Is Private Practice for Me?

The 5 Questions to Consider Before Starting Out.

The most common question I hear in my coaching calls with potential clients is by far, “Is private practice for me?” Most clinicians at some point in their career consider private practice and wonder if it may be an option for them.

The appeal might seem obvious. The flexibility, clinical freedom and the opportunity to make more money can all be benefits of working in private practice. Often, it is the less appealing elements of private practice that some don’t consider. Challenges like where to find clients, financial inconsistency and navigating the insurance maze are all common challenges in owning your own practice. 

The first step I recommend to anyone considering starting their own practice is to do a brief self-assessment and consider the following questions to see if you are ready for private practice!

1. Determine your WHY

I’m always curious about what specifically draws someone to starting a private practice. Has it always been your dream to have a practice? Is it in reaction to feeling burnt out in a current job or negative experience with an employer? For me, I grew up in a family business, so the idea of being an entrepreneur was very familiar to me. I always appreciated the flexibility my family had. I knew early on that I wanted to have children of my own and being able to have a work schedule that allowed me to work around their schedules was very important to me. 

I also grew frustrated after years of working in mental health settings and feeling limited to how I could practice clinically. The red tape and bureaucracy around starting a group or having to follow clinical guidelines that didn’t quite fit, influenced my desire to be able to provide therapy in a way that both catered to client needs and felt right for me clinically. 

Consider what is the driving force behind your desire to start your own practice. Do you want the opportunity to make more money? Do you want to travel and have more time off? Do you have a clinical specialty or niche you want to focus on? I encourage you to picture the kinds of clients you want to work with AND the lifestyle you want for yourself. This is the motivation to turn your dreams into reality. 

2. How comfortable are I with taking risks?

Although starting your own practice is absolutely doable, it does involve some risk. Depending on how risk-averse you are, will help inform how you go about starting your own business. 

I started a small private practice while I was still employed full-time. Although the extra workload can be overwhelming at first, for me having the financial security of my full-time paycheck allowed me to “test the waters” before fully committing to private practice. As I slowly built up my caseload, I was able to eventually phase out of my full-time job and transition to full-time private practice.

There are so many variables that come with private practice. There can be inconsistencies with getting new clients, cash flow, and paying self-employed taxes. If you do not have a solid plan when starting out, these challenges can shut you down FAST! One of the benefits of working at an agency or other mental health setting is typically you have a steady paycheck. It may not be making you rich, but most become accustomed to knowing there is a regular and consistent income which can be comforting.  The ebb and flow of private practice can be daunting and without a plan to manage the expected variables, can trigger panic for some. 

Would you take a road trip without GPS or directions to your destination? You cannot start a business without a plan. It doesn't have to be elaborate and fancy, but you must have intention and concrete goals to help inform every decision you make for your business. Although there is always some risk in trying something new, I work with my coaching clients to develop a clear plan for their practice that considers the above variables. Things like building up a financial cushion to help during the start-up phase and having an automatic savings plan for estimated self-employment taxes are some elements we build into an initial business plan. 

3. Do I want to be a business owner?

This may seem like a silly question, but often I speak with therapists that don’t really see a private practice as a BUSINESS or have any business experience. We commonly hear that most clinical graduate programs do not have courses on private practice or business management, leaving most clinicians unprepared to be business owners. Although you don't necessarily need business experience, you absolutely need to have an INTEREST in business. This is not a hobby. If you are thinking about private practice, it is a business and you must treat it as such to be successful. The therapists I see struggling the most in their practice often don't enjoy the business side of private practice. If this is the case, you may want to consider joining a group practice instead of establishing your own practice. This option would still allow for the clinical experience of working with clients in a private practice setting, but often the practice itself handles marketing, billing and finances, and other aspects of running the business. 

Although I ABSOLUTELY LOVE working with clients, I found myself craving a break from my clinical work to mix up my time. When I first started to think about private practice, I  read books and looked for any resources to learn about running a business. I was surprised to see how much I loved learning about something new and different. It was exciting to start to think about how to apply what I was learning to my practice and help me grow and scale. To this day, I can be found bingeing on business podcasts while driving or out walking the dog! 

Through my years both in owning a group practice and being a practice coach, I have seen amazing clinicians that are not great business owners and great business-minded folks that are not skilled clinicians. Ideally, to find success in private practice requires a good combination of both! Sometimes, clinical skill is overlooked when considering private practice. Remember, ultimately this is the service you are trying to sell. If you do not have solid clinical skills and the ability to engage clients, the best business plan won't make up for this. I always incorporate ongoing clinical training and specialization into business planning with clients. It is essential to continue to focus on keeping up your clinical skills while also growing your practice. 

4. What is my money mindset?

In my experience, this may be the biggest challenge for therapists transitioning to private practice. Money is often a taboo subject and can be really challenging to have tough conversations when most of us did not have direct involvement with billing and payment in our previous counseling positions. Therapists often get stuck around difficult conversations about money and finances with clients or “feeling bad” for charging clients for their services or enforcing a late cancellation fee. 

We all have a “money story” for ourselves that includes how money was or wasn’t talked about growing up and our own financial relationship with money for ourselves and with partners. Our relationship with money directly affects how we will approach our business. Setting your fees, budgeting, and having solid financial boundaries with clients are all ways your money mindset is vital to your success in practice and business.

5. What is my speciality or niche? 

This has become a hot topic. Although you don’t have to have a niche to be in private practice, I would argue that it is one of the most helpful things to consider. Depending on your area, the market may be FLOODED with therapists. For your ideal client, it can be super overwhelming to try and find a therapist that is a good fit for them. When you focus on a specialty or niche, it allows you to market your practice directly to your IDEAL CLIENT. For example, consider a woman who is searching for a therapist to help her with an eating disorder. 

She searches Google and scrolls through ALL of the therapy listings feeling overwhelmed. Then, she sees your ad that speaks directly to her describing the speciality and service she specifically needs. It also gives you a super clear vision of providers to market your services to, such as MDs, nutritionists, eating disorder programs, etc. Of course, you can still see clients outside of your speciality but a niche really gives you the opportunity to align yourself as an EXPERT among the bigger group of general clinicians. 

So, after reading through these questions, what are you feeling? Are you feeling excited and ready to go, or are you feeling overwhelmed and questioning if this is the right path for you?  You may naturally have the traits that will set you up for success or you may have questions about some of the challenges I discussed. The good news is, most of what I discussed is figureoutable. Luckily, there are so many resources available today to help get you started. 

How you get started really depends on the kind of person you are and how much time you have available to devote to your practice building journey. There are countless books, websites, podcasts and Facebook groups that focus on private practice. For those that are resource savvy and have the time, you can find lots of helpful information and DIY your way into private practice. If you are someone who prefers one on one guidance and looking to streamline starting your practice, coaching might be a good fit for you. Working with a practice coach or consultant will give you personalized guidance on how to start your practice and save time and money on helping you do it the right way, while having the support built in from someone who has built a successful business. 

If you are ready to start planning your dream practice, click here to learn more about how I help therapists find success!