Preventing Burnout as an OT Entrepreneur :: Secrets From A Successful OT Private Pay Practice

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Many Occupational Therapists become entrepreneurs as a way to have more time freedom, more treatment freedom and more money freedom. It is a way to escape high productivity standards that often lead to OTs experiencing burnout. But, if you aren't careful, you can also experience burnout as an OT entrepreneur.


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There is nothing more exciting than Occupational Therapists seeking to escape the burnout that so many experience working in factory like practice settings that make unreasonable demands. But yet, if you aren't careful, you could experience burnout when starting your own OT private pay practice.

In this video, Doug Vestal, Ph.D., discusses 3 crtical things OTs can do to reduce the likelihood of them burning out when starting their OT private pay practice. Focusing on these 3 items are a must have for any Occupational Therapist looking to strike out on their own, remove the shackles of insurance companies, and create more freedom in their life.

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.

Transcript of Video:

Burnout is an epidemic that has been affecting occupational therapists hard for a while. 

Increasing productivity standards, less time spent with actual clients and more time spent documenting, stagnant pay with high student loan debt.

Its no surprise that more and more OTs are looking for ways to have more control, more agency and more freedom.

And that leads many OTs to go down an entrepreneurial path to become their own boss, set their own hours, have more say over their caseload and their pay.

But – if you aren’t careful, you can actually jump out of the frying pan and into the oven.  And your dream of being an OT entrepreneur may increase feelings of burnout.


You don’t want to replace you job working 40 hours a week with a job working 80 hours a week for yourself. 


So, today I’m going to share with you how we’ve been able to operate our OT private pay practice without experiencing burnout.


My name is Doug Vestal and I help OTs just like you start and grow thriving private pay practices.  My wife and I founded a very successful OT private pay practice in NYC and I make these videos so you can learn from our mistakes. 


So burnout is also sometimes called emotional exhaustion and there’s a lot of different signs: physical and emotional exhaustion.  Feeling cynicism at work – so called compassion fatigue.  And also blaming yourself.


What we see the most in ourselves and mentoring other OTs who go on to become OT entrepreneurs is the physical and emotional exhaustion.  Typically, OT entrepreneurs feel less cynicism at work because they are building the work place they want.


But – as an OT entrepreneur is it very easy to fall into the trap of over-work, overwhelm and end up very exhausted and depleted.


So – let’s talk about some key ways we’ve found at preventing burnout within our own private pay practice and what’s worked with the other OTs we mentor in our online course Private Pay MBA.


The first thing I’m going to talk about is slightly controversial in the OT community and that is money. 


One of the biggest culprits when it comes to burnout in general, not just OTs, is stress around money.  If you are struggling financially, under the weight of student loans or mortgages, or what have you, it is going to take a toll on your emotional well-being.


And, when a lot of OTs become Entrepreneurs they have a dream of being in more control financially but they make a really critical mistake in the very beginning.


And that is how they price their services.   Pricing your services has a ton of implications that really have to be thought through.


You really have to understand your numbers, and how it relates to your potential income levels, and work load.


Let’s take an example of an OT entrepreneur who starts their own private pay practice.  Well, if you are the sole therapist, the only time your practice is generating income is when you see a client.


And what we find is that many will price their services too low in the beginning without understanding the implications.  So what happens is, they price their services low, so then to produce the income they need and desire, they have to start seeing more and more clients.


The problem is that as the practice owner, they also are in charge of running the practice: seeing clients isn’t their only responsibility.  They have to do marketing, meeting with referral parties, put in place systems, policies for hiring – all these tasks that come outside of seeing clients.


And so, you absolutely have to account for this time when you price your services.  Your prices have to be reflective of the entirety of what it takes to deliver the service – not just your time with the client.


Otherwise, as you become an OT entrepreneur you will have just given yourself a job where you are the lowest paid employee by the amount of work you are doing.


And so, typically what we find is that if full-time as an employee was defined by working 40 hrs a week and maybe seeing 8 clients a day, as an OT Entrepreneur you need to factor only being able to see at most 4 or 5 clients a day so you can factor in the other work.  And your pricing should reflect this.


This is super important: it is the difference between you having a good lifestyle and income and working from 8-4 everyday without bringing home work for the evening or weekend versus another OT who owns their own business but is super stressed, overworked, underpaid and still exhausted at the end of the day.


The second aspect we’ve found for preventing burnout with OT entrepreneurship is building your team.

In the beginning, you likely will be doing everything on your own.  And that is fine for getting it off the ground.  In fact, that is the price most OT Entrepreneurs pay that others don’t want to.  It can be a lot of work in the beginning.


But, you have to look at your energy levels and the tasks you are doing and really ask 2 things:

  • Is this something that me and only me can do with my unique skillset?
  • Can someone else do this better than me?


And the number one mental shift to make is to view things from an investment mentality rather than a cost mentality.


Let me give you an example from our own private pay OT practice.  In the beginning, we didn’t have an assistant.  So all phone calls, all emails, all scheduling changes had to be handled by my wife.

In the very beginning, as we were starting off, that was fine because we were building our reputation so we wanted to provide a high touch service plus we were bootstrapping this so we just didn’t have the money to hire.


But, once we started getting clients, we transitioned to hiring an executive assistant who worked about 10 hrs a week.  She replied to emails, rescheduled clients, answered questions on the phone, etc. 

Yes – it cost us money.  But, we switched our thoughts about this cost to one of being an investment.


We now freed up 10 hrs a week in our schedule.  The investment was we got 10 hrs back.  We could work on the business during that time.  We could see clients if we wanted with that time.  Or, we could just lead more balanced lives because now were weren’t playing phone tag with clients after hours so we could actually put the work down.


This is a balancing act – you probably don’t want to hire too early because you might not really know what the tasks are for the employee plus have enough work to keep them busy.


But at the same time – don’t wait too long to hire help.  Your job as an OT entrepreneur isn’t to do everything yourself.  It is to generate money in your business so you can hire other people to help you.


Next, the 3rd thing to preventing OT entrepreneur burnout is scheduling.  There’s a lot of tasks for the owner.  And scheduling really becomes your BFF.

Tasks switching, where you go from say seeing a client, to then working on a marketing campaign, to then seeing a client again has shown in research studies to cause a lot of cognitive fatigue.

So – instead of task switching and having days that are just unstructured where you go from one thing to the next, unrelated thing, you want to really schedule and block off your time by activities.


So, to give you another example we had days where we saw clients and that’s all we did.  And then, on the other days we worked on business related items.


That worked for us.  But you may find that you see clients in the morning and work on business in the afternoon. 


The point is to be really intentional about it.


And critical is the plan your week out in advance.  Get super specific and say on Tuesday from 12 – 2pm I am writing the new community workshop.  From 2:30pm – 4pm I am writing the marketing material for the community workshop.


You will find that you get a lot more done with a lot less overwhelm because things will have their place in your calendar and it removes the cognitive stress of thinking “oh gosh  - this week I’ve got this to do, and that, and maybe I’ll sneak this in here, and so forth.”