I don’t think I have ever shared my full journey to private practice on the blog. I always get emails asking how I started and how did I know it was right for me. I am addressing all of those today. So buckle up buttercup! Here we go!

I can’t remember the exact date I started this planning of my private practice. All I can remember was my dad kept bringing it up. “I really think you should start your own practice” was his “subtle attempt.” If you know my dad, he is anything but subtle. When I did finally bite the bullet, I moved fast. I was working for a home health agency at the time where I did home visits and clinic visits. I supervised assistants in the clinic too. I preferred to carry a higher caseload than other therapists, so of course that meant longer hours.
One day, I realized I was working for the wrong people. Pouring my energy into another person’s business…who did not care about “my kids.” “My kids” were dollar signs to the corporate people who showed up 1x a month. You always knew they were there because their expensive cars were parked in the parking lot when you showed up for work. It hit me one day. Working my tail off to pay for your car is not my dream!
That was when I started my process of becoming a private practice owner. When my paperwork was official, I told my clinic manager. Since I lived in a rural away 45 minutes away from the clinic, they did not seem to worried about me competing with them. Plus, I don’t think they really thought I would ever leave or actually succeed in my practice. The shocker was they allowed me to continue working there. Usually when an SLP starts their own practice, they are immediately let go of their responsibilities.
Eventually, I changed to another agency that had just started. My practice had one client that I saw 2x a week so I needed another income. The new agency was well aware of my dreams to grow my practice. They still hired me! I had a sweet friend that was part owner of the new company so that did help. Over the next year, my business grew slowly. I marketed day cares that were near my house…like the one my son attended. I offered free speech and language screens to parents that signed their kiddos up. Being in network with only one private insurance did not help my chances at the time. What did help was having a reasonable out of pocket rate and going to the child. Many want to start with an actual building but with that comes more expenses. I had already worked a clinic setting and was EXTREMELY familiar with cancellations and no shows. That was not a road I wanted to go down again.
I continued to apply as a provider for more insurances as well as Medicaid. That is something I wish to NEVER do again! Talk about a beating! I think I was most excited when I became a provider for Blue Cross and Texas Medicaid. After I became a Medicaid provider, I started to gain more clients. I felt comfortable marketing doctor’s offices in my area. I knew my area was heavy with that need. (That’s key! Know the area.) I would say approximately 2 years after starting my business process, I was at what I considered a full caseload. I don’t really remember what that number was. I was still working for another company at that time. But my caseload with them was minimal. One day I looked up and realized we were living off my private practice income more than my employed income. Pulling the trigger on going solo was gut wrenching. I worried if I was making the right choice-even though my numbers supported the decision. Another concern was what if all these families leave me tomorrow?!
Eight years later, I am still rocking. I see about 10-11 kids a day. It seems most private therapists see around 6-8 kids a day. Some may have “heavy” days and “light” days. I have “heavy” days 3 days a week. Seeing kids in their homes and schools is what I prefer, which means I have to account for drive time between appointments. As long as your families are happy and the children are making progress, doctors will refer. Happy families are the best advertisement!
Billing, insurance verification, lesson planning, website design, marketing, etc. are all part of my job description as the owner. It’s a lot so if you are not prepared for it, don’t get into private practice. I spend many hours on the phone with insurance, disputing claims, checking benefits and/or claims. Would I change any part of it? Not a chance! This is all mine. I am in control of it.
In a nut shell, that is my journey to private practice. It’s been a long ride but it’s been awesome! Knowing each and every morning that I can control the way my business goes is the best feeling in the world. Overwhelming but still the best feeling!
Are you ready to start?
