She Loved the Paperwork: Kadie Jackstadt on Why She Started Clinic Chats

Most speech pathologists dread the paperwork. The scheduling, the Medicaid billing, the report writing. Kadie Jackstadt loved it. And that single difference, the realization that she was wired for the business side of therapy rather than back-to-back sessions, set her on a path from school-based SLP to private practice owner to podcast host. In the very first episode of Clinic Chats, Kadie introduces herself with refreshing honesty about what worked, what didn't, and why she eventually picked up the phone and called ClinicNote ready to throw in the towel.

When Back-to-Back Sessions Drain You Instead of Fill You

Kadie's career started the way many SLPs' careers do: in the schools. She graduated from Southern Illinois University of Edwardsville, landed a position serving grades 3 through 5, and worked with specialized programs for autism and functional life skills. She even took a summer gig at a skilled nursing facility to keep her adult treatment skills sharp.

But something felt off. "Therapy back-to-back just wasn't something that fulfilled me and more so drained me, quite honestly," she says. While her coworkers complained about paperwork, scheduling, and report writing, Kadie found those tasks were actually her favorite part of the job. That's not a small thing. Recognizing what energizes you versus what depletes you is one of the most important decisions any clinician can make.

She started contracting with a local practice on the side, and the freedom she saw in that owner's life stuck with her. Even after stepping away from contracting when she got pregnant with her son, those private practice dreams never left the back of her mind.

Crunching the Numbers and Making the Leap

After her son was born, Kadie started picking up private clients again, this time on her own. And when she ran the numbers, the math was hard to argue with. "About half my caseload in the schools would be all it would take to make a substantial more amount of money," she explains.

So she weighed her options. Schools meant three months off. Private practice meant working part-time year-round. For a new mom trying to find balance, the flexibility won. But leaving the school district was gut-wrenching. "I left the place of work where I had made friends, a good reputation. I know they didn't see it coming and I felt terrible. I still do, honestly."

That's the part nobody talks about enough. Starting your own practice isn't just a business decision. It's a personal one that affects relationships, reputation, and your sense of identity. Kadie doesn't sugarcoat it, and that honesty is exactly what makes Clinic Chats different from the typical "follow your dreams" content.

The Credentialing Gauntlet

Once Kadie committed to private practice, she had to credential with insurance companies. She started with Blue Cross Blue Shield and found the process overwhelming. "This credentialing process was a little overwhelming when I didn't know what a lot of those terms meant that the paperwork was asking for."

After finishing that first packet, she hired a credentialing company for the other two insurances she wanted to accept. Looking back, she wishes she hadn't. "It was really a big expense and looking back it probably would have been fairly simple since I had just completed the Blue Cross Blue Shield packet." And depending on the company, the turnaround dragged on for months.

For anyone building a private practice today, the credentialing lesson is real: the first application is the hardest, but once you've done one, you can likely handle the rest yourself. Good EMR software can also help you keep track of payer information and deadlines so nothing falls through the cracks.

Cancellations, Cash Flow, and the Guilt Factor

Kadie's practice grew. She was splitting her time across three to four days a week, fielding new client calls, and starting to think about hiring. But then reality set in.

"I had my cancellation policy but yet this guilt took over where I was so, so bad at enforcing it and actually charging people for cancellations that really weren't excused." The result was inconsistent pay. Combine that with waiting on insurance payments, and the financial stress mounted.

This is one of the most common struggles in private practice, and Kadie names it plainly: "The thought of paying someone else when my own income seemed unstable was really stressful." She loved the freedom, the pride, the success of owning a business. But the income volatility was real, and pretending otherwise doesn't help anyone.

From Practice Owner to Podcast Host

Here's where the story takes its turn. Kadie was a ClinicNote subscriber, using it as her speech therapy EMR. One day, feeling ready to give up, she called the owner of ClinicNote just to vent. "Lo and behold, I eventually got an offer from their team."

Now instead of seeing clients, Kadie gets to focus on the business and organizational work she always loved, while still using her degree. Her total time in private practice was only about a year and a half, but she doesn't see that as a failure. "It really was a great journey because it led me to where I am today."

And that journey led her to create Clinic Chats, a podcast where she interviews other practice owners about their real experiences. Not just the marketing tips and billing tricks, but the honest struggles. "Let's dive into some struggles that small business owners have, particularly those in the speech therapy world," she says. That's the mission, and it starts right here in episode one.

Kadie's story is a reminder that there's no single "right" path in this field. Whether you're built for the therapy chair or the business side, having the right tools matters. ClinicNote helps private practice owners and university clinics manage the paperwork, billing, and scheduling so you can focus on what actually fulfills you. Learn more at clinicnote.com.

Transcript

Kadie: You are listening to Clinic Chats, an inside scoop on speech therapy private practice, a podcast full of personal journeys where we will 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 Jackstadt, and this is episode one.

Kadie: Today, I want to give you a little background and introduction to myself. I have a speech pathology background, graduating from Southern Illinois University of Edwardsville. Since then, I've worked in a variety of settings in, well, not a super lengthy amount of time. I actually began my career with a school district where I served grades 3 through 5. This school had several specialized programs, including a functional life skills program and specialized programs for autism.

Kadie: During one of my summers off, I worked for a skilled nursing facility mostly because I wanted to use what I learned in college in relation to adult treatment. You know what they say, if you don't use it, you lose it. This was a fun adventure but not particularly enjoyable for me. It just wasn't my thing.

Kadie: I returned to the school for another year and a half and I also began contracting with a local private practice and came to appreciate the freedom that this particular owner had found. I struggled with being torn on staying in the school or remaining in private practice as a contractor, but not too far down the line, I was pregnant with my son and decided I couldn't continue to do both. So something had to give.

Kadie: I was working my school job, I think it was 8 to 4, as well as evenings as an independent contractor. At that time, I decided to stick with the school and gave up doing therapy on the side as an independent contractor. Those private practice dreams and freedom really never left the back of my mind.

Kadie: So I often had felt overwhelmed in the school. Therapy back-to-back just wasn't something that fulfilled me and more so drained me, quite honestly. I found it interesting that other SLPs and coworkers complained about paperwork, scheduling, report writing, Medicaid building. However, that was actually my favorite part of my job in the school.

Kadie: So I slowly began to realize that potentially another transition in seeing clients on the side, I could do more so of the business work instead of back therapy in the school with large groups and large numbers. So as I began to pick up some clients on the side, remember I was pregnant, so I decided I was going to do this on my own this time just for the extra cash.

Kadie: And as more and more clients heard about this, I crunched some numbers and realized it was an easy decision, that about half my caseload in the schools would be all it would take to make a substantial more amount of money. So I was weighing my options. Schools, I would get three months off, but private practice, I could work part-time year round.

Kadie: And while I was fully aware that therapy was draining to me, it was also something that I took pride in. So I knew I was doing a good job. And that's what kept clients coming and my connection to parents kept clients coming. But once again, I was working at this point as I was building my private caseload, probably from 8am to 8pm, at least three nights a week, maybe more.

Kadie: And it became clear that I had found more freedom in private practice with more of my organizational and paperwork tasks that were actually fulfilling to me. So as silly as that sounds to some and crazy for some speech therapists, it is my truth. I loved providing clients with evidence-based therapy and getting results for them, but yet I also put all of this pressure on myself to get results fast, make progress.

Kadie: So I was excited to take more of an independent standpoint in my therapy and scheduling. So I credentialed with Blue Cross Blue Shield as clients came and wanted me to accept. So this credentialing process was a little overwhelming when I didn't know what a lot of those terms meant that the paperwork was asking for. So it probably took me longer than it really should have.

Kadie: But I was a little bit overwhelmed and defeated after completing this huge packet of information. So I looked into a credentialing company to assist with the other two insurances that I wanted to take pretty much immediately. This was really a big expense and looking back it probably would have been fairly simple since I had just completed the Blue Cross Blue Shield packet.

Kadie: So I am not discouraging anyone if they don't want to spend the time, go ahead and use a credentialing company, but in hindsight I think I should have just made it work and could have figured it out myself. And actually depending on what credentialing company you use, it seemed to take a long time. Blue Cross Blue Shield was my first to come back. The other two were months and months and months.

Kadie: So remember this was on the side of my full job while planning for my first baby while seeing clients on the side. So developing my business, I did need to reach out for help at some point in time. So long story short, I started to grow and grow, not only business-wise, but also in my pregnancy, which led to the need to make a decision pretty immediately.

Kadie: I could not keep up with these hours, these clients, phone calls to families, new evaluation calls. Just something had to give. And I knew when my son came in December, I pretty much had to let the district know right then. So I only took three to four weeks off for my private clients. And I had planned on 12 with the district, but as I got back in the swing of things, being a new mom, worrying about how I would do all of this, it was the hardest thing I've ever had to do.

Kadie: But I left the place of work where I had made friends, a good reputation. I know they didn't see it coming and I felt terrible. I still do, honestly. However, at some point you have to make a decision that's best for yourself. So I know I'm not the only one who's placed with these tough decisions.

Kadie: And especially when you become a mom, or a dad, parent, whatever, I think a lot of what other people think might become null because you're making a decision not only for yourself, but for your whole family. So I had to find a work-life balance and also a little bit more fulfillment in my day-to-day job. And for me, that was going to be switching to solely private practice.

Kadie: There were some instances where I thought this was the perfect decision for me. The business was growing. I was able to spend time at home with my son. I would say I was able to split up my time between three and four days a week. Some days I had all of these new clients calling where I thought I'm going to need to hire someone and I'm going to get to step back. The more clients I get the more I'm going to get to step back.

Kadie: But yet there were other weeks or days where my caseload would be increasing but yet so many cancellations. I had my cancellation policy but yet this guilt took over where I was so, so bad at enforcing it and actually charging people for cancellations that really weren't excused. So there was this inconsistency in pay from cancellations as well as waiting on insurance payments.

Kadie: And on those days, I felt stuck. As fulfilling as managing the business was, there were still parts of me that were wondering, how am I going to grow this business to the point of hiring yet to rely on this income? And the thought of paying someone else when my own income seemed unstable was really stressful. So this is a very honest and open take on my struggles in private practice.

Kadie: So I loved so many parts of the freedom and pride and success as a business owner. However, I just remember as I worked with, or I was a subscriber of ClinicNote, which was the EMR software that I chose to go with. And I remember calling one day. I don't know why I chose to call the owner of ClinicNote. I think I was basically ready to throw in the towel and just telling her my struggles.

Kadie: And lo and behold, I eventually got an offer from their team. And so, you know, instead of seeing clients, now I get to do more of the paperwork and business aspect and still use my degree. So it was really the right switch for me. In total, I only had about a year and a half in private practice, it really was a great journey because it led me to where I am today.

Kadie: And I'm still very passionate about the field, other private practice owners' journeys and experiences. And I, of course, still love to stay up on the current research. I plan to continue holding my C's and knowing the best practice in the field. So even though therapy every day isn't for me, isn't for some people, the idea of growing the business to the point of hiring others so you could just manage was really intriguing to me.

Kadie: So I am so excited to hear a multitude of private practice owners' experiences, whether they only like doing the therapy or if they are in it for more of the business aspect. So my hopes in interviewing other private practice owners is that we can share not only about becoming successful, marketing yourself, billing insurances. These are all great, great tips that we all want to learn from, but I want this to be realistic.

Kadie: Let's dive into some struggles that small business owners have, particularly those in the speech therapy world. So our very first interview will be with Nicole, the owner of Speech Suite in LaSalle, Illinois. We will be tuning in with her next time.

Kadie: So for now, that's all we have time for for today. Thank you for listening to Clinic Chats, an inside scoop on speech therapy private practice. 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 personal journey through private practice, please email Kadie at clinicnote.com. That's Kadie with K-A-I-D as in dog, E at clinicnote.com.