11 Years Later: Why SB Physio Is Evolving (And What Hasn’t Changed)
A reflection on where we started, where we are now, and why this change matters
Eleven years ago, I signed our first lease at 41 Hitchcock and opened SB Physio. I had a clear vision of the kind of clinic I wanted to build: a place where people could come for physical therapy throughout their lives, not just for an injury or short-term problem.
Back then, my biggest worry was simple:
“Will I get enough patients to keep this going?”
I didn’t realize yet just how much Santa Barbara needed timely, high-quality outpatient PT. The demand created opportunity, but it wasn’t what made SB Physio succeed.
SB Physio grew because we put everything we could into patient care — the quality, the consistency, the organization, the relationships. The community felt that, and they spread the word. Word-of-mouth was powerful, and it was a major reason we were able to grow in those early years.
Looking back now, 11 years later, the landscape has shifted — and the challenges look very different than they did in year one.
Today’s Problem: There Aren’t Enough PTs in Our Setting
The demand for outpatient orthopedic PT in Santa Barbara is higher than ever.
The number of therapists available to meet that demand?
Not enough — not even close.
Here’s the reality behind the scenes:
Santa Barbara’s cost of living keeps rising
Insurance reimbursement hasn’t kept up — and in many cases has declined
Outpatient PT wages don’t match the reality of living here
Great clinicians leave or avoid outpatient ortho entirely
Access suffers
Waitlists grow
Follow-ups get spaced out further than they should
Quality and consistency become harder to sustain
And when clinics are pushed into volume, patients lose the chance to build a genuine relationship with their provider
This combination makes it nearly impossible to maintain the standard of care we expect of ourselves while also operating sustainably.
Our care has never been compromised — but the ability to sustain that level of care long-term was under real pressure because we couldn’t retain enough PT staff in this environment.
Why SB Physio Is Moving Out of Network
This shift is not about exclusivity.
It’s not about rejecting insurance.
It’s not about becoming boutique.
It’s about protecting:
the care we deliver
the staff who deliver it
and the mission we started with
Here’s what going out of network allows us to do:
1. Retain great PTs
We will be able to offer wages that make it realistic for high-quality clinicians to stay in Santa Barbara.
2. Remove the time pressure of insurance
No more racing the clock.
No more high-volume mandates.
No more working against visit limits or billing rules to do what’s best for the patient.
3. Serve patients who actively choose their care
Whether they are still in-network with us or choosing private-pay through a self-pay agreement, the care becomes aligned and intentional.
4. Improve outcomes, culture, and long-term sustainability
Motivated patients + supported clinicians = better care, better results, less burnout.
5. Protect access and our mission long-term
Being your PT provider for life has always been the goal.
Under the traditional insurance model, that goal became harder — and eventually impossible — to fulfill.
This shift allows us to finally make it real.
What This Means for You
SB Physio is still here for the Santa Barbara community that supported us from the beginning.
Whether:
you are with an insurance we continue to accept, or
you choose care through our private-pay agreement
you’ll receive care that is more personal, more focused, and not dictated by insurance limitations.
Nothing about our commitment changes.
What changes is our ability to keep that commitment forever.
11 Years In: Same Mission. Stronger Direction.
When I signed that first lease 11 years ago, I had a vision of what SB Physio could become. The path to get here looks different than I anticipated — but the mission is exactly the same:
To remain the physical therapy home Santa Barbara can rely on — not just today, but for the next 11 years and beyond.
The healthcare environment has changed.
Reimbursement has declined.
The cost of living has exploded.
Outpatient PT availability has dropped.
And yet our commitment to quality, connection, outcomes, and community has remained constant.
We are evolving not because our care has slipped — but because we refuse to let it slip.
This is the direction SB Physio is going, and it’s how we will remain strong for the long run.
