Top OT Private Practice Mistakes

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We made a tons of mistakes starting an occupational therapy private pay practice - including wasting tons of money on a certain type of activity.


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For Occupational Therapists looking to open their own private pay practice there can be a huge fear of making mistakes. And that is totally understandable.

But making mistakes is part of the process - its how you learn what works and what doesn't.

In this video, Doug Vestal, Ph.D., discusses the top mistakes he and his wife made when they opened their OT private pay practice back in 2014. These 3 mistakes are easy to have happen to you and luckily, also easy to avoid.

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:

When my wife and I opened our private pay practice in 2014 we had more dreams than knowledge. 

We didn’t even know where to start.  We knew that private pay was for us because we wanted the freedom that came with having a private pay practice: more time freedom, more money freedom and more treatment freedom.


But, if you are like my wife, I bet you didn’t have a single class on business in OT school, am I right?


I’m Doug Vestal and I help OTs just like you start and grow thriving private pay practices.  And I make these videos based on what we’ve learned owning our own OT private pay practice so that you can have the success you want faster.


Okay, back to the mistakes.  And so, we made a huge number of mistakes along the way.  And, since we’ve been coaching other OTs on how to start their own private pay practice we’ve encountered that many OTs want to start their own business, but they are afraid to start, they are afraid to make a mistake.


You can have this huge passion, but then get a deer in headlights look when it actually comes time to take that leap.


So here are 3 of the top mistakes we made when we opened our private pay practice.


Mistake #1 was not being intentional about our marketing.  In the beginning we were primarily focused on marketing to doctors.  We thought this was the best thing to do – afterall, it seems logical that doctors would refer to us.


And this is true, except not all doctors and their practices are the same.  We encountered doctors who were set up more like a factory and so when we’d approach them we would often hear from the receptionist that the only way to get in front of the doctor was to buy the entire office lunch.


Seriously – a doctor making 6 figures wanted someone to buy him a sandwich to talk to him.


At first, we were quite surprised but thought, that maybe we just didn’t know any better.  So we did a few of these and it was completely underwhelming.

We’d spend like $200 on buying lunch for the whole office and you’d get like 5 minutes with the doctor who was completely stressed and half paying attention.


It was a complete waste of time, money and energy.


And over time, we came to realize that there really need to be a synergy in how a doctor ran their practice and the ethos of how we ran our practice.  If this synergy wasn’t there, if there wasn’t an overlap in the ethos, then they just weren’t going to be a good referral source.


And so we started to become a lot more discerning on how we did our marketing which made all the difference.


And that’s why we teach more effective marketing strategies in our course, Private Pay MBA, which we learned the hard way on how to really target referral sources that are right for your private practice and avoid the people who aren’t a good fit for your practice.  We teach an entire section on client life-cycle in Chapter 4 which really allows how to hone into who is going to be the best referral sources for your practice.


Mistake number 2 was we took too long to be intentional about scheduling.  And here’s what I mean.  When you first start your private pay practice, you will be so happy to get your first clients.


And, the natural tendency is to want to bend over backwards to accommodate their schedule. 


But, before you know it, your schedule is going to be filled with more holes than swiss cheese.  You will have a client at 9am on Monday and then 1pm that afternoon.  And then on Tuesday you’ll have 2 clients in the morning and then a long break and one client at 4pm.


And all the sudden, because your clients are so spaced out, you can start to find that that “in-between time” is really wasted.


And you’ll never get that time back but luckily there is a solution.


That’s what happened to us.  My wife was doing home visits in NYC and in the beginning she would have a client in Brooklyn in the morning, followed by a client on the upper west side at lunch, and then another client in battery park city at the end of the day.


And if you know NYC, these places aren’t actually close to one another.  And so she’d be running herself ragged getting from one appointment to the next.

And this commute time she’d never get back and it was unproductive.  She’d have just 3 or 4 clients but no time to work on the other stuff.


And I find this true of my mentoring students as well even if they don’t have a mobile practice.  They will let the clients dictate the time to be seen rather than what works best for them.


And I get that, in the beginning, as you build up your reputation it is easy to have this desire to be very accommodating.  But what you’ll find is that that time in between clients isn’t actually productive time.


And so what we always recommend is to pack your client in.  Start by just offering 1 day and fill your schedule.  And put the appointments back to back.


If you are going to see 3 clients in a day, it is better that they are all in the morning so you can see clients, be done with that, mentally move on, leave that client energy behind, and step into the other types of tasks you need to do in the afternoon.


That is much better than trying to do marketing or something else during the 90 minute break you have in between clients. 


You’ll get a lot more done as you’ll be able to focus and do deep work.


So, eventually, for us, we started offering appointments only in certain neighborhoods on certain days of the week. 


And clients totally understand this. 


When you call the dentist or one of your doctors, they don’t really allow you to dictate when you come in.  They tell you what’s available and then you work around it and don’t think much of it.  Your clients will be the same way.


And mistake number 3 is we waited too long to hire someone to help with booking and calls.  In the beginning, you will probably have more time than money.  And so you won’t mind hoping onto a call with a potential client and talking with them.  In fact, it will probably be something you will enjoy.


But, eventually, as more and more clients start to call, this is going to take more and more time and energy from you.  You’ll end up playing phone tag more and more because you’ll be busy when they call you back because you’ll be in the next client session.


That was our experience and we probably waited a little too long to hire an assistant who would call potential clients back, answer their questions and get them scheduled.  And we trained this assistant on all the standard questions they may get.


This ended up being a huge time saver and stress saver.


And you may be thinking that this is a cost you can’t afford.  And I totally get that.  But, at a certain point, you will start to see this as an investment rather than a cost.


You will get more of your time back and won’t be encumbered by administrative tasks that someone else can do.  And they can do them well which allows you to focus on treatment or growing your business.


And this is one of those areas where its important to differentiate between working in your business versus working on your business and stepping into your role as a CEO.


And that’s why in our online course Private Pay MBA we have an entire chapter, chapter 6, on leaning into your CEO role as a private pay OT business owner, how to structure your time, how to set goals, and how to monitor the health of your business.