It's August. Your IT person is rebuilding student accounts from scratch again, deactivating the cohort that just graduated and setting up the new one by hand. A supervisor down the hall is reconciling co-signatures on a spreadsheet because there's no single place to see which student notes still need a signature. If you're searching for a SimplePractice alternative for university speech clinics, you've probably lived some version of this.
Here's the honest part: SimplePractice is good software. It just wasn't built for a teaching clinic. This post walks through where it strains in a university setting, what your costs actually look like, and what to look for in an alternative built for the way graduate programs really run.
Where SimplePractice Fits, and Where a Teaching Clinic Is Different
SimplePractice was built for private practice, and it does that job well. Solo clinicians, group practices, scheduling, billing, and even a supervisor sign-off feature for prelicensed clinicians are all there.1 If you ran a private speech therapy practice, it would cover most of what you need.
A university speech clinic looks similar on the surface. Patients come in, students see them, notes get written, billing happens. But underneath, the logic is different. You're not managing a handful of licensed clinicians. You're managing 20 or 30 student clinicians who rotate through every semester, each one assigned to a small slice of the caseload, each one supervised by faculty who have to review and sign their work. Then there's FERPA sitting on top of HIPAA, and a university IT department with its own list of requirements.
So when a program director starts looking for a SimplePractice alternative, it isn't a knock on the software. It's recognizing that a graduate training clinic was never the thing it was designed for.
The Four Gaps Directors Run Into
Most of the friction shows up in the same four places.
Student caseload restrictions. In a teaching clinic, a student should see only the patients assigned to them, not the entire clinic roster. Private-practice EMRs generally assume every clinician can see the full caseload, because in a private practice they can. That leaves directors either restricting access by hand or accepting a privacy gap they'd rather not have. For student records covered under FERPA, that gap matters.
Supervisor co-signature at cohort scale. SimplePractice does let a supervisor review, edit, and sign a supervisee's notes.1 The problem isn't the single note. It's the cohort. When you have 30 students each turning in notes, there's no clean view that surfaces everything still waiting on a signature. So supervisors fall back on spreadsheets or paper checklists to track sign-off status, which is exactly the kind of manual workaround an EMR is supposed to remove.
Per-semester account rebuilds. Students change every term. Without a built-in cohort cycle, your IT staff deactivates the graduating group and sets up the incoming one from scratch, twice a year, every year. It's repetitive work that never really ends.
FERPA layered on HIPAA. This one trips up a lot of programs. Records on students treated at a campus clinic are often education records or treatment records under FERPA, and they're excluded from the HIPAA Privacy Rule even when the institution is a HIPAA-covered entity.2,3 Your university IT team knows this, which is why they'll ask about IP restrictions, audit logs, and access controls before they approve any tool. A private-practice EMR is built for the HIPAA-only world and doesn't really speak that language.
What SimplePractice Actually Costs a Training Clinic
Pricing is where the per-seat math catches people off guard.
To add team members at all, you need the top Plus plan, which runs $99 per month.4 From there, each additional clinician is an add-on: roughly $74 per month for the first few, dropping to around $69 as you add more.4 There are also smaller line items, like per-text appointment reminders and a per-clinician annual fee.4 A 10-clinician group practice lands somewhere near $675 per month before payment processing fees.4
Now picture a teaching clinic. You don't have 10 clinicians. You might have 30 student logins on top of your supervisors. Per-seat pricing that makes sense for a small private practice climbs fast when every student needs an account.
And the bigger cost is the one that never shows up on the invoice: the staff hours spent on the workarounds above. The manual account rebuilds, the co-signature spreadsheets, the access cleanup. That's real budget, it's just hidden in people's time instead of a line item. (Pricing changes, so confirm the current numbers before you decide. The point isn't the exact figure, it's the shape of the cost.)
What to Look for in a University-Built Alternative
If you're evaluating university speech clinic software, here's what separates a tool built for teaching clinics from a private-practice tool you're trying to bend into shape.
- Patient-level caseload restrictions. Students should see only their assigned patients, with that limit built in rather than bolted on after the fact.
- A real supervisor review-and-sign workflow. You want pending student notes to surface in one place, with document completion verification, so a supervisor can see at a glance what still needs a signature instead of rebuilding that view in a spreadsheet.
- Repeatable cohort onboarding. New students arrive every semester. Setup should work the same way each term, and the basics should be learnable in an hour or two so you're not burning a week of orientation on software.
- Security that satisfies university IT. Multi-factor authentication, IP-based access restrictions, role-based permissions, and audit logging are the things your IT department will actually ask about.
- Templates that match how you already teach. Your SOAP notes, evaluations, lesson plans, and treatment plans exist for a reason. Good software recreates your vetted forms as easy fill-out templates so you keep your curriculum instead of rewriting it around the tool.
Write these down before you sit through a single demo. Then make every vendor show you each one, live, on a real workflow. It's the fastest way to separate a tool built for your setting from one that just says it can handle it.
SimplePractice vs. ClinicNote at a Glance
So how does this comparison shake out? Here's the simplepractice vs clinicnote read, framed honestly around those same four gaps.
For caseload restrictions, supervisor sign-off across a cohort, semester onboarding, and FERPA-aware access controls, SimplePractice can get you part of the way, but mostly through workarounds. It's strong for private practice. Those university workflows just aren't its home turf.
ClinicNote was built for this setting. It's used by 175+ clinics, including 117 speech clinics, and it handles those four gaps natively: students see only their assigned patients, supervisors get a real review-and-sign workflow with completion verification, onboarding repeats cleanly each cohort, and the security model (MFA, IP restrictions, role-based permissions) is designed to meet university IT requirements. Faculty send their existing templates, and those get recreated as fill-out forms so you teach documentation your way.
Neither tool is wrong. They're built for different jobs. The question is just which job is yours.
Built for a Teaching Clinic
The real question was never whether SimplePractice is good software. It is. The question is whether it's built for a teaching clinic, and for student caseloads, cohort turnover, supervisor sign-off, and FERPA, the honest answer is that those are workarounds, not features.
Before your next demo, write down your four must-haves: caseload tiers, supervisor sign-off at cohort scale, repeatable onboarding, and FERPA-aware access controls. Make every option prove each one. That checklist will serve you well no matter which tool you choose.
Want to see what that looks like when it's built in from the start? ClinicNote is designed for university SLP and audiology clinics, with student and supervisor workflows that match how your program already runs. See how it works for universities, or work with us to walk through your clinic's setup.
Sources
- https://support.simplepractice.com/hc/en-us/articles/360048689851-Adding-a-supervisor-to-review-and-sign-notes
- https://www.hhs.gov/hipaa/for-professionals/faq/518/does-ferpa-or-hipaa-apply-to-records-on-students-at-health-clinics/index.html
- https://studentprivacy.ed.gov/resources/joint-guidance-application-ferpa-and-hipaa-student-health-records
- https://www.trustradius.com/products/simplepractice/pricing