From practice owner to employee (and then maybe entrepreneur again): why Switzerland is the perfect intermediate step

After 15 years of my own practice, the workload feels different. The claims, staff challenges, rising energy costs and the administration for health insurers are piling up. According to the Small Business Physical Therapy Index 54% of practice holders are now thinking about quitting.

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But there is also another route: what if you temporarily step aside? Not to give up, but to gain perspective.

The numbers behind the challenges

The numbers don't lie. The same survey shows that 17% of practitioners are taking concrete steps towards sales. The causes are clear: low rates from health insurers that barely increase in line with costs, staff shortages in 40% of practices, and administrative burdens that keep increasing.

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Practice owners are seeing their costs rising on various fronts. Energy, housing, software and pension contributions are becoming more expensive, while income is lagging behind. The absence of a collective agreement makes it difficult to retain staff. Physiotherapists in the second line earn according to ABN AMRO up to 1,000 euros more per month, which reinforces the outflow.

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The treatment index determines your options, patients are reluctant to make their own contributions, and net margins remain limited. For many practitioners, the balance between effort and return is lost.

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The Switzerland strategy: recovery in employment

If you sell your practice to a chain or successor, you get capital in the bank. At the same time, you have invested years in doing business and you are probably ready for a different form of work.

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In Switzerland, there is a special rule: you must first work as an employee for two years before you can start independently there. For most entrepreneurs, that sounds like a limitation, but this can actually be an opportunity.

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Those two years offer you the space to break free from the responsibilities that come with a practice. No personnel management, no negotiations with health insurers, no energy bills. You treat patients and then go home. That peace provides perspective.

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The salary is between 6,000 and 6,500 euros gross per month for starters. With your experience as a practice holder, you can count on 7,000 to 8,000 euros, plus a thirteenth month. That is considerably more than what you would earn as an employee in the Netherlands.

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Why Switzerland is attractive for experienced practitioners

The differences with the Netherlands are significant. The rates are higher, which means that physical therapy is valued differently. There is no treatment index that determines how many treatments you can give. Reporting requirements are limited. You get the space to treat how you think is best based on your experience.

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The personnel issue is also different. Dutch physiotherapists are popular because of their solid training and approach. The offer to vacancies is spacious, so you're not alone when you're there.

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The administrative burden is lower than in the Netherlands. That gives you time to focus on what you are good at: helping patients move forward.

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After two years: three scenarios

This mandatory employment period gives you two years to decide what to take next. With a good salary, a buffer from sales, and without managing a company's pressure, you can make informed choices.

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Scenario 1: Continuing to work as an employee

Entrepreneurship is a choice, not an obligation. After two years, many former practice owners notice that working as an employee is a good fit for them. The salary is solid, the workload manageable and there is time for other things besides work.

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The mountains are close by, the quality of life is high, and financial security provides peace of mind. For some, this is the permanent choice.

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Scenario 2: A New Practice in Switzerland

Do you notice that you want to do business again? After two years, you know the Swiss system, master the language and understand the market. With your Dutch practical experience and your Swiss network, you can start a new practice there.

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This time with higher rates, less regulatory pressure and a financial buffer. By now, you know what you want and what you don't want in a practice, which is valuable when starting up again.

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Scenario 3: Returning to the Netherlands

Returning is also an option. After two years, you've stepped back, got your finances in order and recharged. If you want to do business again in the Netherlands, you can do it from a stronger position.

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You can opt for a smaller practice, specialize in a niche market, or work in a hybrid form: partly salaried, partly independent. The choice is yours and is not dictated by financial necessity.

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From practical sales to departure to Switzerland

When selling a practice, it is wise to hire an advisor to guide you in the tax settlement. Chains such as Fysiogroep Nederland and Hecon regularly adopt practices and know the process from within.

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Valuation is often based on profit before interest, taxes and depreciation. In the healthcare sector, people use: Brooks an indicative range between 5.9 and 6.9 times the annual profit. An advisor can assist you with sales and tax settlement.

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For Switzerland, there are a few important things: diploma recognition via the Swiss Red Cross, German at B2 level and a workplace that suits you. Takeoff supports you in this process, from the first interview to your first day of work. With a network of more than 100 practices in Switzerland, we know our way around and what's involved.

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Take a look at it too how our guidance works and how we help you emigrate to Switzerland.

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A strategic choice

After years of doing business, it is only logical to explore other routes. Selling doesn't mean giving up. It can be a conscious choice to create space for what comes next.

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Those two years in Switzerland offer prospects. Peace to recover, space to decide what to take next, and a financial basis to take that step forward. Whether you stay, restart or return to the Netherlands with new energy.

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Your practice doesn't have to be your final destination. Sometimes it's the stepping stone to something else.

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Start a conversation with Tijmen to discuss without obligation whether this route suits your situation.

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