School-Based Therapy vs. Private Practice and How to Make the Jump

Last week I tweeted about a great article on starting your private practice that got a lot of attention. While many SLP’s thrive in a school environment, there are a lot of people that are interested (or at least curious) about the experience of starting and running a private speech therapy practice. If you’re currently working in a school setting, you might be wondering what it would be like to set your own hours, charge higher rates, and run your own business. You may have entertained visions of hundreds of clients chanting your name with perfect articulation as you lean out your Hummer to give high fives to the adoring throng. Or maybe fear held you back as you imagined living underneath a bridge after watching your private practice implode and selling your kidneys to cover your debts.

To learn a little bit about the pros and cons of school vs. private practice, I sat down with Ann Dorais, a local SLP in private practice to get her take on it. Ann worked in schools for four years while seeing clients in their homes on the side. Today she has a permanent office and a thriving private practice.

Working in schools definitely has some pros:

  • Security and stability
  • Paid holidays
  • Time off in the summer
  • Regular hours
  • Great way to get a lot of experience with a lot of different kids.

And some cons:

  • Large caseload
  • Constant intensity and potential for burnout
  • Pressure to remediate so many students
  • You don’t get to work closely with the child’s family

Working in private practice has its own benefits:

  • Working with fewer clients
  • The flexibility to set your own work time and days
  • A relaxed atmosphere
  • You can choose what to specialize in
  • Better interaction with parents and one-on-one time with kids means more progress in a shorter amount of time

And it has some downsides:

  • Billing insurance companies can take time (Ann suggests that if you work with insurance, have parents pay up front)
  • You have to find clients on your own
  • The size of your practice is limited by the amount of time you can invest


So if private practice offers more money, more flexibility, and better client remediation, why don’t more people make the jump? The answer of course is fear. Let’s take a look at some common fears that people have as well as some resources to make it a little less scary.


1. The business stuff.

You probably became an SLP because you thought speech language pathology was fascinating, or you like to work with kids, or you just want to make the world a better place. I doubt many SLP’s have visions of ruling a corporate empire. Words like cash flow, limited liability, and rules of incorporation might be way more intimidating than apraxia, dysfluency, and electropalatography.


2. The cost.

There are initial investments and ongoing expenses of running a business. In uncertain economic times like these, a new expense is nothing to sneeze at.


3. Possibility of failure.

No one wants to end up under a bridge without kidneys. What if the clients just don’t materialize?


Those are all valid concerns. Here is what Ann had to say about each of them.


1. Get a good accountant.

A qualified tax professional is worth their weight in gold. They make your life infinitely easier, not only with taxes, but the day-to-day financial operations of the business. Finding someone that you can trust is a crucial investment and a sound business decision. Ann just went to a local H&R Block and has had a great experience.


2. The cost is lower than you think.

Imagine if you wanted to start your own garbage collection company. You would need at least at one garbage truck (if nothing else) and I bet they are pretty expensive. You would also need the proper training and certifications. Now compare that to starting your own speech therapy practice. The most important asset is your highly educated brain, and you’ve already paid to cram it full of useful information. From an expenses standpoint, you’re already 98% of the way there. You might purchase some workbooks and other teaching materials, an iPad, some apps, and hey, a Palatometer system would be a great idea too. At most we’re looking at a few thousand bucks. Considering the expected return from plying your cerebral trade for the benefit of mankind, the additional expense to start your practice is minimal.


3. Start small and believe in yourself!

Ann started her private practice part-time while she was still working in schools, and she says that’s a great way to begin.  She never had to go hunting for clients; her practice simply grew through referrals until eventually she had enough clients to set up her own shop. Instead of setting up a giant operation right off the bat, she recommends that you start small and your practice will grow. If you believe in yourself and the results you can produce, you can make it work. People really will pay you for your helpful expertise. You can do it!


Additional Resources

There are a lot of great resources out there to help SLP’s interested in starting their own private practice. Here are a few tips:">ASHA Find a Professional service

ASHA Frequently Asked Questions - Tons of good info here

Business Matters: A Guide for Speech-Language Pathologists – You have to purchase this one, so I can’t say how good it is but It looks helpful.

How to Write a Business Plan: A Guide for Physical, Occupational and Speech Therapy Providers – This is a great article that addresses some key points of a business plan and will get you thinking about how to set up your practice.


Do you have helpful tips to share about starting your own practice? Have any thoughts about working in schools vs. private practice? Tell us about your experience by joining the discussion on our Facebook page