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When you hear success stories from masterclasses or social media about starting your own private practice, it sounds like a dream. “Be your own boss! Control your income! Answer to no one!” But the reality of running an ethical private practice is more complex. Let’s debunk some of the myths and explore the realities of this challenging, yet rewarding, path.
Myth #1: No Boss? Not So Fast
One common misconception is that by running your own practice, you have no boss. While it’s true you don’t have a supervisor telling you when to see clients or how to run your day-to-day operations, you still have many “bosses.” These come in the form of insurance companies, ethical guidelines, and legal regulations that govern how you practice. From marketing rules to the promises you make to clients, there are still many authorities overseeing how you operate.
This doesn’t mean that being your own boss isn’t liberating in some ways, but it does come with its own set of pressures and responsibilities. You have to manage compliance, follow rules, and maintain high ethical standards to ensure you are practicing legally and ethically.
Myth #2: You Can Focus Solely on Therapy
Many people believe that owning a private practice allows you to focus purely on seeing clients. In reality, running a private practice involves wearing many hats. Aside from therapy, you need to manage administrative tasks, such as scheduling, billing, verifying insurance, building maintenance, dealing with the landlord, and managing utilities at the location. If you accept insurance, you’ll spend a lot of time on the phone dealing with insurance claims and payments.
Managing insurance claims can be time-consuming. Representatives may keep you on hold for 20 minutes or more, and you might only resolve a few issues before needing to call back again. Even if you choose to go the self-pay route, you’ll still need to invest significant time in marketing your services to ensure a steady stream of clients. Building and maintaining your client base while balancing the administrative side of things can become overwhelming.
The Hidden Costs of Running a Practice
When clinicians think about private practice, they often focus on the potential income—”If I don’t have to split my earnings with a group practice, I’ll make more money!” But they forget the hidden costs. Running your own practice means paying for everything from rent and utilities to electronic health record (EHR) systems, billing software, and more. You’ll also need to handle your own marketing, which requires both time and financial investment.
Additionally, there are weeks when private practice owners might not get paid. This is especially true for those running group practices. Often, group practice owners have to prioritize payroll for employees and contractors over their own paycheck, leaving them with less income than those who work under them.
Balancing Passion with Business Realities
Ultimately, owning a private practice is a double-edged sword. On one hand, it offers autonomy and the chance to build something on your own terms. On the other hand, it’s a demanding and complex business. Between insurance follow-ups, marketing efforts, staying up-to-date on trends, and managing billing codes, there’s a lot more to it than just seeing clients.
For those passionate about therapy, group practices can provide a balance between independence and support. They allow clinicians to focus on providing care without getting bogged down in the business side of things. However, if you’re determined to go solo, make sure you do your research and prepare for the realities of running a practice. It’s rewarding, but it’s also hard work.
