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NOTES FROM THE EDITOR

Private-pay vs. Courses

Throughout the years I've worked with therapists who considered building a course or a coaching program. Some wanted to do it for revenue diversification; others felt that trading time for money was becoming outdated.

In many cases it was driven by the anxiety about the future. What I found is that building a course or a coaching program as a practice owner is not the best way to future-proof your income.

I believe that leveraging your profession and credentials first, is a much better way to stabilize your income and the future of your practice. Of course, if your caseload is full, and you want to amplify your message beyond one-on-one work, building a program or a course is a great idea.

But for a provider under $500K in annual revenue, this is more likely a distraction than a financial solution.

The Clinician's Edge

Therapists have several advantages that most coaches and creators don't. To start, there's a proven demand for therapy services, so testing the market with a novel idea is not necessary.

Secondly, you have a built-in trust through your credentials and expertise. And finally, people stay in therapy for an average of 16 weeks. For most clinicians I speak to, it averages closer to a year.

The Costs of Launching a Program

When you're building a course or a program from scratch, the road to success becomes significantly bumpier. Here are just a few things that you'd need to do:

• Prove the concept and market demand to make sure that people will actually buy it.
• Build and produce the program.
• Significantly increase your audience online.
• Create a strong promotional strategy.
• Consistently launch your program to keep attracting new clients.

Let's Do the Math

Let’s assume your private-pay fee is $200 per session and you see 20 clients per week.

If the average client stays with you for 20 weeks, that’s:

$200 × 20 weeks = $4,000 in lifetime value per client

With 20 active clients, that’s:

20 × $200 = $4,000 per week​
$4,000 × 48 working weeks = $192,000 per year

To maintain that revenue, you don’t need hundreds of buyers.

You need roughly one new client every month or two to replace natural attrition.

Now compare that to a course.

If your course is priced at $997, and you want to generate the same $192,000 annually, you would need:

$192,000 ÷ $997 = 193 buyers per year

That’s about:

• 16 buyers per month
• Or 48 buyers per quarter
• Or a 100-buyer launch twice a year

That level of volume requires:

• a significantly larger audience
• consistent promotion
• strong launch execution
• and ongoing marketing effort

Is it possible? Yes.

Is it easier than filling a private-pay caseload with high lifetime value per client? Rarely.

The Hidden Cost

The risk isn’t that a course won’t sell. The risk is that while you’re building and promoting it, your private-pay foundation quietly weakens. Your messaging shifts. Your visibility fragments. Your referrals slow because your positioning becomes less clear.

So instead of stabilizing your income, you end up destabilizing the one asset that already compounds: a high-trust, high-lifetime-value private-pay practice.

If this math makes you uncomfortable, that’s not a sign you should build something new. This usually means one of two things: either your private-pay practice is under-optimized, or you’re trying to add to it before it’s stable.

The new PPS Visibility Diagnosis is not a validation exercise. It’s designed to surface gaps, friction, and decisions you may be avoiding.

If you’re open to that level of clarity, you can start here.

See you next week,

Avivit

And now to the news!

NOTEWORTHY

Talkiatry Raises $210M

Digital psychiatry platform Talkiatry secured $210 million to scale its AI-supported care model and national footprint.

​Read More​

Why it matters: Independent clinicians aren’t competing on funding, but they are competing on distribution, access, and positioning.

BUSINESS AND PRIVATE PRACTICE

Government Shutdown May Disrupt Tax Season

Heard outlines how a potential 2026 government shutdown could delay IRS processing and impact tax timelines for private practice owners.

​Read More​

Why it matters: Policy instability affects cash flow, filings, and planning for practice owners operating without a financial buffer.

INDUSTRY NEWS

Behavioral Health Market Projected to Grow

A new market report forecasts continued expansion of the global behavioral health market, driven by rising demand and service integration.

​Read More​

Why it matters: Industry growth doesn’t guarantee practice growth. It depends on your setup and visibility.