In this video clip, OTPreneurs Justin Oakley, Emilia Bourland and Brandy Archie talk about what triggered them to step out of the traditional medical model and grow private practices. For the full convo check it out here!
Looking for more? Below, we expand on that by exploring the most common triggers that lead OTs to take the leap into private practice.
1. Desire for Professional Autonomy
One of the biggest motivations for OTs to start their own practice is the ability to make independent decisions. In traditional healthcare settings, we often face:
- Rigid schedules ⏰ that limit flexibility
- Productivity quotas 📊 that prioritize numbers over patient care
- Administrative policies 📋 that may not align with our personal treatment philosophies
By starting a side gig or a private practice, therapists can shape their own schedules, treatment approaches, and client interactions—leading to greater job satisfaction.
2. Frustration with Insurance and Billing Restrictions
It’s easy to feel restricted by insurance reimbursement rates and policies that dictate how we deliver care. Common frustrations include:
- Limited treatment session approvals that may not be sufficient for a patient’s needs
- Lower reimbursement rates that undervalue our expertise
- Excessive documentation demands that take time away from patient care
Private practice allows us to explore cash-based models, out-of-network billing, or hybrid approaches that offer more control over revenue and service quality.
3. Burnout and Workplace Dissatisfaction
The high demands of traditional OT roles can lead to exhaustion. Burnout often results from:
- Heavy caseloads that leave little time for personalized care
- Pressure to meet productivity standards instead of focusing on patient progress
- Lack of growth opportunities in structured healthcare settings
Private practice offers a chance to design a career with better work-life balance, more meaningful patient relationships, and room for professional growth.
4. A Strong Passion for a Niche Population
We often develop a deep interest in a particular client group and want to provide specialized services that aren't widely available. I know you’ve seen examples like:
- Pediatric therapy with a focus on sensory integration
- Hand therapy or ergonomic consulting
- Mental health-based OT for trauma survivors
- Home-based therapy for aging adults
Private practice gives OTs the freedom to tailor services to their ideal clientele without being restricted by an employer’s scope.
5. Financial Growth and Earning Potential
Traditional employment often comes with salary caps or ceilings to our professional growth, and private practice can provide greater income potential. By controlling service pricing and reducing overhead costs, therapists can:
- Increase hourly rates compared to standard employment
- Diversify income streams (e.g., online programs, workshops, consulting)
- Scale the business by hiring staff or expanding services
While there are initial startup costs, a well-structured private practice can lead to long-term financial stability and growth.
6. Encouragement from Clients and Professional Network
You might also just feel the push directly from encouragement from clients, colleagues, or mentors who recognize your talent and expertise. Have any of these happened to you:
- Clients asking for you to work with them privately
- Colleagues (like us!) sharing their success stories about private practice
- Finding a supportive business mentor or community that makes the transition feel achievable
Next Steps
Hearing success stories and realizing that others have successfully built thriving practices can be the fuel to fight the fear and take the first step. Want to hear more? Check out Why You’re More Capable of Starting a Private Practice Than You Think.