Lessons Learned Carving My Own Path as an OT in Private Practice

My journey as an occupational therapist (OT) began over 20 years ago—a drastically different time. 

Technology wasn’t what it is today and occupational therapy tools, like weighted blankets, were only sold in specialized catalogs—requiring insider knowledge to even understand the benefits. 

I started off my career by working in schools, but I always wanted something to do over the summer, which led me to build my own home-based private practice. 

Getting started in my OT private practice was a slow and gradual process, since I already had a full-time job in the public school system. (Nowadays, starting a private practice would be called a “side hustle,” but back then, there wasn’t a popular social media catchphrase to explain the extra work I was taking on.)  

I’ve always loved working in schools, but it also always felt a bit lonely to me.  Being a school-based OT can be a solitary business. I didn’t know a lot of other OTs, and networking was much different without social media. 

Prior to starting my own OT private practice, I never connected with parents, caregivers, and family members one-on-one nor in the home. At that time, I only connected with families during meetings or progress updates in the school setting. In retrospect, part of the reason I wanted to build a private practice in the first place was because I was looking for more connections with adults during my workdays.  

Starting my business

My journey started when a friend referred me to a family who was looking for services for their toddler. I didn’t have the money or capital to open a clinic—it was my first client after all—so I purchased a few toys and a large therapy bag, and went to their home. 

The parents were thrilled with the convenience, and I was happy to keep costs low since I was just starting out. Things grew from there.

I kept my business at home, which reduced business costs in addition to aligning with my own therapeutic values and treatment objectives.

As an OT working with children, I determined an office wasn’t needed or appropriate for my clients or for my work. I’ve always felt that children are best treated in their own environments, and carryover can be much higher when ideas and strategies are introduced in the home. 

Seeing that first child led me to develop my business. I didn’t have a handy eBook on How to Start a Private Practice on the Side to guide me through creating my own side hustle, so I had to figure it all out myself. 

I came up with a business name: SuperKids Pediatric Occupational Therapy. I taught myself the insurance game, mostly by trial and error.  Also, I learned by making a lot of phone calls while sitting on hold for hours on-end and never getting the same answer twice. 

Next, I created invoices and brochures to advertise my business. I began seeing more pediatric clients in my OT private practice. I reached out to other therapists and doctors and sought out referrals through word of mouth. 

I added my name to directories and delivered continuing education presentations at various OT conferences. 

Eventually, I became a contractor in my own full-time OT private practice to allow myself more freedom to grow my home-based business. That meant I had to learn about taxes and private practice bookkeeping, which I found intimidating at first. 

I purposely limited how many private clients I took on so I didn’t get in over my head and made sure I was setting myself up for scalable success.

Building new connections

All the schooling and experience I had as a clinician didn’t prepare me to be a business owner. 

I can’t say it was always easy. I did a lot of self-directed learning, but I learned from others, too. 

For example, I networked with other OTs who were also setting out to create their own private practices, we would occasionally chat and share ideas.  Cultivating a professional community was instrumental as I navigated the initial stages of private practice ownership.

I also fostered a deeper connection with my clients and their families in my home-based private practice—which wasn’t an option in a school-based setting. 

I enjoyed going to people’s homes and acquainting myself with the client’s environment. Besides, there was no better place to treat children than in their natural environment. 

Being in someone’s home is a much different experience than having parents sit in a waiting room, or hardly ever seeing the parents, like in the school settings I was previously accustomed with.

It allowed me to build connections and integrate ideas into the family dynamic and daily routines. I met grandparents, played with siblings, and was better able to understand my clients’ daily struggles and celebrate milestones. 

I cherished these connections that allowed me to practice OT differently than I could before.

Learning new things along the way

When I started my own practice, there were very few resources to help guide me through my journey. The internet wasn’t a robust repository of resources for practitioners at the time, and there weren’t any books on the topic of running your own home-based OT private practice. 

Regardless, I pushed forward and continued to look for resources and support. I spent time creating templates for invoicing, notes, and brochures. I created my own website, and then a few years later, launched another improved website. (Here are 9 tips for practitioners looking to create a private practice website.)

Time passed quickly, and I’ve continued my business for over 20 years. Now, platforms like YouTube, social media, Canva, and WordPress have made things so much easier. I am also in the process of adding teletherapy as part of my services. 

I immensely enjoy the private practice portion of my work. I am now expanding into other options and services including educating and supporting other therapists on their journey.

4 tips for OTs and other clinicians looking to start their own private practice

Throughout the process of starting my own private practice I learned many lessons. 

These are some of my most significant takeaways and tips:

1. It’s important to learn the ins and outs of health insurance. Many private practices don’t accept insurance, but whether you do or don’t, you still need to understand how insurance works.
2. You can create a private practice that works for you. There is no one right way to become a private practice clinician. You have an opportunity to build something that works for you. I know clinicians who have an office, I know some who do home-based services, and I even know of a few who have their own mobile clinics.
3. Build over time, if you can. This will give you time to figure it all out. 
4. Connect with others who have started their own private practice and are willing to share information with you. If you can, find a mentor. 

Starting and running my own private practice hasn’t always been easy, but it has always been worth it. I am grateful for my journey and where it’s led me so far. 

How to start building your own private practice

If you are thinking about building your own private practice, but you need help figuring out where to start, here are my top suggestions:

Develop a business plan 

The first step in starting any private practice is to develop a business plan. This plan should outline your vision, goals, and strategies for achieving those goals. It should also include financial projections, marketing plans, and a list of potential referral sources. A solid business plan will help you stay focused and organized as you begin to build your practice.

Establish your legal structure

Next, you’ll need to decide on the legal structure of your practice. Will you operate as a sole proprietorship, partnership, or LLC? Each structure has its own benefits and drawbacks, so it’s important to research each option and choose the one that best suits your needs.

Develop a marketing plan

In order to attract clients to your practice, you’ll need to develop a marketing plan. This may include creating a website, establishing a social media presence, attending local events, and building relationships with referral sources such as pediatricians and schools.

Establish billing and payment procedures

Finally, you’ll need to establish billing and payment procedures for your practice. This includes determining your fees, creating invoices, and establishing a system for accepting payments.

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