From Local Indie to National Franchisee: A Physical Therapist Looks Back & Ahead

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Carl Malmquist founded Quality Rehabilitation Network in Yuma, Arizona, in 2001. In the 18 years since, a big part of their success came from aquatic therapy in their Endless Pools. Now that he and his team at QRN have grown into a successful four-location physical therapy practice, they're making a big shift.

In 2018, Carl transitioned from the independent QRN to being a franchisee of FYZICAL Therapy & Balance Centers. FYZICAL is the fastest-growing system of physical therapy, balance and healthy lifestyle centers in the United States with more than 340 centers in 41 states.

As Carl and his team rebrand under the FYZICAL banner, they're in the process of installing their third Dual Propulsion Endless Pool. Like each of the previous two, the new pool will feature two Underwater Treadmills.

We spoke with him recently to discuss the changing financial landscape for physical therapy practices and how he's stayed relevant (and in the black) with a positive ROI from aquatic therapy.

A Dual Propulsion Endless Pool serving 3 physical therapy patients at FYZICAL in Yuma
With three patients using the Dual Propulsion Endless Pool at once, the former Quality Rehab Network "made our return on investment in our first year," according to founder Carl Malmquist. As he transitions to being a FYZICAL Therapy & Balance Center franchisee, he recalls, "At the two-year mark, we had had over 20,000 sessions in the pool." 

Q. Was your plan always to feature aquatic therapy at your facilities?

"Yes. I always knew the importance of aquatic therapy in rehab, sports, aerobics, and fitness. For me, it was a no-brainer. I thought it would be a very viable part of our business and something that the public would enjoy, that the doctors in particular would be very supportive of it.

"I thought that the return on investment would be there as well. The proof's in the pudding – we've done that."

Q. How long did it take to get the ROI on first pool?

"We made our return on investment within that first year. At the two-year mark, we had had over 20,000 sessions in the pool."

Q. Do you have aquatic therapy competition?

"There's no competition in Yuma County. There are some in Phoenix, but that's a couple hundred miles away."

Q. Who are your patients and which ones do you treat in the pool?

"In the pool, we can treat every ailment or diagnosis there is. Especially if there's a high pain element, aquatic therapy almost always comes to the rescue. The top diagnoses that we see are lumbar or spinal issues, knee injuries, and a diagnosis of fibromyalgia. We've gotten a tremendous response in breaking the pain cycle of fibromyalgia.

"Our patients are probably 50% Medicare, and the other half are either private insurance or the secondary health providers. I'd say 98% are happy with the experience – very happy."

A Dual Propulsion Endless Pool planned for FYZICAL aquatic therapy in Yuma
Carl's third Dual Propulsion Endless Pool is slated to open this summer under their newly acquired FYZICAL brand. He researched competing therapy pools before buying his first, and he found that, "for the money that we wanted to invest ... Endless Pools met all of those criteria. In the pool, we can treat every ailment or diagnosis there is."

Q. Did you look at other pools before buying your first Endless Pool?

"Oh sure. It came down to HydroWorx and Endless Pools. For the money that we wanted to invest, the features that we wanted, the output – Endless Pools met all of those criteria."

Q. Which pool features did you need?

"There had to be an underwater treadmill, resistance currents, and the jet feature. [Endless Pools offered] the ability to heat the water and to provide a variable water environment for all the different types of things that we do."

Q. When you started in 2001, was it always your goal to be part of a national brand?

"No. Back in that day, life was good. We got reimbursed for things like cold packs and hot packs. You could make a very good living just doing the basics. But now, as reimbursement rates have declined, it’s a much different environment. It's still a great career, but you have to be innovative, you have to be ahead of your competition, you have to be doing things that weren't done before.

"That's one of the reasons that I got into aquatic therapy – because it's an additional avenue to treat patients. We need a viable product where we can offer a number of different services instead of just your normal routine physical therapy."

Q. What's your experience of working with Endless Pools?

"John Satir [Endless Pools' commercial sales representative], from the very first phone call, offered a lot of solutions. As a result of his experience in the industry, he saw things that I didn't see. I knew that Endless Pools would be the primary focus of our aquatic therapy products. It's been a good working relationship."


This week, Carl attends his first national event for his new brand. Called FYZICAL Brand Triumph, the conference anticipates more than 600 attendees for five days of networking and education. We wish him and his team all the best in this new chapter of their physical therapy service to the greater Yuma region.

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