May 13, 2019

Setting the Stage

As some of you know, I re-launched my private practice in May, 2019 after a multi-year break. If you can call years spent raising very small children a break, which in my opinion you cannot :). In any case, I'm excited to jump back in.

What's less exciting is re-starting from scratch.

No pieces of my old practice remain, other than what I learned from so many years of working with clients. The logistics, though, the bits and pieces and forms and all of that? I needed to start ALL over. 

I thought I'd write up the process in case it's helpful to other people who may be starting over or even starting up for the very first time. I know it can be hard to anticipate all of the things that need to happen and how much things will cost. 

Am I missing anything? Probably. I'm definitely not an expert in this, so please don't read this as a manual but rather as my attempt to detail one person's "getting started" process.

If you want a printable list of the steps listed here, you can download one when you sign up for my mailing list for practitioners ❤️

Get a copy of my practice-starting checklist

Business Set-Up

My least favorite part. Except for taxes, maybe? Still it's not that painful if you just go through the steps and start early.  Here's what I did. The order is important here. 

  1. 1
    Get a Registered Agent: You don't need this if you don't mind having your home address published everywhere or if you have a business address where you will be accessible during business hours for legal purposes. I do mind and I do not have regular business hours, so I wanted an RA. In Virginia, you can get a registered agent for $49 per year via Virginia Registered Agent, which is what I did. Note that this is significantly cheaper than what is offered via LegalZoom. Shop around! 
  2. 2
    Form an LLC: You can stick with sole proprietorship, but the LLC option provides a bit more legal protection so that's what I opted for.  In Virginia, you can do this online or mail in a paper copy; either way it costs $100. Note that when you fill in the online form, it automatically creates your articles of incorporation, so you don't need to pay someone to do this for you necessarily.  Filing this online and getting the forms electronically took < 15 minutes. You do need to list your Registered Agent when you set up your LLC, so be sure to do step 1 first if you're going to use one.
  3. 3
    Get an EIN: This is like a social security number for your business. You need to have your LLC paperwork filed first. It's free but you can only file for one online during business hours. Again, some places will charge money to help you with this, but it's super easy.
  4. 4
    Make an Operating Agreement and get it notarized: You can pay a lawyer to draft your operating agreement, but if you have a single-member LLC and things are uncomplicated, you can Google "[your state] operating agreement template" and find a lot of options that are easy to adjust for your situation. I had mine notarized for free at the bank when I went to set up my business checking account. You can also get things notarized at the public library or many UPS stores for a small fee ($3-5).
  5. 5
    Get a separate business bank account: You definitely need one of these. Do not mix personal and business funds. I went with a local credit union that has no fees and great service. You will need your EIN, operating agreement and LLC paperwork to open one. Call ahead and make sure you have the specific documents that they will need. It took about an hour to get this set up in my case.
  6. 6
    Set up Accounting Software: This is not mandatory, but you do need some kind of plan to manage your finances, particularly since you will need to start filing quarterly taxes as soon as you start making money. I use Wave, which is a free tool that integrates with your bank account. Other paid programs that are popular with small businesses are FreshBooks (great if you need invoicing) and QuickBooks (more complicated than FreshBooks).
  7. 7
    Outstanding Tasks: I still need to get a home occupancy permit and register with the Clerk of the City Court to get a local business permit ($50 for home occupancy permit and $30 estimated city taxes 2019). Then this part will be over-ish. 

Website Set-Up

mortar and pestle with basil leaves

For marketing and web design, I am starting out as simple as I possibly can. I don't want to spend a ton of money on web design, logo design, etc so I'm just using what I already have to do the best I can. When my practice starts bringing in money I may choose to upgrade; for now, I'm aiming for good enough! 

  1. 1
    Buy domain name and hosting: Rockaway Hosting (I actually currently use their sister company Reclaim Hosting for this website, which is extremely inexpensive and designed for academics; I will be switching over to Rockaway when I have five seconds to breathe as they are geared toward commercial sites.) It's a little more expensive than BlueHost or similar, but the service is awesome and I like to support smaller companies where I can. Cost: $120/year
  2. 2
    SiteTheme/Design: I like WordPress sites for their flexibility and control. I use Thrive Themes and do the site design myself. Even though I have VERY limited skills, I feel like I can get my point across and help people find me. Thrive Themes are super easy to use and I find that the cost is worth it in time savings. Cost: $120/year (I have a grandfathered price from several years ago; I think it's higher now.) 

Practice Management

Image by DarkWorkX on Pixabay

Here's where things get fun :). I previewed a bunch of different practice management tools. I do not currently have an office location; I will be seeing clients from a distance via phone or online so it's important to me to have something that is streamlined, secure, and easy-to-manage. I am so impressed with how far practice management software has come since I was last in practice. It's amazing! Here's what I ended up with: 

  1. 1
    Practice Better: Overall practice management software for a very affordable price. Some of the features that sold me on Practice Better are the secure video conferencing software, easy to create forms that integrate with client files,  customizable food logs, and the ability to run courses. Scheduling, invoicing, and secure messaging are also built into the platform. Currently it's $49/mo for up to 200 clients, with some lower price points for fewer clients and higher ones for unlimited clients. Here is my review of Practice Better that details why I like it so much. (Note that the link above is a referral link!)
  2. 2
    MailerLite: I'm using MailerLite as my mailing list software because it's inexpensive, has the features I need, and is easy to use. It's free for up to 1000 subscribers and $15/month for 1,001-2500 subscribers. MailChimp is another popular option, and SendFox is the simplest, easiest way to get started if you need the most basic email provider possible.
  3. 3
    Zapier: I needed to set up a Zapier account to connect Practice Better to my mailing list. This means that when clients are created in Practice Better they will automatically be added to my practice mailing list. This is free, but did take about 30 minutes worth of twiddling on the computer.
  4. 4
    Stripe: Practice Better Integrates with Stripe, which means this is where money will be deposited when clients pay. It was easy to set up after I created a free Stripe account. There is no charge to set up the account; the fee per use is 2.9% + 30c per transaction. 
  5. 5
    Fullscript: Practice Better integrates with Fullscript for product recommendations. They have the option to provide supplements to clients at cost or with an upcharge. I prefer to provide supplements at cost, so that's what I'll be doing. I still need to go through and add my preferred products and figure out what they do/don't offer. This will definitely be easier than sending people Amazon links or hoping that their local health food store carries something reasonable. Fullscript does need to verify your license/credentials, which takes a few days. After getting that account set up it was easy to connect with Practice Better.
  6. 6
    HPSO: I use HPSO for liability insurance. They also offer a rider for consulting/education. Since I'll be offering online courses, I will add this on. Cost: $167/year for standard policy + education rider. 
    UPDATE: I am now using Proliability instead of HPSO. HPSO wanted to charge a great deal extra - more than double the cost listed above! -  to cover telehealth and to list my LLC as an insured, while Proliability included both of these items as well as an endorsement covering consulting/education for a total of $149/year. I spoke on the phone with representatives from both companies and found that Proliability won out in this category as well, hand's down.  

increasing rates money

What's the Total Cost?

The cost of everything above for one year (assuming my mailing list does not get > 1,001 and that I stay at the lower tier for Practice Better): $1026.  This comes out to $85.50 per month, in case you're wondering. 

If I Wanted to Cut Down on Costs:

I could use BlueHost for web hosting and design (~$4/month for the first year), and I could use a cheaper WordPress theme (say one that costs $50 once). If I did these things, the cost would be closer to $884 for the first year of business. 

While it is a lot of money up front, compared to most small businesses the startup costs are minuscule. As my business grows, I'll have money to reinvest into reaching more people, having a more polished website/logo/etc., offering additional courses, and all that. 

Get a copy of my practice-starting checklist

What is NOT on this List?

  • Education: The accounting above doesn't include the 8+ years of higher education that I'm building on when I see clients. It wasn't free 😉
  • Marketing: I didn't pay anyone to do my logo, web design, etc. I picked a font  and then used Canva to write my name in that font. I found a color scheme I liked on Design Seeds and then used those colors in my website/logo. I may eventually upgrade; for now, this works! (Note that since this post was written I have paid for logo design!
  • Licensing: The one thing I did have going in was my nutrition license, which I have fortunately kept up with when my practice was on hiatus. Fees vary by state; in Maryland, it costs $250 every 2 years.  My Registered Herbalist credential through the AHG is $150 per year as well.
  • NPI: Even if you won't be billing insurance, you still need an NPI so that you can provide superbills for clients who want to file for reimbursement or apply HSA funds. I already had an NPI from my previous practice; you can apply for one here if you are licensed. 
  • Continuing Education: There are plenty of free options for CEUs, so I didn't budget for this.
  • Professional Help: I'd like to set up a meeting with a lawyer to go over my informed consent and terms/conditions forms, as well as a meeting with an accountant to make sure I'm keeping my books properly and know what to do at tax time. Not sure how much this will cost. Do I want to know? Sigh. If you have a lawyer to recommend, or know of an alternative, let me know!
  • Physical Space: I won't have a physical office where I'm seeing clients, so I don't have things like rent, electricity, printing, etc. 

Am I Missing Anything?

Those of you who have been in practice for a while, let me know if I've overlooked anything. (Part of me wants to know and part of me wants to just be done :). 

Seriously, though, if you have tools, advice or recommendations for people starting their practices, put them in the comments or send me a message and I'll keep adding. It's hard enough to get started, so more voices and more support is a great thing. 

Lastly, if you want some help & accountability getting things started, check out my online Roots course. It has 10 lessons to walk you through each step so that you can get your practice up & running. Start anytime.

About Camille Freeman, LDN, RH (she/her)

Hi there! I'm a clinical herbalist and licensed nutritionist specializing in fertility and menstrual health. I run the Monday Mentoring community of practice and also offer continuing education programs for highly-trained herbalists and nutritionists (Check out this year's Deep Dive!). I'm also a professor in the Department of Nutrition at the Maryland University of Integrative Health, where I teach physiology, pathophysiology, and mindful eating.

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