When you talk with James Higgins, it’s clear he’s as committed to his patients’ well-being as he is to the smooth running of his Midtown Manhattan practice.

James began his career in physical therapy after playing rugby in college, drawn to helping others recover from the kinds of sports injuries he knew well. Ten years ago, he joined Integrative Physical Therapy, where he now co-owns the practice and is steadily completing a sweat-equity buyout from his longtime mentor and partner, Frank Ruggiero.

For James, running a business has been a crash course in systems and mindset. “You can’t procrastinate,” he says. “As you gain more responsibility, things pile up quickly. Handle what you can now — your future self will thank you.”

His approach to leadership mirrors his care philosophy: clear structure, consistency, and a focus on the long game. When a long-time PT recently left, James and his clinical director built a simple, organized hiring system — breaking down the process into manageable steps so it felt less overwhelming. “Once you organize things, they’re less scary,” he shared.

Like many in the wellness industry, James walks a fine line between purpose and profit: “You want to see as many people as possible, but you also want to give high-quality care.” His team’s solution? Strategic scheduling and a “weaning down” system that supports patients as they heal while creating room for new clients — a win for both impact and sustainability.

Despite insurance reimbursements lagging behind inflation, James remains optimistic. With a loyal patient base and partnerships that include a chiropractor and acupuncturist sharing his space, he’s found ways to keep both collaboration and cash flow healthy.

“It’s rewarding to help people heal — but also to see how the business runs smoothly,” he says. “You get to have your cake and eat it too.”

Behind the Numbers is a Fit For Profit series sharing real stories from wellness business owners doing meaningful work while navigating today’s economy.

If you’d like to explore how to improve cash flow and profitability in your own wellness business, reach out at fitforprofit.com — we’d love to feature your story next.