Starting Slow on Purpose: Maria Gianfilippo on Building a Two-Location Speech Therapy Practice

Maria Gianfilippo watched her parents run a business growing up. She saw the late nights, the financial stress, and the freedom on the other side. So when she launched Organic Speech Therapy with co-founder Allison Ortega, she didn't try to sprint to a full caseload. She kept her part-time clinic job, took on clients at a pace she could manage, and gave herself room to actually build the practice the way she wanted it.

One year in, Organic Speech Therapy operates across two Florida locations, Clearwater and Fort Lauderdale, serving both pediatric and adult populations. It's still small. And that's the point.

Serving Both Ends of the Age Spectrum

Most speech therapy private practices pick a lane. Maria and Allison picked two. On one end, they work with late talkers and kids up to age five with speech sound disorders. On the other, they treat adults recovering from stroke, working on language, dysphagia, and cognitive rehabilitation. They also fit AAC devices for patients who need them.

Finding adult clients in private practice hasn't been the uphill battle you'd expect. Many of their adult patients come after insurance benefits run out following acute care or inpatient rehab. They still need therapy. They're willing to pay out of pocket. And there aren't many private practices set up to see them.

"Their insurance doesn't allow them more therapy visits, but they still need more therapy visits," Maria says. "So really I've been able to focus with them."

The COVID Pivot to Teletherapy

Like every practice owner in 2020, Maria and Allison had to shift to teletherapy fast. They'd been doing home visits before COVID hit, which meant they didn't have office space to worry about. But they did have to move all their materials to digital formats and figure out which platform worked best.

The SLP teletherapy community on Facebook turned out to be a lifeline. Therapists who'd been doing telepractice long before the pandemic shared resources, tips, and materials freely. Maria credits that generosity with helping them get through the transition.

And something unexpected happened: new clients actually preferred teletherapy. Parents didn't want to bring their kids or aging parents to a clinic. They wanted services from home. The demand was already shifting before COVID forced the issue.

Keeping Overhead Low and Growth Intentional

Maria's operating costs are remarkably lean. No office rent. G Suite for organization. A website. Digital materials from Teachers Pay Teachers. LLC maintenance fees. That's about it.

With seven clients on her caseload and therapy two days a week, she's not running at full capacity, and she's fine with that. She still works part-time at a clinic, which takes the financial pressure off and lets her build Organic Speech Therapy without the anxiety of needing it to cover all her bills right now.

"I'm not too much in a rush to grow it," she says. "It's been able to help me focus on the business and not stress as much about the finances since I still have a part-time job. Easing into it has allowed me to focus on making it how we want it."

That patience is strategic. She and Allison manage their own caseloads independently across two cities. They're not trying to scale before the foundation is solid.

Community Education as a Growth Strategy

What sets Organic Speech Therapy apart is the focus on prevention and education. Maria noticed a pattern during her hospital work: stroke patients would arrive days after their first symptoms because they simply didn't recognize the signs. That stuck with her.

Now she's building community education programs on both ends of their practice. For adults, it's stroke awareness, teaching people how to recognize symptoms early enough to make a difference. For families, it's language development classes that help parents identify delays and communicate more effectively with their children.

They're working to move these programs into virtual classes, which would expand their reach well beyond Clearwater and Fort Lauderdale. It's a long game, but it doubles as both community service and referral generation.

What Makes It Work (and What Makes It Hard)

The best part of running her own practice, Maria says, is the flexibility. Not just schedule flexibility, but clinical flexibility. When you're doing home visits with kids or adults, you see their real daily life. You can make therapy goals functional in ways that are hard to replicate in a clinic setting.

The hardest part is the same thing every new practice owner struggles with: wearing every hat. Therapy, marketing, billing, policies, documentation, scheduling. In the early stages, you're in charge of all of it, and figuring out how much time to give each piece is a constant balancing act.

Her advice for anyone thinking about starting? Do it calculated. Keep a part-time job if you need to. Let it grow at a pace that doesn't break you. And stay organized with your finances month by month, because scrambling at tax time is no fun.

"If you just keep believing in yourself and really aim to help your community," Maria says, "I feel like that always comes back to you."

Running a practice across two locations means twice the admin. ClinicNote is a HIPAA-compliant EMR built for private practices and university clinics, handling therapy notes, scheduling, and billing in one platform so you can focus on patients instead of paperwork. See how ClinicNote works.

Transcript

Kadie: You are listening to Clinic Chats, the speech therapist's private practice podcast, a podcast full of personal journeys where we not only talk about success stories, but also real life struggles of small business startups. Clinic Chats is sponsored by ClinicNote, a HIPAA compliant, cloud-based EMR platform used specifically by private practice owners and university clinics. I'm your host, Kadie Jackstat, and thank you for joining me today.

Kadie: Today I'm going to be recording with Maria Gianfilippo, who is the owner of Organic Speech Therapy. Hi, Maria. How are you?

Maria: Good. How are you? Thanks for having me.

Kadie: Good. So we get to chat with you and I'm interested in your business that you have created. So how long have you been in business for?

Maria: Just about over a year now.

Kadie: And where are you located?

Maria: So we actually have two locations. We're in Clearwater, Florida, which is right outside of Tampa, and then in the Fort Lauderdale area.

Kadie: Oh, awesome. So you get total best of both worlds, go to the office, hang out at the beach.

Maria: Oh, yeah. I love the beach life.

Kadie: That's great. So tell me a little bit about your background in speech therapy before pursuing private practice, and what gave you the urge or the kick to go for it?

Maria: Sure. So I went to Florida State and had a lot of experience with adults in acute care setting and outpatient, so really had a passion for that. And then right out of grad school, I worked for a company with pediatrics, doing kind of home visits. And then I also worked PRN at a hospital because I wanted to keep my adult skills up. And then worked in acute care, as well as outpatient, so kind of had a little bit of everything, which I liked because I like both kids and adults.

Maria: I actually have always thought about having my own practice. My parents owned their own business growing up, so I got to see the pros and the cons of it, but always just had it in the back of my mind that maybe one day I would have my own practice in the future.

Kadie: And so does your business focus on all populations, or did you choose to find a niche?

Maria: We have some niches. So we do kind of early intervention, but up to ages like five. So the late talkers, kids that have trouble with their speech sounds, and then also adults following stroke. We work with language, dysphagia, also like cognitive therapy, working with adults, too. So those are kind of our niches.

Kadie: Wow. Yeah. So you're kind of on both ends of the spectrum there, as far as age range goes. I feel like it's really rare to find a private practice who does serve adults. Do you feel like that aspect has been more difficult to get patients in, or how has marketing on that side gone for you?

Maria: Yeah. So I haven't heard of too many doing adults either. So I guess that's a kind of good thing as well. I've gotten a lot of adults, too, where their insurance runs out, or just private pay. And so their insurance doesn't allow them more therapy visits, but they still need more therapy visits. So really I've been able to focus with them. We also work with people that need AAC devices. So that's been pretty helpful of getting patients the services they need for that.

Kadie: Right. So after they come out of, say, acute care or inpatient therapy, and their benefits have run out, then they can seek you with their private pay.

Maria: Yes.

Kadie: And is it just you? You said two locations, so I'm assuming you have hired.

Maria: Yeah. I have a co-founder. So I'm not the only founder of Organic Speech Therapy. Allison Ortega heads the Fort Lauderdale area. So she's down there, and I'm up here. And we kind of focus on the same. She's more adult-focused as well, but we love our little kiddos. So we like to see them, too.

Kadie: Oh, nice. So it's just you two as co-founders, or are there any contracted SLPs as well?

Maria: No, just us two right now.

Kadie: So those first steps of starting your business and where you're at now, what is day-to-day or week-to-week like as far as amount of time you allocate to patients and then amount of time allocated to, say, billing and marketing?

Maria: I'd say it's about half and half right now. We kind of had to transition to teletherapy, and luckily, all of our patients it worked out with pretty well, or at least most of them, to see them with teletherapy. So we spent kind of a lot of time adjusting to that and learning what the best platform we wanted to use and how to navigate teletherapy.

Kadie: What about taking on new clients during COVID? How have you approached evals, new patients?

Maria: So we've had to move our materials to digital materials. Luckily, on the Facebook world, the SLPs in telepractice who had already been doing this before COVID were all so nice and kind to share their resources. So that was kind of one hump we had to get over. But a lot of the calls we had gotten, people wanted to do teletherapy. They didn't want to bring their child somewhere or their parents somewhere. They wanted to do it from home. So that kind of worked out.

Kadie: Yes, yes, absolutely. You're so right. That teletherapy Facebook group blew up and so thankful for that. I actually recently switched to a teletherapy company who was servicing in the teletherapy model even pre-COVID. So it's nice to be with a company who has experience in that regard.

Kadie: So what are the next steps for you guys in growing your business? Are you happy with it being you and the co-founder? Do you have goals for expanding one day?

Maria: Yes, we'd like to expand in the future and hire other therapists, but we're also pretty passionate about community education. So our focus has been on stroke education and then also on language development. So on both ends of the spectrum. So we're kind of focusing on that as well as a kind of a preventative approach.

Maria: When I was working in the hospital, I noticed a lot of people would come in with a stroke and they'd come in days after their symptoms first started. They just didn't know they were having a stroke. And I thought, you know, if people just knew, and why would they know unless they've worked in that setting or they've known somebody who's had a stroke or just been taught it, why would they know the signs of a stroke? So I thought, you know, if I could share this with more people, maybe it would help prevent one or prevent it from being even worse than it could be.

Maria: And then same thing on the kid's side with the language development of teaching parents how to communicate with their child better and when to know if there's a delay. So we've been focusing on the community education and working to expand that into virtual classes. So in the future, we hope to expand that and then also hire some more SLPs.

Kadie: Yeah, that would be awesome. So I'm curious how you derived the name Organic Speech Therapy and if there is meaning behind that.

Maria: Yeah, that was all Allison. So she came up with the name. But we liked a definition that we found that it was organic as all parts of a whole working harmoniously together. And we feel like that's what we're doing as far as helping people with their communication or their cognitive linguistic functioning is really a big piece of your whole life and being able to do the things that you love. So we thought it really reflected the care that we want to give to our patients.

Kadie: That's great. Absolutely. Especially with your adult population. It's about reobtaining those skills to communicate and function in the community.

Kadie: Let's see, what has been the most challenging part of starting your own private practice? Has it been all rainbows and butterflies?

Maria: Not all rainbows and butterflies. It has been pretty smooth. I've been pretty lucky with that. I think the biggest challenge is knowing how to balance all the pieces. So as your own private practice, at least in these beginning stages, we're in charge of everything, not only the therapy, but marketing and getting patients and your policies and procedures and the way that you go about your paperwork and your billing and all of that kind of stuff to figure out. And so I think that's been the biggest challenge as far as how much time to allocate to each thing and finding a groove and a good schedule throughout the day.

Kadie: Yes, it is. It's so hard to allocate time, like you said, and just grow all that unpaid time. But hopefully it'll all pay off in the long run. I'm sure it will. And do you all pay for two separate locations, say, pre-COVID, or were you going to people's homes?

Maria: So we were just going to people's homes. We were actually looking for office space, but it turned out to be a little bit of a blessing in disguise that we didn't find anything at the time.

Kadie: Right, yeah.

Maria: But that was kind of a future plan. But at the time, we were just going to our patients' homes. So when COVID hit, we just had to transition to teletherapy because we couldn't be going into our patients' homes.

Kadie: Yeah. So what are your overall costs? You don't have a rental space, so that's great. It's private pay. What are your costs that you do have to budget for?

Maria: We have costs for the website. We use G Suites for kind of our organizational system, send them to people for fill and sign. But our costs are relatively low. I mean, if there's any materials that we need, like online stuff, we pay for, like Teachers Pay Teachers, things like that. But generally, they're pretty low besides just operating, keeping the LLC up, things like that.

Kadie: Yes. Well, that's phenomenal. If you're able to keep those price points low, then less overhead is definitely a good thing.

Maria: Yeah, that's the goal. Keep that part low.

Kadie: Oh, absolutely. So how many clients do each of you have at this point?

Maria: On caseload, I have seven right now. So just really doing therapy two days out of the week. And I'm not quite sure about Allison. I haven't really checked in with her recently. We kind of manage our own caseloads.

Kadie: Yeah, yeah. So are you able to kind of take things slow, less pressure to have this full caseload right out of the gate?

Maria: Yes. And I work part time as well, still at a clinic. So I am doing this part time and then still doing part time at the clinic. So, yeah, it's been kind of a slow growth and then it kind of ebbs and flows after you discharge a patient, pick up a new one. So it kind of fluctuates sometimes.

Kadie: Yes. Well, that's perfectly fine. And I'm happy that you came on to share that part of your business because I think people need to know it's okay to start small. It's okay to do two things at once and let it grow organically and see how big it can get.

Maria: Yeah, absolutely. And I'm not too much in a rush to grow it. It's something that I was really happy about that it's been able to go kind of slower. I'm not in a rush. Of course, in the future, I'd like to grow that, but I think it's been able to help me focus on the business and not stress as much about the finances, I guess, since I still have a part time job and kind of easing into it has allowed me to focus on making it how we want it.

Kadie: Yes, yes, exactly. Like you said, develop it exactly how you want it. And you can always change gears too if you change the direction of the business.

Maria: Yeah, exactly.

Kadie: How is the area as far as competitors in private practice?

Maria: There are a decent amount of private practices, but my experience with them in the Clearwater area, Clearwater, Tampa, St. Petersburg, is that everybody seems to have their own little niche. So I actually think it's a good referral point because there's so many people out there that need our services that I don't think there's really that much of competition.

Maria: There's other clinics in the area and some of which have been very helpful to me with starting up, like Christina Madden from Madden Therapy Solutions, just been very nice with giving tips and things. And I know she sees speech and language, but she also really focuses on feeding with her practice. And then there's some other people that do AAC and take insurance. So it's been more of, I see it more as kind of everybody helping each other out and being good referral sources since we all do different things.

Kadie: Yeah, exactly. That's wonderful to have that viewpoint. Is there anything that you would like to add for those listening on the best and worst parts of having a business? Any tips and tricks? What are your thoughts?

Maria: The best parts, I think, are being able to be flexible, not only with your own schedule, but with your patients. We really try to incorporate, especially with aphasia, a life participation approach. We want everything to be so functional, which of course we all strive for in therapy. But sometimes when you're going to the home, whether it's with kids or adults, you really get to see the day to day and how you can incorporate your treatment in their everyday lives and make it very functional for them. So it's nice to have the flexibility of your own schedule, the flexibility to really do what you need and see them at a frequency for them.

Maria: The tough part, I guess, that can also be a thing. You have to be kind of self-motivated and keeping yourself on track for getting things done and not taking too much time for just fun stuff.

Kadie: Yes, absolutely. Isn't that the truth?

Maria: Yeah, but tips and tricks, I'd say, if you're thinking about it and you can set yourself up to take a risk, if you were thinking about doing your own practice, but you can kind of do it calculated, I'd say go for it. It's been such a fun learning experience, not only for therapy, but also just on a business aspect of it. I'm learning so much more than I ever thought I would. And if you just keep believing in yourself and really aim to help your community, I feel like that always comes back to you.

Kadie: Yes. And you have just probably been working on filing taxes as a quarterly income for only about a year now. How is that going? I feel like that's a learning curve.

Maria: Yes. Luckily, my parents, like I said, had their own business. So the accountant has been very helpful. Having a good accountant is very important, I think, to help you keep track of things and keep track of them every single month. So I've been lucky to have some assistance with that. But I would say with the financials of tracking your income and your expenses and things like that, it's very important to stay organized month by month because you don't want to end up at the end of the year and try to scramble. I had a little bit of that going on.

Kadie: Yes. Well, that's great that you did have your experience in the family already. I think that most who take insurance or who might be servicing a large amount of clients would, of course, say get a separate bank account. But I'm curious, for a practice your size, is that something you've done or are you leaving it just in your personal name?

Maria: No, I have a separate bank account. We have an LLC. And I like to keep all that separate. I think when you mix it together is when it gets kind of messy.

Kadie: Yes. And hard to keep track of. So if you have your own separate bank account, that's where the transactions go for your business. That's where you keep your money there. I think it's best.

Maria: Well, in my opinion, I like having it separate.

Kadie: Yes, 100% agree. I was thinking that too. I mean, it's just so much more clear cut when you're looking back at those statements.

Maria: Yeah. I'm not a numbers person. They don't come easy to me. So as clear as it can be, that's the best for me.

Kadie: Exactly. Don't mix in my weekly coffee stop into my business account.

Kadie: All right. Well, I am so glad that you were able to come on and share your private practice story. I wish you the best to get through COVID times and back to in-person therapy.

Maria: Thank you. We're starting the transition. I appreciate you having me on though. It's great to talk with you.

Kadie: Awesome. Yes, you as well. Thank you for joining me and listening to Clinic Chats, the speech therapist's private practice podcast. 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 at clinicnote.com. That's K-A-I-D-E at clinicnote.com.