Whether it's providing a soothing massage, or dressing a sprained knee, keeping the human body healthy is a vital service for any community.
That's what Rascal Creek Physical Therapy has been dealing with, for profit, for 25 years. They opened in 1987 when Sue Sulley, the founder, came here after a stint with a hospital north of Merced where, she recalls, "management put the patient last."
Instead of working for someone else, she "decided it would be better if I were my own boss." Today she believes Rascal Creek is the oldest such business in Merced under the same ownership as when it started.
In 1987, the center opened with only 180 square feet and three employees, including Sulley. Until she got more business, she also did physical therapy for people in nursing homes.
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For the next six years, Rascal Creek continued to grow. Then came the first of what would be several changes in health care law that affected her operation. Insurers, she said, began cutting what they'd pay for under managed health care.
People eligible for physical therapy didn't get it, or only a fraction of what they'd been eligible for under the old system, Sulley says. Revenue shrank 20 percent to 30 percent. Then patients began going to their employers and telling them the company insurance wasn't enough, that they wanted preferred provider organizations.
Last year Rascal Creek and other private therapy centers contended with a state Assembly bill that would have added licensed physical therapists to the list of professional physicians that medical corporations could employ. The bill was defeated last summer.
Rascal Creek's biggest breakthrough came six or seven years ago when she hired Tony Hernandez. The onetime soccer defender/sweeper for Merced College had been a patient. He landed with a career-ending knee injury. After months of rehab, he decided to become a therapist himself.
He studied it at Fresno State, switching from computer science, returned to Merced and eventually became Sulley's partner. He was to take on the Human Resources responsibilities and manage employees while she concentrated on patients and keeping up with the latest trends and technology.
Two years ago, Rascal Creek went to computer cloud-based electronic medical transfers instead of paper records. The move already had been mandated for doctors and hospitals. She believes her firm was the first privately owned outfit in town to make the switch.
"I've always prided Rascal Creek on being at the cutting edge -- we rely on continuing education and using evidence-based research to direct your clinical treatment," she says.
Keeping close track of patient records lets Rascal Creek document for doctors how their patients are responding to therapy on a weekly basis. "People walk in on crutches and they walk out without them -- or they run. Of course, not everyone gets better so fast."
Hernandez brings at least two special qualities to the business. He's bilingual in English and Spanish and so he's able to deal closely with Latino patients.
"Details can get missed through a translator," he notes.
And because he was an athlete, he knows how to handle sports injuries and players who may want to skip or speed up their rehab -- which often leads to a setback.
"I knew the most important part (of therapy) was to be patient," he says. "I can talk a lot of sense to them."
His wife, Heidi, works at Rascal Creek as a physical therapist and women's health specialist. They met in undergraduate college and have three children, Madison, 11, Eric, 9, and Alexis, 7. Sulley has a 22-year-old daughter and an 18-year-old son. The daughter is a UC Merced grad, her son graduated from high school last year.
Sulley is literally a hands-on manager, giving massages, stretching limbs, overseeing people on the dozens of machines and devices Rascal Creek contains to deal with people's injuries, aches and pains.
"I started with a very clear picture of what patient care should be," she says. Rascal Creek "is what I'd want if I were a patient or my mom was."
Rascal Creek participates with most insurance companies, according to its website. The center lets potential patients know just what their insurance covers in terms of therapy. Orrie Taylor is one of those whose endorsement appears on the website.
"Their hands-on care with smiles helped me feel both mentally and physically energized," Taylor wrote. "I think RCPT is like a 'one-stop shop' that could also minimize headaches, stress or any other agonizing pains."
Some patients have returned to the clinic off and on for decades, as new ailments cropped up. Earlier this month, some 120 people showed up for a 25th anniversary party.
Sulley's approach to running a business is to take care of employees as well as patients. The staff goes on regular rafting, kayaking and mountain-climbing trips. Those group activities, she believes, help build team morale.
As for patients, her goal is to make Rascal Creek "somewhere you feel you want to be." The duties of the therapists and aides encompass orthopedic problems, physical therapy, neurology, women's health issues, oncology, spinal rehab, occupational and speech therapy and acute care.
Most of them specialize. Some work mostly on golfers with injuries, for example; others focus on infants and toddlers; and some deal with temporomandibular joint disorder, chronic pain in the jaw area.
"Every single person is different," Sulley says. "We need to build a clear picture of what your problem is on a weekly basis."
MRIs (magnetic resonance imaging) changed physical therapists' diagnoses substantially. The pictures provided from the process reveal what could be the most effective ways to treat a person. In a whiplash injury, for instance, fat can move into the affected muscle, or nerves can generate pain.
"Research-based care is radically different from 10 years ago," Sulley says.
After three expansions of its floor space, Rascal Creek employs 17 people, down from a peak of 24 two years ago. There are six treatment rooms, 14 treatment tables and constantly updated machines, including stationary bike machines made by SCIFIT that were in nonstop use one afternoon last week.
All over the clinic people were exercising by themselves or with someone from Rascal Creek. It looked like a busy sports club except for all the high-tech devices and the hands-on care of the Rascal Creek workers.
As for running a business, Sulley says, "The most important thing is to have a vision and figure out how to make it come true."
Two-hour sessions by patients are common, she says. Such intense care is part of her vision: "I'm lucky to find people who support it."
Executive Editor Mike Tharp can be reached at (209) 385-2456 or firstname.lastname@example.org