When Arlyn Thobaben started her physical therapy practice, ReStory Physical Therapy, she had two active patients. Everyone told her she needed to take insurance. That going out-of-network wouldn’t work. That people wouldn’t pay cash for virtual PT.
Today, Arlyn runs a 100% telehealth practice with 23 active patients, specializing in bariatrics and long-haul COVID. She has an almost 100% conversion rate on consultation calls. And she’s building toward an online program with a community for her clients.
This is the story of how she got there—and the lessons that apply to any wellness practitioner considering going online.
The Niche That Nobody Was Serving
Arlyn started her practice because of two specific patients living with long COVID. These patients helped her see something that changed everything: there’s a massive population that needs help and isn’t getting it.
Her niche is specific and compassionate. She works with people living with energy limits—those with chronic fatigue, post-exertional malaise, and post-exertional symptom exacerbations. These conditions make it extremely difficult for people to move and exercise traditionally.
She also specializes in bariatrics, where she’s been working for over nine years. But unlike traditional bariatric practices focused on weight loss, Arlyn runs what she calls a “body inclusive practice.” The focus isn’t weight loss—it’s helping people feel embodied and move in ways that feel good.
This population is often body-shamed by the practitioners they see. They’re made to feel worse, not better. Arlyn brings something different: compassion, empathy, and guidance that doesn’t add to their discomfort.
Finding a niche where you can serve people who aren’t being well-served elsewhere creates immediate differentiation. Understanding how to position yourself as the go-to expert in your specific area is one of the fastest paths to building a sustainable practice.
The Insurance Question That Almost Stopped Her
When Arlyn was planning her practice, she talked to business advisors and colleagues in the field. The message was unanimous: she needed to network with insurance companies. That was supposedly the only way to get started, the only way patients would have access to her services.
The voices were telling her people wouldn’t work with her unless she took insurance.
But here’s what she knew deep inside: she didn’t want to work with insurance companies. After 14 years as a physical therapist, she had spent enormous amounts of time and energy on rigorous documentation, chasing authorizations, dealing with denials, and going through appeals.
And her patient population—people living with chronic conditions—often doesn’t get insurance support for ongoing maintenance care. Insurance companies want quick fixes, not sustained support for people who need long-term help.
This created a real conflict. She wanted to start her practice. She wanted to go out-of-network. But everyone was telling her it wouldn’t work.
Then something shifted.
The Question That Changed Everything
During a consultation call, when Arlyn wasn’t even sure she would sign up for coaching, she shared this big thing she was dealing with—the insurance question that was blocking her planning.
The response was simple: “What do you want to do? And why?”
That question gave her permission to reflect on why she was doing this in the first place. Not what the advisors thought. Not what the market supposedly demanded. What she actually wanted and why.
From there, Arlyn discovered something important about herself: she’s creative. She had transitioned her practice to telehealth because she learned how. She’d been an orthopedic resident, a clinic director, and had grown a startup clinic. If she could learn all of that, why couldn’t she be creative in meeting her patients’ needs without becoming an insurance-based clinician?
Learning to trust your own expertise and make decisions based on your actual goals rather than what everyone says you “should” do is often the breakthrough moment for practitioners building online practices.
From 2 Patients to 23: What Actually Changed
Arlyn started with two patients. She now has 23 active patients on her caseload.
But the numbers don’t tell the whole story. What changed is how she feels about her business.
When she gets a free consultation on her schedule now, she never dreads those calls. She loves them. She’s confident that what she gives and what she offers is valuable to people. And her conversion rate is almost 100%—she meets with patients, figures out how to make it work because she’s flexible with care plans, and they sign up.
That confidence didn’t come from a bigger audience or a fancier website. It came from getting clear on her offer, her niche, and her value—and then showing up consistently.
How Patients Are Finding Her (With a Tiny Audience)
Arlyn builds her caseload through several channels: referral sources, word-of-mouth referrals from friends and family of existing patients, Instagram, LinkedIn, Substack, and workshops.
The remarkable part? Her Instagram following is around 170. She started from zero. And she’s already signed a client from Instagram.
She also has 18 Substack subscribers—not a lot by typical measures, but it’s a starting point and it flows for her. She’s published four or five posts and is putting her thought leadership online.
This is what gets missed in the conversation about online marketing: you don’t need a massive audience to build a sustainable practice. You need clarity on who you serve, an offer that genuinely helps them, and consistent visibility in the places where they spend time.
Overcoming the Resistance to Instagram
Arlyn was resistant to Instagram. She’d been resistant to social media in general as both a consumer and a user.
Here’s what shifted her perspective: realizing how connected her ideal client is online.
These are people with significant energy limits. Sometimes leaving the house is the biggest thing they’ll do all month. For some, getting out of bed is the biggest thing they’ll do all day. They’re part of online support groups, robust Facebook groups, Discord chats.
If Arlyn wanted to meet them where they’re at, she had to be willing to be online.
She also realized that being online doesn’t have to be a detriment to her clients’ lives. It could actually help them gain a sense of belonging or feel seen by a provider like her. There aren’t enough physical therapists out there talking about the needs and accommodations for people who live with energy limits.
Coming online became almost a responsibility, not just a marketing tactic.
Shifting from viewing social media as self-promotion to viewing it as service is often the mindset shift that helps practitioners show up consistently.
Following the Nudge: Starting a Substack
Arlyn had been a Substack user for over a year before she started her own. She enjoyed the platform—it doesn’t move super fast, asks you to sit with a single article for at least three to ten minutes, and features long-form content.
She didn’t pressure herself to be on there right away. She just observed, followed providers in the anti-diet space, and saw what the platform could be.
Then she wrote a LinkedIn article to spread the word about an upcoming bariatric workshop. It came really easily. And she got so much positive feedback—from people who knew her and people who didn’t—thanking her for talking about the difficulties of living in a larger body, experiencing anti-fat bias, and having the courage to create a clinic that actually supports people who struggle with movement.
Colleagues shared it. Leaders from her previous company reached out privately to thank her. That response showed her she shouldn’t be afraid to write.
She took that LinkedIn article, made a few tweaks, and reposted it as her first Substack. Content repurposing turned one piece of writing into visibility on two platforms.
What 100% Telehealth Physical Therapy Actually Looks Like
One of the biggest questions practitioners have about virtual practice: can you actually do effective physical therapy over Zoom?
Arlyn has been doing telehealth since 2020. She spent the first decade of her career in brick-and-mortar clinics as a manual therapist and orthopedic clinical specialist. A large part of what she did was hands-on.
She didn’t anticipate going into telehealth. But when circumstances required it, she got creative about physical assessments, safety, and objective measurements. And after that first year of figuring it out, she found it’s actually well-supported by research—there’s good reliability on assessing people through video calls.
The advantages surprised her:
Homework retention is dramatically better. In traditional clinic settings, patients come back and have forgotten what was assigned. In telehealth, Arlyn is there with them at home, giving them things to work on in their actual environment.
Barriers to care are removed. For people living with energy limits or significant pain, getting ready, driving to a clinic (or relying on someone else to drive them), and then starting a session creates enormous emotional and physical load. With telehealth, those barriers disappear. Patients might actually crash before even starting to move if they had to go through all that to get to a clinic.
Virtual becomes an asset, not a limitation. Being in the patient’s home means seeing their actual environment, their actual barriers to movement, and making real-time modifications that stick.
Recognizing that online practice can be more effective than in-person for certain populations opens up creative possibilities that practitioners often don’t initially see.
The Reframe for Manual Practitioners Considering Online
Arlyn’s advice for practitioners hesitant about going virtual: telehealth is just another setting.
Being a telehealth physical therapist is no different from being an outpatient PT versus a home health PT versus an inpatient rehab PT. It’s a setting. There’s a learning curve—just like there would be if you had to take a job tomorrow in inpatient rehab and needed to learn where equipment is and how to use different tools.
Physical therapists are some of the most creative people focused on helping people live better, move better, and feel better. Using that creativity in a different setting opens up possibilities: you’re not limited to people within five or ten miles of your clinic. You can serve people in remote areas who need your help and can reach you by clicking a button.
For PTs in compact states like Texas, practicing in other states is possible through the PT compact. There’s a jurisprudence test and a fee, but after the first visit with that patient, it’s handled.
The Wellness Service Addition
Beyond telehealth PT, Arlyn also offers a wellness coaching service. Many clients don’t need focused, specific rehab—they need coaching. They need help improving how they pace, which can’t be taught in a generic online course because everyone is different.
This wellness service gives flexibility. Clients can pop in and pop out. When they’ve reached a new baseline—maybe after an experimental treatment where they’re feeling much better and their whole world has shifted—they can come back for coaching on how to move into the next phase without crashing.
Adding a coaching or wellness service alongside clinical work creates flexibility for both the practitioner and the client, moving away from insurance-dictated or clinic-volume-dictated care toward truly client-led support.
What’s Coming Next: Building an Online Program
Arlyn is now working on developing an online program. She knows the content pillars. It encompasses the principles she teaches and leads clients through.
She’s planning curriculum, recording videos, and figuring out where to house them. The program will be available to her one-on-one clients, and she’s exploring packages where people can meet with her several times a month plus have access to her portal and coursework.
Eventually, she wants to create a community—a space focused positively where people within it “get it.” A place where clients can show up, relax, learn, and feel a sense of belonging they wouldn’t otherwise have.
Building toward scalable offers while maintaining the high-touch nature of your work is the progression that creates sustainable six-figure practices.
The Wisdom: What She’d Tell Practitioners Who Feel Stuck
For anyone stuck transitioning online or stuck in the beginning stages of their business, Arlyn’s advice is practical:
Journal about what you want and your why. Sit down with an empty notebook and write. Write about what you want to accomplish, about your why, about what your strengths are. It might look like chicken scratch, but it’s there—in your subconscious. There’s a reason you’re being pulled toward entrepreneurship.
Remember you’re your own worst critic. That’s why you need those things in writing about your why and your strengths—to remind yourself when things get uncomfortable, hard, and uncertain. When you’re tempted to measure yourself on external metrics that maybe do matter but you might hyperfocus on in unhelpful ways.
Think critically about your internal drive to hustle. A lot of practitioners who end up in entrepreneurship wanted to succeed and got into the field to help people. Those two things together are powerful, and you can lose sight of why you’re doing what you’re doing. It’s okay to hustle at times, but ask why. Is it because you want to help people who need you? Or because you’re worried about looking bad to others?
Know that healing your relationship with work is a gift of early entrepreneurship. You might be coming into entrepreneurship feeling frustrated, undervalued, overworked, not in alignment with the work you’re doing. Having space to be creative and heal your relationship with work is one of the gifts of building your own practice.
The Bottom Line: It Works If You Work It
Arlyn went from two patients to 23 without taking insurance. She runs a 100% telehealth practice serving people who desperately need compassionate, body-inclusive care. She converts almost everyone who books a consultation because she’s clear on her value and flexible with her care plans.
Her Instagram following is 170. Her Substack has 18 subscribers. And her practice is full.
The lesson: clarity on your niche, offer, and value beats audience size every time. You don’t need insurance networks. You don’t need tens of thousands of followers. You need to know who you serve, how you help them, and the confidence to show up consistently.
If you’re a physical therapist, massage therapist, yoga teacher, or wellness practitioner considering going online—or already online but stuck—Arlyn’s story is proof that it works. Not because everything was perfect or the conditions were ideal, but because she got clear on her why, got creative about her how, and showed up even when it was uncomfortable.
Ready to Build Your Online Practice?
If you’re a wellness practitioner who wants to transition from brick-and-mortar to online—or scale your existing online practice—book a consultation to explore what’s possible for your specific niche and goals.
The 100K Online Practice Blueprint helps physical therapists, yoga teachers, massage therapists, and health coaches build sustainable online practices without depending on insurance, needing massive audiences, or burning out.
You don’t need everyone to say yes. You need the right people to find you. And when you’re clear on who you help and how you help them, they will.
Related Reading
- How Betty DuPont Grew Her Somatics & Physical Therapy Business Online
- 4 Types of Online Programs for Wellness Entrepreneurs to Grow Your Business
- Simple Instagram Strategy to Grow Your Health and Wellness Business
- Telehealth Physical Therapy: Just as Effective as In-Person Visits
- How to Make Your Online Wellness Business Legitimate and Successful
