Why I Started Private Pay Practitioners

I was walking the AIDS Walk in 2016 when a friend told me about money recovery.

I'd asked her to come with me. We knew each other from another recovery program. I had no idea she was also in money recovery until somewhere along the route, she started telling me about it. The meetings, the steps, the work.

Something cracked open. I said, "I need that."

At the time, ABLE Life Recovery, my practice, was being hammered by insurance companies. Clawbacks. Audits. The kind of thing where you've done the work, you've billed the work, and months later they want the money back. I was in serious debt. Taking out loans to pay my staff. Not paying myself.

I was bleeding out and I knew it. I just didn't know what to do about it. I had a business to run. I owed people what they were owed. So I kept going.

You probably know this feeling.

The Meeting That Changed Everything

I went to my first money recovery meeting the next day.

The first person I met recognized me from my book, I Just Wanted Love. A fellow therapist. The rooms keep showing you what you need to see.

I came in thinking I had a money problem. I left understanding I had a choices problem. I'd been operating like I didn't have any.

Money recovery taught me I had options. About my debt. About how I paid it. About who I talked to about it. It also taught me I had amends to make. Real amends. To family, to friends, to anyone impacted by my not understanding money, by my borrowing, by my difficulty repaying.

I had to take ownership.

For a therapist, that part hits a particular way. We're trained to help other people take ownership of their lives. We're not always great at doing it ourselves. I'd been telling clients about boundaries for years while my own business was a boundary-less mess.

The Bombshell

One of the first things they told me landed like a brick. They said, "Staying on these insurance panels is actually costing you money. It's draining you and your business. This isn't sustainable."

My response: Well, what in the hell am I supposed to do about it?

Being on insurance panels felt necessary. It was how I served clients. The fact that I might not actually get paid for serving those clients was a separate problem. Or so I told myself.

They said, "We think you need to drop the panels."

I was freaking out. I didn't know a single therapist who wasn't on insurance.

The Plan

What I came to love about money recovery was the planning.

Every week, I sat down with people in the program and we reviewed the plan. We talked through the challenges, the stressors, the things that were hard about running a business, paying staff, making it all work.

They weren't all therapists. The one who'd recognized me from my book was, and she helped me. What none of us had in common was a blueprint for what I was doing. Not one person in that group had ever left an insurance panel. What they had was the framework for looking at my finances honestly and building a plan I could actually execute. That mattered more than I understood at the time.

It wasn't a vision board. It was a plan.

Little by little, I started downsizing. I closed the group practice. I transferred my lease to a colleague. I moved my practice into my home and started seeing clients in my den.

A reset. A rightsizing. I wasn't willing to just close up shop and go work at Target. I needed something. And what I held onto, all the way through, was that I had choices. My higher power was with me every step of the way.

Leaving the Panels

One by one, I left the panels. I'd submitted my termination notices months in advance. When the contracts ran out, I was fully private pay.

It was scary. I was afraid of losing clients. I did. Some. Maybe 50%. Others stayed.

I made allowances for reduced rates, temporarily, as I got my grasp. As time went on, more structure surrounded my reduced rates, but only after full-fee clients started coming in. And strategically, I raised rates.

People love to call this kind of thing brave. It wasn't. I had a weekly meeting and a plan and I kept showing up scared. That was the whole thing.

What Came Next

After I went fully private pay, I needed something I didn't have: a community of other private pay practitioners. I didn't know anyone.

Somebody suggested I start a Facebook group. I had familiarity with that. I'd already run a Seattle-based networking group. So in 2017, I created Private Pay Practitioners.

It was just me at first. For about a day. Then people started finding me.

Almost ten years later, the main group has over 17,000 members. There's a Black Private Pay group with more than 500. There's a Georgia chapter with nearly 300 since I moved back from Washington. And there's a Patreon community of clinicians doing the deeper work together.

I didn't build any of that on purpose. I built it because I needed it. Then other people needed it too.

Why This Matters

Every therapist running a private practice deserves a sustainable one. Doesn't matter if you're taking insurance or you've gone private pay.

This matters because the work depends on it. If you spent the morning fighting an insurance company about a clawback from eight months ago, you're not going to be much good to your 2pm client. If your bank account is in a trauma response, you can't do trauma work.

Your nervous system is your clinical instrument. If it's fried, the work suffers. That's not a moral problem. That's mechanics.

My practice didn't get healthy because I read a business book. It got healthy because I went to a meeting. The work you do on yourself shows up in your business. You can't compartmentalize integrity. It either runs through everything or it leaks out everywhere.

If You're Drowning

If you're a therapist who's drowning right now in clawbacks, in debt, in the math of taking insurance, hear me.

You have choices. You may not feel like you do. You may not see them yet. But they're there. The fact that you can't see them is not evidence that they don't exist. It's evidence that you need different eyes on the situation. Other people's. People who've done this before.

And you don't have to figure it out alone. That's the whole reason this community exists. That's why I keep showing up. That's why I'll keep doing this work as long as there's a single private practice clinician who needs to know they're not the only one.

You're not the only one.

Private pay isn't a dream. It's a decision. The same one I had to make in 2016. The same one thousands of therapists have made since.

It's available to you. Come find us.