1. I wish I knew more about marketing and funneling referrals. Graduate school doesn't prepare therapists to start their own business. I am almost 4 years into my private practice and still feel like there is so much to learn about this. 2. The most difficult part of starting my private practice was overcoming the fear of failure. It's a huge professional and financial risk going into private practice, but once I got started, my confidence grew. 3. Therapists who value autonomy, flexibility, and have an entrepreneurial spirit would be amazing private practice owners. Therapists who enjoy focusing solely on clinical work, value being on a large team, and having predetermined systems in place may prefer working at group practices or other placements.
One thing I wish I knew: I wish I had recognized the substantial amount of "invisible labor" associated with credentialing and being on insurance panels. Many providers leave their salary-position jobs expecting to see private-pay patients right away; however, the paperwork needed to accept insurance takes a minimum of six months to complete. Starting the credentialing process prior to leaving your current job, and having at least six months' worth of financial resources available, can help you successfully launch your practice without as much stress. Most difficult part: The most challenging part of scaling a practice is moving from being a "doer" to being a "leader." When you are the only provider, you are limited by the number of hours you can work; however, moving to a group model requires completely different skills in both human resource management and operational management. For me, the most important thing I did to regain my time and focus on high-level clinical strategy was learning how to delegate administrative tasks. Tips for starters: My best tip for a new practice owner is to prioritize cybersecurity and HIPAA compliance from the moment you purchase your first laptop. In this age of telemedicine, a data breach can be devastating to a new practice both legally and reputationally. Invest in a secure email service and data storage, and require that any business associate you work with signs a proper Business Associate Agreement (BAA). Who should/shouldn't start: If you have a vision for a specific type of patient care that is not being adequately provided within your community, you should start a practice. However, if you are simply seeking an "easy way out" from the stress of corporate medicine, you should probably not start a practice. The responsibilities of ownership tend to be more demanding than people expect, involving a high level of risk tolerance and a willingness to do everything from troubleshooting IT problems to handling janitorial tasks in the early stages.
One thing I wish I knew: When I became a private practitioner, I became a small business owner in addition to being a clinician. Graduate school focuses heavily on learning therapeutic techniques, but almost no time is spent learning about taxes, creating a website (or learning about SEO), or negotiating a commercial lease. Adopting a "solopreneur" mindset is a crucial part of avoiding administrative burnout and creating long-term financial stability. Most difficult part: Transitioning from a generalist practice to practicing within a specific clinical niche was the hardest part of growing my business. I felt it was wrong to turn away potential clients, but I learned the hard way that "marketing to everyone is marketing to no one." Once I refined my area of specialty, I was able to market to my ideal clients. This gave me a much more stable referral stream while also increasing my fulfillment as a professional. Tips for starters: My biggest piece of advice is to build a strong peer consultation group before you even sign your first lease. Private practice can be tremendously isolating, and having a group of consultants will help you avoid losing your clinical edge while providing a safety net for complex cases. Also, start using an automated EHR for billing and intake processes on day one. Using less brainpower on forms and billing helps you remain focused on your clients. Who should/shouldn't start: If you have strong self-discipline and really enjoy being completely autonomous, you would do well in private practice. However, it might not be for you if you prefer a predictable structure, like an agency or hospital, or if you depend on immediate social support from colleagues nearby. If managing your own health insurance and quarterly taxes causes you significant distress, the administrative burden of private practice may outweigh the benefits of autonomy.