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Lessons Learned from Starting a Private Practice

In 2006, I launched my own private practice as the sole practitioner of Stepping Stones Occupational Therapy (SSOT). My treatment model was providing home visits for children with special needs and let me tell you, I put a lot of miles on my car that first year! My caseload grew and it became apparent that I would need to set up shop.  Since those early days, my practice has evolved from a ‘mobile’ office, driving in the Seattle rain and jumping puddles with all of my therapy equipment, to a dynamic, multi-disciplinary clinic that offers out-patient and school based therapy services. 

As my business approaches its 10 year anniversary, I’ve had some time to reflect upon my professional journey as a clinician and business owner.

I am passionate about therapy and the positive impact that we, as clinicians and coaches, have on the lives of our clients.

So, what do I wish I had known prior to this journey? See six tips below that I have for all therapists starting out.

jessica mcmurdie

Jessica McMurdie, OTR/L, has been working exclusively as a pediatric occupational therapist for over a decade. She’s currently the clinic owner and OT at Stepping Stones Occupational Therapy, a nationally recognized practice for clinical excellence, advocacy and leadership.

  1. Know where you are going.

Take some time to think big and dream big! Imagine incredible success. What does that look like in one year, five years, and ten years? Why does your practice exist? What is your vision for the company? How will it serve the needs in your community?   It’s very important to do a market analysis and know who your customers are and what they are looking for.  How can you set yourself apart to become the first, the only, or the best service for your clients?

  1. Stay on track.

Just as you set goals for your patients, set specific and measurable goals for your business.  What do you want to achieve in the short term and the long term?  How will you get there?  Setting goals will help you stay on track to achieve your vision for the future. Work with a business counselor (find one here) or executive coach to support you and hold you accountable to achieving your goals.

  1. Pace yourself.

Avoid the pitfalls of growing too rapidly by creating systems and processes to keep your practice running smoothly and efficiently.  Understand the key metrics that drive a thriving and successful therapy practice. Set the pace of your business growth by analyzing those key metrics for success.  Set aside time every week to work ON your business, not just IN your business as a clinician.  By taking the time to grow your business at a healthy pace, you have a greater chance of success in the long run.

  1. If you stumble, get up and keep going!

Keep in mind there are no mistakes, just lessons to be learned.  If you make a mistake, it’s OK, nobody’s perfect.  Strive to be self-aware and learn from your mistakes to come back stronger and wiser.  Over the years as my practice has evolved, I’ve moved into various office spaces to accommodate for clinic growth. As time consuming as it was, it was very exciting to search for a new home base and to dream up exciting floor plans for future therapy space and equipment.  However, in all of my excitement, I failed to objectively assess the space or accurately forecast what my future needs would be in terms of the best location.  After the first week of working in my second floor treatment room, I received a complaint from my neighbors that “whatever was happening in my office was too loud!”  Adjacent to my office was a massage therapy practice and directly below it was a hair salon.  I realized immediately that my mistake of having a mini trampoline and not sound proofing my room, resulted in me being a noisy neighbor.

I also noticed that whenever my pediatric clients were using the ball hopper down the hallway, that the dentist next door would open his suite door to see whether the floor reverberations were the result of an impending earthquake.  Fortunately, my lease was month to month so it wasn’t long before my office neighbors had the peace and quiet restored to their building.  Presently, my clinic space is amazingly ideal being situated on the first floor and in the back of a building that backs up to green belt. What this means for my kids is that they can jump and play and laugh as loud as their heart’s desire.

  1. Don’t run alone.

Sometimes as the owner of a small business, it can feel overwhelming and even lonely “at the top”.  You may even wonder, “How did I get myself into this gig?”  Sometimes I felt as if I was running in a hamster wheel, spinning my wheels, yet going nowhere!  You know what, those feelings are all normal! I can assure you that at some point in their career, all clinic owners have felt a sense of loneliness and solitude. That’s why it is so important for private practice owners to seek out the company and camaraderie of other small business owners.

With today’s technology, you’re not limited by geography to connect with other people who can commiserate, collaborate and encourage you to persevere on your entrepreneurial journey.

Networking groups, online or in person, and other business owners can be an amazing resource and support system; so take this idea and run with it! For instance, check out this newly launched Empower Community – chock full of outpatient rehab experts and active discussions around the things that keep you up at night.

  1. Know when to take a break and know what energizes you.

As a new business owner, I didn’t realize how much time, energy and resources it would take to own and operate a private practice. As an OT, prescribing self-care and leisure is what we encourage our patients to do to live a balanced life.  Unfortunately, we aren’t very good at listening to our own advice.  I encourage you to take some personal time to recharge your batteries; take a coffee break, go for a run, take a vacation or spend time with your loved ones.  Taking breaks and enjoying the energizing activities and relationships in your life will enable you to return to work refreshed and with a renewed energy to tackle the various aspects of running a private practice. The same goes for your staff.  It’s important that you provide them with opportunities and encourage them to take time off to rest and relax.  One person can influence the entire culture of a clinic.  As the boss, keep in mind that employees who are happy at work often produce happy clients – so spread the cheer!

One day you will be able to sit back, relax and appreciate how far you’ve come on your journey as a therapy entrepreneur.  Go the distance and keep up the good work!

9 thoughts on “Lessons Learned from Starting a Private Practice

  1. I needed to read this! Thank you for the insight! So many little pieces to take care of WHILE practicing is a tough balance. Thanks for letting us know it can get done 🙂

  2. Thank you for sharing your experience Jessica. As an aspiring occupational therapist, your article helped with envisioning the process of becoming an entrepreneur in the field one day.

  3. Starting practice this week with first client. Could use some advice on Liability insurance (coverage needed and where to shop), how to set-up a HIPPA compliant practice), permits needed from state and federal regulatory to legally operate (CA state). I think these practice basics should be addressed, first, when “starting” a private entity but, unfortunately, there’s not enough information. Cuz, without this bases covered, you’re operating illegally and exposing your private assets to potential liability.

    • Hi Terry,

      Absolutely! These are all important bases to cover. Keep an eye on our blog as a continue to discuss topics like this.

      Thanks so much for your feedback.

      -Taylor

  4. Would you need a specific degree to open your own practice? I am only about to start my bachelor of science but I am contemplating my future and would just like to know if I would need a Doctorate of Occupational Therapy to accomplish what I have in mind? Great read! It is nice to know what to expect and how to operate a business.

  5. Tonight was a night that I definitely needed to read this. I have been contemplating starting up a practice; however, I am a COTA and it seems to be twice as hard. I see a very strong need in my community for a pediatric multi-disciplines clinic. Parents travel about 1.5 hrs to get treatment and their comments are “It’s to far to do 2 to 3 times a week, etc.” I must admit I’m scared, and figuring out the first step is hard. Any guidance?

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