1.    Don't think like a PT or Healthcare Provider

In fact, try to forget that you are one altogether.  Rather think like a CEO / business executive or business owner (if you don't want to do this you should not be in private practice or own any type of business at all).   Executives set strategy and vision and think about ways to help their companies grow and be successful in the market place.  They spend time thinking about issues such as maximizing customer value; increasing market share, revenue and profitability; creating differentiation and competitive advantage; molding company culture and motivating employees and teams; etc.

2.    Thinking that you will be successful in private practice because you are a good PT

This is one of the primary nemesis that drive most service professionals turned entrepreneurs out of business (chefs, accountants, lawyers, PT's, etc.) Being good at treating patients WILL NOT guarantee business success - on the contrary this could turn out to be a liability in the long run.  Ironically, most successful therapy operations that I know are led by PT's who are really NOT great at patient care (they just hire really good clinicians).  Running a business and treating patients require completely different skill and it is EXTREMELY difficult to be excellent at both.  If you don't have a business background and are planning to go into private practice that's okay as long as you thoroughly educate yourself on how to run a private practice, study general business principles and get sound consulting and advice

3.    Spending too much time being "In the business" rather than being "On the business"

PT private practice owners tend to get too deeply involved in patient care and tend to forget about the health of their most important patient - the company. Being‘IN' the business means that you're actually focus on the day - to - day operations of the business.  In the beginning you're going to have to do this because you'll be forced to wear many hats so you'll have to treat patients and get involved in other operations of the business.  But a successful practice owner will have to spend just as much time if not more ‘ON' the business - looking at trends (patients, referral sources, competition, financial health) and setting overall business strategy; leading and motivating employees; analyzing potential new markets and innovations; researching competition and regulatory environments; relentlessly looking into ways to maximize customer value; etc.  Being ‘IN' the business too much can be extremely detrimental to your practice.  Successful business owners realize that they have to spend more time leading rather than managing - that is doing the right things rather than doing things right.  The ultimate goal should be to spend ALL of your time ‘ON' the business.  In fact, if the practice can run and operate effectively WITHOUT you then you are on the right track.

4.    Not asking yourself why you want to go into private practice.

Running a successful private practice has a lot of benefits and is a wonderful thing for our profession and the community.  However, as a business owner one has to be ready to shift focus from provider to executive and be ready to work long hours, think all the time, give up some freedom and make some important sacrifices.  When I ask struggling practice owners why they got into private practice I typically get: "I wanted to be my own boss"; "I hated my boss"; "I wanted more money"; and my personal favorite - "I wanted more freedom".  Conversely, some answers to this question that I've gotten from successful practice owners are: "I saw a substantial need in the market and I went for it";  "I've always wanted to do it so I studied the operations of every practice I worked for"; "I wanted to make a big impact in my community"; "Through years of practice and relationship building I had all these doctors that knew me and were ready to feed me all their referrals".  Before you jump in make sure you have a compelling reason as to why you are going into private practice because there will be some important sacrifices to make along the way.

5.    Not seeking advice from other business owners, mentors, coaches, etc

Asking for advice and consulting is essential when starting out in private practice (and throughout the duration of your business).  There are some great mentorship programs through the APTA Private Practice Section (PPS) that you can join.  If you're not part of the PPS join - this is a worthwhile investment.  I made many avoidable mistakes when starting out in private practice that cost me a lot of money that could have bee prevented with some simple advice.  So, network with other practice owners and also seek advice from good business people that are NOT in the physical therapy business.  You can achieve this by joining your local Chamber of Commerce or local business - networking group.  All great companies have a sound advisory team or board of directors and you should be no different - DO NOT go at it alone.

6.    Not putting together a business plan

A business plan will force you to do important market research and answer some very important questions prior starting your business.  A good business plan will allow you to set overall business strategy; define your competitive advantage; clarify where in the market space do you want to position your practice; how much capital you need to start the business and when you expect to break from your original investment; analyze market saturation levels and competition (direct and indirect - POPS, chiros, massage therapists, etc); research potential referral sources; study barriers to entry (i.e. insurance network entry; availability of therapists); define target markets; analyze strengths, opportunities, weakness and threats (i.e. Medicare and healthcare regulatory environment, etc); project financial results; etc.  In essence your business plan should answer the question - is opening up a practice in this market economically viable? If the answer to this is NO then you should not open a practice.  If you don't know how to put together a business plan you can buy business - planning software (i.e. Business Plan Pro) or hire a consultant that can guide you through it.  But it is essential that YOU do it not the consultant!

7.    Not having a specific mission AND vision

This is a fundamental piece of your business plan AND the life of your company.  The mission statement of any company should be it's essence, it's reason for being and the essential building block of any decision making process going on forward.  To define your mission you should ask questions like ‘what is the purpose here? What do we stand for or what do I want my company / practice to represent'.  The mission will guide every hiring decision you make, every market you decide to enter, how you treat customers, how you deal with employees and the type of company culture that you will shape in the future.  The vision of the company answers the question - where do we want to go.  Good leaders typically have a sound vision of where the company should be in 10 years and even beyond that.  A vision will define the impact that you're trying to crate in the market and it should be clear and be specific in the early stages of your practice.  When defining visions I like to paraphrase Steven Covey, "Begin with the end in mind".  So think, if you're starting a practice, what is your ‘end'?

8.    Not focusing on a particular target market

This is tied to the vision of your company.  What do you want to be good at?  The question to this will depend on your resources, areas of expertise and market that you're in (you don't want to specialize in sports ortho when 75% of the market you're in consists of a demographic of 60 - 75 year olds).  A common mistake PT's make is to take on anything that comes in.  The main reason why you want to concentrate on a target market is that you want to develop a strong competitive advantage  - something that you do way better than your competitors which will give you and edge in the market and make your practice unique.  Your target market will define your marketing strategy and advertising channels so be ready to have a defined target market before you open doors.  Example of target markets include Peds, Geriatrics, athletes, neurologically impaired patients, cash / out of network high - end markets, etc.  Let me warn you about general ortho type markets - there are too many providers out for this market so competition is fierce (specially among POPS). But if this is where you want to go my recommendation is to aggressively specialize in something that will make you different (i.e. back & neck specialist; knee OA specialists; sports; etc).  The key is to define your competitive advantage and then go after the market in where your advantage will offer the most value.

9.    Not enough cash on hand at start up

If you're a brick and mortar you will need cash for initial operations and periods in where you might have negative cash flow.  As a brick and mortar start up you should try to raise capital of at least 6 month of operating expenses (preferably 1 year) prior to opening doors.  The number one reason why business start-ups in ALL industries go out of business within the first year is because they are undercapitalized - basically they cannot cover accounts payable and payroll because there is not enough cash in the bank.  The irony of this is that you might have finally reached profitability but you can still go out of business.  In fact profitable companies can go broke because there are not enough liquid assets in the balance sheet to cover obligations.  Financing can come in many different forms such as loans, investment, lines of credit, personal assets, etc.  But the key here is to have enough cash in the bank to sustain operations and maintain positive cash flow.  I strongly advice to try to raise more capital in the form of investment rather than debt since this will dramatically reduce your personal credit risk - most (if not all) of start up loans will be guaranteed by you or else the bank wont' give you any dough.

10. Spending too much early on

As a start - up you need to be penny conscious.  Capital expenditure to start a good practice does not have to be high.  I know of a good business owner in South Florida who had good manual skills (I mean carpentry skills) and he and his dad made all the plinths for the practice and they all looked very professional and were very comfortable.  The reality is that if we have good tables, decent modalities and sound therapeutic equipment (i.e. bands, Swill Balls, Bozu, dumbbells, etc) we really don't need much for great patient care.  Initial capital expenditure at start up needs to be low for risk minimization and cash retention; monthly operating expenses need to also be low so that your initial start up capital is not too hard to raise and you can speed your break even point. On the contrary it does not pay off to be frugal in things such technology (PT practice management software; accounting systems; etc), good consulting, human resources and a sound online presence because this will lay some basic foundations for your business.