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Private Practice is a consistently growing area of Speech-Language Pathology. For a variety of reasons, speech-language pathologists (SLPs) are transitioning away from employee and into the role of employer. There are a variety of ways SLPs can use a combination of research and creativity to expand their “thinking” with regard to revenue generation as we face the issue of healthcare reform. SLPs may have to extend beyond the traditional service delivery model to maintain a thriving practice.

PRACTICE PATTERNS AND EARNINGS

Due to changes in health care reform, politics, and the economy, SLPs are finding they need to adapt to the current business climate. In 2015, private practice owners who earned an hourly wage worked a median of 24 hours per week, compared with 25 hours per week in 2013 and 20 hours per week in 2011 (ASHA 2015). From 2007 to 2015, private practice owners spent most of their adult clinical services time on swallowing (at least 40%), aphasia (at least 15%), and cognitive-communication (at least 15%). (ASHA 2016)

Whether making the transition from employee to employer, or changing their current road map for an established private practice, SLPs are beginning to search for new ways to compete in today’s market. This includes recent graduates, who are representing a new job mindset as the millennial generation. A survey by Gallup (Adkins2016) found that millennials are seeking change from the typical caseloads, paperwork requirements and overall job expectations.

Being a specialist is evidence of hard work, builds a community of similarly specialized individuals and garners its own level of respect.

The survey also found that 87% of millennials say professional development or career growth opportunities are very important to them in a job.  As professionals with experience in the field, we have a responsibility to be a guiding force. We must be open to adapting our traditional views of private practice in order to compete, while leading the next generation of SLPs in creating a work-life balance and propelling our profession forward.

CREATING A UNIQUE PRIVATE PRACTICE

One way to create a unique private practice with a competitive edge, while also driving business, is by finding a niche. Private practices are often “jacks of all trades”, meaning that they see a wide variety of the needs addressed by our field. While these practices are needed, to stand out in the field it helps to focus on a specific need and specialize in that area. Often additional training and specialized certifications are needed, but the business they bring in can offset this cost. Research by MIT professor and sociologist, Ezra Zuckerman, on specializing in your field versus generalizing, found the following: “First, to the extent that various tasks require (investments in) highly specialized skills, we are greatly limited in the extent to which we may be generalists.

Being a specialist is evidence of hard work, builds a community of similarly specialized individuals and garners its own level of respect. While being an SLP is already a specialized field, it is also one that offers a large variability in work environment and therapy application. While this is a benefit for the SLP, becoming further specialized helps one stand out amongst other private practices, providing an advantage in today’s market.

Another way to create a unique private practice is through diversification.  By creating multiple streams of revenue, SLPs can leverage their skills, increase their reach and create a financially stable business model. SLPs can diversify from a standard face-to-face, timed model by utilizing one or many of the following strategies: telepractice, public speaking, running training seminars, consulting with other service providers, hosting webinars and establishing interdisciplinary collaboration.

People trust the ideas and opinions of people with whom they have relationships.

Most SLPs did not have business courses when studying at the university level. This can make business decisions an overwhelming task. But, in order to stay competitive and meet the needs of their clients, SLPs need to think like entrepreneurs.

There are key areas SLPs need to understand and utilize within their business:

  1. Price competitively. The differences between a private practice owner’s pricing points greatly impacts their customer’s perceived value of the products and services.
  2. Identify your market and research the skills required to help promote yourself.
  3. Highlight your unique strengths and place an emphasis on quality of services rather than quantity (Ciotti 2012), this can bring attention to your specific business and services.

Three key areas SLP’s should consider to make their private practice unique:

  1. Finding your Niche
  2. Diversify Your Offerings
  3. Be Business Savvy

FINDING YOUR NICHE

One way to create a unique private practice with a competitive edge, while also driving business, is by finding a niche. Private practices are often “jacks of all trades”, meaning that they see a wide variety of the needs addressed by our field. While these practices are needed, to stand out in the field it helps to focus on a specific need and specialize in that area. Often additional training and specialized certifications are needed, but the business they bring in can offset this cost. Research by MIT professor and sociologist, Ezra Zuckerman, on specializing in your field versus generalizing, found the following: “First, to the extent that various tasks require (investments in) highly specialized skills, we are greatly limited in the extent to which we may be generalists.

Being a specialist is evidence of hard work, builds a community of similarly specialized individuals and garners its own level of respect. While being an SLP is already a specialized field, it is also one that offers a large variability in work environment and therapy application. While this is a benefit for the SLP, becoming further specialized helps one stand out amongst other private practices, providing an advantage in today’s market.

Some people may be tentative when they think about developing a niche because they are concerned about becoming too specialized and missing out on business. The truth is, most people get into private practice because they want to specialize in a particular area of interest. So finding the niche is not the problem. What can be challenging, however, is convincing people to see the benefits of committing to a niche.

There are three steps to finding your niche:

  1. Your passion
  2. Your knowledge
  3. The needs of the clients/patients in your area

Practitioners, who have a niche private practice, often have less competition, and are able to capture more of the market share and practitioners become big fish in the small pond of generalist clinicians. Become an expert because specialization is important in finding your niche. Some private practitioners worry that their geographic area is already saturated with people who have the same certifications. It is possible to broaden services WITHIN the area of specializations. Geographic area saturation should not deter you if you consider the following:

  1. Further differentiate yourself, establish credibility and limit the competition.
  1. In addition to offering a variety of services that meet a range of needs, you also want to offer resources in a variety of formats and on different platforms. (Hall 2017)

Currently I have a private practice with a specialization in dysphagia. Living in a rural community means patients often have to travel into the city for specialized dysphagia care.

The building of a practice is always a work in progress.  It may take a long time to create a masterpiece. Remember you are likely not going to start out the way you will finish.  It is a marathon, not a sprint and it is likely that the masterpiece you envision on day one, may look very different than what it actually is years from now.

After earning my board certification in swallowing, I began marketing to local physicians, specifically ENT’s and neurologists. Developing a specialization within a niche helped to propel my practice even further as I became the only clinician within a 75-mile radius to perform fiberoptic endoscopic evaluation of swallowing (FEES).  It’s vital to make sure that the niche you select is needed; otherwise, it doesn’t matter how knowledgeable or passionate you are about something, because the market just won’t support it. Because clients see niche practitioners as someone who can help their SPECIFIC problem, they are often willing to pay a premium for services.

WHERE DO I FIND CLIENTS?

  • Use social media, such as Facebook, LinkedIn and Twitter, to share news and information about communication disorders and other relevant topics.
  • Write articles about aspects of your practice and submit them to local news outlets/agencies.
  • Provide day care centers with information about your practice and offer free speech-language screenings for children.
  • Reach out to and share information with other related professions (physicians, social workers/case managers, occupational and physical therapists) who may then refer clients to you. Pierotti, A. (2014).

 DIVERSIFY YOUR OFFERINGS

We are all in this together and collaboration is the key to diversification.

One way to diversify is to collaborate with others and cultivate relationships.

Align yourself with those who share your vision.

According to ASHA 2017 health care survey report interprofessional collaboration was defined in the survey as occurring “when two or more individuals from different fields work together to provide comprehensive, integrated services (e.g., develop and implement a treatment plan collaboratively as a team) in a health care environment.”   79% reported that regardless of employment function, they engaged in interprofessional collaborative practice in their primary work setting

BUILD COMMUNITY RELATIONSHIPS

People trust the ideas and opinions of people with whom they have relationships. You want physicians and other clinicians to give your name when a patient or client asks for a recommendation. But for that to happen, the provider has to know you and the quality of your services, and trust that you can help their client.

It takes time to develop and maintain relationships with referral sources. But once they are established, they are the best way to get high-quality, consistent referrals over the long term.

If you stick to these guidelines, you may find that physicians, specialists, other professionals, clients and people in your community start talking about you, referring clients to you, and recommending you as an excellent clinician who is the best in your area. But to become “the one,” you have to give them something to talk about. Castro-Casbon, J. H. (2017).

Have a plan, put it in writing, and ask others how they do what they do.  So often we feel that we are on this private practice island alone.  Ask a colleague if they will partner with you or mentor you if their vision fits in with your idea of what the practice will look like.

BE BUSINESS SAVVY

Sometimes it seems as though insurance companies set out to thwart our progress, but do not let insurance companies deter you. Reimbursement from private and federally funded insurance companies can set you apart as a private practitioner. Speech and language services can be costly and many patients would not be ale to afford our services.  Becoming a participating provider with insurance companies will broaden you patient base.

Finally, there is a wealth of support and information on social media platforms , but fact checking is important.  There are many advantages to using social media effectively to aid in becoming business savvy, the top three include: Learning, networking and marketing (Bland 2014) Start with identifying your client base, and researching your targeted market. (Roehl, 2015)

The building of a practice is always a work in progress.  It may take a long time to create a masterpiece. Remember you are likely not going to start out the way you will finish.  It is a marathon, not a sprint and it is likely that the masterpiece you envision on day one, may look very different than what it actually is years from now.

CREATE the kind of practice you have always dreamed of.  Your success depends on you.

Acknowledgements: I would like to thank my partner Tara Roehl for her contribution; this post is adapted from our 2017 ASHA presentation entitled: Be YOU[nique]: Ethical and Innovative Service Delivery Models to Grow Your Private Practice

 

References

Aaker, D., & Keller, K. (1990). Consumer Evaluations of Brand Extensions. Journal of Marketing, 54(1), 27-41. doi:10.2307/1252171

Adkins, A. (2016, May 11). What Millennials Want From Work and Life. Retrieved March19, 2017, from http://www.gallup.com/businessjournal/191435/millennials-work-life.aspx

Adults Prove the Main Focus for Health Care SLPs. The ASHA Leader, 20(10), 28. doi: 10.1044/leader.AAG.20102015.28.

American Speech-Language-Hearing Association. (2015). SLP Health Care Survey report: Privatepractice trends, 2007–2015. Available from www.asha.org

American Speech-Language-Hearing Association. (2017). SLP Health Care Survey report: Annual salary trends, 2005–2017. Available from www.asha.org

At a Glance: SLPs’ Earnings Keep Climbing, Survey Finds. The ASHA Leader, 18(10), 24. doi: 10.1044/leader.AAG.18102013.24.

Bland, A. (2014). Get Social: On Being Socially Savvy. The ASHA Leader, 19(2), online only. doi: 10.1044/leader.GS.19022014.np.

Brown, J. (2015). Health Care SLPs Face Productivity Pressures, Fewer Full-Time Positions. The ASHA Leader, 20(9), 34-35. doi:  10.1044/leader.OTP.20092015.34.

Can They Make Me Do That? Is It Even Ethical?. The ASHA Leader, 20(3), online only. doi: 10.1044/leader.OV.20032015.np.

Castro-Casbon, J. H. (2017). Give Them Something to Talk About. The ASHA Leader, 22(8), 42-43. doi: 10.1044/leader.IPP.22082017.42.

Cehrs, A. (2015). Make Your Business Stand Out. The ASHA Leader, 20(5), 34-35. doi:10.1044/leader.IPP.20052015.34.

Ciotti , G. (2015, January 25). 10 Classic Studies on Pricing Psychology. Retrieved March 19, 2017, fromhttp://www.huffingtonpost.com/gregory-ciotti/10-classic-academic-studi_b_6182498.html

Freidson, E. (1980). “Conceiving of Divisions of Labor”. Paper presented at the annual meeting of the American Sociological Association. New York University.

Grooms, D. (2016). Show Us the Merit. The ASHA Leader, 21(12), 30-31. doi:10.1044/leader.BML.21122016.30.

Hall, N. (2017). That Special Niche. The ASHA Leader, 22(3), 38-39. doi:10.1044/leader.IPP.22032017.38

How Much Do SLPs Earn in Private Practice?. The ASHA Leader, 20(11), 20. doi: 10.1044/leader.AAG.20112015.20

Petrilla, M. (2016, February 20). ‘Millennipreneurs’ Are Starting More Businesses,Targeting Higher Profits. Retrieved March 18, 2017, from http://fortune.com/2016/02/20/millennial-entrepreneurs-study/

Polansky, R. & Arsenault, J. K. (2016). Mobile Health Care: A Private Practice Niche.The ASHA Leader, 21(10), 40-41. doi: 10.1044/leader.IPP.21102016.40.

PwC’s NextGen: A global generational study (2013). Retrieved March 18, 2017, from http://www.pwc.com/gx/en/hr-management-services/publications/assets/pwc-nextgen.pdf

Roehl, T. (2015). Grow Your Practice Through Social Media. The ASHA Leader, November 2015, Vol. 20, online only. doi:10.1044/leader.GS.20112015.np

Ruark, J. L. (2004). Food for Thought Little Research on the Development of Oral Skills for Swallowing: Is Ignorance Bliss?. Perspect Swal Swal Dis (Dysph), 13(1), 20-22. doi:10.1044/sasd13.1.20.

Zuckerman, E., Kim, T., Ukanwa, K., & Von Rittmann, J. (2003). Robust Identities or Nonentities? Typecasting in the Feature-Film Labor Market. American Journal of Sociology, 108(5), 1018-1074. doi:10.1086/377518

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Yvette McCoy, M.S. CCC-SLP, BCS-S
Yvette McCoy is a speech-language pathologist with over 25 years experience, specializing in adult neurological rehabilitation with a special interest in dysphagia and stroke rehabilitation. She owns Speak Well Solutions, LLC. She is certified by the American Speech-Language-Hearing Association, a board certified swallowing specialist, eight time ACE Awardee, mentor and CFY supervisor. She currently serves on the Adult Services Committee for the Maryland Speech-Language and Hearing Association. She is a member of the Dysphagia Research Society where she has served on the Website Communications and Public Relations Committee. She is co-creator/author of the mobile app 'Dysphagia Therapy', and published author for the ASHA Leader. Finally, she is an adjunct instructor at the University of Maryland, College Park.

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