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Writer's pictureKaren Peabody, LICSW

How spending more and reducing my clinical hours made me more successful.



I've been at this private practice thing for 7 years. I opened in 2013 and I was renting out a 3 office suite. I asked (or begged) a few therapists to rent a room from me. One might think it was a savvy business move to diversify my income, but to be honest I just did not want to be alone. Before long I was overwhelmed with paperwork, behind in my billing, screwing up my accounting and not returning potential client inquires. I was making enough money to keep afloat, but I had no plan to keep it going. It wasn’t awesome. Professional reinforcements were needed immediately, but I did not want to spend my hard-earned money in that way. Let’s not talk about the unthinkable...using my billable hours and not seeing clients!


What I failed to understand was that I was not financially invested in my business. I looked at paying for these services as a defeat. I thought that I needed to pay someone else to do tasks because I couldn't keep it together.

What I realized was that I needed to stay in my lane... which in this case meant being a therapist.

If I started to assign the task that I knew little about and let professionals handle these tasks, I was making more money, even if I had the extra expense of paying them.


I have a team now: my accountant, my SCORE mentor, my biller, my office manager and my marketing designer. All of these gems bring their expertise, energy, and ideas to my office to make this business thrive. My first hire was an accountant. This was painful. To be truthful, sometimes this relationship still is. I have a lot to learn about accounting. He has taught me smarter ways to spend money, which ends up saving money. I can see the results as he provides the structure. I still don’t know what he is talking about a lot of the time, but I do what he tells me to do and we make it work.


My second draft pick was my SCORE mentor. Frank is super special because he volunteers his time for me. Essentially he is OZ in my Emerald City. He is the brains of the operation. He keeps things organized, linear and functional. He holds me accountable for the decisions I have to make or fail to make. He is just a phone call away. People often remark that my business structure is so smart, and I usually feel pretty guilty accepting the praise because it is all Frank.


Next comes Kim, my office manager, personal assistant, personal organizer, quasi therapist, expert problem solver and the muscle behind the operation. She goes through the emails, pays the bills, communicates with the therapists and cleans the office. You probably want a Kim and I don’t blame you.


Last is Tina, marketing guru, tech support, content advisor and yoga instructor (complete bonus). Tina has been my most recent find. She develops my online presence. I am not sure I ever thought I would need such a thing, but guess what! We probably spend 1 to 2 face to face hours a month to hash out what we want to do and how we are doing to it. Probably the very best thing she always says to me is, “Don’t worry, I got you!”.


Long story short... YES, I take time out of my clinical practice and YES, I pay more money out to develop my team, but it works. Currently, I run my office with 9 therapists (plus 5 waiting to join), 2 office buildings, 1 realty company, and another pending consulting company. My original plan was about renting an office space or two and seeing my clients. My team made my plan way better! Trust me, I got you!


Karen Peabody, LICSW is a therapist and business consultant for social workers and therapists interested in starting their private practice. She founded Forgewell Solutions in East Bridgewater, MA. Her office is a great place to start a private practice. Visit her FOR THERAPISTS page to learn more.


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