue through small group training Using KPIs and financial data to make better decisions Delegating discovery calls and daily clinic responsibilities Growing a profitable practice while protecting personal time Key Takeaway Building a successful cash-based physical therapy practice doesn't require having everything figured out from the beginning. Michele started with a folding treatment table and a few patients, then gradually expanded by hiring great clinicians, developing specialized services, and creating recurring revenue opportunities. By understanding her numbers, empowering her team, and staying connected to her community, she's built a business that creates meaningful patient outcomes while giving her greater flexibility and freedom. Technology Spotlight Documentation continues to be one of the biggest frustrations for physical therapists. Claire is an AI scribe built specifically for PTs that dramatically reduces documentation time, allowing clinicians to focus on patient care instead of paperwork. Try Claire free for 7 days Free Resource Thinking about starting your own cash-based physical therapy practice? The free PT Biz Part-Time to Full-Time 5-Day Challenge helps you determine your income replacement goal, calculate the patient volume and pricing you need, and create a practical plan for transitioning into full-time practice ownership. Join the Free PT Biz Challenge Already running a clinic and looking to scale? Take the free Clinic Growth Blueprint Assessment to identify your biggest opportunities and receive a customized 90-day growth plan. Take the Clinic Growth Blueprint Assessment PT Biz Training YouTube Get more practical training on starting, growing, and scaling a cash-based physical therapy practice, including patient acquisition, hiring, recurring revenue, financial management, and building systems that create time and financial freedom. Watch PT Biz Training on YouTube Connect Summit PT and Performance Summit PT and Performance on Instagram Physical Therapy Biz PT Biz Training YouTube