5 mistakes to avoid when starting your own practice

Dave James is a podiatrist, business coach, speaker, and mentor in the UK, helping practice owners reach their goals of building a successful business while living happy, fulfilling lives. Take a look at his hard-earned advice on how to avoid some of the common missteps of private practice.

Doug Pohl·

Dave James opened his podiatry practice in 2010, setting up shop in a spare room at a dental clinic. (Teeth and feet make quite the pairing, eh?)

He made lots of mistakes. Tons of them, he claims. But thankfully, he learned from those mistakes and went on to run a successful business for more than 8 years before selling his practice and becoming a full-time mentor and business coach for allied health professionals.

I caught up with Dave to talk about his experiences and ask his advice for practitioners who have recently gone into private practice or might be thinking about taking the leap.

He had a lot to say, practically overflowing with insight (tons of mistakes, remember?). I’ve done my best to condense it all down for you in this article, presenting his suggestions for how you might begin to approach the idea of private practice.

This is not intended to be a comprehensive guide. Instead, think of it as an outline that can help you organise your thoughts and start your new endeavour with a clear vision of what you want and how you will achieve it.

I’ve also included quotes from Cliniko users who’ve had similar experiences. We asked our Instagram followers what they ‘wished they’d known before starting their practice’, and you’ll see some of their responses sprinkled throughout the article, illustrating that these are all pretty common missteps for new practice owners.

Mistake #1: Not realising that it all begins with you

As I spoke with Dave, I noticed a common thread weaving through everything he told me: as the practice owner, you are the foundation of your business.

If you strip away the training and expertise, the office and equipment, the website and the marketing, what are you left with? Just you. In fact, you are your business.

Building and maintaining a strong personal foundation will increase your likelihood of building a successful practice that you enjoy.

That’s a lesson that Dave learned the hard way. It took years of frustration before he finally looked inward to examine who he was as a practitioner and what he wanted from his practice.

‘You’ve got yourself at the bottom of the base of this business’, Dave says, ‘and if you’re not okay, if you’re not learning and growing and developing, you can’t really build too much on it.’

Here are some of the primary parts of your ‘foundation’ that Dave suggests you develop before you begin to build your practice:

  • Know yourself.
    You need to understand your worth as a practitioner and the value you’ll bring to others. Maintaining a strong sense of who you are will help answer some of the tough questions that lie ahead.
  • Know what your practice will be.
    From a business standpoint, what will your practice look like? Take the time to review all the possibilities and decide what works best for you and your vision.
  • Know where you’re going.
    Moving forward can be treacherous without a clear direction. Create a business plan and map out how you will achieve your goals.
  • Know who you want to work with.
    Dave said some appointments would drain all of his energy for the rest of the day while others would invigorate him for hours. It’s better to know your niche now and seek out the patients that excite you.
‘[I wish I would have known] to stick to your beliefs and goals and to not bend over backwards to everyone's demands and ideas on how you should run your business.’ - Nicole Kwan - So, Physio - Aukland, New Zealand

Mistake #2: Being unsure if private practice is right for you

In Dave’s experience as a business coach, he says most people never actually answer the question, ‘Do I really want to be in private practice?’.

That can be a problem when they dive into the work because they often find themselves committed to a business that is much more difficult and complicated than they expected.

Make no mistake, running your own practice can be very challenging. Your resolve will be tested over and over. If there’s any doubt about your desire for private practice, there will likely be a reckoning at some point.

That’s what happened to Dave. ‘I realised that actually running the clinic wasn’t where I wanted to be. I’d done that. I’d enjoyed that. I’d been successful at it. It was time to move on.’

So ask yourself if running your own clinic is truly right for you. Based on your understanding of who you are and what you want, can you commit to the idea and see it through no matter how tough things might get?

If the answer is no, that’s fine. It’s better to know now than to find out later after you’ve already started your business.

But if the answer is yes, it’s time to gain some knowledge.

Mistake #3: Having too little information

Dave discovered through trial and error that being a practitioner and opening a private practice are two very different things. He had a lot to learn about running a business, and he says it would have been great to know more about it before he started.

Take advantage of helpful resources

Before launching your practice, Dave recommends exploring your government’s online resources. The UK government’s small business website turned out to be really helpful for him. It was full of advice, tips, and recommended resources that made a big difference early on.

‘In the UK’, Dave says, ‘the government website is quite good for a lot of the stuff around self-employment, taxation, etc. That’s really quite useful.’

Here are links to some government small business websites to help get you started:

Dave’s also a bit of a book junkie and has some recommended reading that he wished he’d known about before he opened his practice:

‘Tyson’s book looks at the practicalities of running a practice’, Dave says, ‘whereas the other two offer a wider outlook and introduce the reader to powerful concepts.’

Consider a business coach

In 2015, Dave took on a business coach and says that’s when his practice really started to improve. His coach was an incredible source of information and experience that was always there to lend a helping hand when Dave needed one.

Dave said, ‘Probably the biggest thing for me was being coached. That was the thing which really made a difference to my practice because it helped me to work out more about who I am’.

A quick Google search will likely pull up a long list of coaches you can contact. But you might have better luck reaching out to friends and other practitioners to see who they recommend.

Or, you might consider some of the services that we’ve featured on the Cliniko blog:

However you go about it, just try to find someone experienced with running a private practice who also fits well with your personality. Most coaches will first want to have a conversation with you to make sure you’re both a good fit for each other. This is an important part of the process, because at the end of the day, the relationship has to work.

Once you have your coach, try to soak up all you can from them. But be careful. Dave warns that there can be too much of a good thing. At some point, you’ll have to stop taking advice and just dive into the work.

Yes, you’ll make mistakes, but that’s fine so long as you learn from them. Each time you do, you’ll become a little wiser and a little more confident.

‘Confidence comes from experience.’
Ben Carrigan - Acupuncture West London - London, UK

Mistake # 4: Not enough planning

Even though the path will be different for every person and practice, Dave has learned that some paths are better than others. Below are recommendations that he says can save you from having to double-back and start over the way he did.

Go paperless from the start

Dave began his practice by keeping paper records for each patient. When he finally decided to use practice management software, he had more than 2,000 patient files to convert into digital records.

‘Yeah, absolutely go electronic at the beginning’, he says. ‘Even though you look at it as a significant investment, it’s actually not in the grand scheme of things because it gives you an opportunity you can leverage. You can access it from any place, and you’ve got the integrations too.’

Embrace outsourcing

It was hubris that caused Dave to resist hiring a call service to answer his office phone. He thought he could juggle everything and do a better job for his practice than some stranger could.

But he was wrong. Dave missed out on bookings when prospective patients scheduled appointments elsewhere while waiting for him to return their call. Answering his own phone was costing him money.

After hiring a call service, though, Dave was booking more appointments than ever, with a steady stream of new referrals coming in. The service handled all the calls leaving Dave free to focus on patient care.

‘Taking on a call service was an absolute genius move’, he said, ‘because I could let the calls go to someone else, and it was alright. They’d take the calls, and they’d pull people in’.

Dave also recommends hiring a virtual assistant (VA). This helped him avoid extra hours at the clinic handling administrative tasks. He’d let his VA take care of that work instead.

Dave said, ‘Having a virtual assistant made a huge difference because it meant that if I had a letter I had to dictate, I could [voice] record the letter between patients, send that to my VA, and then she would have a copy sent back to me. It was just a really, really simple system’.

Light bulb


Ask your network for referrals of good call services and VAs. They’ll likely be your best resource for learning what companies will work well for your practice.

Get your marketing off to a good start

Marketing is one of Dave’s specialties. If you haven’t seen it yet, check out the recording of his social media marketing chat with Cliniko’s founder, Joel. It’s full of great advice!

Dave suggests three ‘must-haves’ for marketing your new practice:

  • Google My Business (GMB)
    This is one of the most important things you can do for your practice. When prospective patients search online for services like yours, Google My Business makes it easy for them to discover your practice. They can find your website and phone number, locate your clinic, and even book an appointment directly from Google.
  • A practice website
    You need to have a proper website with good branding. This lets you control how you present yourself and your practice, and provides a centralised location for your content (like blog posts and videos).
  • Choose a social platform
    In the beginning, just start with one social page and do your best to post often. You can add others later when you’re ready. If you’re ever unsure of what to share, Dave recommends just ‘being yourself and having some fun with your personality’. Talking about the things that excite and interest you can make it easier to connect with people.

Dave also suggests that you start networking straight away. ‘Networking made a really, really big difference. I actually started to get out there and meet people as a business owner. I started to refer people to other businesses and got referrals myself.’

If you’re not sure how to go about networking, Dave says it can be as easy as, ‘...ringing people up and saying, “Hi, I’m in your area. Can I buy you a coffee?”

Try not to be shy. Just do your best to get out there and let the community know you’re ready to help them.

Track your performance

Keeping a close eye on your financials is one of the best ways to make empowered decisions for your practice. From the beginning, you need to keep up with your numbers and maintain a clear understanding of how your business is doing.

To help with this, Dave says hiring a bookkeeper is well worth the investment. They can keep you informed on what’s happening within your business and help you discover ways to improve.

Reach out to your networking contacts for bookkeepers or accountants they use and recommend. You might also ask for suggestions in online forums or contact your professional organisation.

The Institute of Certified Bookkeepers could also be a good option for you. They have separate websites for Australia and the UK, and both make it easy to search for qualified bookkeepers in your area.

Mistake #5: Not preparing for growth

Some of Dave’s early mistakes were centred around money. He learned the hard way that financial decisions must be based on how well they help you achieve your business goals. And those decisions are all part of the preparation necessary to grow the way you've envisioned.

Preparing for growth means generating enough revenue, keeping healthy margins, and spending smartly, all without losing sight of your long term goals. Here’s what Dave recommends:

  • Choose appropriate pricing
    Practitioners often underprice their services based on what they think people can pay (or might be willing to pay) rather than having the confidence to charge what their services are truly worth.
  • Know your operating costs
    New practice owners can underestimate the costs of running their business. After paying their bills, they often discover there’s no money left to pay themselves.
  • Spend wisely
    Many people (including Dave) purchase equipment they don’t need because they think they're ‘supposed to have it’ or that it might make them appear more impressive somehow. But in the end, it’s wasted money. Purchase only what you need.
  • Create a rainy day fund
    If you can, try to save at least 3-months of expenses in your bank account as a precaution against unexpected challenges. If you’re able to do more than three months, that’s even better.

Beyond the finances, Dave says it’s important to stay adaptable as your business grows. Your role will need to constantly evolve if you’re going to continue providing the support your business needs.

...[Never knew] I’d grow like I have...Not complaining, I love it—just maybe needed to be more prepared for it.’
Michelle Rimmer - Hills Massage - Kalamunda, West Australia

Final word

We’ve covered just a handful of suggestions in this article—barely scratching the surface, really. With any luck, though, you’ll now be able to avoid some of the more common mistakes that new practice owners make. But one article can’t save you from all of them.

And maybe that’s a good thing. Making a mistake might be just what you need from time to time.

I’ll leave you with Dave’s thoughts on this idea:

‘I can certainly say in the first five years of my practice, it was “growth by pain”. I learned by basically banging my head off a brick wall. Yes, you make mistakes, but sometimes those mistakes are a great place to learn from.’

Good luck!

Author information

Doug is a writer. When he's not banging on the keyboard, you'll probably find him listening to old Willie Nelson records or chasing chipmunks on a mountain trail.

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