3 Profit Killers Hiding in Your Private Practice (and How to Fix Them Fast)
If you’ve been running your practice for a while, chances are you’re not new to hustle. You’ve sat through CEUs on ethics and trauma care, learned more about CPT codes than you ever wanted to, and figured out how to make Zoom therapy feel personal.
But when it comes to the money side of things? That’s where most therapists feel like they’re winging it.
Plenty of therapists make a ‘decent’ living. But I for one don’t think that decent is good enough for the work that we do. If you’re going to spend your days saving marriages, rebuilding self-esteem and healing what you never broke, you deserve to take a vacation and to feel secure in your finances.
But so many of us are not feeling secure. I pride myself in working with clinicians and mission-driven business owners, and I’ve seen three specific patterns quietly and consistently draining profits—no matter how smart or seasoned you are. The good news? Each one has a clear (and doable) fix.
Profit Killer 1: Random Pricing
The Symptom:
You set your rates based on what feels fair, or what other therapists in your area charge. You might even feel a little guilty asking for more, especially if you came into this field to help people, not “get rich.”
The Problem:
Your rates don’t reflect the actual cost of running your practice. That includes not just your time in session, but everything else, EHRs, liability insurance, marketing, admin tasks, and yes, your salary and taxes. I think almost every piece of tech software that I use in my business has increased in cost over the last 18 months, with some being raised 10% or more. All of that adds to the cost of what I provide. If your costs have gone up, but not your rates, there’s a problem.
The Fix:
Do the math. Calculate your true cost per session:
Add up all monthly expenses (fixed and variable)
Add in the salary you want to pay yourself
Divide by the number of clinical hours you work each month
Add a profit margin (yes, you deserve one)
You might discover that your current rates are barely covering your expenses—let alone funding your life.
Profit Killer 2: The Seasonal Cash Flow Trap
The Symptom:
Your income swings wildly, great in September, ghost town in December. You brace yourself for the summer slump, but it still knocks you off your game every year.
The Problem:
Inconsistent income creates constant stress. You don’t know how much you can pay yourself or invest in your business, so you either overcommit or pull back too hard.
The Fix:
Review your income over the past 12 months. Identify your high and low revenue months.
Then, during peak seasons, set aside 20–30% to carry you through the slower periods.
This one strategy alone can turn chaos into calm and keep your nervous system regulated (which helps everything else, too). Bonus tip: Sometimes inconsistent revenue is a symptom of inconsistent marketing efforts, so making a plan to keep leads coming into the practice is another way to fix this issue.
Profit Killer 3: The “Everything’s a Business Expense” Mentality
The Symptom:
You’ve justified that new course, that fancy planner, and five different coaching subscriptions by saying, “It’s a write-off.”
The Problem:
Just because something can be deducted doesn’t mean it should be purchased. If it’s not tied to profit or essential operations, it’s likely draining your resources. There will be no ‘girl math’ on my watch.
The Fix:
Sort your expenses into three buckets:
Revenue Generating (ads, software that helps convert leads, consulting)
Essential Operations (EHR, malpractice insurance, supervision)
Nice to Have (anything else)
Then be brutally honest: what needs to go—or at least shrink? Protect your profits by tightening the tap on the non-essentials.
Bonus Tip: Weekly 15-Minute Profit Check
Block 15 minutes a week to ask yourself:
Are my prices still aligned with my actual costs?
Am I prepared for my next seasonal dip?
Am I spending with intention—or just justifying?
Small course corrections now prevent financial burnout later. You can grab my free guide to CEO dates to get some other questions to review if you want to make sure you’ve got a solid plan to keep more of what you earn.
Being a helper doesn’t mean you have to live on the edge of burnout or broke. You can do meaningful work and build a sustainable business. Start with these three tweaks and watch what happens and if you need more of a adjustment than a tweak, check out the Revenue Reset Workshop which will give you the strategy that you need to boost your revenue in 3 days or less.