His mother, looking overwhelmed said, “Do you treat private patients?”
I took a breath. It was the question I had been waiting months to hear. “Yes, I do.”
She exclaimed, “Wonderful! How much do you charge?”
My head kept saying, ’100! 100! 100! 100!,’ but my mouth said, “I charge $80 per hour.”
And So It Started
Months prior to this fateful day, I had been becoming more and more interested in the prospect of developing my own private patient business. I had watched two of my SLP colleagues grow their practices to their desired levels. They were both working part-time at our work so they could have benefits and colleague interaction- otherwise they were making nearly double the income in half the amount of time with their private patients.
I was three years out of graduate school at that time. I had gained both knowledge/skills and also the confidence to feel that I was truly worth $80 (or $100!) per hour. My colleague Rick said, “Someday soon someone will ask and you simply say, ‘Yes.”
A Conflict of Interest?
My first private patient was a two year old boy who had been born extremely premature and was now presenting with many developmental delays. There was a conflict of interest at hand: I was evaluating him at the hospital where I worked. At the time, my schedule was so full that I could only offer them therapy once per week. They were interested in the private therapy to supplement his treatment and to help increase the chances of carryover in the home. While part of me felt uneasy about this, I told them that as soon as I had more openings on my schedule, I would offer him a second slot at the hospital.
A few weeks later, my schedule at the hospital opened up and as promised, I told the mother that I could now see him twice weekly at work and we didn’t have to continue privately. (The part of me that was enjoying the extra cash was a little sad about this- but I knew it was the right thing to do.) To my surprise, the mother said, “What if we continued once weekly at your office and increased private therapy to twice a week?” As the little boy was very complex, she found that he was more comfortable in the home and felt that he was making more progress there.
* On a side note, money was not an issue for this family and I think the mom liked the added convenience of my coming to her.
I felt like although the makings of a conflict of interest were certainly present, I offered all of the choices to the family and they chose to do both private and insurance based therapy. I know that private patients are like customers: they need to be informed of their options and they make the best decision for themselves/their families.
Lessons Learned With My First Private Therapy Client
I saw my first private patient for several months and then the family moved out of state. To be honest, the family was turning out to be a bit strange and I was somewhat relieved when they told me of their plans to move. I would have referred him elsewhere if they had not moved.
I learned quite a bit about myself during this experience:
- Don’t sell yourself short. While it’s okay to charge a bit less your first time, make sure you charge what you feel your services are worth.
- Don’t pass up opportunities! The opportunity to treat my first patient fell into my lap. (Okay- I had been waiting for months) If an opportunity comes along, say “yes” first and then figure out the details.
- Get advice from mentors. If you’re lucky enough to have colleagues who are successfully treating privately, don’t hesitate to ask them about their practices. I’m sure they will have some valuable tips to share.
- Don’t conflict with your employer. Make sure that by treating the patient you are not taking away business from your employer. Give the patient/family the available information and then let them choose.
- If you’re feeling uncomfortable, refer on. Just as your private patients make a choice to see you, you have the choice to see/not see them. Be careful though- don’t dump odd families on fellow clinicians without a heads up. No one likes that
Jena H. Casbon, MS CCC-SLP is a speech-language pathologist and private practice consultant. She started her own speech therapy private practice in 2006. She is the founder of The Independent Clinician and author of The Guide to Private Patients and The Guide to Creating a Web Presence for Your Private Practice. Since 2008, she has helped thousands of clinicians get the flexibility, income and freedom they desire from starting their own private speech therapy, occupational therapy and physical therapy practices.