Making the decision to open your own practice is the start of a terrifying and exhilarating journey. Nicole Craddock’s been there. Having made the leap of faith to set up her own physiotherapy practice in 2021, her Cape Town (ZA) clinic is thriving and coming up to its first birthday! Nicole kindly sat down with us to share what she’s learned along the way.
While Nicole had always dreamed of opening her own practice, she knew the timing had to be right. This wasn’t something she felt she could do immediately after graduating – transferring skills from university to real life is always a learning curve. As Nicole notes: “you’re taught the basics and textbook cases, then you go into the real world and it’s completely different. To open your own practice, you have to feel like you’ve got enough experience and can make calls by yourself”. After a community service year at St. Andrews Hospital (Harding, ZA), Nicole built up her skills working in private practice for several years while also pursuing a Masters. Then, just when she felt ready to branch out on her own, COVID-19 hit. With restrictions in place in South Africa, it didn’t seem like the right time to launch a new business. It wasn’t until May last year that she finally got her chance.
With a secure job as the physiotherapist for Reddam High School and a supportive fiancé, Nicole felt that she had enough of a safety net to live out her dream. She found a space in Kirstenhof, south of Cape Town, which she painted and filled with various physio staples – a plinth, foam rollers, kettlebells, and therabands. At long last, the clinic was ready to go!
Nicole admits that the early days of setting up and opening the practice were busy and overwhelming – there were many late nights and occasions where she felt completely at sea. Figuring out how patient reimbursement worked was a particular headache (Nicole has some horror stories about this process and advises all other South African practitioners to be on top of medical aids before opening the clinic doors!). But even after she started to find her rhythm – which took two or three months – other challenges emerged.
There are certainly some unique difficulties that arise when you’re a solo practitioner. Nicole is aware that she is the centre of her business and its public face, which can be time-consuming – as she says, “when people phone, they want you.” Likewise, Nicole is the one sending exercises to clients after their appointments and asking for their feedback. A solo practitioner is constantly wearing multiple hats – you’re a clinician, secretary, and marketer rolled into one superhuman – which isn’t always easy. Nicole’s experience is a common one. Cliniko’s 2021 survey found that most allied health professionals are involved in many different aspects of running their clinic and report time management as one of the biggest stressors.
It doesn’t help that healthcare is ultimately a people-focused profession and, as much as you might love seeing your patients, there’s no doubt it also requires a lot of energy. As Nicole explains: “In this profession, we are dealing with people – and it’s not just the physical – it’s their physical, emotional, and everything else. And it can be quite tiring at times. To have that brave face every day and stay connected with clients, when you’re also trying to run everything else on the sidelines can be a bit draining.” Even if you’re the world’s biggest extrovert and social butterfly, there are times that you’re going to struggle
But despite the challenges, the first year in business has also marked some great successes for Nicole and the business has grown considerably since it started. Nicole was pleasantly surprised earlier this year – despite anticipating January being a quieter month, she was busier than ever over that period. She acknowledges that it feels good to see the hard work paying off: “Putting my processes in place with marketing and trying to grow the business has clearly worked, so that’s been amazing.” We can imagine!
Nicole’s seven tips for starting out:
So, what advice would Nicole give to someone else starting out? What does she wish she’d known beforehand? She gave the following tips:
1Have a vision of what you’re trying to create
Nicole recommends you get clear about this as your first step: “you need a vision of what you are aiming to create before anything else. You need to decide the type of practice you want to have and the type of market you’re wanting to appeal to.” This will allow you to come up with a marketing strategy – for example, decisions about your logo and the style of your website will be influenced by your overall vision for the business.
2Come up with a financial plan
A financial plan is also crucial. Nicole says, “work out the absolute bare minimum that you need to earn to cover all your expenses. Anything over and above that in the first few months is a bonus.” Nicole explains that, for her, crunching the numbers took some of the pressure off – when she broke down her expenses and looked at what she needed to earn (i.e. how many patients she needed to see a day), those targets turned out to be surprisingly achievable. This can be an effective way to lessen that panicky feeling of being overwhelmed.
3Let yourself find a routine
Through the process of booking in and seeing patients, Nicole started to get a feel for what worked for her on a daily basis. She started to space her appointments a bit further apart, so she could get invoices and exercise programs to a client immediately after a consultation and learned “not to diddle daddle around” (her words and we love that expression!). But this one can take some time. Nicole reminds you to practice some self-compassion – “don’t be so hard on yourself,” she encourages. If you’re struggling to find a routine with your marketing, for example, remember that it’s okay to leave it for a few weeks and come back to it when you’re in the right headspace.
4Play around with your marketing
If you’re like Nicole, you might feel that marketing doesn’t come naturally to you. She identifies one of her most persistent challenges as finding the motivation to keep pushing the business to grow, especially using social media. Nicole suggests playing around and experimenting with different marketing strategies to see what works for your business. For example, put a certain amount of money into a Google ad, then see what the returns are and decide whether it’s a worthwhile avenue for you. If marketing isn’t your forte, have a browse around the Cliniko blog – we’ve got a bunch of articles on this topic to help you get going.
5Have your outlets, both professional and personal
“It’s really important to have your outlets,” Nicole says. She encourages anyone starting up an allied health business to connect with fellow practitioners to debrief about work or bounce ideas off. Without a professional outlet, private practice can feel quite isolated. But it’s equally important to preserve self-time and have personal outlets too. For Nicole, that means exercising or spending time in nature. Find out what self-care means for you and make sure you’re prioritising it.
6Set boundaries between personal and professional life
Having clear boundaries around work is important, especially for a practice owner – otherwise your new clinic can easily consume your entire life. Clients tend to message at unpredictable times, as Nicole describes: “people will reach out to you at all times of the day. They don’t do it in a mean way – they just don’t think that maybe nine o’clock at night is not the most appropriate time.” Nicole recommends having a separate phone number that’s just for business or setting – and sticking to – a cut-off time where you don’t deal with work. For example, set a clear boundary with yourself (and your patients) that you’re totally off the air between 7pm and 7am and won’t be responding to any messages.
7Ask for help
Finally, Nicole is a firm believer that new practice owners should ask for help: “Reach out. Ask for advice where and when you need it. People love to share their story and love to help.” Nicole has experienced incredible generosity from peers and colleagues during her start-up journey – many people have given her their contact details and been genuinely helpful when she’s needed a hand. She also likes to pay it forward, encouraging anyone starting up to reach out to her if they need advice. “I think all business owners get excited when they hear that someone else is starting their new business,” she says with a smile. “We don’t all have the skills in every single department – we choose a career path because generally that’s what we love and what we’re good at. If there’s something that you don’t know, don’t be afraid to ask.”
Nicole's three practice essentials
Nicole’s clinic has a few essentials that make her work life easier, and we asked her to share these with us. She said there are three main things that make a huge difference in her practice:
1Practice management software
Nicole (who jokes that she’s computer illiterate) recognised that using technology to help her run her practice would save a lot of time in the long run: “I thought, if I’m going to be practising on my own, how can I set up things that are automated, so I don’t have to do admin for two hours at the end of my day.” She then took the time to research different practice management software and find a platform that suited her – she knew she wanted a system that had a variety of integrations and was user friendly. And she ended up choosing Cliniko. We think she made an excellent choice, but maybe we’re a little biased. Just a little! So what should you look for when you’re trying to choose practice management software? Check out our list of questions you should be asking yourself.
2A space that you enjoy being in
It was important to Nicole for her clinic to be a space where she would enjoy spending time. She paid particular attention to the décor during setup, painting the walls (one blue and the rest neutral colours) and hanging paintings that she liked. “Create a space that you like walking into and that represents a little bit of you,” Nicole advises. Given that you’re the one who’s going to be spending the most time in your clinic, it should feel good to you – not just to your patients. A comfy treatment table is another essential! Clients always comment on how squishy Nicole’s table is. “And it’s a nice size,” she adds with a laugh. “They don’t look like they’re going to fall off.” We think that’s definitely a win!
3 A website
Creating a website means that people can find you much more easily. Once this is up and running, Nicole suggests having a “book now” button on your website which links to your practice management software. This saves your clients from having to pick up the phone to make an appointment, while also presenting you as an up to date and tech savvy practitioner. Nicole used WIX, which she found enjoyable to use and cost effective.
Thank you to Nicole for sharing her story. We hope you learned something new or, if you’ve been on the fence, that you might even feel inspired to think about branching out on your own. Go on, we believe in you!