Winter Practice Clean-Up
Most clinicians are great at taking care of people and significantly worse at taking care of their business. We start our practices with a folder of borrowed paperwork and "good enough" policies, and then we never look at them again until something goes wrong.
If your administrative house is currently a mess, January is the time to clean it up. Here are the three areas where I see my peers in Ohio and Massachusetts getting stuck.
1. The "Suggestion" vs. The Policy
We’ve all been there: a client misses a session, and we waive the fee because we feel guilty or don't want to deal with the awkwardness.
But if you find yourself waiving your cancellation fee more often than you’re charging it, you don't actually have a policy—you have a suggestion. This isn’t just about the money; it’s about the professional boundary. Take a look at your manual. If your cancellation policy is no longer realistic for how you actually work, change it to something you will actually enforce. Then, notify your clients of the update. Being clear isn’t "mean"; it’s professional.
2. HIPAA is a Process, Not a Product
I see a lot of therapists who think that because they pay for a HIPAA-compliant EHR, they are "covered."
Security is about your daily habits, not just your software. When was the last time you did a proper risk analysis for your practice? Do you have a Business Associate Agreement (BAA) for every single tool that touches client data—your email, your cloud storage, your backup drives? If you’re still using a free personal email address for client communication, you’re already behind.
Cleaning this up isn't just about avoiding a fine. It’s about respecting the data your clients trust you with. If you wouldn't leave a paper file on a park bench, don't leave your digital files in an unsecure environment.
3. The "Insurance Math" Check
If you’re in private practice, you’re a business owner. That means you have to look at the numbers even when it’s uncomfortable.
With the cost of living and overhead rising, when was the last time you adjusted your private pay rates? For those who take insurance, have you looked at your newest contracts lately? Insurance companies aren't going to call you to offer more money; they’re going to wait for you to realize your reimbursement rates haven't kept up with your expenses.
Don’t wait for a bank statement to tell you that your practice is no longer sustainable. Review your fee schedule and make sure the math still makes sense.
Pick One Thing
You don’t have to fix the entire practice in one week. Just look for the biggest bottleneck and start there. Whether it’s updating your secure email or finally enforcing your late-cancel policy, just get your feet back on solid ground.
Running a solo practice is hard enough. Don’t make it harder by letting your admin fall apart.
I offer one-on-one consultations for clinicians who need a second pair of eyes on their practice logistics—specifically regarding trans-affirming care and neurodivergent-friendly business systems. Reach out if you’re looking for a consult.
For clients looking for virtual therapy in Ohio or Massachusetts, you can book a free 15-minute phone consultation here:
