Hello from a therapist who has been about to start a private practice for two years

Hannah Lee· Licensed therapist planning a private practice; still at a group practice· Idea stage, Health & Wellness·1w

Hi everyone. I'm a licensed therapist at a group practice, and I have been roughly three months away from opening my own private practice for about two years, which I think makes me the mascot of the idea stage.

The math isn't the problem. I know what the group keeps from my sessions and I know what I'd bill on my own. The problem is everything around the math. I don't know whether I'm taking insurance or going private pay, and that one decision seems to change the whole business: the billing, the software, how many clients I need, whether I can afford to be careful about fit.

Underneath that is the part I don't say out loud at work. My caseload here is full and stable, and that's a very comfortable thing to walk away from when my husband's job covers our insurance and not much else.

What I'd like from this group is people who did it while still employed. Not follow-your-dream, actual logistics. Did you build the practice on evenings first? How did you handle telling your employer? How long were you doing both before it stopped being sustainable?

Still at the group practice for now. That's the honest stage.

3 replies

Jen Okafor· Open·1w

Not a therapist, but the full-and-stable caseload thing is exactly what kept me at my job an extra fourteen months, so here's the useful part: your comfortable thing isn't free. It's costing you the years where starting is cheapest.

On insurance versus private pay, I can't answer that for your field, but I had the equivalent decision for the studio (packages versus memberships) and what broke it was writing down how many clients each version needed to cover my actual household number, not my revenue goal. One needed 34 people and the other needed 61. That turned it from a philosophy question into an arithmetic one.

Dana Kowalski· Open·1w

HR person here, so take the employer part from me rather than from the internet.

Read whatever you signed when you joined the group practice before you tell anyone anything. Not because I think they'll come after you, but because non-solicitation language about clients is common in practice groups and you want to know the exact words before the conversation, not during it. In my experience most are narrower than they sound and some aren't enforceable where you live, which is a question for an employment attorney in your state and about an hour of their time.

Then tell them later than feels polite and earlier than is rude. Two to four weeks of overlap, not four months.

Hannah Lee· Idea stage·1w

I signed something in 2019 and I genuinely couldn't tell you what's in it, which is its own answer. Pulling it out of the folder tonight.

The 34-versus-61 framing is the most useful thing anyone has said to me about this. I've been running the decision as an ethics debate with myself and it's actually a headcount question I can do on paper this weekend.

Sign in to reply

Replying and upvoting need a free LaunchAdvisor account. Reading is open to everyone.