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If you're an Occupational Therapist yearning for more freedom - treatment freedom, time freedom, and financial freedom - then this video is for you! Discover how to build a strong client base for your private pay OT practice and break away from the constraints of insurance-based work.  

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Forget about trying to juggle a thousand tasks to attract clients willing to pay out of pocket. This video simplifies the process by honing in on key elements that will yield the most significant results for your practice.

In this video, Doug Vestal, Ph.D., shares the 2 areas you should be focusing on to build your caseload for your OT private pay practice.

This video is not intended as professional or legal advice. Be sure to seek the services of a professional and understand the risks you are undertaking.


You are an occupational therapist who has incredible skills.  You know you can help people.  And you want to get away from the restrictive world of insurance companies and build your OT private pay practice to give you more treatment freedom, time freedom and money freedom.

But, how do you build a client base for your private pay practice?  How do you fill your calendar with clients who are happy to pay for your services?

So stick around – because that’s exactly what I’m going to show you today.  How to build a client base for your private pay OT practice.

I am Doug Vestal and I’m the founder of Freedom of Practice which helps OTs gain more treatment freedom, time freedom and money freedom by starting thriving private pay OT practices.  My wife and I started our own OT private pay practice in NYC in 2014 and I make these videos based on that experience to help you avoid some of the same mistakes we made.

Alright, let’s jump right into how to attract clients for your OT private pay practice.

I find that many times it is easy to overcomplicate the business part of an OT private pay practice.  And it is easy to get overwhelmed thinking that a.) it is going to be super hard to attract clients and b.) that you need to be doing a thousand and one things to attract clients willing to pay out of pocket.

But, that’s just not true, and in fact, just focusing on a few key things, and ignoring everything else, is going to give you the vast majority of results.

Your OT "Niche" Allows You To Attract Clients

If you want to attract clients to your OT private pay practice then you have to get super clear on who you help and what service you provide for them.

You may have heard of this before as being your “niche.”  And honestly, when we first starting thinking about opening our OT private pay practice this idea of picking a “niche” just seemed overhyped.  It seemed like a made up marketing term that you could just skip.

But really, a niche is just getting super clear on exactly who you help, what you help them with, and why your service would be important to your client.  Doing that allows you to connect with your potential clients in a way that resonates with them by putting what you do in context of what it means for your client’s lives. 

The average American watches 7 hours of media a day through TV, social media, etc.  The average person sees over 362 ads a day but registers just 3% of them.  That means we are ignoring a whopping 97%.  And Microsoft did a study which showed the average attention span is about 8 seconds.

So, why does this matter to you and to your OT practice?  Because, just like you, your clients are a.) super busy and b.) overloaded with information.

This means that if you are vague about what your OT practice does, how it does it, and why it’s important to your client then you’ll just be part of that 97% that gets ignored.

And that’s no good for your OT private pay practice.

Getting super specific means that you can craft a message about your practice that makes you standout.  It makes you unique.  It makes you memorable.  It creates desire in the mind of your OT clients.

If you are vague then you will get vague results.  There’s a great saying “what happens in vagueness, stays in vagueness.”

This clarity becomes the strong foundation on which you are going to build your caseload.

Okay, so let’s say you get super clear on who your OT private pay practice serves, what it is you do for them, and why it is important for them. 

What do you do next?

Focus On Just Two Activities To Build Your Practice

Look, I am not going to be giving you a list of 15 different things to do that we know is impossible to achieve.

In fact I’m not even going to tell you to do 10 things, or 5 things, or 3 things.

Just focus on 2 things. 

The first is focus on how you are showing up in your community.

The second, is giving value to prospective clients before they ever even book with you.

You’ve probably heard about the 80/20 rule, also known as the Pareto principle.

It basically says that 80% of your results will come from 20% of your effort.

And, if you apply the Pareto principle to itself, you get that 64% of your results come from just 4% of your effort.

As an occupational therapist looking to build your caseload of clients I want you to apply the 80/20 principle or the 64/4 principle to what you are doing.

And that means really focusing your effort on just these 2 things: how you are showing up in your community and the value you are giving to prospective clients before they ever even book with you.

If you focus intensely on these 2 activities you can attract your OT clients faster, operate your practice with a lot less overwhelm and start to build a practice that works for your life.

Focus On How You Show Up In Your Community As An OT Practice Owner

As an OT private pay practice owner, what does focusing on how you show up in your community mean?

First, it means recognizing that you are a valuable member of your community and that relationships in your community is the best way to grow your practice.

But, many people overlook this.  They get obsessed with posting to IG all day, or to Tik Tok or trolling Facebook.  Or if they aren’t posting they are guilty of consuming a lot of social media content.

Various studies have shown that the average adult spends more than 2 hours a day on social media.

Trying to find your OT private pay clients on social media is like going to the middle of the ocean with a cheap fishing rod, a little bit of bread on the hook and dropping it off the side of the boat.

You just aren’t going to get the results you want for your OT private pay practice.

This doesn’t mean that you can’t do social media as part of your efforts but it shouldn’t be the primary focus and it shouldn’t distract from something that is much more powerful and impactful to your practice.

Focus On Building Relationships In Your Community

Instead, focus on building real life, in the flesh, face to face relationships in your community.

Your real life face to face relationships for building your OT private pay practice should have 3 components.

Number one, a robust outreach to potential and existing referral relationships.  Your perfect clients are already interacting with other practitioners in your area.  Go build strong relationships with the exact people already interacting with your future clients.

Imagine you get in with an aligned doctor or a teacher or another aligned practitioner who is interacting with 20 or 30 of your ideal clients each and every day.  Now imagine you have 3 of these relationships in place. 

All the sudden you’ll have more referrals than you can handle.  This is much better than randomly posting on social media and hoping to reach clients.

Don’t hope to reach clients, go where your OT clients already are. 

Do a time study of your week.  How much time last week did you spend interacting with potential or existing referral relationships?

What can you remove from your schedule to prioritize reaching out to them and fostering and nurturing a relationship?

I have an entire video on how to build strong referral relationships and I’ll link to that video below.

Focus On Giving Community Workshops To Build Your OT Private Pay Practice

Part of establishing your OT private pay practice in your community is offering community workshops.

Community workshops are the perfect way to get directly in front of your ideal clients, be seen as an authority in your subject, but also help them directly with a problem they are facing and give them value before they ever even book with you.

You should be looking to do at least 2 workshops a month until you find yourself so busy that you don’t think you can continue doing them.

We offered community workshops regularly in NYC and it was one of the number 1 ways that we got new OT clients.

Offering community workshops for your OT private pay practice not only gets you known within the community itself, but also deepens the relationship you have with the business owner whose space you are using.

Offer your OT private pay community workshops in spaces that are aligned with your business.

So for us, working with the pre and post natal population we offered workshops at a pre-natal yoga center, at doula collectives, at OBGYN offices among others.

Not only did we attract our ideal clients, but we were partnering and furthering the relationships with potential referral sources in a very natural and mutually beneficial way.

Position Yourself As An OT Leader In Your Community To Attract More Clients

Being seen as a leader in your OT private pay practice is a great way to build your caseload.

And the easiest way to do this is to start a group that meets regularly.  And the people you are going to invite to this group are aligned practitioners.  People already interacting with your ideal clients.

And the purpose of this group is to meet monthly as professionals to discuss topics that are relevant to all of you.  It is kind of a “study” group if you like.

In NYC we had a monthly “pelvic health study group” we started and we invited other OTs, PTs, doulas, yoga instructors and fitness instructors.

And the entire purpose was to connect around client case studies, host speakers for continuing education topics and build community as the practitioners who were interacting with similar clients.

Starting a group as an OT private pay practice owner gives you a natural reason to interact with aligned practitioners.  It positions you as a leader in the OT space you are in.  It allows you to help other practitioners in your area and they will be much more likely to refer clients to you because you’ve established a relationship with them.

Everyone craves community.  Create that with other aligned practitioners in your area and you will see your bookings soar.

More OT Clients Will Book With You If You Give Them Value Ahead Of Time

The second thing I want you to focus on is the value you provide to prospective clients before they ever even book with you.

Helping your potential OT client solve a problem that is important to them before they ever book with you is a long term winning strategy to filling your private pay practice.

The best way to market your practice is by being helpful.  Give value.  Get them a small, micro result that allows them to get to know you better.

It can be risky for your clients to jump right in and book right away.  They will be concerned about the cost.  They will be concerned about whether or not you are the right person to help them.

But when you get them a result ahead of time, those fears are assuaged and they are much more likely to book with you.

Get your prospective OT clients results ahead of time by focusing on community workshops.

Get your prospective OT clients results ahead of time by making educational videos on common problems you see and things they can try at home.  Those videos should go up on your website.  And, you can splice up those videos to use for social media.

Get your prospective OT clients results ahead of time by creating an educational marketing material.  Things like an e-book, a report, or an exclusive training.

Create that once and put it on your website as a download where they have opt in with their email address to receive the information.

This is great because when they opt in to receive this information you know that they have that problem.  They have self-identified.

So, if you work with new Moms and you have a free C-section massage video, when they raise their hand to receive that you know they’ve had a c-section.

Or, let’s say you work with children, and you have a free 5 part at home exercises parents can do to improve handwriting.  Guess what?  When the parent downloads this you know that one of their struggles is on handwriting.

In both these examples the power is in a.) you are helping them with a problem they have and b.) they self identify as needing that.

This allows you to get so much more specific with that person.  You are no longer talking to a stranger.  You are now talking to someone who has a problem you know you can help.

And because they gave you their email address you can now follow up with them.  And don’t just pitch them to come into your practice.

Give them even more value.  Because you know what the problem is they are facing, you can get even more specific with your tips, recommendations and insights.

And then you can gently start following up with them and asking how they are doing.

And you will find that they will reply and asking you how they can book with you.

So focus on building your community.  Focus on providing value to your prospective clients before they ever even book with you.

Those are the secrets to filling your OT private pay practice.