As a busy SLP working in a school or hospital setting, you might have—at one time or another—felt somewhat stifled by the constraints of your work environment. You might even catch yourself dreaming about starting your own private practice—and silently yearning for the flexibility that inevitably follows suit. After all, when you’re a business owner, you’re your own boss. That means you make the final call on all patient treatment, set your own schedule, and even build your own clientele. But even with all of these dreamy perks, there are some drawbacks you should consider before going into private practice for yourself. Here’s the breakdown of pros and cons:

The PT Patient’s Guide to Understanding Insurance - Regular BannerThe PT Patient’s Guide to Understanding Insurance - Small Banner


  1. You only have to answer to yourself. You have all the power (cue dramatic and dark laugh—mwahahahah). No, seriously, you have the power to treat your patients as you see fit. Furthermore, you can choose an EMR that suits your workflow—which means you can document efficiently without having to deal with the rigmarole of school or hospital forms.
  2. You have the opportunity to make more cash. It might be a slow process, and you still have to pay taxes, but the money you make is your own. And ultimately, you get to decide how you invest your earnings.
  3. When it comes to building relationships with your patients, the sky's the limit. You can send out as much communication as you find appropriate and truly nurture client relationships. In the same way that you have the freedom to determine how and when you interact with your clients, you also have the freedom to limit the volume of clients you take on.
  4. You’ll enjoy a certain amount of flexibility in all aspects of your business. You can decide to practice part-time, accept clients outside of your normal nine-to-five business hours, or work full-time as a private practice owner-therapist. In short, you have the final say when it comes to how—and when—you work.


  1. You’re your own boss. Sure, it’s a perk in some ways, but being in charge can be both a pro and a con. If you’re going solo, you shoulder the entire burden of running your business.
  2. It’s your responsibility to manage cash flow. Remember that part I mentioned (twice) about being your own boss? One more time for good measure: You’re in charge of all things financial, from bills and taxes to ledgers and receipts.
  3. Speaking of cash flow, your income might be inconsistent in private practice. This is a truth that all business owners must face at one point or another. If you lose a client, you lose a revenue source. With proper planning, this type of situation doesn’t have to be a nightmare, but it does require solid preparation for when it does occur.
  4. If you’re a solo practitioner and own your own business, you might find yourself spending a lot of time alone. If you don’t have a good support system or a network of fellow colleagues, this could be a depressing—or at the very least, stressful—work environment.

Next Steps

Once you’ve made your own list of pros and cons to starting a private practice, you may—or may not—be ready to begin your entrepreneurial journey. If you are, congrats! As you make your foray into private practice ownership, follow these tips for success, as adapted from this article:

  1. Set business goals, and create a plan. It might be tempting to jump right into the dream of having your own practice—complete with snazzy office space and a full staff. However, this dream might not be realistic—at least at first. Before taking the plunge, you might want to start treating clients out of your home on a part-time basis to get your feet wet (as long as your state practice act allows it).
  2. Prepare, plan, and prepare some more. You’ll want to make sure you have enough savings in place to cover at least your own health insurance or have steady income from a spouse or partner to supplement your own. And before you even think about treating patients, you must have liability insurance to cover all of your legal bases. Another safeguard you’ll want to have in place: a HIPAA-compliant documentation tool (hint: an EMR can certainly help fulfill this need).
  3. Grow your client base. Before you give up your full-time job, you’ll want to make sure you’ve got a steady stream of referral sources. Part of generating these referral sources is creating a brand and making it visible. You’ll want to put together some print collateral—like business cards—and create a website that’ll make your practice visible online. If you aren’t sure how to start marketing your practice, we’ve got tons of resources for you here.
  4. Figure out your payment model. To alleviate some of the stress that comes with owning your own practice, you might consider starting your clients on a cash-pay basis. From there, you can research payers and find out if the reimbursement rates are worth the contracts—or the compliance requirements. On that note, an EMR can help you stay compliant, especially when it comes to Medicare regulations.
  5. Don’t try to go it alone. As you begin this exciting new chapter, you’ll want to make sure you’re staying up to date on the latest industry trends. You can do this by consulting with your network of peers and colleagues. Additionally, you’ll want to rope in a lawyer and an accountant to help you manage all of the ins and outs of running your business.

Starting your own private practice might seem out of reach. But with some thoughtful consideration and proper preparation, the dream might not be as unattainable as you once thought. Have you considered opening your own SLP private practice? Share your story in the comments section below.

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