How To Set Up Your Occupational Therapy Private Pay Practice For Success

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There are 5 critical things to focus on to set your occupational therapy private pay practice up for success from the very beginning.


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Many Occupational Therapist receive little to no business training in OT school. However, that doesn't mean you still can't start and grow a thriving OT business.

In this video, Doug Vestal, Ph.D., discusses 5 critical things to focus on if you want to set your OT private pay practice up for success.

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:

Starting an occupational therapy private pay practice can be intimidating.

When it comes to business, many OTs can feel like they have 2 left feet.

So, today I want to demystify how to set up your OT private pay practice for success.  Because, after all, who wants to set it up for failure?

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 successful OT private pay practice in NYC and I make these videos so you can learn from our mistakes and have success faster.  I think the world is a better place when OTs can treat how they know best without the shackles of insurance.  And I’m here to help you make that possible.


Alright, so you want to start an OT private pay practice and you want to make sure it’s set up for success.

Its easy to get overwhelmed with a checklist that has 97 items on it.  That’s all well and good, but sometimes we can get so stuck in the weeds and details that we lose sight of what’s important and why we started this in the first place.


So, let’s rewind ourselves just a bit and remember what’s important here about starting and running a private pay OT business.


We need to make sure we can survive financially – because without that the business doesn’t move ahead, we can’t provide the OT services, and we go back to having to work for someone else.  So that’s principle number 1.

Next, we need to make sure we are providing excellent care and retaining clients.  Without that, we have an empty shell of an OT practice.  But luckily, that’s probably what you are already really great at.  So that’s principle number 2.


And finally, we have to ensure we have a way of attracting clients.  So that’s principle number 3.


Sometimes we can make things so complicated, but operating an OT private pay practice really boils down to these 3 things: attracting clients, making sure we provide amazing care to them, and that we are financially sound so we can keep operating.


Doesn’t that make it seem a lot more attainable and less complicated?

Okay – with those principles in place, let’s cover 5 key things to set your OT private pay practice up for success.


And the first thing is don’t take on too much risk in the very beginning.  You don’t need to invest a lot of money in the very beginning.  You don’t need to go out and sign a 10 year lease in an expensive part of your city before even having your first client.

You really want to ensure that you are in a position to absorb some mistakes.  Because you will definitely make them.  Starting and growing a practice is a learning curve, and that learning curve is a lot easier, and a lot less stressful, if you are in a position to absorb mistakes.

So, what can you do to limit your risk and expenses in the very beginning? 


You can do things like starting part-time.  Keep your full-time job and work on your business in the evenings or weekends.


Or drop your full-time job down to 4 days a week or 3 days a week while you work on your business the other 1 or 2 days.


Instead of signing a lease and being financially committed, you could start by offering services in your client’s home.  That cuts your real estate cost to 0.


Or you could rent a space from another business where you only pay for it 1 day a week or half a day a week.


And that leads me to the second item. 

You should really know your numbers.  You want to make sure that there is alignment between your income goals, the rate you are charging and how many clients you can actually see.  These things have to work in harmony with one another.


Running your numbers doesn’t need to be complicated and you really only need a 1 page business plan to get started.  If you haven’t watched it, I have an entire video on how to write your 1 page business plan.  I’ll add a link to that video in the description.

And when you go through this 1 page business plan, not only make sure your numbers are aligned with your goals but that there’s room for growth.


Alright – the 3rd thing you need to set your OT private pay practice up for success is, in the beginning, pick just one person to serve.

You’ve probably heard the advice before, but you need to niche down and find your ideal client.


Who is the person you are uniquely drawn to serve?  Getting specific on this is incredibly important.


My wife, the OT, is a pelvic floor therapist.  As a pelvic floor therapist she could see adults, see could see kids.  She could see men.  She could see women.  She could see athletes.  She could see geriatric clients.  She could see clients recovering from prostate surgery.

The list is really endless and I’m sure it is for your OT specialty as well.

But, we decided to focus solely on seeing pre and post partum people.


This was incredibly important because we could go very deep on attracting this type of client.  It focused our efforts. 

If you are too general then no one will know its for them.  You want to get so specific that when someone hears what you do they raise their hands and say “oh, that’s me.”


Let me give you an example from pelvic floor therapy.  When you are very general you advertise community workshops with titles like “Learn what your pelvic floor is, what it does, and how it affects you.”


Its super generic.  No one knows what that means or why it should be important to them.  We have to step into their shoes.


But when we geared everything to our postpartum population, we now were offering community workshops titled “How to deal with low back pain, pesky leaking, and painful intimacy after you’ve given birth without spending countless hours at the gym or needing to take pills.”


Boom – it was so much more specific.  It attracted people to our workshops in droves, and because we were specific by using phrases like “after you’ve given birth” it only attracted those clients who we wanted to work with.


Fourth, focus on client retention.  You will hear a lot of practice owners say that their big focus is on attracting new clients.

But, I always think, what about your existing clients?  Retaining your current clients is a lot easier, and a lot less expensive than attracting new clients.

And for this, you need to really realize that in each session you have with a client you are convincing them of the importance of the next session with you. 

You can’t take it for granted that just because they need another session that they will actually show up and continue their plan of care.

Some people lose motivation when they get to 70% of their goal and can drop off from your schedule.

You want to make sure that doesn’t happen and that they complete their plan of care.

So bringing your language back to their goals in each session is vitally important.  They need to see the work being connected and how the next session is going to push them even further.  You’ve got to make them excited about it.

And then, you should be following up between the sessions to check in.  Call them and ask how their exercises are going and answer any questions they have.  Email them a new adaptation to an exercise. 

Send them 48 hour appointment reminders.  Stay on their radar.

Put a system in place for follow up and communicate between appointments and you’ll see no shows dramatically drop.

And the last thing that’s critical for setting up your private pay practice for success is having a marketing plan in place from the very beginning.

Yes, client retention is important, but you need to also focus on attracting new clients.

Word of mouth is important and if you are providing good services, it should comprise a lot of your new referrals.

But, even if you have good word of mouth, you shouldn’t ignore having a marketing plan.  Word of mouth can be fickle.  You can have times where you get a lot and then periods where there is a lull.  Word of mouth is the best form of marketing because people will trust their friend the most, but ultimately, you as the practice owner don’t have control over when it happens and how often it happens.


So, having a marketing plan in place that’s steady, that’s consistent, ensures that you are generating new clients regularly through a means that you have control over.


And your marketing efforts should focus on educating your ideal client, the one you got super specific on for step 3.



Don’t just focus on the problem, but connect it to a deeper desire they have.  Focus on the problem behind the problem.


What is their problem preventing them from doing?  Focus on that.  So, as an example, with pelvic floor therapy a common symptom is urinary incontinence.


If your ideal client is someone who does tennis, you wouldn’t just put out information like 10 ways to stop urinary incontinence.  Instead, you’d make it more specific to your population and what problem the problem is causing. 

So, in the case of tennis you could say “10 ways to stop leaking so you are back on the court this Spring playing doubles again.”


See – it connects their problem to the problem it is causing in their life.  Yes, of course they want to stop leaking – but most people have a stronger desire to get back to the thing they were doing they loved.  So, it’s much more powerful to incorporate the two and draw that connection directly in their mind.