It was Andrew Shirk’s negative first-hand experience—literally—with the inefficient healthcare system that led him to launch a startup that could help prevent others from facing the same struggle. Durham-based CityPT uses telehealth to provide on-demand and personalized physical therapy for patients.
In April of 2019, Shirk woke up to discover that his hand, especially two of his fingers, were numb. As a software engineer of 19 years, he said it was terrifying because he needs dexterous control over his fingers.
Shirk went to urgent care, where he was diagnosed with an ulnar nerve condition and later had surgery. He then received poor advice from health care providers, he said, which worsened his pain.
“I kept experiencing all kinds of obstacles and delays just in the whole healthcare system in the process of trying to figure out what was going on with me,” said Shirk. “And I suddenly lost control—things were cascading through my body—and I suddenly lost control of my shoulder, and my other arm.”
He decided to be proactive and get a physical therapist. He said he had to advocate for himself and do his own research.
“I was really lucky to find a great therapist right off the bat,” Shirk said. “And he’s very empathetic and creative, and a good educator. And those are the three key things in PT—empathy, creativity, and being a good educator.”
His impression was that PT is a powerful modality of care, but one which is relatively underutilized and undervalued.
Upon further research, he discovered that statistically, one out of every two Americans have a musculoskeletal health issue every year that would be a good candidate for physical therapy. But only a fraction of them have access to quality PT.
“We want to do a better job for clients by making it easier for people to get access to care,” Shirk said. “As easy as it would be to order a pair of shorts from Amazon.”
He said that CityPT’s patients get higher-quality care than they would if they went to their corner clinic because they’ll see a more experienced and qualified, specialized clinician for their particular issue. They will also receive fast care, because Shirk knows that a patient may have a debilitating condition that’s permanently damaged if they wait too long.
His goal isn’t only to provide quality and accessible care for his patients but to support therapists. He said clinicians are getting underpaid and overworked in the industry.
“Our clinicians have a whole hour with the patient, and I try to pay them more by about twice than they would get on an hourly basis in an outpatient clinic,” Shirk said.
He said they do a lot of marketing for the clinicians and educate them. They receive in-house tutorials on how to be the best telehealth clinician. The clinicians receive the majority of the fee that CityPT charges for the evaluation appointment and the follow-up appointments.
He said the company has been doubling the number of consultants and contractor PTs that they have on staff. The startup is now entering a period where it’s making two strategic full-time hires.
“We have not had any full-time employees other than me up until this point,” Shirk said. “But we just hired a clinical product manager. She is a DPT—doctor of physical therapy—and a board-certified orthopedic clinical specialist who lives in the Pacific Northwest.”
All of CityPT’s clients have been from Durham, starting with a successful test run last April. Currently, the startup is only serving North Carolina residents but plans on expanding to other states.
“This is my life’s work,” Shirk said. “This is a manifestation of so many things that I believe in. And it is just so delightful and exciting to see it come to life.”