More OT Freedom Through Private Pay

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Are you an occupational therapist who loves their clients but don't like the manner in which you have to do your job?  You can achieve more freedom in your life and still be the amazing occupational therapist you are.  You just have to change how you get paid.


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Being an occupational therapist doesn't mean that you have to burn the candle at both ends only to end the day completely burnt out. Many occupational therapists wish they could become class parent, volunteer at their kids school, take a Friday off to just do self-care, or even change how much they are paid to build financial freedom.

But many occupational therapists feel overwhelmed with never ending documentation, increasing productivity standards and treatment protocols that are dictated by a third-party. Something has to give because occupational therapists love helping their clients but find themselves not loving the manner in which they have to work.

In this video, Doug Vestal, Ph.D., discusses how occupational therapist can get more time freedom, more money freedom, and more treatment freedom by breaking the shackles of insurance and moving to a private pay model.

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:

See most OTs I know are super excited to join the field and to make an impact. That's why you became an occupational therapist, but typically I see this pattern repeat where once you get that first job, maybe it's in your first job. Maybe it's in your second job, but you start to hit a wall.

Hi, I'm Doug Vestal and I own Freedom of Practice, which helps occupational therapists like you start and grow thriving, private pay practices. And the reason why I make these videos is so that you have the opportunity to learn from the mistakes that my wife and I made when we founded our OT private pay practice so that you can have the shortcut to success.

And today I want to talk about how you make money. So occupational therapists, OTs, and money, it's a little bit of a controversial subject, but here's the thing.

There has to be a congruency between the way you make your money and the life that you want to live. These two things have to exist in harmony for you to be successful, for you to be fulfilled and for you to be happy and feel like you are living your best life. So I want to start by asking a question, which is what does freedom mean to you? What does having freedom to do things actually mean?

If you had the ability to do things, what would you prioritize? Would it be to be the class parent? Would it be to go on that vacation? Would it be to go in late on Tuesday mornings because you have a volunteer activity, right? Only you can ask what freedom actually means to you. Maybe it's working part-time in the summer while your kids are off from school, but you can still earn an income.

Maybe it is working towards your dream of financial freedom by paying off your student loans, by paying off your mortgage and saving for retirement. So let me ask you a couple of more questions around this freedom topic. Are you in control of your schedule? Are you in control of your time? Are you in control of how much time you spend in the hospital, the clinic?  Are you in control of what you can actually do during your treatment sessions? Are you in control of how much money that you can make? Are you in control of whether or not you can leave early on Fridays to join your kids recital?

Most OTs I know are super excited to join the field and to make that impact. That's why you became an occupational therapist, but typically I see this pattern repeat where once you get that first job. Maybe it's in your second job, but you start to hit a wall, right?

And the wall looks something like this. Your hours are really fixed. Something changes in your life. Like let's say that you have a kid, let's say your spouse or your partner gets sick. A family member gets sick and you start to require a little bit more flexibility. The documentation standards start to go up and up and you find yourself really kind of spending more time outside of a session, doing documentation than you are actually in the session. Or you're having to speak to insurance companies around plans of care, or you just have really high productivity standards that get placed onto you.

And you're not able to see either the number of clients you want to see, or you're not able to see them for the length of time that you want to see them. And so OTs are in this fascinating situation where they kind of love the job they're doing.  They love their clients that they're seeing, but they don't love the manner in which they have to work.

And for a lot of OTs, this may happen around the time that you have kids and you want to be a class parent. You want to show up and suddenly you start realizing, wait a minute. I'm spending all of this time at work. My hours are only increasing in the day. I'm having to do a little bit of work at night. I'm not able maybe to pick up my kid from daycare and I haven't received a raise really in the last two or three years. And all of that money that I'm making as an OT is going towards paying off student loans or paying for childcare, paying for someone else to take care of your kid. And a lot of OTs come to this conclusion of something just has to change.

I love the profession that I'm in, but it just isn't working for the life that I want to live. And so it's really no wonder that so many OTs just feel like they're treading water because in fact, you, you probably are just treading water, trying to get through the day, trying to get through the week.

So one OT, I spoke to said this, and I thought it was a fantastic quote. Was that the way in which she was being asked to work, just didn't work for her and her family anymore. And here's the thing. You are really just one decision away from making a critical change. So my mentor Richie Norton has this phrase, which is so true, which is that if you change the way you get paid, you change your life, change the way you're paid and you change your life. It's really that simple.

So this one decision, this decision about how to get paid. It's normally something that we really take for granted. We go through school, we you know, join the workforce in a traditional way. And we never really stopped to consider the manner in which we're paid or even think that it's a choice that we have, right. It's just kind of seems like it's the default, but this one decision influences so many other things. So how you get paid, the job that you, that you sign up for dictates not only how much you can earn, but most likely where you're going to live, what your hours are, what the protocols for the treatment sessions look like, what the documentation standards look like.

The free time that you have, the social circle that you're going to run in while you're at work. There's all of these other decisions that are already made for you once you decide how you're going to get paid. And that's why I say you're just one decision away from changing your life. If you change the way you get paid, then you have the ability to change all of those other factors.

So my wife and I, we faced this decision ourselves back in 2014 and we approached it a little bit differently. So we wanted her to be able to be class parent. She wanted to be able to drop the kids off at school, pick them up after school, volunteer on Fridays.

And so we knew if she took a traditional job in a hospital, if she took a traditional job at an outpatient clinic, she wouldn't be able to do those things. And we also wanted to have the ability to earn more money over time.

And so for us going the private pay route made the most sense because once we broke those shackles of the insurance company, well now the documentation is different. Your correspondence with insurance companies is totally different. That's now between your client and their insurance provider.

You now suddenly have control of your schedule. You now suddenly have some clarity around your revenue in the business because their client is paying you up front in either cash, check or credit or HSA at the time of service. So, you know, if you bill a certain amount, you are going to be paid in full that amount at the time of service.

And that leads to so many other knock on effects because now you're in control, you are in the driver's seat.

So we got control of, of our schedule. So she could be class parent. We got control of our finances and the revenue. She was able to work part-time and still earn six figures. We were able to weave in this work life balance all throughout building this private pay practice. So that's why we always say that the OT and the client benefits the best when you're able to see who you want, when you want, where you want and for as long as you want, because that's really the freedom to practice.

And all of this led to more freedom, more freedom of choice, more freedom of income, more freedom with her schedule, more freedom for designing the treatment. And that leads to a better work life balance, which doesn't lead to the same amount of burnout that many of her colleagues were facing.