Yet here I am.
I spent my early years working for private practices and enjoying the flexibility and control I had over my schedule. Then in February 2020, I decided to make the leap to pursing my private practice full time and put in my required 30-day notice. You may be able to guess where this story is going. Day 30 of my notice was the day the world shut down. Of course, it was going to be a welcomed 2-week break and then my home health based, in person practice would be able to flourish. Enough time has passed that I can laugh about it now.
That foundation taught me a lot about myself, being a business owner, and a trusting in my service product. Over the years, I’ve learned that running a successful practice requires much more than clinical expertise. It requires business skills, confidence, boundaries, and a willingness to learn continuously.
If you’re considering private practice, or you’re already navigating the journey, I hope sharing some of my experiences can help.
Learning to Market Myself
Many speech-language pathologists enter the profession because we love helping people, not because we enjoy sales or marketing. In fact, marketing felt uncomfortable to me for a long time. Marketing isn’t about convincing people they need your services. It’s about helping the right families find the support they’re already searching for. Once I shifted my mindset, marketing became much easier.
Building Relationships
Many of my referrals come from relationships with pediatricians, occupational therapists, lactation consultants, daycare directors, and other speech pathologists. I may offer a service that someone else doesn’t such as home visits or lactation support. Many of our patients receive multiple services and genuine collaboration often creates stronger referral networks than any advertisement ever could.
Being Visible in the Community
I identified and attended community events, parent groups, local business networking, and professional presentations to establish credibility and increase awareness of my services. So far this year, I’ve presented at a local WIC event and attended a neighborhood Montessori school’s spring family event. While not all events yield new clients, sometimes getting your name and services out there makes sure the right family has it when they come along.
Dealing With Imposter Syndrome
Even now, there are days when imposter syndrome sneaks in.
Sometimes it sounds like:
- “Am I experienced enough?”
- “There are so many clinicians who know more than I do.”
- “What if I make the wrong business decision?”
- “Who am I to teach others?”
What’s interesting is that imposter syndrome didn’t disappear when my practice became successful. If anything, it evolved as my responsibilities grew. I’ve learned that confidence doesn’t come from knowing everything. Confidence comes from trusting your ability to learn, adapt, and problem-solve.
Whenever self-doubt starts creeping in, I remind myself:
- I don’t have to know everything to be effective.
- Every business owner learns through trial and error.
- My clients don’t need perfection; they need expertise, compassion, and commitment.
- Growth always feels uncomfortable at first.
- I have a network of professionals there to help me when needed.
One of the greatest gifts of private practice has been realizing that expertise is not a destination. It’s a process.
Managing a Caseload Without Losing Yourself
One of the biggest adjustments I faced was realizing that a “full caseload” in private practice looks very different than it does in a school or clinic setting.
When I worked for someone else, my primary responsibility was providing therapy. As a business owner, every therapy hour represents only part of my workload. Documentation, scheduling, billing, parent communication, marketing, networking, and administrative tasks all require time and energy.
Early on, I made the mistake of focusing solely on filling my schedule. More clients meant more income, which seemed like the obvious goal. I accepted almost every new referral and didn’t always stop to think about the fit or logistics. I quickly discovered that an overloaded caseload left little room for running the business itself.
Now, I regularly evaluate my schedule and make sure that the schedule is sustainable, I am mapping out administrative time, I have flexible days for evaluations or consultations, and I am protecting time for my personal life.
One of the most valuable lessons I’ve learned is that growth is not simply about adding more clients. Sustainable growth means building systems that allow you to serve clients well without sacrificing your own well-being.
Protecting Yourself from Burnout
Burnout is common in helping professions, and private practice ownership can add another layer of stress. There was a period when I felt like I needed to be available all the time. I answered emails at night, worked weekends, and squeezed in appointments whenever families requested them. While my intentions were good, the result was exhaustion. Over time, I realized that serving others effectively requires protecting my own capacity.
I recently began working with a professional business coach for private practice owners. The best thing you can do for your practice is realize when you do not have all the answers! Surround yourself with seasoned clinicians or professionals who can take the mental load off figuring out the next steps to take. One of the first things she had me complete was a business health assessment. This addressed things such as my knowledge of tracking things like KPI’s (key performance indicators), number of hours worked, identifying systems, and making changes to how I see myself within my practice. The coach is constantly reminding me that although I don’t have a business degree, to be successful and protect myself from burn out, I must think like a business owner. As a speech-language pathologist, my business is the service that I provide, but as a business owner, therapy is only half of the story.
Three main things I am currently addressing in my practice:
Remembering Why I Started
When stress levels rise, I intentionally reconnect with the reasons I built this practice in the first place: flexibility, autonomy, meaningful relationships with families, and the opportunity to create services that align with my values and interests.
Transitioning from clinician to private practice owner has been one of the most challenging and rewarding experiences of my professional life. I’ve learned that success isn’t measured solely by the number of clients on my caseload or the revenue generated each month. Success is creating a practice that allows me to make a meaningful impact while also building a career that is sustainable and fulfilling.
To any therapist considering private practice, know that you don’t have to have everything figured out before you begin.
You’ll learn as you go. You’ll make mistakes. You’ll grow in ways you never expected when you surround yourself with a village that can offer you support and guidance. Somewhere along the journey, you’ll remember that you were always in control of the life you envisioned living.