Life in the Private Practice World- What I Have Learned in the Last Year

It has officially been one year since I left my amazing contract company: Staffing Options and Solutions (SOS) and placement in a private school that treated me like family to pursue a full time commitment in my private practice at my home.  Why would I leave such a seemingly great situation you ask?  Truth be told:  my private practice forced me into making that decision.  Running a one man show keeps me busy and I found myself unable to follow-up on insurance calls and offer daytime treatment slots while commuting an hour round trip and working three days a week at a school.  There simply were not enough hours in the day to run an efficient private practice, especially since most insurance companies close when I would be in the middle of afternoon treatment sessions.  So, after working in the schools and early intervention settings for a couple decades, I took a leap of faith and quit working for someone else.  I'll never go back either; as much as I miss the last school placement that I will ever work in, I just don't see myself going back to work for someone other than myself.  I realize that I am fortunate to have the ability to venture into the private practice world and I'm grateful that I can finally provide speech services that not only fit my brand, but also allow me to have a home/life/work balance that I feel like I've been looking for my whole life!  After thinking about this past year and reflecting on all that I have accomplished, I outlined eight things that I feel significantly contributed to the success of my practice in my home.  In no particular order, here are the top eight things that brought me good fortune.

1.) Way before I left my school job, I started using an EMR billing software: Therabill.  I first heard about this company at an ASHA Business Fair that I attended in Nashville.  I liked the price tag on the service and I especially liked the idea of submitting claims in three, simple clicks!!  I cannot tell you how much time I have saved and how many errors I have avoided by using Therabill.  Their customer service is extremely helpful and they even created a Facebook group to further answer questions.  I also use this software to schedule clients, print invoices, write evaluations, and send appointment reminders.  I highly recommend researching companies like Therabill and trying the one that works for you and your business.

2.) Before I started taking private clients, I spent months, and I mean MONTHS, applying for insurance network participation.  I found that being in network with most insurance companies has brought me far more clients than I would have otherwise serviced.  In fact, most of my new referrals come from network participation.  In my neck of the woods, I'm surrounded by several therapy clinics, all of which are in network with most major insurance companies, so in order to stay competitive, I found it necessary to join networks myself.  That being said, I had to terminate one contract that wasn't worth my time and all the hassle, but I do not regret at least participating in that network for a couple years.  One of my very first clients had that coverage and could only work with me because I could submit in-network provider claims.  That client has brought me two other clients and those referrals have led me to more clients. At some point though, I knew my limits and I had to terminate my participation.  A word of advice for anyone who accepts in-network insurance coverage, call them and tell them that you are considering leaving the network or ask for an increase in your reimbursement rate, especially if you have been in contract with them for some time.  It was my experience that if you don't ask, you won't receive!  You may be pleasantly surprised by their response!

3.) The greatest thing about moving my private practice when we downsized homes last summer was finding a space that I could build my practice around instead of trying to fit my office and materials into an established setting.  I gained a blank slate and changed the carpet, wall colors, and added a wall where there were French doors leading into our family room.  I also love that clients enter my home and head straight down the hallway to my home office space.  No more darting after little ones jumping on my couch in the family room or chasing kids around my kitchen table.  We get right down to business faster than you can say:  I love speech therapy.

4.) If you are an SLP, then storage is key!!  Having that blank space without closets gave me an opportunity to purchase custom cabinets to store all my supplies within reach during my sessions.  I spread all my inventory out and decided how many shelves, containers, and hangers I needed for my master plan.  Instead of storing toys in three or four giant tote bins and stacking them in a closet, I gained the luxury of taking all of my toys and materials out of over sized bins and displaying them on shelves or sorting them into easy to reach opaque, categorized containers.

5.) Working in private practice means setting your own rules.  I'm happy with my hours of operation, which I edit in the summer to allow me time for bringing my son to daily swim lessons and Fridays off for fun time!  I also have a strict rule about no weekend hours.  Saturday and Sunday are and always will be reserved for family time.  I only take a couple hours on Sundays to prep materials and print lesson plans for each client.

6.) Ever since I initiated and successfully orchestrated a speech and language pool group for Hasbro Children's Hospital's early intervention program in Rhode Island more than a decade ago, I have dreamed of putting together another group at the pool. This summer, that dream became a reality when I partnered with Rush Copley Hospital's Healthplex in Aurora, Illinois.  Not only did my clients enjoy the six week session, but caregivers and even an older sibling had a blast as well.  I even gained a couple new clients by marketing the group!  Winning!!  ASHA recognized my success too because they interviewed me about my pool group for an, "In the Limelight" article to be released in December.

7.) Having a home office means finding a balance with work, calling insurance companies, making meals, and doing housekeeping.  I'm not one for hiring a cleaning service and it would be challenging having this service in my home while protecting client confidentiality.  So, I toured Pinterest and found a routine that works for me.  I wanted one big job a day that I could accomplish before walking my son to school and I found one that has worked wonders over the last few weeks.  Now, I can stay on top of laundry, vacuuming, dusting, mopping floors, and cleaning the kitchen without letting all the work pile up or consume too much of my time.  This is the schedule that I found, but there are tons out there to explore if this isn't the right match for you.  I'm still working on the dinner planning thing though and may give Hello Fresh a try since my blogging buddy and working mom from Simply Speech, Kristin Cummings, raves about it.

8.) When it comes to networking, some things worked and some didn't. Ironically the ones that were successful were also free of cost!!  Renting space at fairs like special education or back to school events did not yield a single, new client.  I even volunteered as recording secretary on a district wide special needs PTA and didn't generate any new opportunities.  I don't regret these decisions because I still helped people learn more about my services and got my name out locally.  However, networking with other neighborhood SLPs, connecting with an OT practice within a couple miles from my office, and good, old fashioned word of mouth referrals brought me much of my caseload.

If you are thinking about taking the private practice plunge, then I hope that this post provided some insight and encouragement!  More informative resources can be found by purchasing materials from The Independent Clinician at the link on my blog wall.  I'm also happy to answer any questions that you may have in the comments section below or via email at nanettecote@gmail.com.