Introduction

For many allied health professionals working in small private practices, the traditional model of trading time for money presents a significant barrier to scaling their business. As demand for healthcare services grows, practitioners often find themselves at a crossroads, facing the dual challenges of managing an increasing workload and exploring opportunities for growth. This article follows the journey of clinical neuropsychologist Dr Alex Knopman and his process of scaling from a sole trader to a more sustainable growth business model to identify practical strategies for scaling an allied health business effectively.

About Alex

Having established his Sydney practice as a leading provider of neuropsychological assessment and tailored cognitive rehabilitation, Alex was looking for the most effective way to scale his practice from being a sole provider while optimising his clinical expertise. Given the growing demand for adult ADHD and autism spectrum assessments over the past five years, as well as increasing demand for early dementia diagnosis and cognitive support, Alex felt that broadening his referral base and bringing on additional therapists who specialise in cognitive health would be crucial to the continued growth of his practice. To help facilitate this, Alex completed the Allied Health Business Canvas with the support of the Empowering Allied Health Entrepreneurs business support program and community of practice, gaining the skills and confidence to take his business to the next level.

Tell us a bit about your journey to founding and growing your own practice as a clinical neuropsychologist

“I started straight out of uni after my Masters degree working at Westmead Hospital. This was a fantastic grounding, working for nearly a decade at Sydney’s biggest tertiary referral hospital with both inpatients and outpatients with a wide range of health issues. I moved to part-time work as I completed my PhD, then opened my private practice in 2014, combining it with part-time work at Uniting War Memorial Hospital (UWMH) and in dementia clinical trials. I now work one day a week with older adults at UWMH, while devoting the rest of my time to private practice. I enjoy the breadth of my practice from clinical to medico-legal work and supervising and mentoring junior clinicians.”

What are the biggest challenges you’ve faced as a clinician and practice owner?

“Adding insurance, fitness for duty and broader medico-legal assessments to my areas of specialty was challenging—the whole process for these assessments is very different to anything I was taught through university and I was definitely out of my comfort zone when I first started. I think I am about to take on my biggest challenge in this area, as I move from being a sole practitioner to bringing on new team members and expanding my practice. Like any clinician or allied health practitioner, our training is wholly focused on supporting patients in that clinical space. This is still the heart of what we do, but there are lots of new skills to learn about running a practice as a business.”

Are there any moments from your clinical career that stand out in terms of making a difference to community or care outcomes?

“Working with the neurology and neurosurgery teams at Westmead hospital stands out—assessing patients with disorders such as epilepsy and Parkinson’s, helping to determine their suitability for surgery and contributing to a dramatic improvement in their quality of life. At the other end of the spectrum, I lead workshops in memory and healthy brain ageing for older adults, empowering them to maintain their independence and cognitive functioning.”

Tell us about the evolution of Focus Neuropsychology

“I established my own private practice nine years ago in Bondi Junction, Sydney. When I started I was primarily working with dementia and neurology patients, and have now grown to include everything from autism and ADHD diagnosis to complex medico-legal cases. I’m now at the point where my practice has grown to the extent that I am ready to expand the team.”

The Time-for-Money Challenge

Understanding the Limitations

At the heart of the scaling issue is the time-for-money trap. Most allied health professionals charge for their services on an hourly basis. This model inherently limits revenue to the number of hours one can work in a day. Moreover, it doesn’t account for the time spent on administrative tasks, professional development, and other non-billable activities. This model not only caps income potential but also leads to poor work-life balance. As demand increases, practitioners may find themselves working longer hours, leading to burnout and reduced quality of care.

Strategies to Support Growth and Scaling

Several strategies are available to allied health practitioners to support opportunities for sustainable growth and innovation. Not all strategies are relevant to all businesses, but some of the opportunities are outlined in this article Leveraging Your Skills: Entrepreneurial Opportunities for Allied Health Practitioners , and explored briefly below:

Diversifying Income Streams

1. Group Therapy Sessions: Conducting group sessions can maximise your time while serving more clients. This approach is particularly effective for conditions that benefit from peer support, such as mental health or chronic pain management.
2. Online Programs and Workshops: Developing online courses or workshops on specific health topics can help reach a broader audience. If designed as asynchronous, ever-green products, they can provide passive income, while also helping to further establish your brand and profile.
3. Product Sales: Selling health-related products or developing your own line of products can provide an additional revenue stream.

Leveraging Technology

1. Telehealth Services: Offering remote consultations can expand your client base geographically and make your services more accessible.
2. Automating Administrative Tasks: Implementing practice management software can streamline scheduling, billing, and record-keeping, freeing up time for more clients.

Building Your Team

Expanding your practice to include other allied health professionals can diversify the services offered and attract a wider range of clients. This approach also allows for cross-referral within the practice.

Establishing Partnerships and Referral Networks

Building relationships with other healthcare providers and community organisations can lead to a steady stream of referrals, reducing the need for individual marketing efforts.

Strong Branding and Online Presence

Establish a strong brand identity that reflects your practice’s values and specialties. Develop a professional website and maintain an active presence on social media platforms to reach potential clients and engage with the community.

Focus on Niche Specialisation

Developing a specialisation can set your practice apart, attract clients seeking specific expertise, and justify premium pricing.

Alex’s Approach

Alex’s business growth was overly dependent on his own expertise, and particularly his focus in specific niche areas. He recognised that business growth would require him to employ more staff, and potentially diversify the skillset within his business. However, in order to employ more staff, Alex required larger premises which required a substantial investment in the development of his business.

The Allied Health Business Canvas

To help guide Alex’s business growth strategy he worked through the Allied Health Business Canvas as part of his participation in the Empowering Allied Health Entrepreneurs business support program and community of practice. Adapted from the Business Canvas Model, the Allied Health Business Canvas is a business-plan-on-a-page that helps allied health businesses identify the problem to be solved, customers, the business’ value proposition, a range of solutions to meet customer needs, resource requirements, partnerships, revenue streams, and key metrics to determine success. Supported by expert facilitators, a community of allied health practitioners at the early stages of starting or scaling their business met weekly for eight weeks to develop their individual Allied Health Business Canvas.

Alex’s strategy included developing a strong focus on the areas of niche expertise of his business, clarifying the market for that expertise, and identifying the partnerships and networks he would need to develop to have that expertise recognised by relevant professionals and referral partners within his health network.

Alex explored the range of funding models, and came to the conclusion that while some insurance reimbursement is available to his clients, he could continue to grow his business without Medicare funding for several of the diagnostic tests and interventions he routinely performs. Building a strong value proposition and being clear about his audience (customers) and the benefits he offers them was critical in giving Alex the confidence to expand his business within his area of expertise.

Alex developed revenue projections based on the customer segments and referral pathways above and developed a 12 month strategy to expand his premises, which would in turn allow him to expand his staff and service. He also identified a range of growth strategies and diversification approaches, including opportunities to work with different client groups (older children), develop and deliver workshops, and provide training and expertise to other practitioners to extend his expertise beyond his own practice.

How important have interdisciplinary partnerships been to growth?

“I have developed strong referral bases within local hospitals, private medical specialists, GPs, allied health professionals, regulatory agencies such as AHPRA and medico-legal providers. Maintaining good relationships and clear communication with these partners is important—I treat them as my clients as well as their patients.”

In terms of service delivery and community need, how do you anticipate Focus Neuropsychology will grow in the coming years?

“In terms of community need, there has been huge growth in demand for adult ADHD and autism spectrum assessment over the past five years. That will be a key area of focus as I expand my practice, not only in assessment but in coaching and cognitive rehabilitation. I also maintain a special interest in supporting older adults through early dementia diagnosis and cognitive support, which also has major growth potential given my expertise and our ageing population.”

How did COVID affect your practice, and what lessons have you learned from the experience?

“Being unable to perform assessments face-to-face resulted in a huge paradigm shift. I found new ways of working that allowed me to maintain the quality of assessments even when performed over video calls. I’ve continued doing this where needed for clients unable to travel as well as some who live remotely and interstate, so this has expanded my referral area.”

What advice would you have for clinicians who are in the position you were in 20 years ago?

“Twenty years ago, I was just starting out in the public hospital system in NSW. I was very focused on finding a full-time clinical role. However, my skill set and referral streams actually expanded more once I was part-time in a hospital and gaining experience with other providers and in private practice. I also learned about running my own practice from some of those providers. So I’d say: get as much exposure as possible to different fields and ways of working. I’ve also maintained close relationships with many of my university neuropsychology cohort and we continue to support each other with clinical and business advice.”

As a clinician, how do you feel about the scope of practice review taking place at the moment?

“Unfortunately, patients don’t have access to Medicare rebates for neuropsychological assessment—I would hope this will come under the review so more people have access to neuropsychology regardless of their financial circumstances.”

So you’re now an alumnus of The Allied Health Academy’s Empowering Allied Health Entrepreneurs course—and receiving the Judges’ Choice Award at the graduation ceremony—what aspects of the course did you find most useful?

“Thank you. I loved connecting with other allied health professionals in a similar position looking to expand their business, as well as the mentoring and advice from the presenters. I really enjoyed putting my business canvas together—it pushed me to identify the strengths and growth areas for my business.”

Follow Alex Knopman on LinkedIn | This article is the latest instalment of our Allied Health Entrepreneur series of articles.

Acquiring the appropriate skills to scale your allied health business or organisation is the first step towards success. Our sister company The Allied Health Academy is pleased to announce the Empowering Allied Health Entrepreneurs Learning Community & Pre-Accelerator Program for 2024—designed to bridge the gap between clinical expertise and business acumen, helping you create a profitable service delivery model that empowers you to do more of the work that matters to you. We are hosting a free introductory webinar and Q&A session, February 27. To attend, please submit your details via this link.