Podcast Summary: Private Practice Startup Podcast

Episode 143: 5 Private Practice Pitfalls and How to Fix Them
Hosts: Dr. Kate Campbell & Katie Lemieux
Guest: Sheri Shaki Pope, LMFT
Air Date: July 7, 2019

Episode Overview

This episode features guest Sheri Shaki Pope, LMFT, accomplished group practice owner and author of Therapist Practice in a Box: The Ultimate Guide to Building a Private Practice. Sheri joins Dr. Kate Campbell and Katie Lemieux to discuss five major pitfalls therapists face when starting and running their private practice—and, importantly, practical strategies to avoid or overcome them. Drawing on her experience running a thriving practice with 25 therapists across two locations, Sheri offers actionable insights, blended with humor and real-life anecdotes, to empower clinicians at every phase of their private practice journey.

Key Discussion Points & Insights

1. Pitfall One: Letting Fear Take Over (06:17)

• Fear is the first and most common pitfall: People envision the freedom of private practice but become paralyzed by uncertainty.
  • “We become fearful and we become paralyzed, and we don’t bet on us. And so part of the real need is for us to bet on us as people and go, I can do this.” — Sheri (06:36)
• Many therapists give up too soon: Sheri notes she has hired team members who left solo practice out of fear from lack of clients or income, sometimes just months away from a breakthrough.
• Advice: Hang in longer during the tough early months; support from community and mentorship is crucial.

Memorable Story: Facing a Cash Flow Crisis (07:50)

• Sheri recounts almost having to lay off staff at Christmas because a major insurance company delayed $300,000 in payments.
  • “For about six weeks, we had reserves. After that, if we couldn’t get it squared away, we’d have to…”
  • The crisis taught Sheri the importance of income diversification (see pitfall five).
  • The insurance later issued the necessary payments, saving the practice.

2. Pitfall Two: Skipping the Business Plan (11:05)

• Not having a business plan and clear vision: Therapists often start without clarity on target market, services, finances, or branding. This leads to reactive, scattered efforts (e.g., “throwing spaghetti at the wall”).
  • “Writing a business plan is putting their vision out of their head on the paper… it allows us to see pitfalls we may not think about.” — Sheri (11:08)
  • “Branding is not just business cards and a logo.” — Sheri (11:40)
• Highlight: Importance of “SWOT analysis” (Strengths, Weaknesses, Opportunities, Threats); understanding both internal and external influences.

Resource Reference:

• Episode 68: Amanda Patterson on creating a business plan (14:35)

3. Pitfall Three: Unrealistic Expectations & Impatience (16:19)

• Expecting instant results: Therapists often abandon promising strategies (e.g., blogging, AdWords) after just a few weeks, rather than committing long enough to see results.
  • “We have to stick with a couple of things... for say, six months, eight months, a year. Then you make tweaks. But we get impatient…” — Sheri (16:26)
• Drive-by marketing: One-off communications (e.g., dropping off flyers) rarely work; consistency and follow-up are essential.
• Not realizing insurance isn’t always reliable: Even when services are provided, payment can be denied or delayed due to coding or eligibility changes.

Hosts’ Reflection: Early Struggles

• “We did everything wrong… walked around with pamphlets, hoping something stuck.” — Katie (17:59)
• Both hosts stress the value of coaching for avoiding wasted energy and frustration.

4. Pitfall Four: Ignoring Legal and Ethical Responsibilities (18:47)

• Neglecting legal and ethical requirements leads to risk:
  • Not knowing how to handle nonpayment, dual relationships, or state-specific laws.
  • Most common mistake: not completing CEUs correctly or on time, leading to compounded errors.
  • “You have to stay with the knowledge of what’s the ethics of your system, what are the laws and regulations in your state… you have to make sure you’re tracking those things.” — Sheri (19:31)
• Hosts emphasize: Don’t piece together paperwork from random sources; make sure everything complies with your state’s laws and professional ethics.

5. Pitfall Five: Failure to Diversify Income (22:19)

• Relying on a single income stream is risky: Sheri stresses the importance of multiple revenue sources—different insurance panels, cash-pay services, classes, books, or renting space.
  • “Make sure you have three or four different income streams... It just needs to be more than just one insurance company and one form of income.” — Sheri (22:26)
• Passive or semi-passive income options: For service-based practitioners, having additional sources (e.g., renting your room) increases stability.
  • “It could be as simple as renting your room when you’re not there.” — Sheri (23:18)

Notable Quotes & Memorable Moments

• “Bet on yourself.” — Sheri (06:36)
• “Failure—I never even thought about failure… But we were a little bit too singled on one particular income source.” — Sheri (07:50)
• “Branding is not just business cards and a logo.” — Sheri (11:40)
• “We have to stick with a couple of things, which is why business plans are so good… but we get impatient.” — Sheri (16:26)
• “People who start private practices are visionaries. But we get distracted by, ‘Let’s try this, let’s try that.’” — Sheri (21:51)
• “The skills you talk about or I talk about, are just skills… We all made it through graduate school. We can learn these things.” — Sheri (23:32)

Memorable Story: Childhood Tree Rescue (03:06)

• Sheri recounts being stuck in a swaying tree as a child, coaching her friends to climb down—an early foreshadowing of her leadership style and ability to stay calm under pressure.

Timestamps for Key Segments

• [06:17] Pitfall 1: Fear / “Betting on Yourself”
• [07:50] Sheri's cash flow crisis and lesson in diversification
• [11:05] Pitfall 2: Lacking a Business Plan
• [12:22] Explanation of SWOT analysis
• [16:19] Pitfall 3: Unrealistic Expectations & Impatience
• [17:59] Hosts’ lessons from their own marketing missteps
• [18:47] Pitfall 4: Legal/Ethical Responsibilities
• [19:31] Most common ethical issue: CEU tracking
• [22:19] Pitfall 5: Diversifying Income Streams
• [23:32] Final takeaway and encouragement

Final Takeaways & Action Steps

• You can do this: Business and marketing are learned skills, not innate talents. All five pitfalls are navigable with information and support.
  • “There’s nothing so miracle about them. They just are things. We all made it through graduate school. We can learn these things.” — Sheri (23:32)
• Don’t isolate yourself: Seek mentorship, community, and reliable resources.

Special Offer

• Sheri offers 35% off her book, Therapist Practice in a Box, with code “startup” at purchase ([25:04]).

Further Resources

• Sheri Shaki Pope’s book and more at her website (referenced in show notes)
• Episode 68: Amanda Patterson on business plans
• Private Practice Startup’s downloadable A-Z Cheat Sheet (see episode intro)

This episode is essential listening for all therapists in private practice or considering the leap—from identifying and overcoming fear, to planning, execution, and growth. As Sheri and the hosts reinforce: the journey has pitfalls, but with the right mindset and strategies, a thriving, sustainable private practice is within reach.