Building a Practice While Everyone Has an Opinion

One of the unexpected realities of owning a private practice is discovering just how many opinions people have about how it should be run. Some advice comes from experienced clinicians who genuinely want to help. Other suggestions come from colleagues sharing what has worked well for them. Friends and family occasionally offer ideas despite never having owned a business themselves, and every once in a while even clients have thoughts about how a practice could operate more effectively.

None of this is necessarily a bad thing. One of the strengths of our profession is the willingness to share knowledge and experience. The challenge is that if you listen long enough, you begin to realize that much of the advice contradicts itself.

One therapist encourages you to specialize as quickly as possible, while another believes keeping your practice broad creates greater stability. Someone suggests it's time to raise your fees because people value what they pay for. Someone else warns that charging more will reduce referrals. You're encouraged to advertise, then told that the strongest practices grow entirely through word of mouth. One clinician believes seeing more clients is the key to financial security, while another insists the healthiest practices intentionally protect a smaller caseload. More recently, artificial intelligence has entered the conversation, bringing another set of opinions about what every therapist should or should not be doing.

After a while it becomes obvious that there is no shortage of advice. The difficulty isn't finding people willing to tell you what they would do. The difficulty is deciding what actually fits the practice you're trying to build.

Most practice owners experience a season where almost every conversation introduces another idea that sounds completely reasonable. One discussion leaves you wondering if your fees should change. Another makes you question your schedule. Someone else convinces you that you should advertise more, while the next person suggests you shouldn't advertise at all. Individually, none of the advice is necessarily wrong. Collectively, it can become overwhelming.

Over time, many clinicians come to an important realization. Most people are not telling you the right way to run a practice. They're describing the decisions that have worked well for their practice.

There is an important difference.

A therapist with a long waiting list in a large city is making decisions within a very different context than someone building a new practice in a smaller community. A clinician raising young children will naturally organize their work differently than someone approaching retirement. Some therapists genuinely enjoy supervising, teaching, or writing alongside their clinical work, while others simply want to spend their professional lives seeing clients and then going home to their families.

None of those choices is inherently better than another. They simply reflect different priorities, different circumstances, and different definitions of what a satisfying professional life looks like.

One of the most important lessons in practice ownership is that building a successful business isn't about collecting everyone else's opinions and trying to combine them into one perfect strategy. It's about listening carefully, remaining open to good ideas, and then making thoughtful decisions that reflect your own values, your own circumstances, and the kind of practice you want to build.

That doesn't mean ignoring advice. Some of the best business decisions come from conversations that challenge our thinking or introduce perspectives we hadn't considered. Good advice broadens our understanding. It encourages us to think differently and sometimes helps us avoid mistakes we might otherwise have made.

But there is an important difference between learning from someone else's experience and assuming their solution should automatically become your own.

One of the responsibilities of owning a private practice is accepting that every decision involves trade-offs. Whether you're deciding about fees, advertising, office hours, technology, the number of clients you see each week, or whether to incorporate artificial intelligence into your business, there will almost always be someone who would have chosen differently. If your goal is to build a practice that everyone approves of, you'll spend much of your career feeling uncertain because that goal simply isn't possible.

Instead, a better question is whether your decisions are helping you build the practice you actually want to own.

Confidence rarely comes from receiving everyone's approval. It develops gradually as you make thoughtful decisions, understand why you made them, and accept that not everyone would have chosen the same path.

If you spend your career trying to follow everyone's advice, you may eventually discover that you've built a practice that doesn't really belong to anyone.

Least of all yourself.

---

Build a Practice That Fits You

The healthiest practices are rarely built by following someone else's blueprint. They are built by making thoughtful decisions that reflect your values, your circumstances, and the kind of professional life you want to create.

At FOUNDATIONS FOR PRACTICE, our courses are designed to help clinicians build sustainable private practices with greater confidence. Whether you're establishing your practice, strengthening its foundation, or thinking about long-term sustainability, the goal is not to build someone else's version of success. It's to build a practice that fits you.

If you're looking for a place to begin, explore our courses to strengthen the business side of your practice. If you're unsure where your practice stands today, the free Business Health Diagnostic can help you step back, evaluate the overall health of your practice, and identify areas that may deserve more attention as you continue building a business that supports both your professional goals and your life.

Explore Our Courses