Build the Foundation First: Expanding Profit, Pay & Planning

Starting a private practice is exciting — but let’s be real, it can also feel overwhelming. Money anxiety, imposter syndrome, and perfectionism can creep in, making you feel like you have to “do it all” right away.

Here’s your gentle reminder: building a thriving practice is about steady, sustainable growth — not rushing or overspending. Let’s break down the key foundational pillars you should focus on:

1️⃣ Increase Profit: Focus on Attracting & Retaining Clients: Before you think about expanding or upgrading, your first job is to fill your caseload consistently.
You don’t need a fancy website or paid ads (yet) — start with:

• Google My Business (optimize your listing for local search)

• Psychology Today (strong SEO, broad reach)

• Word of mouth (tell colleagues, former supervisors, friends — let them know you’re accepting clients)

Retention matters too:

• Offer strong clinical care → clients who feel supported tend to stay.

• Communicate boundaries and policies → reduces late cancels, no-shows, and burnout.

• Evaluate your niche and rates → are you charging enough for your expertise and specialization?

💡 Mindset tip: Profit isn’t greed — it’s what allows your practice (and YOU) to survive, thrive, and continue helping others.

2️⃣ Get Comfortable Paying Yourself: Many clinicians fall into the trap of reinvesting everything back into the business or over/underpaying themselves.
Start by:

• Calculating your personal monthly needs → rent, groceries, bills, transportation, savings.

• Setting a baseline salary or draw → what amount will consistently cover your life expenses?

• Tracking income trends → is your revenue seasonal? Are there months you need to cushion more?

💡 Mindset tip: You are allowed to be paid for your labor. Under-earning isn’t noble — it’s often rooted in old survival patterns or scarcity stories.

3️⃣ Cover Business Expenses Confidently: Most practice expenses are fixed and predictable:

• EHR (like SimplePractice or TherapyNotes)

• Liability insurance

• Rent (if you’re renting space)

• Phone, email, HIPAA-compliant tools

Make a simple list of these fixed costs. Set them aside from your revenue first before you pay yourself or reinvest.

💡 Mindset tip: Treating your business like a real business (with clear expenses and priorities) builds long-term stability.

4️⃣ Prepare for Taxes: Quarterly taxes don’t need to be scary.

• Set up EFTPS (Electronic Federal Tax Payment System) to pay online — no paper checks or mail required.

• Open a separate savings account for taxes → each month, transfer 20–30% of your profit so it’s set aside.

• Use a bookkeeping tool (like QuickBooks) that estimates taxes automatically.

💡 Mindset tip: Taxes are not punishment; they’re part of being a responsible, empowered business owner. Planning ahead reduces anxiety.

5️⃣ Start a Tiny Savings Cushion

Even saving 1–5% of your monthly profit is a win. This can go toward:

• Future website upgrades

• Paid time off (PTO) or sick leave

• Continuing education or certifications

• Unexpected emergencies

💡 Mindset tip: Small, consistent savings = proof to your nervous system that you can handle uncertainty and build long-term sustainability.

Example: Breaking Down Your Monthly Profit

Let’s walk through what this actually looks like in practice.

Say you generate $7,500/month in gross income.

Here’s how you might break that down:

Gross Revenue: $7,500

Business Expenses (EHR, rent, phone, insurance, etc.) → ~$1,500–2,000 $1,750 (avg)

Quarterly Taxes (approx. 25–30%) → ~$1,875–2,250

$2,000 (set aside)

PTO + Sick Leave Savings (even 2–5%) → ~$150–375

$200 (set aside)

Future Expansion (website upgrades, marketing) → ~$150–300

$150 (set aside)

CEU + Professional Development → ~$100–200/month

$150 (set aside)

Emergency Cushion → ~$100–200/month

$150 (set aside)

Net Pay (what you take home) → after all of the above

~$3,000–3,200

💡 Notice: That $7,500 does not all go to you as salary — and that’s normal! You are building sustainability and future stability when you allocate money intentionally.

Set a Realistic Savings Goal

In a powerful presentation on Entity Structure and Process by Christopher Missimo (JD, LPC, MA), he recommends clinicians aim for a minimum $10,000 savings cushion in their business.

This is not something you have to achieve overnight. Start by saving small percentages consistently, month by month, until you slowly reach that goal.

• You can set up a separate business savings account dedicated just to this.

• Automate transfers so you don’t have to rely on willpower or remember each month.

• Track your progress and celebrate milestones (even the first $1,000 counts!).

Final Encouragement

You do not need to rush or panic. Sustainable growth takes time — and your nervous system, bank account, and future self will thank you for staying steady and intentional. When you focus on profit, fair pay, planned expenses, taxes, and slow savings, you create a business foundation that honors both where you are now and where you’re going.

Your practice doesn’t have to look perfect in year one. Start where you are. Build profit slowly. Pay yourself fairly. Plan ahead for expenses and taxes. And gently stretch into the version of you who runs a thriving, sustainable business — one step at a time.