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Welcome back to Ask Allison. The following question is from somebody who just finished a really big chapter. Hi, I'm a new follower and you've got me thinking. I had a small practice previously but have had to focus on full time nonprofit work for loan forgiveness. I have a new freedom now that it's complete, but I have a history of serious health issues and I'm concerned about leaving the security of agency benefits, paid sick time, FMLA, life insurance, etc. In case I get sick again. How would you typically advise about this? So before I get into that, I would like to thank TherapyNotes for sponsoring Ask Allison. I've talked about them for years. I know their features by heart, but what truly sets them apart is that they genuinely care about your experience. It's not just about troubleshooting. They actively implement user suggested features like Therapy search, secure messaging, a smooth super bill process, and their AI feature, therapy fuel. Everyone at TherapyNotes believes in the product and they want you to love it too. Plus, they're independently owned, which means no venture capital and no pressure to prioritize their investors over their customers. This independence allows them to keep their prices fair, to focus on innovation, and to prioritize customer experience. With over 100,000 therapists already on board, they've proven you don't have to compromise success for quality. If you're ready to see for yourself, try Therapy notes free for two months with the code abundant@therapynotes.com all right, first of all, congrats on finishing your loan forgiveness. It's a huge deal. I know it took a lot of discipline and a lot of patience. So now that you've got the freedom to make choices that aren't dictated by student debt, which is like, exciting and scary. Let's talk about the tension you're naming the pull towards private practice and the fear of losing benefits. This is one of the most common reasons people stay in agencies or group practices, even when they're burned out. And honestly, it's not an irrational fear. Benefits in the us are tied to employment in a way that makes entrepreneurship a lot trickier than it should be. So I want to validate that it makes sense that you're pausing before you leap. Here's how I'd usually walk through this with someone in your shoes Number one Separate the fear from the facts Sometimes the idea of losing benefits feels scarier than the reality of replacing them. So start by writing down what you currently get at your agency. Health insurance, sick leave, FMLA protections, disability, life insurance, retirement match. Whatever it is, look at what you're already paying for them because most of those things aren't free and clear. And look at which of those are actually non negotiables for you, given your health history. For example, if paid sick leave is essential because of your past health issues, that's something to prioritize. If life insurance feels less urgent, then maybe that's something you could purchase individually without it being a deal breaker. Clarity here helps us move on from I'm going to lose everything and be unprotected to Here are the specific things I need to put in place if I leave. Number two Health insurance and medical care. It's a big one. If you're worried about health coverage, the good news is you have options outside of agency employment. There's marketplace insurance. Depending on your state, you might find a plan that's comparable to what you've had. Yes, it can be expensive, but not as expensive as people assume, especially with subsidies. If those continue, I recommend meeting with an insurance broker to look at your options. They're free to work with and they have access to more options. You can also do spousal coverage if you have a partner with benefit. Sometimes you can hop on their plan and that's the simplest fix. Private or associated plans Some state therapy associations or professional groups offer health insurance to members. The key is not just assuming that you can't get good coverage, it's actually looking at the numbers for your specific situation. I've worked with plenty of practice owners who, once they've compared, realize their out of pocket cost wasn't much different from what they were already paying with payroll deductions at the agency. Number three Sick leave and time off. This one's trickier because private practice doesn't have built in paid sick leave. So here's the mindset shift you get to build in your own safety net. This might look like creating a savings cushion specifically for sick time. Some therapists keep two to three months of expenses in a separate account so that if they need to take a break they're not panicking. Building your fee structure with time off in mind. So for example, if you know you want four weeks off a year, price your sessions so that your annual income still works even if you're not billing during that time. And that means like if you wanted those four weeks off a year just for vacation or time off, buffering that, adding a buffer so that maybe you are factoring in six weeks or eight weeks off, depending on how often you're typically sick. Consider short term disability insurance. This can replace some income. If you can't work for medical reasons, you lose the automatic, like I'll just call HR safety net. But you gain the ability to design a system that actually fits your needs. FMLA doesn't pay out money. It just holds your position for you. So your position will be held for you. It's your business, so you don't have to worry about that part. If you need a legal guarantee of job protection, like you don't need it, you're the boss. No one can fire you. You may lose income if you take months away, but you're going to come back. You're not going to come back to your caseload reassigned or your position gone. So the workaround here is again, financial planning. When we have health conditions in private practice, when we are aware of our health conditions, sometimes people experience them or realize they have them mid dream. Essentially you're going in aware. So there's just so much financial planning that you can do on the front end that's going to save you so much stress and worry. So having a solid emergency fund plus disability insurance, if your health issues flare up again, could go a really long way. Number five, life insurance, retirement extras. Life insurance and retirement are often wrapped up in agency benefits, but both are really doable on your own. You can get term life insurance independently. You can set up a SEP, IRA or a solo 401k for retirement. That actually gives you more flexibility and potentially better tax advantages than your current plan. So this is less about losing access and more about having to initiate those pieces yourself. Most find that working far less, like 15 hours a week, means they have fewer health flare ups and they have more time for appointments, their own appointments. So typically they make way more seeing those 15 hours per week of clients than they did working full time. So you can build your coffers for paid sick leave, you can buy your own Life Insurance, etc. In order to really maximize your insurance or your income so that you can work less. I almost always encourage therapists with chronic illness to charge premium fees. So for instance, if you charge $250 a session, you see 15 people. That might be five people three days a week or three to four people four days a week. Then you have long weekends every weekend, or more time off between your work days. If you plan for six weeks off a year, which would include some of those unexpected sick days as well as vacation, you'd gross $172,500 a year. And number six, because you've had serious health issues before, I want to say this really clearly. You don't have to make this decision overnight. You are allowed to ease into private practice. Some people do a hybrid keeping nonprofit work for the benefits while building their practice. That way they can kind of test the waters and see if private practice income feels stable enough to replace the benefits cushion. It gives you an opportunity to save money for the leap. I strongly, strongly recommend putting every single dime of your private practice income into savings if you go this route. That way you can get out of that two job scenario a lot faster. Others go all in, but only after building a strong financial buffer. Six months of living expenses and savings, disability insurance purchased, marketplace plan researched. There's really no moral high ground on either option. The best choice is the one that keeps you physically safe and emotionally at peace. 7. The emotional piece and let's not skip over this. Fear about health is different than fear about marketing or getting clients. This isn't just like what if I fail? This is what if I get sick again and I can't provide for myself? That's a tender, very real fear. So I'd encourage you to ask yourself, what would make me feel safe enough to take the lead? Not perfectly safe because entrepreneurship never offers that, but safe enough. Safe enough. Maybe that's a certain dollar amount saved. Maybe that's having a disability policy in place. Maybe that's testing your private practice part time before quitting your nonprofit job. Your nervous system deserves to be a part of this decision, not just your business brain. So number eight, my bottom line advice would be get really clear on which benefits matter most to you. Price out the private practice version of those benefits. Build a savings cushion for time off and emergencies. Consider part time or hybrid work during the transition. Don't shame yourself for valuing security. It is wise. It's not weak. Private practice gives you the autonomy, better income potential and control of your time. Agency work gives you structured benefits and predictability. You get to decide which makes serves your health and your life best right now. And the good news is the decision is not permanent. If you try private practice, it's too stressful. Without benefits, agencies will still be there. They'll still be hiring. So to the person who sent this, thank you for being honest about the push pull here. A lot of therapists are in the exact same boat and don't always say it out loud. My hope is that this helps you see that you have more options than just jump without a net or stay forever. You can build your own net. This week's free worksheet is all about common fears. Because once you work through the plan to manage your illness, that next phase of fears is going to hit you. So this worksheet can help you. If you want the worksheet, you can DM me the word sheets. I'll send you this one and a link to all the previous worksheets that's on social media. If you're listening to the podcast, you can find the link in the show Notes. All right, y'. All. If you want more support building a private practice that's sustainable for you, check out the Abundance Party. All the resources that we've created to make this whole thing a whole lot less overwhelming. All right, take care.