In August 2018, I finally made the transition from being a home-based SLP to working from an office. I was excited for this next step in my private practice. Now that I was no longer traveling from house to house, I could reap the benefits of my new, more stable setting. I was ready for my evaluations, consults, and therapy to be exactly how I pictured them since making the transition from mobile to office-based treatment.
The growth I had experienced in mobile therapy was eye-opening for me. I didn’t realize that being mobile forced me to decompress and take a breath between clients. There was physically only so much distance I could cover each day before my clients were getting ready for dinner and then bed. You could say I was forced to have a manageable caseload.
Once I was in my office, I enthusiastically started marking my availability for online appointment requests and new client calls. Now that I wasn’t driving between different counties and neighborhoods, it appeared at first glance that I had all this room for new clients. This was partly true—but eventually, that mindset led me down a really dark rabbit hole.
Navigating the Learning Curve
I definitely had available appointments. And I filled them—quickly. There are ebbs and flows with scheduling, as all private practice clinicians know. As a speech language pathologist, you start to see the pattern: Summer slows down, but in back-to-school season, the phone starts ringing.
Before I knew it, business was booming, and I was easily seeing between eight and eleven kids every day. I was also so enthusiastic about getting and keeping clients that I scheduled those appointments back-to-back—which gave me little time for that necessary breather between sessions. I specialize in childhood apraxia of speech, so treatment is intense and very individualized. Having so many intense sessions each day eventually led me down that very familiar, exhausted path I had been dealing with back when I was mobile. I was starting to feel burnt out.
But I kept denying the burnout. “You should be thrilled!” I would tell myself. “Business is great and your clients come to you. This is what you wanted!” And to a point, that was true. The practice I was building was the one I had wanted. I was using this reasoning to justify my heavy schedule, and kept doing that for about six months. I had a real fear when it came to turning away clients. If I wasn’t able to schedule someone at their desired time, word would get around, right? Finally, I came to understand that while my office was a dream come true for me, that didn’t mean I had to book every minute of my day to provide the services I wanted to.
Finding the Right Balance
I had always intended to be a solo, reputation-based clinic. I wanted to be the person families called for my speciality, and I wanted to have a referral network of current and past clients, as well as other healthcare providers. I wanted to be known for the treatment I provided, not as a therapy factory with too many clients squeezed into a day. And for a while, that was working for me. But as I started to feel more burnt out, I started to wonder: What if I had help?
What would that even look like? Did I need a receptionist? Did I want another speech therapist to help split up my sessions? Or should I start working with an occupational therapist, and offer a more holistic approach? At the same time, I know that my vision for my practice was for it to be a solo one—not a huge group practice with multiple clinicians and weekly staff meetings.
I had a colleague at the time who was my resource for everything about being a woman-owned small business. She had started her own mental health practice years before, and her business was thriving with several independent contractors working for her. I started to relate to everything she would tell me about her scheduling issues—similar to my own—and what it took for her to acknowledge to herself that she needed help.
After hearing about and digging more into her experience, I felt encouraged enough to at least advertise an independent contractor position in my own practice. By going this route, I would get the support that I and my clients needed—without compromising my vision for a smaller practice.
The Search for an Independent Contractor
I knew I was doing the right thing the minute I published my ad for an SLP who worked as an independent contractor. As soon as I clicked “Publish” on my ad, I felt a surge of not trepidation, but thrill and excitement. As resumés started coming in, I felt more in control of my career than ever. It was a reminder that this was my practice, and I got to make the decisions. I wanted help in my business, and that was okay. Needing that support didn’t mean I was compromising my vision for my practice.
The process of advertising for that position and interviewing the top candidates helped me realize that if I could find the right fit, it would actually help me expand my reach. I could help more kids and their families.
I ended up interviewing three candidates, and I loved each of them for different reasons. I tried to think of a way to hire all of them—which was not entirely realistic. I just had a hard time saying no to perfectly good candidates. To help narrow it down, I really examined what I wanted my practice to look like, and what skills I needed to help make that happen.
Throughout this process, I came to realize that not everyone is the right fit. Even as I recognized that fact, I felt bad turning people down. It was difficult for me to pass on people. But in the long run, I knew that having those uncomfortable conversations in the search for someone who was the right fit was what’s best for my practice and my clients.
“Looking back, I’m so glad I made the leap and hired an independent contractor.
I share this hiring experience because as SLPs, we tend to be constantly thinking about how to help our clients and their families. We want to make people happy and help them live fulfilling lives. Saying no to these candidates was not in my comfort zone.
I needed a clinician who could jump in and conduct evaluations right away. A lot of the candidates I interviewed didn’t have the evaluation experience for speech disorders like I needed. But I had a feeling about one of the candidates almost from her first email—she had the exact experience I was looking for. And beyond that, I knew her personality and charm were a match for me, and I knew my clients would love her.
Looking back, I’m so glad I made the leap and hired an independent contractor. I still see myself as a small practice, and I don’t anticipate that vision changing. What I love is having a full waiting room in the afternoons, and knowing those kids might be on a waiting list somewhere else if I hadn’t taken the steps to get support.
If you’re considering taking those same steps, it’s helpful to remember that while it might be uncomfortable at first, it’s in the service of the clients and families you serve. I love that my decision didn’t only help me, but had a direct impact on the clients that enter my office each day.
There are some fears associated with bringing on that support—like what we would do if they left, or how quickly we’d be able to bring on someone new—but those risks are all part of being a business owner. As private practitioners, we’re resourceful, and even in the face of those challenges, we can figure anything out.
Disclaimer: This article is for informational purposes only and is not nor should be considered legal advice. State laws vary regarding who is considered an independent contractor or employee, so check the laws in your area or IRS guidelines before making hiring decisions.