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A Conversation with Keith Pacific


How did you manage to gather such an incredible team?

It took some time, and getting the right people on the bus wasn’t easy. This job is not for everyone. We do physical therapy a little differently from the traditional model. We only do one-on-one and are focused on a specific population: military, active-duty, retired, dependents, and the overall active population. We focused on our niche and had to find providers interested in working in that realm.


Describe what you do at Physique Physical Therapy.

We do personal training with a twist. Most of our patients are people who need a little bit more than your average certified personal trainer. Our clientele is looking for someone more qualified and knowledgeable about physical therapy. In many cases, they are overcoming complex injuries. They have likely had multiple surgeries and cannot attend a regular fitness class.


What is the difference between a personal trainer and a physical therapist?

Fortunately, being licensed physical therapists, we have a background in differential diagnosis, which is looking at different symptoms, knowing when it’s out of our scope, and when to refer to other medical providers. For example, if someone is not responding to a healthier lifestyle with regular workouts over a month or two and continues to have issues, then we recommend they get something checked out rather than try to push through and suck it up.


How do you choose who you refer your patients to?

Once someone gets used to better-than-average, one-on-one care, sending them to a provider who doesn’t operate that way isn’t easy. Outcomes are better when patients have more of a relationship with their provider, so we are trying to grow relationships with independent practitioners who work as we do. We have a great Podiatrist who has a practice in Tampa and has a vested interest in the military like we do. He also spends a great deal of time with each patient. Methods like this are a good fit for our patients.


Take us back to your startup. How did you get started?

I started Physique Physical Therapy and Personal Training over nine years ago. When we started, it was just me, and I operated downtown out of the Bank of America Building when the lightning wasn’t good, and there wasn’t a River Walk. It was a difficult time. Things changed for the good once I was able to accept TRICARE patients. Being in the TRICARE network allowed me to make connections. Through word-of-mouth, I began seeing patients willing to drive downtown despite the iffy parking situation.


You have been in your current location for a couple of years. Will this location continue to sustain your business?

I would love to expand the practice. Planning for our future is very difficult, primarily because of TRICARE. I’m unable to forecast the spending cuts levied on TRICARE patients. As their co-pay goes up, ironically, our reimbursement goes down. This creates a challenging work environment where we are trying to do more for less money. Cuts have battered the healthcare industry. We battle burnout as we try to deliver excellent care while trying to maintain morale in the workplace. TRICARE is based on Medicare rates, so as Medicare gets cut, so does TRICARE. We made more money per visit in 2017 than we did in 2023. TRICARE used to be one of the premier insurance coverages because the federal government backed it. Most places accepted it. Now we’re finding out, especially in terms of a specialist, only some people are keen to accept TRICARE. As they continue to cut rates, more and more providers are finding that it’s not financially feasible to accept TRICARE anymore. That leaves the beneficiaries of TRICARE unable to find the care they desire.


It is the very people you wish to serve that are suffering from this.

It is unfortunate. Active Duty personnel are covered 100%, but when it comes to retirees, many of whom are under 50 years old, they are not covered for the healing process. When they have significant surgery on a knee or shoulder, the healing and recovery process will take a lot of time. It will take more than a few physical therapy visits to get them back to 100%. With higher co-pays, the cost can be a deterrent and may cause someone to skip the treatment.


Would these people use a home workout plan to get through their therapy?

When you hand someone a piece of paper and tell them, “Here, just do these exercises for the rest of your life,” it usually doesn’t pan out well. With personalized therapy, you can experience the extreme importance of technique and the mark on motivation. Most people will show up when they have an appointment. Alternatively, if they have to wake up every day and tell themselves, okay, I will do this every day before work, or after work, or whatever, they don’t do it. Some people have it built into them, but many don’t.


How do you grow your practice and get the word out to the community?

We are very grateful for the opportunity to serve veterans and their families. We have gotten involved with local Chambers of Commerce, VAN, and other Veteran groups to get out and meet people. We grow organically by word-of-mouth. We are just down the street from MacDill AFB, which helps our military patients.


We interview every client to make sure we match them up with the right therapist on our staff


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