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Over the past few years, I’ve learned and written about what it takes to succeed in private practice from office culture to marketing, technology, and more. And it has been my honor and joy to share all of my knowledge (and humble opinions) with you all.

For many years, the idea of making money in counseling was taboo, but the tides are turning and people are asking, “Healthcare professionals of many flavors are running successful (thriving) practices, why not us?” While it isn’t always fun to be the face of money in counseling, I recognize that it’s part of the role. And it’s more than worth it when I meet counselors who have been able to make a living or put their kids through college with my help. 

In reflecting over the last several years, this month I thought I’d give 50 private practice ideas—points taken from 50 columns. Enjoy:

1. Having a well-run business will allow you to provide better service to your clients.
2. You don’t need a lot of money to get started.
3. Good therapists can fail due to poor practice management.
4. Complete all of your clinical notes before you leave for the day.
5. Work on your practice, not just in your practice.
6. Starting a practice is a big transition.
7. Marketing takes a lot of energy at first, but gets easier over time.
8. There is hope even if you hate networking or “selling yourself.”
9. Know who your target client is, then get to know him/her better.
10. Differentiate your practice from the rest.
11. Solo practices can provide a good income—but are difficult to sell.
12. You should know what your practice is worth right now.
13. Practice “thought leadership”: put what you know in writing.
14. Some counselors are excellent, but half are below average.
15. Don’t criticize insurance reimbursements if you’re letting sessions run 20 minutes over.
16. Medical billing is important; a 90% collection rate is death.
17. Protect your time to protect your creativity.
18. Don’t be timid to charge for services.
19. Don’t shy away from no-show fees.
20. Preventing provider turnover starts at recruitment.
21. Hire team members slowly and carefully; check references.
22. Be generous to your employees, your clients, and even your competitors.
23. Your team members should know where they stand what it takes to be promoted.
24. It’s important to honor employee birthdays, anniversaries, achievements.
25. Great employees demand more money, recognition, and ongoing growth opportunities.
26. Don’t wait for someone to pick you; don’t seek approval from others.
27. Don’t blame anyone else if you’re not where you want to be.
28. What prevents you from success is within, not without.
29. Be curious and question many things.
30. It’s okay to not have all the answers.
31. Nobody has everything figured out. Seriously, nobody.
32. Have patience, but proceed with urgency.
33. Stress management and rest are important.
34. For the love of god, proofread.
35. Don’t spend thousands of dollars on advertising unless you’re sure it will work.
36. Answer your phone!
37. Consider buying your building if you’re going to be there awhile.
38. Time is of the essence; get your service to market quickly.
39. You can open a counseling center, and see your first client, in a week.
40. McDonalds opens at 5am. Coffee refills are free.
41. Delegation is a learned skill—and an important one at that.
42. Be smart about what you name your practice. (Please, no puns).
43. Set goals for the year and work like crazy to surpass them.
44. A new website looks dated, very quickly.
45. Figure out what you need before you find the technology.
46. No matter how good you are, you will get some negative reviews.
47. Start getting on insurance panels now, because it takes months.
48. Whether to hire counselors as contractors or employees is an important decision.
49. Your office might look better than most, but clients expect what they see on TV!
50. Growing from a solo practice to a group isn’t for everybody.