Yap Sesh S2 E3: The Private Practice Episode

Anna: Welcome to Yap Sesh. We’re your hosts. I’m Anna Diemer.

Maurice: And I’m Maurice Goodwin.

Anna: And as of the release date of this podcast, we are less than a week away from our next live course, Building Balance: Addressing Vocal Fold Lesions in Singers, which will be Saturday, September 20th at noon Eastern Time. Maurice, tell us a little bit about Building Balance.

Maurice: Building Balance is all about the tools, the strategies, the tips, the knowledge, the information required for feeling competent and confident when working with singers who either have a suspected lesion or have been diagnosed with a vocal fold lesion. The main lesion categories we’re covering are vocal fold nodules, cysts and pseudocysts, and polyps. As a speech pathologist myself, I’ve spent the last eight years working with clients with these diagnoses, and when I’m working with singers I’m often collaborating with their voice teachers—figuring out how to get through rehearsals, what strategies are safe while they’re under the care of a laryngologist and a speech pathologist. We’re also going to spend time talking about postoperative voice care—what that timeline can look like for different singers, and what the relationship can look like as someone transitions from care with a speech pathologist to care with the singing voice teacher. So much of working with singers who have vocal fold lesions is just really understanding how the whole process works. How do the pieces fit together? What is everyone’s role? Having that knowledge makes me a more confident clinician, especially now in private practice.

Anna: Excellent. We hope you’ll join us live. You still have time if you’re listening to this episode when it comes out. If you can’t join us on September 20th, the replay will be available for one year, and you can earn ASHA CEUs both live and by watching the replay. So come join us at noon this Saturday, September 20th, and you can register on our website, voiceproed.com/courses. We are pumped. This is the second time we’ve run this course and it gets bigger and better every time. We always say buckle up, strap in—we’ve got a jam-packed two hours of content.

Maurice: Yeah.

Anna: And learning ready to go for you.

Maurice: Jam-packed.

Anna: So today I thought I’d pick your brain because we always get questions about this, and I know you get so many questions in your DMs: “You’ve started your private practice, how did you do that?” The inquiring minds want to know. So finally, y’all, it is time for our private practice episode of Yap Sesh.

Maurice: Perfect. I recently made the transition from working at a large hospital and a voice center to being in private practice—working as a speech pathologist and a voice teacher. And you’ve been doing this for a couple of years now.

Anna: Yeah, my studio technically opened in 2018, so… yee-haw.

Maurice: Oh, you mentioned last time you’d passed the seven-year itch.

Anna: Yes, yes. So fingers crossed, we’ll have longevity and prosperity—and surviving in capitalism—for as long as I need to.

Maurice: In it for the long haul. My biggest motivation for private practice was just the opportunity to do more of the work I wanted to do, in the way I wanted to do it. Having a hospital job means working 8 to 5, and sometimes I wanted evenings, weekends, or not to work before noon. That may sound trivial, but it was a big part of how I wanted to live my life, and I felt like I’d finally gotten to a place where maybe I could make those decisions. With private practice you sacrifice other things: I don’t work alongside the laryngologists I partnered with for years, I don’t have the same equipment, and my SLP colleagues—though just a text or call away—aren’t next door. It’s a different type of work, especially solo. And now I primarily practice virtually—teletherapy and voice teaching—so I don’t have any in-person clients. How was that experience for you?

Anna: Yeah, it definitely can be a little isolating, especially during the pandemic when everything went online. Telehealth existed before COVID, but it became much bigger after. Voice lessons online weren’t really a thing—maybe occasionally you’d hop on Skype with a teacher in New York or LA—but then suddenly everyone was doing it. That opened up possibilities, and like you said, it’s just me in my studio. I don’t miss the small talk, but I do like being around like-minded folks. It helps that they’re just a text away—“Hey, I have a client experiencing this, any ideas?”—and I’ve found those communities online. But sometimes I do miss other humans.

Maurice: Yeah, I hear you. What surprised me was how different my day-to-day tasks are. At the hospital—similar to a teacher working at a managed studio—my primary tasks were all client management. Communicating with clients, making sure care aligned with the team, and sharing that with the rest of the team. I was very busy, seeing 30 to 45 clients a week, sometimes more. Now the pace of client care is slower, but the tasks are broader. I’m my own scheduler; when someone reaches out, I respond. If they have insurance questions, I answer them. I keep my website up to date, pay all the bills to keep a practice running. I don’t think it’s easier—the pace of care is slower, but it’s just different work compared to when someone else managed those things.

Anna: Yeah. So how do you feel about that being part of your job now? You’ve gone from being further down the tree to being the CEO. You’re not just the speech pathologist and voice teacher—you’re also the CEO. Are you enjoying that?

Maurice: So far, yeah. There are definitely parts I enjoy. I like managing my own time and the business side of things. The challenge is that my clients are kind of scattered, so it’s not consistent. At the hospital I was there every day, 8/9 to 4/5—so even if the schedule changed, I was present. Now, that’s not the case. Like, Tuesday I didn’t see any clients—it was just a day working on other stuff to keep the business moving. I have an adjunct faculty job, I’m working on VoiceProEd things—it’s still work that has to be done, just a different kind. I’m still figuring out the groove of what’s “business running the business” versus other work, and fitting it all into one job.

Anna: I think there are different strategies for different folks. I’ve tried lots of schedules. One year I started clients at 10 AM, had a 10 and an 11, then nothing until after 4. I always crash in the afternoon, so that helped, but it made my days feel like 10 hours because I wouldn’t finish until 8 PM. The middle block was too awkward to use. Now my schedule’s more regular, but I’ve also been doing this longer and refined what works. I’m trying to drop my latest slot—getting done at 7:30 vs 8:30 is a huge difference. If I finish at 7:30, I can cook, eat, and be done by 9, then wind down. It can be tough to find where everything fits, but it gets better.

Maurice: I’ve already realized this: a misconception I had at the hospital was that folks chose clinics purely by preference. But some people literally cannot make it to a hospital between 8 and 5, so they need evening appointments. Most hospital clinics aren’t open evenings or weekends. A lot of people can’t take daytime off regularly. I’m finding folks choose me not because they wouldn’t go elsewhere, or because I’m special—it’s just practical.

Anna: Mm-hmm.

Maurice: What works for my life also works for theirs. And that’s reason enough. What you didn’t like about that split schedule is probably what I really enjoy. This morning I had a client at 8 AM, and I won’t have another until 6 or 7 tonight. I’ll just chill during the day—gym, house stuff, business tasks. I love the spread, and the space between sessions to just be a human.

Anna: Yeah, that makes me cringe hearing that. I sometimes get the neurodivergent “frozen-ness” if I have a thing planned later—like I can’t get too deep into anything because then I’ll have to pull myself out of it to go do this other thing. So I have days like that sometimes.

Maurice: Uh… ah… yeah, yeah, yeah.

Anna: But they are not my favorite. I’d rather just be done. There’s something freeing about that in my brain. So I love—get in the comments and let us know what your schedule is like, how you like to plan your days, what works for your brain. Everyone is different, and I love to—

Maurice: Oh, for sure.

Anna: —hear about this.

Maurice: Besides the schedule, was there anything else in building your own studio or practice that you tried and it just didn’t work?

Anna: Oh, that’s a good question. I’m gonna have to think about that, because I am—like we talked about last episode—I’m quick to ditch something if it isn’t working. So even if I tried it, it may not have lasted long enough to register before I said, “Yeah, no, we’re getting rid of that.”

Maurice: Yeah, yeah, yeah. I think what I’m finding in my own practice is feeling comfortable with ditching things. It’s not unfamiliar—we’ve had to cut things with VoiceProEd or other projects I’d committed to and then realized, “I just don’t want to do this anymore.” But the unique thing about owning your own business in private practice is that it feels very personal. It was your idea, or something you really committed to, and then you realize it isn’t working. And that’s OK too.

Anna: I did think of something—and it was trying to be a content creator, specifically.

Maurice: Yeah.

Anna: Not just using social media for advertising. Which is funny, because most of my clients find me by word of mouth or Google. Just existing on the internet is part of my marketing strategy. But there was a while when I was putting out unique content four or five times a week for six or eight months. I even recorded barbershop quartet tags on the Acapella app—four of my heads singing together. That was fun, and I’m proud of those, and it was nice to feel that creative flow. But it was also exhausting, and I realized my energy was better put into actually teaching and seeing clients.

Maurice: Yeah, I would agree. I think the assumption—and I wouldn’t assume everyone who listens to this podcast follows VoiceProEd or either of us on social media—but we’ve both invested a lot in it. I still see it as a good vehicle for people to know who I am and what I do. But the assumption is that having a following automatically makes your private practice or business more successful. That’s not necessarily true. The two things are very different.

Maurice: I’d say I’ve maybe gotten one or two clients from social media. The rest are referrals—from people who know me, from ENTs who know of me, from voice teachers I’ve worked with, or from Google. Very rarely does someone say, “I found you on Instagram and I think we’d be a good fit.” Not that that’s bad—it just doesn’t drive the business. Someone into business or marketing would probably say, “There’s a way you can make that work better for you,” but I’m OK with where it’s at. Before I started, I probably would have assumed social media would be a big client source. But honestly, my following is mostly clinicians, other voice teachers, some singers and performers. It’s interesting how that’s turning out.

Anna: So kind of to follow up on that—what would you say is your ideal client? I think this can be twofold: who’s actually finding you, and who are the ideal clients you want to teach and work with as an SLP? And where do those overlap?

Maurice: For sure. I feel really lucky that all the clients I’m seeing now align with what I enjoy doing. That has been a surprise. At the hospital, I was lucky—I had a great job, good training, work I liked. But I had no choice over who I did or didn’t see. And for me, I don’t really enjoy doing cough or upper airway cases. Not that I can’t, it’s just not the most fun. Same with some neuro-voice or motor speech work—it’s interesting, but I’m not great at it.

Maurice: That doesn’t come up in my private practice. Usually people who find me know me for working with singers, singers with voice problems, professional singers with something coming up who need help digging through their voice. That’s 100% of my caseload right now, and that’s fun. It makes the work enjoyable. I love working with voice teachers, with other SLPs, with singers at any level—and thankfully that’s who I see. How about you?

Anna: Yeah, that’s fantastic. I also love working with voice teachers, choir directors, SLPs. I get all sorts—from choir directors who need help managing their vocal load and their students, to folks figuring out how to carry vocal hygiene into the classroom. And I love working with SLPs who want to get more into voice. We always recommend: take your own voice lessons. Come see me. I love that so much because of the shared language we already have around the voice and the body.

Anna: I’ve even been seeing a physical therapist who does pelvic floor therapy—that’s been fun because of the shared language, even though she’s a beginner to voice. She understands motor learning, so when we get into tricky spots I can connect it to her work. Having that extra layer is so much fun for me.

Anna: I also see a lot of avocational adults. I know I’ve said this a million times on the podcast, but the Singing Through Change population—folks going through perimenopause or post-menopause—are a big part of my client base. I love deconstructing: what was your past in voice, and how can we change that in a way that serves you better now?

Maurice: Yeah, yeah, yeah.

Anna: I love working with clients on reframing and guiding—vocal technique, but also, “How are we going to wrap our heads around this?” I love holding space for that.

Maurice: Yeah. Are there any populations in the future you’d want to work more with?

Anna: I always love working with trans folks. I’m phasing out of my last couple of voice feminization clients, and I’m like, “Oh no, I need more trans folks in my studio.” People coming in for speaking voice usually don’t stick around as long because of the nature of the work. I’m here to support as long as needed, but usually there’s a point where they say, “I’m confident with my speaking voice now,” and I get to set them free into the world to use their beautiful voice.

Anna: So I’m always looking for more folks from my community to work with. And speaking voice work is a fun change for me—different from singing exercises, keeps my brain engaged. It’s novelty, and it’s fun.

Maurice: Yeah, yeah, yeah. Cool. As you’ve grown as a teacher, a person, a human, a business owner—are there any resources you think are helpful? I’ll shout one out really quick. I know I asked you the question, but honestly, owning and running a private practice wouldn’t have been possible for me without YNAB—You Need a Budget. I’m a serial YNAB-er. It’s a budgeting tool that works powerfully for personal finances, but I also use it for business. I would not have been as successful transitioning from a stable paycheck to the less stable solo-practice lifestyle without YNAB.

Anna: I love that you shouted that out because I didn’t even think of it—and I’m a YNAB Certified Coach! So if you’re interested in learning more about it, I’m—

Maurice: For anyone who didn’t know, Anna is my YNAB daddy.

Anna: It’s true. I have several generations now of children.

Maurice: I’ve shared the gospel of YNAB, so you definitely have grandchildren.

Anna: Oh yeah, I have children and grandchildren. Back in 2017, I remember being stuck in my apartment during Hurricane Harvey, going through my finances in YNAB and trying to figure out if I could start my private studio. It was such a powerful tool to help me feel confident in both my personal and business finances. I use a separate budget for each. If you’re interested in the tool, I’m a certified coach—you can find me at ynab.gay, my website.

Maurice: YNAB dot gay.

Anna: Yep, ynab.gay. I love helping other small business owners do this—it’s so important to know you can pay your bills, feel secure, and still do the things you want to do.

Maurice: Oh my goodness, yes. We had talked about surprises in starting a business, and I recently made a TikTok you commented on—I am 100% making less money than I did at the hospital. Just overall, with running a business, taxes, everything. However, I’m way happier. My head is more on my shoulders, I feel like a better human, a better version of myself. Even though I’m not bringing in as much income right now, I’m still saving, still putting money into retirement, still paying my bills. And I’m able to do that because of a tool like YNAB. If not YNAB specifically, then some system like it. Honestly, that was one of the biggest things that gave me the confidence to jump into working for myself—knowing I could make it work financially.

Anna: I love that. I was about to ask—were you surprised that you’re happier now? Where are we going with this? [laughs] Because for me it wasn’t necessarily a surprise, but yes, I also enjoy having agency over my schedule, the clients I take, and what I do. That makes things easier.

Maurice: Yeah. We’ll talk more in the future, but I’ve been thinking about this a lot. Sometimes the cynicism we feel—as SLPs working in hospitals especially—comes from being in environments that take so much from you. Even though I loved my job, my colleagues, my clients, it created a relationship to work that wasn’t always healthy. It made me feel like my energy was constantly being drained. And sure, I thought, “I should be paid more,” but honestly, even if I had made more money, I probably still wouldn’t have been happy. That’s when I realized I had to figure out something else.

Anna: I think this work in general—anyone seeing one-on-one clients, interfacing with lots of people—it’s draining. Even though I don’t see the caseload numbers I once did, it’s still tough work.

Maurice: The further I get from it, the clearer that feels.

Anna: Exactly. But I still want to show up as my best self, with my most focused brain, for my clients. And the beauty of having a private studio is that when I show up for my singing clients every week or two and say, “The brain isn’t braining today, y’all,” they’re like, “That’s fine.” We can both come in as who we are in the moment. I’ve structured my studio to hold space for that, and I really appreciate it.

Maurice: Yeah. And the structure of my sessions is different now too. You can make things work the way that you want, not just the way an electronic health record requires, or how a past teacher ran things. You literally get to make it up. If it works for you, you keep it. That’s another great part of doing your own thing.

Anna: Yeah. Which brings me back around to resources—for Tool Time today, I thought we could just talk about resources and tools we use. Maybe more rapid-fire. We’ve already sung the praises of YNAB. And now I’m like, “What else do I actually use?” I teach a lot on Zoom. I used LiveLab a lot, but it just went away.

Maurice: RIP LiveLab.

Anna: RIP LiveLab. We’re using Cleanfeed to record this podcast—thank you, Cleanfeed. I do my bookkeeping in Google Spreadsheets. The scheduling software I use is called Fons, and I really like it.

Anna: They have great support. They changed a feature and I couldn’t find it, so I messaged them and they were back with me in like an hour. I’ve really enjoyed that program. What else? You can go ahead and jump in with a few of your faves.

Maurice: Yeah. So there are a few things I have to have in private practice when dealing with clients’ medical information. I use Google Workspace for client contact, since I have a BAA signed for HIPAA compliance in terms of email, document storage, and saving files. I use Sessions Health for my electronic health record. If you haven’t heard of it, it’s actually a therapy platform built for mental health therapists or counselors, but it works perfectly for a solo SLP. It may not be as flexible if you had multiple therapists working under you, but for me it’s $37 a month and perfect. It creates superbills, and they’re also a small company—I’ve had features added that I needed, and they were happy to do that.

Maurice: For my non-therapy voice clients, I use Acuity for scheduling, which works really well. I use ClickUp—I have a personal Goodwin Voice account where I take notes during sessions, so that’s where I keep everything. And I’m a serial Apple Notes user, so I always have tons of tabs open with thoughts and things I need to complete. Those are the things I use daily.

Anna: Yeah, as I look at the Apple Note with our podcast outline right now. Of course we’re using ClickUp. We use a service called Esmoriz to host and sell our courses, which is also great because it’s a small business and they’ve added features for us.

Maurice: They have definitely added features.

Anna: Like a non-zero amount, which is so great. Fons is a smaller company too. I love being able to go in the Facebook group and talk to the owner of Fons, or just email Leo at Esmoriz and ask, “Hey, could you add this feature?” And then they’re like, “Oh, we added it—it’s in settings now.” Being a small business that supports other small businesses is awesome.

Maurice: Yeah, that’s great. One of my fears starting out was, “Oh my goodness, now I have to tackle something like SimplePractice,” or when we were looking for course hosting websites—these giant platforms with a million options. That’s not what we wanted. In my private practice, I didn’t need something complex. I needed something simple that let me log in and get started. Streamlining the process was a priority.

Maurice: If you’re hearing this and feeling overwhelmed by all the options—there are a lot when it comes to managing your time, data, and information—know that there are simpler platforms out there that make complex work as simple as possible.

Anna: I love that. OK, I have one wrap-up question for you. Let me word this right: someone is ready to start their private practice when… blank.

Maurice: I’ll answer with the first thing that comes to mind. Someone is ready to start their private practice when, in the area of voice, they feel they have the confidence and competence to independently sit in front of a client and offer support rooted in evidence-based practice—and when they’re able to fully be present and offer what makes them unique. Working in voice disorders is tough. There’s a lot to know. I’m grateful I spent so long in a hospital setting, on a team, working alongside others. That doesn’t have to be everyone’s path, but for me, it gave me a huge foundation of knowledge that now allows me to just be present with a person and help them in a way that works best.

Anna: That’s fantastic.

Maurice: Kind of a complex answer.

Anna: But it’s a complex thing, right? My answer is complementary to yours. If you’re ready to start a private practice or private studio, you’re ready when you understand what goes into building a business and are prepared to tackle that. Yes, it will give you freedom to sit with your clients, be present, and do meaningful work. But that means nothing if you can’t successfully run your schedule, don’t know where to get business insurance, or aren’t prepared to be not just the specialist and artistic director but also the CEO.

Maurice: Mm-hmm.

Anna: If you’re ready to take on that combo, take that leap of faith—then maybe private practice is for you.

Maurice: That’s great. Complementary responses.

Anna: Maybe we should start a business together—we’ve been such a good team. Oh my gosh. Well, as a matter of fact, you can see how we work together! [laughs] I’m always the promo person, coming in with my announcer voice: If you haven’t yet experienced how we vibe together in a learning environment, you should come to Building Balance on September 20th. Learn all about vocal fold lesions with us.

Anna: If you can’t make it live, no worries—the replay will be available for a year and you can still earn ASHA CEUs. So we hope to see you this Saturday the 20th at noon Eastern for Building Balance. If not, check it out on our website. The replay will post a few days after the course, and you can also explore our evergreen courses there, including Voice Notes: Documentation for Voice Clinicians and Achieving Competence as an SLP Working with Singers. If you’re brand new to working with singers, that’s your place to start. Check it all out at voiceproed.com/courses. We’re excited to be back for the fall!

Maurice: We’ll see you.

Anna: See you soon. Bye.