When a Mentor Changes Everything: Stacey Kaut on Building a Bilingual Therapy Practice from a 700 Sq Ft Office

"I have nowhere to send these kids."

That's what kept running through Stacey Kaut's mind in 2016. She was doing bilingual developmental evaluations for nonprofits in Tulsa, identifying Latino children who needed speech therapy, and then hitting a wall. There was virtually nobody in the city who could provide services in Spanish. She knew, ethically, that referring these families to English-only providers wasn't going to cut it. So she started asking herself the question every reluctant entrepreneur eventually faces: do I need to be the one to build this?

Stacey is a bilingual speech-language pathologist and partner at Therapitas in Tulsa, Oklahoma. On this episode of Clinic Chats, she shares how a random email from a stranger named Edwin changed her trajectory, why she credits mentorship for everything she's built, and how her practice grew so fast she had to move offices twice in under three years.

The Email That Changed the Plan

Before meeting Edwin, Stacey had already started laying groundwork on her own. She formed an LLC, began the credentialing process with Oklahoma Medicaid, and even had a library offering her a room to see clients. The overhead was practically nothing. But she was figuring it all out alone.

Then in January 2017, she got an email from Edwin, the owner of two bilingual therapy clinics in Oklahoma City. He'd gotten her name from a doctor she didn't even know. He wanted to meet.

Their first meeting played out like one of those scenarios where you're on a date but hit it off with your date's friend instead. Stacey's nonprofit boss was in the room, but the real connection was between Stacey and Edwin. They were both seeing the same gaps in how Latino children were being served, and Edwin had already built something to address it.

His pitch was simple: "I know you could do this on your own, but would you like support?" Stacey didn't hesitate. "I would be a fool to turn this down."

From 700 Square Feet to a Full Caseload

On the eve of her 30th birthday, Stacey opened Therapitas in Tulsa. Her first office was 700 square feet, costing about $400 a month. She hit the ground running, visiting pediatricians and building referral relationships with doctors in the community.

Within the first week, she had two referrals. By the end of April 2017, she had half a caseload. By summer, the caseload was full and she'd already hired her first clinician, Jesse. Three months after opening, they had to move into a 3,500 square foot space because the other tenants in the original building weren't thrilled about all the children coming through.

That kind of growth doesn't happen by accident. Stacey credits the back-office support she received through Edwin's network. She never had to worry about billing, credentialing, or finding a biller. All of that was handled centrally in Oklahoma City. Her only focus was finding clinicians, seeing kids, and building relationships with referring physicians.

"I haven't had to have that overhead. I haven't had to worry about having a biller or somebody keeping up with credentialing or anything like that because it's all been in Oklahoma City," she explains. "Everything is reserved for therapy. I have front desk and then I've got clinicians. That's it."

Educating Doctors and Busting Bilingual Myths

One of Stacey's biggest early priorities was physician education. Most pediatricians in her area weren't trained in bilingual development, and many were still operating on outdated assumptions about bilingualism. Some doctors had been in practice for 30 years and were relying on knowledge from an era when home language wasn't considered in evaluations.

Stacey made it her mission to change that. She visited doctors regularly throughout the week, built genuine relationships, and educated them on appropriate bilingual assessment and intervention. Eventually, Therapitas hired a physician liaison to continue that outreach across Tulsa and Oklahoma City.

She also teaches a class every semester at the University of Tulsa on bilingualism, telling students, "You're going to come across it. Whether you speak another language or not, you're going to come across bilingual clients. Let me teach you how to appropriately diagnose and treat these children."

The practice even partnered with Bilinguistics for training and quality assurance. That commitment to doing it right, not just doing it fast, is what sets Therapitas apart. Their mission statement says it clearly: ensure that Latino children have access to the same quality and appropriate services that English-speaking counterparts do.

Growing Therapists When You Can't Find Them

Here's a problem every therapy practice owner understands: hiring is hard. Now imagine you need bilingual speech pathologists who are fluent in Spanish. The talent pool shrinks dramatically.

Stacey's solution? Make them.

Therapitas runs a Spanish immersion program in Guatemala. New hires with a foundation in Spanish go to language school for up to 12 weeks, live with a host family, work with a one-on-one tutor, and focus on speech-related vocabulary. The practice pays for it. Jesse, Stacey's first hire, went through the program for five weeks right after graduating from the University of Tulsa.

"Bilingual therapists are so hard to find that we are willing to make them if we have to," Stacey says. "We see it as such a value and such a need."

Today, Therapitas in Tulsa has five speech pathologists (four bilingual), plus a PT, an OT, and a COTA. They recently built out a 5,500 square foot space and signed a 10-year lease. The practice that started in a tiny rented office now has a waiting list.

Knowing When to Step Back

By year three, Stacey found herself in a place a lot of practice owners recognize but few talk about openly. She'd built something sustainable and successful. The clinic wasn't going to collapse without her. But the day-to-day management role was draining her.

"It had nothing to do with the system, nothing to do with the people. It was just a matter of this isn't something that fits me well," she says. Her strengths are in vision, relationship building, and championing the mission, not in the daily clinical operations grind.

So she transitioned. Jesse moved into a leadership track to handle the clinical operations and scheduling oversight. Stacey shifted into a development role, still seeing kids in the afternoons but focused on moving the organization forward rather than managing the trenches.

"The fact that I built this sustainable, successful clinic, that's a huge success to me. If I step away, great. If I don't, great. But it's not going to die if I'm not there."

That's the test most clinic owners never pass. Stacey did, and she gives all the credit to having a mentor who built the systems that made it possible.

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Transcript

Kadie: You are listening to Clinic Chats. Clinic Chats is a multidisciplinary therapy podcast that was created for students, professionals, clinic directors, and supervisors. Clinic Chats is bridging the gap between graduate programs and professionals, sharing personal journeys of the smallest of private practice startups, large and expanded practices, as well as university clinic triumphs and tribulations. We hope you'll find our podcast informative and helpful in your career endeavors. Clinic Chats is sponsored by ClinicNote, an electronic medical record company for private practice and university clinics. ClinicNote was designed to make scheduling, documentation, report writing, and billing effective, efficient, and HIPAA compliant.

Kadie: Okay, today on the podcast, I have the pleasure of speaking with Stacey Kaut, and she is the owner of Therapitas in Oklahoma. Hi, Stacey. How are you?

Stacey: Hello. Great. How are you doing?

Kadie: Doing good. I'm excited to jump right in. You were just telling me you have several locations open, if you will, so I can't wait to get to the bottom of how all of this began, if you want to start from the beginning.

Stacey: Yeah, sure. So I'm not actually the owner, I'm more of a partner for the Tulsa Clinic. Therapitas has started before me in Oklahoma City. That is, I will say, another cool story to hear, but I will just kind of share my part of it. So in 2017, I was working with some nonprofits in Tulsa and doing bilingual evaluations as a bilingual speech pathologist, Spanish, that is. And I was noticing, because we were only doing evaluations, and so the goal of this nonprofit was to do early intervention screenings and then provide a free developmental evaluation, if needed, after the screening, and then refer on for those children to get services as needed.

Stacey: Well, I was doing primarily the bilingual ones and recognizing that I have nowhere to send these kids. I know of one other girl, we worked at a private practice together 10 years before. She had gone back to the schools, I had actually gone into the schools for a while, so here I was now working with this nonprofit and going, I have nowhere and I have no idea who I could send these kids to, just knowing ethically that they wouldn't be receiving services in the language that would be appropriate for them.

Stacey: And so I thought, oh goodness, do I need to start my own practice? Do I need to start seeing these kids? And my honest thought was like, no, I don't want to do it. I don't want to be the one to open a practice. And I mean, no hard feelings, of course, to the practice I was in before, but I was always told, well, speech doesn't make any money. Speech doesn't make any money. It was a speech and hearing clinic, which always kind of dumbfounded me, but you know, I was young. I was a brand new clinician. I was 24 and I didn't feel like I had much of a life, all that, you know, and so I went into the schools and then from there I thought, man, there's so much more I could be doing knowing Spanish.

Stacey: And so anyway, just divine planning, if you will, led me to contracting with these nonprofits and then going, well, I have nowhere to send these kids. I had started the process probably six months prior. So in the summer of 2016, I was like, okay, I even formed my own LLC, everything, started the credentialing process with Oklahoma Medicaid, because again, most of these families were low income. And so that was like the first stop. I was like, okay, if I can become credentialed with Medicaid, then surely I could at least start seeing a few kids here and there that really need it. And I was even like, I even had a library that was like, oh yeah, just use this room. They were so supportive of it. So it wasn't like I was really going to have a bunch of overhead or anything like that.

Stacey: But the nonprofits I was working for, they're like, well, if you're doing the evaluations under us, you can still use our materials and stuff like that. And then the therapy side would be on me anyway. So I'm trying to work all this out. Well, it was January 2017. And I get this random email from this guy named Edwin, and he was like, hey, you don't know me. But I have two clinics in Oklahoma City that serve our bilingual population, and they've changed the way that Latino children are served in the city. I got your name from a doctor and I'm like, I don't even know who this person is. I don't know what doctor he's talking about.

Stacey: And so he's like, I'd really like to meet you and just hear your story, like what you're about and what you're doing. And so I agreed to meet with them. And it was such a funny interaction because like my current boss with a nonprofit, she was also in the meeting, but it was totally like when you're on a date with somebody and then you meet their friend and you totally hit it off with their friend a whole lot more than you're hitting it off with the current date you're on. It's kind of awkward, but I know my boss is like right here in the conversation and we're just talking about what we're seeing in the Latino community and what I've been doing and what I've been trying to start and all that.

Stacey: Anyway, so we ended up meeting a couple of times and basically he was like, look, this is what we're doing at Therapitas, we would like to expand. He was like, however, I know that you have the capability of doing this on your own, but would probably just need some support. And I was like, absolutely. I know what I'm doing. I've had some business training, I get ROIs, I get all that kind of stuff, you know, needing to serve a need in the community, market wise. And that honestly was my heart. It was like, there's nobody serving these families well in Tulsa and it's a massive need.

Stacey: And so of course it was appealing for someone to be like, look, I want to come alongside you and partner with you and coach you on how to build a clinic. And so I was like, I would be a fool to turn this down. So sure enough, the eve of my 30th birthday, I open up Therapitas in Tulsa and I'm in this 700 square foot office space that costs maybe $400 a month.

Kadie: Wow. I mean, cheap. I mean, great.

Stacey: It's so cheap. It's not expensive to live in Tulsa, but yeah, it's $400 a month, 700 square feet. And I had started going and visiting doctors and just saying, hey, this is who I am. I'm even using Oklahoma City materials and had put a sticker over their information. I was like, I promise it's me. So within the first week I had two referrals, which was huge. And I'm not kidding. By the end of April of 2017, I had half a caseload. We were well into the summer and I had a full caseload and I had already hired another girl.

Stacey: Anyway, and by the way, I don't look like I speak Spanish. I'm like the blondest blue eyed girl you'd meet, yet I speak it fluently. So in May I hired Jesse, who was my first full-time hire. And again, I'm not able to do any of this without the support of Edwin and what he's doing in Oklahoma City. Edwin is really like a coach. I even called him my boss one time and he was like, I'm not your boss, I'm your coach. And it's neat, even what that's transpired into, it's now called One Therapy Network, but they really have just supported me in ways that I never could have done what I've done without them. I've been able to focus on finding clinicians, seeing kids myself, doing what I love while also building this impactful and mission-led practice.

Stacey: So I hired Jesse, she actually went to what we call our Spanish immersion program in Guatemala for about five weeks. She had a lot of Spanish as a foundation, but just wanted to kind of knock the rest off. And so she went to language school right after graduating from TU and then started with us that August. Literally her family and her husband and it was me and her husband, Jesse and her parents so kindly moved us into our new space, the first weekend she was working with me.

Stacey: So even just within those first three months, we had to move out of our 700 square feet, we moved into 3,500 square feet, which was a massive change.

Kadie: Yeah. So going from these little sardines to having so much room.

Stacey: And they moved us in so quickly because the other tenants in the other space were not happy with lots of children in the building.

Stacey: I've been given gifts and talents and a personality that attracts people and just a heart for these families and these kids. And not just to provide service, but provide really quality service. So our mission is to ensure that Latino children have access to the same quality and appropriate services that English speaking counterparts do, you know? Because every kid that speaks English out here, they've got all the services at their fingertips. They've got doctors that speak their language, parents that speak their language, and those doctors and teachers are trained in development of English, but yet they are not necessarily trained in Spanish or bilingual development. Therapitas has a great partnership with Bilinguistics and they've helped us with our trainings and making sure that these kids are being treated appropriately and getting that quality service.

Kadie: Have you had to do a lot of education to pediatricians and different medical practitioners in your area then?

Stacey: Absolutely. That was a big focus of mine for the first two years and even still. We recently hired a physician liaison who goes between Tulsa and Oklahoma City and she's fabulous. She's also Latina and so she gets it. Definitely education is a huge component and Monica, our physician liaison, does a phenomenal job of going out there. I used to go and meet with doctors regularly throughout the week and build relationships with them. I think that's a huge part of building a practice is you have to build relationships with your doctors. And they can tell if you're in it for the good of their patients or if you're just in it as a sales job. They're not going to send to the people who aren't genuine or just out for money. I would like to think that's the case anyway.

Stacey: But they even still needed a lot of education and there's a lot of myths out there about bilingualism. And I hate to admit, I think that Oklahoma is a little behind just medically altogether and I think that we can catch up for sure. But you've got doctors that have been in practice for 30 years and so they're still using the knowledge of 30 years ago when it was totally fine to not worry about home language and because there hadn't been research done in that area. Our research in bilingualism is, gosh, maybe 20 years old. We're still pioneering this part of our field very much so.

Stacey: And I think there's also this concept of, well, I'm not bilingual, so I shouldn't have to worry about it. But it's like, no, actually, I teach a class every semester at the University of Tulsa on bilingualism saying like, you're going to come across it. No matter if you speak another language or not, you're going to come across it. So let me help you and let me teach you on how to appropriately diagnose and treat these children if there isn't a bilingual therapist available.

Kadie: Kind of getting back to your startup in the business, it sounds like it just really took off so fast that you didn't have to do too much advertising. Like you said, you had the mentor of Edwin and you already had a lot of things in place. Is that correct for Therapitas? Like your logo and stuff that was already set up?

Stacey: Yes, it was. It was so nice. So I never even had to worry about billing. What I keep talking about, like Edwin or the back office, it's now called One Therapy Network. And again, a whole other story and how that transpired, but they had already created their own EMR system. My back office has always been centrally located with the other clinics in Oklahoma City. So I haven't had to have that overhead. I haven't had to worry about having a biller or somebody keeping up with credentialing or anything like that because it's all been in Oklahoma City.

Stacey: I just built out 5,500 square foot space and we just moved this last October. And this should be our, we signed a 10-year lease, we should be there for a while. I hope so. Anyway, moving is not the easiest. I've never had to consider, oh, well, where's my biller going to go? Or where's my back office team going to be? It's all reserved for therapy. And so I have front desk and then I've got clinicians and that's it. And again, Edwin was like, hey, look, if you'll just use my name, use the name, I'll give you what you need. And then of course, that's an initial investment, right? And so over the years, I paid that back, but I paid it back quickly and I never had to pay anything out of pocket personally. And so again, it's pretty unique. I mean, incredibly unique.

Stacey: Now, if somebody wanted to join One Therapy Network, it's a pay as you grow kind of thing. So it's not like here you have to pay us X amount to get started. They genuinely just want you to be successful as a clinician.

Kadie: So is that kind of Edwin's goal now, getting other therapists to use him as a mentor and be like investment partners, per se?

Stacey: Yeah. I don't know. Maybe investment partners. I'm not really sure. I'm not super privy to all that, but I just know that he would love for people to join the network just because he knows that he can help them be successful.

Kadie: Very cool.

Stacey: So I didn't have to worry about logo. I didn't have to worry about a lot of that stuff because One kind of did that for me, essentially.

Kadie: And so how did that work as far as finances? I guess I'm pretty new to the partnership. Can you explain how that looks at this point in time?

Stacey: Yeah. So now, and I've actually transitioned, I'm transitioning into a new role. I'm not really sure what that is yet, but knowing my personality and knowing that what best fits me is not to be the clinical director and the day-to-day management of people, that exhausts me and it's not where I flourish. Yet I love talking about what we've done and what we've accomplished and I would love to help people also get their practice started and all that kind of stuff.

Stacey: So financially, it started off as a 50% partnership. So of profit. And so we're very frugal and so everything for the most part has gone into savings. Because we don't want to be reliant on loans or anything like that. I haven't had to go into debt to make the practice work. When Edwin took over, again, this is his story to tell, but he took over for the previous owner because, and I've heard of clinics in town going and having to pay for loans just to be able to do payroll. And it's like, that's not okay. To me, that's like, okay, are your finances in order? Were you over budgeting? What was going on there?

Stacey: And again, thankfully I had the mentorship of Edwin to make sure that I have a four week report. So I know how much we brought in in those four weeks, where it was allotted. 15% went to overhead or we're a little over on compensation right now. But that was like in October, that's since changed. Now we're having this massive waiting list. So any bilingual speech paths out there, come on.

Stacey: So I have this four week report and I know exactly where I'm at. I'm given a budget for the next four weeks just to keep, I personally just value that, knowing like, okay, I'm going to have $2,000 to spend on testing materials. Or if we want to put that towards a wishlist item for the clinic. And we also have PT and OT. So it's nice and we collaborate on that going, okay, I know PT has been really wanting a new trampoline because the one we have is broken. So maybe we'll allot some of that to them.

Stacey: So just sharing in the profit in some fashion. That's kind of up in the air at the moment simply because I'm moving into a different role. Which honestly is my massive success is the fact that I've built this clinic. I'm not going to lie. It took a little bit of a push for them to be like, I think you're ready to transition into something else simply because it is my baby. But also going, yeah, I'm burned out a little bit simply because it just wasn't a fit for my personality. It had nothing to do with the system, had nothing to do with the people. It was just a matter of, I'm not in something that fits me well.

Kadie: So will they find someone to take over kind of your management style and then you're still going to be somehow tied to it, I'm sure.

Stacey: Absolutely. Yeah. So I still see kids in the afternoons. I'm still very much there, kind of more in a development type position. So instead of being in the trenches all day, every day, kind of going, okay, how can I help move us forward? And so yeah, Jesse, I keep talking about Jesse, but she's a big player in this. And we asked her this last summer, actually going, hey, think about joining a leadership track, if you will.

Stacey: There's so much that's happened in three years that I haven't had time to even sit and process it all. She has that personality that she will flourish in looking over numbers and making sure clinicians are on top of things, where I just want to go have fun, you know?

Kadie: The last three years you've probably been treading the waters and finally you're like, okay, we've gotten here and now let me take a breath.

Stacey: Yeah, exactly. But the fact that I built this sustainable, successful clinic, that is a huge success to me. And then going, if I step away, okay, great. If I don't, okay, great. It's not going to die if I'm not there. And I think that's not necessarily the case for a lot of clinics out there, especially clinic owners or directors, they're going, gosh, I can't even take a vacation because I'm afraid the building is going to catch on fire.

Stacey: And so I'm incredibly thankful for Edwin and his leadership and coaching and then what's transpired into One Therapy Network because yes, I may have worked too hard in a sense of my personality was extended past its abilities, but that doesn't mean that somebody who's just like me can't do what I did.

Kadie: It really is quite a journey and sounds just like a crazy last three years. How many therapists are currently at Therapitas?

Stacey: Yeah. So currently there are four speech pathologists and we're all bilingual. Oh, I'm sorry. There's five. We just hired one. She's part time. And she just sees English speaking kiddos. She works, she has a school job and then in the afternoon comes and sees our kiddos that are primarily English speaking or have chosen that language, which that's again, a whole other conversation. So we've got five speech pathologists and then we have a PT and then we have an OT and a COTA.

Kadie: Oh, wow.

Stacey: We would love to find more, even if they're graduating from grad school and want to go to Guatemala for a few weeks and learn some Spanish, then come on.

Kadie: How amazing. Would you guys pay for that person to go to Guatemala?

Stacey: Absolutely. Yeah. Because the thing is, bilingual therapists are so hard to find that we are willing to make them if we have to, because we just see it as such a value and it's such a need. Hey, we will send you to Guatemala for however long you need. Well, I say that like 12 weeks I think is the max, but you probably don't really need much more than that. It's a pretty intensive program where you live with a host family and you have a one-on-one tutor that you work with every day. And then we're working with them too, to make sure that they're focusing in on speech related things. And there's even a clinic down there in Guatemala that I believe Edwin got to meet with when he went down with his family not too long ago.

Kadie: Well, I just think the whole program sounds so unique, like you said, but it's clearly working. Does he have any offices or other SLPs in business that aren't doing the bilingual model or is that kind of his thing?

Stacey: He is the owner of Therapitas and I partner with him for Tulsa. Other than that, it's not about him owning them so much anymore. He owns One Therapy Network and is the CEO of course, but now it's like, we have a partnership with a clinic in Kansas City and they've joined the network. And just recently one in Colorado Springs. Another clinic in Oklahoma City has joined the network, but they're all privately their own. They're not owned by Edwin. He doesn't even have a partnership with them. They are private clinics that have joined the network.

Kadie: So cool.

Stacey: Yeah, very much so. He's great. And his heart really is like, hey, I want to help people build successful clinics that are mission driven and focused and that really just have a heart for the field and want to see kids, yet are under this huge weight of billing and back office nonsense. Therapists don't know that stuff by trade. We weren't trained in this. I know I'm supposed to have a budget, but how much, what is typical?

Stacey: Six months before meeting Edwin, I didn't even know where to start. I thought, okay, if I can become credentialed with Medicaid, then that will be my first step. Well, that never happened.

Kadie: Does billing pretty much all run itself through the network?

Stacey: Yeah. So we have what's called FairNet. So whenever I write a note, it automatically goes to our clinical administrator. She's over our clinic in Tulsa, but she's in Oklahoma City and then she'll take care of it. So what she's responsible for is doing what a clinician should do and then she takes care of the rest.

Kadie: Oh, that's so nice.

Stacey: Yeah. And she's in a little bullpen in Oklahoma City with other CAs that are helping the clinics in Oklahoma City or the clinic in Kansas City or whatever. So it's very central. They're all there together, which is nice. Everyone's doing the same thing. So it's not like so-and-so is doing something different for our Shepherd Mall location and so-and-so is doing something different for me. They all have the same process and procedure.

Kadie: It really sounds like things are just going so well. I look forward to chatting with you again sometime soon.

Stacey: Yes.

Kadie: Thank you so much, Stacey, and have a good rest of your day.

Stacey: Yes, you too.

Kadie: Thank you for joining me and listening to Clinic Chats. If you have a moment, please leave a five-star review for Clinic Chats to help other SLPs find our podcast. If you'd like to share your own personal journey through private practice, please email me at kadie@clinicnote.com. That's K-A-I-D-E at clinicnote.com.