Deeply Kneaded

Evidence-based protocols drive the treatments at Dee PT

by Heleigh Bostwick

dee0312Mike and Justine Dee, the owners of Dee Physical Therapy in South Burlington, have followed their PT careers, and each other, since 1986, when they met in New York at their first post-college jobs.

When Mike Dee, the owner of Dee Physical Therapy (Dee PT) in South Burlington, started college, his plan was to obtain an associate’s degree in music and become a professional musician. “I quickly realized,” he says, “that a career as a professional musician was not for me and began researching other careers.”

An interest in exercise led him to physical therapy, and the Syracuse, N.Y., native enrolled in the State University of New York Upstate Medical University to obtain his degree. Synchronicity was about to come into play: At Northeastern University in Boston, New Jersey native Justine McCuen was beginning her freshman year, also majoring in physical therapy.

In 1986, he and Justine graduated from their respective universities and landed their first jobs — as physical therapists at Roosevelt Hospital on East 49th Street in New York City. Romance blossomed.

Wanting to leave city life, in May 1988 they moved to Vermont where they found work at the Medical Center of Vermont (now Fletcher Allen Health Care). They married that October.

In 1992, Dee decided to leave the hospital and strike out on his own. They set up their first private practice, Advance Physical Therapy, across the street from their current location on San Remo Drive. “It was at a time when managed care was becoming a challenge,” Dee recalls. “We eventually sold it in 1997 to Health South.”

Although the Dees sold Health South the capital assets and equipment, they retained their clients. In February 2000, they bought their current location. “We started renovations in May,” says Dee, “and by October we had moved in.”

Designed by architect Ted Montgomery of Charlotte, the spacious, 5,200-square-foot, ultra-modern facility, with gleaming state-of-the-art equipment and heated therapeutic swimming pool, belies its origins as the former home of Burlington Tool Repair and Burlington Rental, a garage used to maintain trucks.

Hilary Jordan, also of Charlotte, and a former patient at Dee PT, assisted with the interior layout and decor, such as the quirky Mid-Century modern illustrations and prints that adorn the walls.

In less than three years, Health South had run into trouble on Wall Street. A scandal ensued —the CEO was the first to be tried under the Sarbanes–Oxley Act of 2002 — and Health South left Vermont. The Dees took the business over, and Justine joined the practice, which officially became Dee Physical Therapy.

While San Remo Drive remains the primary site, the Dees opened a second location in the Shelburne Athletic Club (now Shelburne Health & Fitness) in 2005. “We were approached by the owners of the club,” says Dee, “because they were interested in having a physical therapist on-site, and we were seeing a lot of clients from Shelburne, Charlotte, Hinesburg, and Vergennes, so it made sense to be closer to these patients.”

Dee estimates he spends about 60 percent of his time on managing the business and the rest doing clinical work. An early riser, he spends his first minutes of the day exercising and checking emails. His work day typically starts at 7 and doesn’t usually end until 7 or 8 at night. “The nature of the business is that you’re a bookend — before and after work; at the beginning and end of day,” he says, adding that people also like to come in for PT at lunchtime.

Dee manages the day-to-day operations of the practice, and Justine, who is a full-time faculty member at the University of Vermont, spends two days a week doing clinical work at the practice. Decisions such as hiring an employee or expanding the business are made jointly.

“Justine has always been involved in the teaching side of physical therapy,” says Dee. “Even back in 2003 she had a part-time teaching job at UVM.”

For the last five years, exercise physiologist Jason Fitzgerald has conducted a “diaper drive” for COTS, says Dee. “We collect, on average, 10,000 diapers for COTS, but this year we collected 20,000. Even Governor Shumlin came and donated.”

The practice also volunteers its expertise for a number of athletic teams in the area, ranging from high school to semi-pro. In 2008, Dee volunteered as a trainer for the Vermont Voyageurs — the only U.S.- based indoor lacrosse team playing in a Canadian league — and is now a co-owner with Jeff Culkin.

Culkin and Dee have roots in common, both having grown up in the West End of Syracuse, although they didn’t meet until they struck up a friendship when Dee’s sons were playing lacrosse for Champlain Valley Union.

“Mike is generous with his time and knowledge and he’s grown Dee PT into one of the largest physical therapy practices in the region,” says Culkin. “The players love having a certified PT and certified strength and conditioning coach. He’s been a great resource for us and also volunteers for CVU athletics and the Vermont Ice Storm team.”

Despite the challenges that managed care presents, his practice is thriving, says Dee, whose clientele is primarily those with outpatient sports injuries and orthopedic diagnoses. “A couple of years ago we were averaging 1,200 new patients a year; now it’s about 1,900.”

One reason is that patients are generally more knowledgeable and participate more in their care and decision-making, he says, adding that Vermont allows patients direct access to physical therapy, bypassing the need for a physician referral. Dee estimates that about 20 percent of their patients are direct-access.

“We are also fortunate to have such a diverse and loyal following of referring physicians and patients who return for new diagnoses or refer friends and family,” he says, gratefully. “It is humbling at times.”

But Dee believes the main reason for the increase in clients is the company’s evidence-based treatment protocols. “I think that’s really what separates us from other physical therapy practices.”

“With Justine’s connections at the university and some of our PTs having advanced degrees and certifications, our PT techniques are state of the art and have been researched and proven to be effective in randomized control studies.”

Dee adds that Justine was recently awarded an orthopedic certified specialist designation from the American Physical Therapy Association, and that one of the PTs is certified in Graston technique, which is instrument-assisted soft-tissue mobilization. Two other PTs are certified in lymphatic drainage, a manual massage technique that reduces excessive lymph fluid in extremities post-surgical and post-mastectomy.

They strive to make the standard of care consistent across the board, he says. “Unlike other professions, there are many ways to get advanced certification after you’ve received your PT degree. So one of the things we’re doing as a group is studying for post-grad certification through the North American Institute of Orthopedic Manual Therapy. It’s something I’ve wanted to do for a long time.”

The 19 people on the payroll include three receptionists, an accounts and billing coordinator, nine physical therapists — three who work at the Shelburne location — five aides who assist the physical therapists with patient treatment and patient-area setup and breakdown, and a part-time marketing person, Karen Whitby, who handles outreach and communications.

Dee says he is stopped “at least three to four times a week by patients with very positive comments about our staff.”

The Dees live in Charlotte, and in their free time follow the lacrosse “careers” of their two sons. Bennett, 21, is studying nutrition at the C.W. Post Campus of Long Island University on a lacrosse scholarship, and Lawrence 18, is finishing up a post-grad year at Bridgton Academy in Maine. Also a lacrosse players, Lawrence was just accepted at St. Michael’s College, where he is planning to study education.

Every year they take a week-long family vacation to the Frost Valley YMCA in the Catskills. They also like to get some beach time in, whether it’s on Lake Champlain or at the Jersey shore. Justine also competes in triathlons.

“Justine is an avid knitter,” says Dee, who admits that he seldom finds time to play his saxophone and flute these days.

“I’m a home brewer who loves to cook.” •