Why a PT Started a Therapy Staffing Company

The short version: I kept seeing two problems that never met. Home health agencies around Acadiana could not find enough therapists to cover their referrals, and good therapists felt boxed in by clinic schedules and quotas. I started Borges Therapy Services to be the bridge between them, run by someone who has actually done the visits.

I am Ryan Borges. I am a physical therapist, and I have practiced since 2014 in skilled nursing, outpatient, and home health. For most of that time, running a company was the last thing on my mind. I liked treating patients. What pushed me into this was not a business plan. It was watching the same two problems sit side by side for years, close enough to touch, and never actually connect. Let me tell you about both of them, because the company only makes sense once you see them together.

The first problem: agencies short on coverage

Home health is booming across Acadiana. People want to recover at home, near their families, in their own kitchens and living rooms, and the agencies that serve them have more referrals than they know what to do with. That sounds like a good problem to have. It is, right up until you cannot find a therapist.

I watched agency after agency around Lafayette, Broussard, New Iberia, and Opelousas hit the same wall. A patient needed physical therapy or a Start of Care evaluation, the clock was ticking, and there simply was not a PT, PTA, OT, COTA, or SLP available to take the visit. The referral was there. The patient was there. The therapist was not. Assistants were the hardest of all to find, and still are.

The second problem: therapists boxed in

At the very same time, I kept meeting excellent therapists who felt stuck. Good clinicians, sharp hands, real hearts for the work, sitting inside clinic jobs that squeezed them. Productivity quotas. Somebody else deciding their Tuesday. A ceiling on what they could earn no matter how hard they worked. A schedule built around the clinic instead of around their family.

A lot of them were curious about PRN home health but assumed it was a hassle to break into, or they could not get a straight answer about what it paid. So they stayed put, a little frustrated, a little underused. I understood it completely, because I had felt versions of it myself.

The two problems never met

Here is what got me. These two problems were the answer to each other, and nobody local was closing the gap. Agencies desperate for coverage. Therapists who wanted more control and more income. The only thing standing between them was a bridge nobody had built. The therapists did not want to cold-call every agency in the region and figure out credentialing paperwork alone. The agencies did not have time to recruit, vet, and credential a roster of contractors on top of running their own operations.

Somebody needed to stand in the middle and make it easy for both sides. I decided that somebody could be me.

So I built the bridge

That is really all Borges Therapy Services is. It is the bridge. I recruit and credential the therapists, I package their documents to each agency, and I keep a roster of credentialed, ready people the agencies can pull from when a referral lands. Therapists get access to steady home health work in the towns they choose without the paperwork headache. Agencies get reliable coverage without building a recruiting arm. Two problems that never met, finally introduced.

What I decided it had to be

Once I knew what I was building, I got stubborn about how it should feel, mostly by writing down everything I had hated as a working therapist and refusing to do those things.

• Publish the pay. No fishing it out of a recruiter over three phone calls. The rates are right there on the site, the same for everyone.
• Credential once. You send your documents one time, and I handle the agency side so you are not re-filing forms for every new referral.
• Cluster the caseload. Your visits get grouped by town so you are treating people, not living on the interstate.
• Talk to a therapist. When you call, you get me, a PT, not a call center reading from a script.

Why a therapist should run this

I think the person setting your rate should have done your job. I have loaded the car with an equipment bag before a full day of visits. I have driven the back roads of Acadiana between patients. I have done the OASIS documentation and the discharge notes. So when I build a schedule or set a rate or ask you to credential with an agency, I am not guessing at what that feels like. I have lived it.

That is also why I stay honest about the tradeoffs. PRN 1099 work is not for everyone, and I will tell you so plainly. If you want to see how I weigh it, I laid the whole thing out in PRN vs W-2 for therapists. No sales pitch, just the real comparison.

Where this goes

I did not start this to build an empire. I started it because I was tired of watching good therapists and good agencies miss each other by an inch. Every therapist I bring on is one more patient in Youngsville or Abbeville or Carencro who gets seen, and one more clinician who gets to work on their own terms. That is a bridge worth building.

If you are a therapist who has felt boxed in, or you are just curious what the other side looks like, see where we are hiring and apply in two minutes. You will hear from me, an actual PT, by the next business day.