Oppor­tu­ni­ties in the sec­ondary health­care mar­ket:
The self-pay­er sec­tor as a sus­tain­able mainstay

Health prac­tice Richter & Lopez from Mönchengladbach


Con­fi­dent­ly mov­ing into the self-pay area in phys­i­cal therapy

Since 1999, the health prac­tice Richter & Lopez has exist­ed in Mönchenglad­bach, led by the phys­io­ther­a­pists Axel-André Richter and his col­league Vic­tor Lopez. On 230 square meters of prac­tice space, they offer their patients much more than a tra­di­tion­al phys­io­ther­a­py prac­tice. While Vic­tor Lopez devotes him­self more to clas­si­cal phys­io­ther­a­py and is main­ly con­cerned, for exam­ple, with the health of chron­i­cal­ly ill or can­cer patients, Axel-André Richter, and his col­league devote them­selves to the offers in the self-pay area.

They inte­grat­ed this into the prac­tice at an ear­ly stage. With the ear­ly estab­lish­ment of the self-pay­er area, Richter and his col­league want­ed to be as inde­pen­dent as pos­si­ble from the statu­to­ry health insur­ance (SHI) or the health insur­ance com­pa­nies in the health care mar­ket. Due to the increas­ing­ly bureau­crat­ic require­ments in the health care sys­tem and espe­cial­ly in phys­io­ther­a­py, the two ded­i­cat­ed them­selves to the sec­ond health care mar­ket with the fol­low­ing thought: Either it is worth it to the peo­ple to make mon­ey in hand for their health. We offer them indi­vid­ual solu­tions and take the time, or not.

We pro­vide ther­a­py far from tra­di­tion­al phys­i­cal ther­a­py, as phys­i­cal ther­a­py encom­pass­es both phys­i­cal ther­a­py and exer­cise ther­a­py pro­ce­dures and has long gone beyond treat­ing the ‘sick.’ ”

Mrs. Richter and the owners Axel-André Richter & Victor Lopez

Mrs. Richter and the own­ers Axel-André Richter & Vic­tor Lopez


Prac­tice Profile
Loca­tion Mönchenglad­bach, North Rhine-West­phalia, Germany
Found­ed 1999
Prac­tice Size 230 qm
Main Focus Phys­io­ther­a­py, Pain Ther­a­py, Move­ment Science
Employ­ees 3 ther­a­pists
More Info www​.richter​lopez​.de


Since 2009, they have also been offer­ing their patients a new pain ther­a­py, accord­ing to Lieb­sch­er and Bracht. Last year, Richter & Lopez opt­ed for Pix­for­mance’s dig­i­tal train­ing con­cept to expand the range of self-pay phys­io­ther­a­py services.

In pain ther­a­py, patients are get­ting younger and younger. Pix­for­mance fits in well with that, too, because it appeals to peo­ple 30+.”

The func­tion­al full-body work­out, avail­able on the health­care mar­ket since 2012, was a good fit for her prac­tice. “With pain man­age­ment, patients are get­ting younger and younger. Pix­for­mance also fits in well with that, as it appeals to both old­er and younger peo­ple 30+. Patients then are not about short-term aches and pains, the beach body or well­ness per se, but peo­ple who are look­ing for a long-term, health-pro­mot­ing work­out,” Richter says.

It was not only in terms of the appro­pri­ate patient group addressed that Pix­for­mance fit in with the new prac­tice idea. For Richter and his team, it was always clear that stan­dard equip­ment train­ing, in which only indi­vid­ual mus­cle groups are trained, was out of the ques­tion. Axel-André Richter, there­fore, prefers to focus on ver­sa­tile, var­ied training:

Patients are usu­al­ly already sit­ting on the way to work, and at work, then they should­n’t still have to sit dur­ing train­ing ther­a­py.” The breadth of Pix­for­mance’s train­ing offer­ings has won him over. At the Pix­for­mance sta­tion, he has more than 200 full-body func­tion­al exer­cis­es avail­able for his patients. These can be select­ed on the online plat­form and adapt­ed accord­ing to the patien­t’s needs and state of health.

The great thing is that I can cus­tomize the new work­out for each of our patients. From com­pet­i­tive ath­letes to grannies, there’s some­thing for everyone.”

He adds: “Thanks to the live feed­back, the eas­i­ly view­able train­ing results, and the Pix­for­mance app, you are super sup­port­ed and can always see where you stand and what you have already achieved. The inno­va­tion is also catch­ing on with cus­tomers. And it also has to be said that when I intro­duce the equip­ment to new peo­ple, they are imme­di­ate­ly thrilled because the sta­tions also look great.”

The approx. 1.30 m large train­ing sta­tion, which at first glance looks a bit like an over­sized smart­phone, can be found four times on the premis­es of the health prac­tice. Thus, Richter and his team have inte­grat­ed a spa­cious train­ing area into their self-pay area, suit­able for indi­vid­ual train­ing ses­sions and group cours­es. “There has been much pos­i­tive feed­back about the train­ing so far. Even if com­pet­i­tive ath­letes are a bit hes­i­tant at first, they’re con­vinced after­ward when I then put togeth­er the right train­ing for them.”

In this con­text, the pos­si­bil­i­ty of vir­tu­al­ly super­vised train­ing — even with­out con­stant 1‑to‑1 super­vi­sion — is also increas­ing­ly impor­tant for the ther­a­pists of the health prac­tice. If their patients have already trained before com­ing to the sta­tion and per­son­al­ized pro­grams have been cre­at­ed accord­ing­ly, they may be able to car­ry out the train­ing on their own.

If ever a ther­a­pist is down, you can offer that as a back­up and just com­pen­sate with Pix­for­mance, so the ther­a­py ses­sion does­n’t have to be canceled.”

If a ther­a­pist ever drops out, you can offer that as a back­up and just com­pen­sate with that, so the ther­a­py ses­sion does­n’t have to be can­celed,” Richter said. He trains in front of the equip­ment him­self 2 to 3 times a week and finds “the cor­rec­tions in real-time are a great sup­port there so that our patients can always train safe­ly and respon­si­bly, even with­out staff.” Beyond the dig­i­tal train­ing at the sta­tion, the Pix­for­mance online plat­form and the Pix­for­mance app also help with uncom­pli­cat­ed patient care.

Now, in times of the pan­dem­ic, the offer via the Pix­for­mance app is also very pro­fes­sion­al. The peo­ple have very well received it we have shown that they can con­tin­ue their train­ing at home in an emer­gency. The advan­tage for patients is that if they can’t or don’t want to come to the prac­tice, they can eas­i­ly access their exer­cis­es at home. And we don’t then have to record pri­vate videos to share the exercises.”

Still, many patients rely on per­son­al and human inter­ac­tion. So, when pos­si­ble, most patients pre­fer to take advan­tage of on-site train­ing at the wards, which can be made pos­si­ble dur­ing the pan­dem­ic thanks to the well-ven­ti­lat­ed rooms and non-con­tact training.

With pain ther­a­py and the Pix­for­mance train­ing con­cept inte­grat­ed in 2020, Richter & Lopez have inte­grat­ed an exten­sive self-pay area into their prac­tice and thus fur­ther con­sol­i­dat­ed their foothold in the sec­ond health market.

The goal has always been to oper­ate large­ly inde­pen­dent­ly of statu­to­ry reg­u­la­tions and SHI and to con­cen­trate ful­ly on the recov­ery of patients. Their expe­ri­ence is that peo­ple who are aware of the added val­ue of the ther­a­py are also will­ing (if pos­si­ble) to pay the mon­ey as self-pay­ers. So this is very ben­e­fi­cial to their busi­ness because it has enabled Richter and his team to build up a thriv­ing self-pay sec­tor and con­vert and retain their patients as cus­tomers in the long term.

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