The Pros and Cons of Running Your Own Practice

Starting your own private practice is an enticing idea for many mental health professionals. The allure of flexible hours, autonomy, and the chance to create a practice that reflects your values can be deeply fulfilling. However, it’s not without its challenges. After more than 20 years in private practice, I’ve learned firsthand that it comes with wearing many hats and facing responsibilities you may not expect.

Here’s an honest look at what it takes to run your own practice—and why, despite the challenges, it’s been worth it for me.

The Pros

1. Autonomy

Being your own boss is liberating. You decide how to structure your practice, which clients to see, and how to organize your schedule.

2. Flexibility

Want to avoid the 9-to-5 grind? You can. Need to schedule time for family, hobbies, or rest? You have that freedom.

3. Creative Fulfillment

Running your own practice allows you to design a space and process that reflect your values and vision. For me, supervising and mentoring emerging mental health professionals has been a deeply rewarding part of this journey.

4. Continuous Growth

Owning a practice keeps you on your toes. Over the years, I’ve developed new skills and insights that have helped me serve my clients better and adapt to changing needs.

The Cons

1. Wearing Many Hats

As a business owner, you’re not just a clinician. You’re also an administrator, accountant, marketer, and problem-solver for everything from broken toilets to parking issues.

2. Financial Uncertainty

Starting out, income may be unpredictable. Managing overhead costs—rent, utilities, insurance—requires careful planning and discipline.

3. Burnout is Real

The flexibility of private practice can also be its downfall if you don’t set boundaries. Managing the emotional load of clinical work while running a business is demanding.

4. Marketing and Growth

Attracting and retaining clients is ongoing work. Learning how to market your services effectively, particularly in today’s digital world, is essential but can feel overwhelming.

5. Ethical Challenges

I’ve noticed some practices are built with the intention to sell. While this is a business strategy for some, I believe it undermines the clinician’s reputation and the trust we build with clients.

What Keeps Me Going

For me, the biggest reward has been the opportunity to supervise and mentor talented mental health providers. Watching them grow into confident, capable clinicians has been one of the most satisfying aspects of my career.

Additionally, running a practice has allowed me to continually evolve—learning new techniques, deepening my understanding of client needs, and pushing myself to serve better.

Final Thoughts

Private practice isn’t for everyone. It’s a balance of freedom and responsibility, creativity and discipline, passion and pragmatism. If you’re considering this path, I encourage you to weigh the pros and cons honestly and ensure you have the support, resilience, and resources to sustain it.

I would love to hear your thoughts and experiences.

What has worked for you, and what challenges have you faced in building your practice? Let’s keep the conversation going.