I am a mental health therapist living and working in Alberta Canada. I work as a mental health therapist through our public health system here 4 days a week, and run a small private practice through my own company on the side. My private practice is booming, I have a great caseload and a waitlist of clients who want to work with me due to my specialization. I am trying to decide if I should quit my public health employee job and just work for myself full time.
Here are some of the facts I am considering:
I am married with a 7 year old child. My partner makes about $2400 a month at a warehouse job. He does not have a pension through his job.
I have fibromyalgia.
It’s a pretty mild case, but it has gotten worse as things at my healthcare job have gotten more stressful
Driving to my current public health job causes me a lot of pain.
Working private practice means I will get to mostly work from home (seeing clients virtually) or walk down the street to an office space I sublet (very affordable, $20 an hour)
I feel a lot better when I can work from home, I can stretch and use heating pads more, cuddle cats, go for a nice walk at lunch and sit near a sunny window.
However, this condition could worsen as I get older (I’m 33) and I sometimes worry I will need to go on short term disability.
Also however the research on fibro says staying as active as I can helps, and luckily my job doesn’t require any manual labor.
My current healthcare job pays my about $3500 a month after taxes, pension payments ($300), parking ($150), healthcare contributions, and EI and CPP contributions.
Through my pension calculator, if I stay at this job I can retire at 60 and get a pension payment of about $3000 a month.
I am lucky to get a small raise every year. The maximum I can earn in my position is $77,000 gross income.
This job is stable, I am not likely to get laid off
I get paid the same even if clients don’t show or cancel.
I like the work, I am mostly pretty autonomous
However, the job is higher pressure than working privately. I see people who are really unwell, often suicidal, and who need very intensive supports.
I do have to show up at work at 8am which means I have to rush my son out the door for 7:20, pay for before care at school.
I am not able to work from home when I need to (which really helps my physical health when I have a flare up).
My private practice has been open for 7 months and in that time I earned a gross income of $14000. This was from seeing about 2-5 clients a week.
I have calculated if I work 4 days a week seeing 15 clients a week and charging $190 a session (the going rate for therapy where I live), and I give myself 6 weeks of paid vacation a year I can make a gross income of $131,000.
If I save 30% for taxes ($40,000), and have about $1000 monthly expenses (space rental, website fee, I have very little running costs) I should take home $79,000 a year, or about $6500 a month.
I have the option to expand, take on a less experienced therapist who fits my specialization, offer them supervision and marketing and a caseload for a cut of their fee. I wouldn’t want to do this unless it was the right person, and I would want a fair deal which I believe is about 30% of their rate. This could land me some mostly passive income.
I leave my private therapy sessions often with MORE energy than when I started them because I find the work truly fulfilling and I feel fairly compensated for my work.
If clients cancel or no show I charge their credit card and still receive some payment, usually around $100 a session. I do not tend to get a lot of no shows and have a software the automatically reminds clients of sessions.
If I were to work for myself I would of course invest in retirement savings (I would welcome any advice on how best to invest), I’m thinking at least $500 a month.
What would you do if you were me and had these options?
My former coworker quit two years to help his wife (an ARNP who’s also specialized in mental health) run their private clinic. Then Covid happened and they closed down the office and went completely to telehealth. Much lower overhead cost and the ability to work from home.
However, it’s a lot of work from what he’s told me. He basically had to take on the role of officer manager while his wife dedicated entirely to the patients. I’d imagine if you’re planning on growing this business you’re going to eventually want to hire someone to help you in a similar capacity. He thought at first he could just work part-time so they could both be on his health insurance but eventually had to quit to focus entirely on the practice.
Ultimately, I think it’s a great opportunity and I wish you the best of luck.
I should add too if I left the health authority it would be on good terms and I could likely get a job there again later in life. Right now having a more flexible work schedule feels important while my son is younger, but I could see myself going back to the healthcare job when he’s a teenager.
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