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Lucie LeDoux: Pediatric Therapy, Taxes & Finances | Clinic Chats

Written by twotone | Mar 11, 2020 7:42:00 AM

It's All Going to Be Okay: Lucie LeDoux on Building a Pediatric Practice with Heart

Lucie LeDoux doesn't pretend to have it all figured out. She's been running Shine Pediatric Therapy and Learning since 2011, she's moved cities, dissolved a partnership, rebuilt solo, and she'll still tell you, without a trace of performance, that organization is not her strong suit. What she does have is a decade of proof that a private practice built on genuine investment in kids and families can survive the chaos.

"I wish someone had told me when I started out: it is all going to be okay. It really, really is."

Lucie is Clinic Chats' first guest from Louisiana, and her story covers more ground than you'd expect. She's dual certified in audiology and speech-language pathology, she's navigated the financial mechanics of solo practice without a business background, and she's already eyeing the next mountain: starting a nonprofit.

Dual Certified and Called to Pediatrics

Lucie's path didn't follow a straight line. She earned her master's in audiology in 1999, practiced pediatric audiology with ENTs, then went back for her speech-language pathology certification. She spent several years in the public school system, working primarily as an SLP while keeping her audiology skills sharp for hearing-impaired students on her caseload.

When she launched Shine Pediatric Therapy, she initially hoped to offer both audiology and speech therapy services. Reality intervened. The equipment cost alone for audiology is significant, and she chose to specialize rather than spread thin. Today the practice focuses on pediatric speech therapy, supplemented with ear mold services and a reading certification she picked up along the way.

"I wanted to really specialize in pediatrics. And under the pediatric umbrella alone, there's so many things."

It's a reminder that narrowing your scope isn't shrinking your ambitions. It's focusing them.

You Don't Know What You Don't Know

Lucie is disarmingly honest about the learning curve. When she first started, she walked into a university small business administration office with an empty notebook and said, essentially, "I don't even know what I'm supposed to be asking."

They helped her build a framework: find a location, estimate rent, price out every assessment tool you need to open your doors, create a hypothetical budget. That scaffolding gave her something to work from when everything else felt uncertain.

But the real lifeline came from an unexpected place. A more established practice owner in her town reached out when Lucie opened her doors, not to scope out the competition, but to offer help. Lucie assumed the call was territorial. It wasn't.

"It was very much like, there's plenty of work to go around. Welcome to the community. Anything we can do to help. And they were true to their word."

That relationship became an unspoken mentorship. Lucie could email questions about vendors, processes, and billing systems without feeling like she was imposing. She tries to pay it forward now when newer clinicians reach out to her.

The Money Side: Quarterly Taxes, 35%, and Keeping It Controlled

For a self-described non-numbers person, Lucie has built a surprisingly disciplined financial system. She pays quarterly taxes, works with a CPA, and sets aside 35% of revenue, which she acknowledges is consistently more than she ends up owing. That overshoot is intentional. It creates a cushion for months when a new reading assessment or unexpected expense throws the profit and loss margin out of alignment.

Her setup is straightforward: everything runs through the LLC's business account, including contract work payments, vendor checks, and her own monthly draw. She reconciles records against bank statements and writes herself a check from what remains.

"If I can handle the organization side and the money side, anybody can. If you love what you're doing and you're in it for the right reasons, it's going to work out."

That's not bravado. It's the hard-won confidence of someone who has watched the numbers work out year after year, even when a week and a half of Mardi Gras cancellations makes February look thin.

The Ebbs and Flows of a Small Practice

Lucie's practice has never been static. She's had locations in multiple cities after her husband's job transfer. She's entered and exited a business partnership. She's contracted with school districts for evaluation work while maintaining her private caseload. At various points she's had other SLPs working under her; at other points it's just been Lucie and her part-time office assistant.

She describes this rhythm matter-of-factly. "It ebbs and flows." And she's learned not to fight it. A small, controlled practice means she knows exactly what's coming in and going out. There aren't a lot of balls in the air at the same time. For someone who admits that organization isn't her natural strength, that simplicity is a feature, not a limitation.

The key investment she credits: bringing on someone to handle the office side. Even at two days a week, that help keeps her on track with scheduling, documentation, and the administrative details that would otherwise pile up.

Turn the Lights Off and Go Home

When Lucie talks about what she'd tell someone starting out, she doesn't lead with tactics. She leads with the thing a mentor once told her that she's still trying to internalize: the work will always be there. Turn the lights off, shut the door, go home to your family.

"In private practice, it can be constant. But you're in charge of it. You've got to decide what's most important."

She's not pretending she's mastered this. She calls it self-inflicted, the tendency to be all in or all out. But she recognizes the pattern and she's working on it. And she knows it matters, because you can't take care of families and kids if you haven't taken care of yourself first.

Looking ahead, Lucie wants to invest in the next generation of speech therapists entering pediatrics. She wants to mentor, to help new clinicians fall in love with the work the way she did. And she's kicking around the idea of a nonprofit, inspired by a thriving organization a couple of towns over. She doesn't know what it looks like yet. She just knows it's the next mountain.

"Just like this was ten years ago. It's like a mountain I've never seen before."

Running a small practice means wearing every hat. ClinicNote is a HIPAA-compliant EMR built for private practices and university clinics, combining scheduling, documentation, and billing in one place so you can focus on the kids and families you're there to serve. See how ClinicNote works.

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 expanding 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: Today I have Lucy LeDoux, and she is the owner of Shine Pediatric Therapy and Learning. Thank you so much for coming on the podcast today, Lucy. How are you?

Lucie: I am great. How are you?

Kadie: I'm doing well. I'm excited. I think you're our first guest from Louisiana.

Lucie: That's awesome.

Kadie: So we're excited to hear your story, and obviously you're an SLP in private practice, but how did you get there, and what was your background before entering the private practice world?

Lucie: Well, I actually started off as an audiologist.

Kadie: No way.

Lucie: Yeah. I'm dual certified. I went to graduate school for audiology first, got my master's in that many moons ago when you could still just have a master's, finished that in 1999, and always knew that I wanted to be dual certified. So I practiced pediatric audiology for a while with some ENTs in various locations like that, and ultimately went back and finished the dual certification and spent several years in the public school system. I've done lots of different contract work and things like that in different arenas, but I always knew that I was going to work just with children. That's what I was called to do, and that's what I was going to be doing.

Kadie: So dual certification in a school setting, were you primarily acting as an SLP, or how does that work?

Lucie: That's right, Kadie. I was acting predominantly as an SLP. They would call me for things, and if there was a kiddo that was hearing impaired, I certainly had them on my caseload, but yes, I was predominantly acting as an SLP. The majority of the time I spent as an audiologist or actively was in the private sector.

Kadie: So after the school setting, then at what point did you start thinking of your own business?

Lucie: So I had always kind of thought about the idea, really adored being in the school system. It's a great schedule for working moms. In 2010, I had my third son, and it was that year that I really felt called to make the leap. And so I did. It's been longer than I realized, just saying that out loud.

Kadie: And so as you made that leap, did you decide that you were going to have both of those services within your private practice?

Lucie: That's a really good question. I have always wanted to have both, and hopefully that eventually will materialize. But honestly, that is not the case right now. I do primarily speech therapy. I do swim molds and things like that, for sure. But number one, there's a large equipment cost with audiology. And there's so much in our field. I wanted to really specialize in pediatrics. And then of course, under the pediatric umbrella alone, there are so many things. So no, unfortunately, we don't have both services here outside of maybe swim molds, really.

Lucie: I've had a couple of different locations. We moved. I had a private practice in one city, and it was great and wonderful. And then my husband got transferred. And so we moved and then had a practice with a partner and then ultimately left that partnership as things changed and moved on and back solo again. So I have a pretty small practice. And I don't have the room for the equipment either. And it is a pretty good cost.

Kadie: If you're able to maintain where you're at now, and you're happy with it, then that might be the best fit.

Lucie: Absolutely. It has been an adventure for sure. These last years, I have loved every minute of it, and I'm excited to see where it goes. I always knew that I was going to be working with kids. And it has been such a blessing and so amazing. Being a private practice owner is a whole other job unto itself, of course. It's been quite an experience.

Kadie: It is an experience and quite a learning journey nonetheless. And are you by yourself still or do you have any therapists that work with you?

Lucie: It ebbs and flows. I'll have periods where we have things going on because I do a couple of different things. I have some contracts with some schools. And we had a season where we had a maternity leave to fill and then I'll have some speech pathologists working with me. And that will be like a temporary thing going on. And I have one full-time staff person with me that helps with all the office stuff.

Kadie: Oh, you do?

Lucie: I do. Well, I say she's full time. She's probably two full days a week. We have a little bit of contract work and the practice itself, and then we go out to the daycares and stuff like that. But right now, where it sits just today in this little season, I recently started doing some contract work with the local school district here just for testing for the appraisal side of it. So currently, it's just she and I, but I do find that it ebbs and flows.

Kadie: Of course it ebbs and flows. I like how you stated "for today."

Lucie: That's where we're at. That's right.

Kadie: How many years total have you been in private practice, even with hopping around for the different locations?

Lucie: It's been since 2010. So I made the leap in 2010. Probably full time 2011.

Kadie: Looking back on your biggest success over the years, is there anything that sticks out exponentially that you're like, this is where I felt like I'm where I'm supposed to be and it's working?

Lucie: I don't know if there is a single moment. I guess we all have different stories. For me, when I'm asked a question like that, I tend to think collectively of so many different little faces looking back at me, so many different little children. Truly, I'm trying not to get weepy, but it is, I just, some families and situations and roads families are walking are harder than others for sure. I have been accused of kind of taking all of that on my shoulders, and I take that as a compliment. It can be stressful. But I'm all in. When I'm with a family, I'm just all in. And I'm a mother. I have three boys, and I've had some great moments.

Lucie: We've had highs and lows and all of it. But really, I think of several kids' faces whose walks were very, very difficult. And there are those days and times where you're like, are we ever going to move on down this road, and trying to be sort of that voice of counseling to families when you're also worried about the child. And then to look back on those situations and see where they succeeded in life or things got better for them, or you were able to help in some small way. Because we really are just a support system. It's not about us. I am very grateful and blessed to be doing what I'm doing.

Kadie: I can just hear that sincerity in your voice. If my kids end up needing any services, that's the kind of therapist any mom wants. You are truly invested. Like you said, it can feel like a heavy weight on your shoulders. But I know that the families just appreciate that.

Kadie: So I know on our podcast, a lot of listeners are kind of in the beginning stages of their private practice journey and just looking for tips and advice. What are some questions you've had along the way that you've had to dig for answers? Anything coming to mind that's been a struggle?

Lucie: Oh my gosh. Among a long, long list. All of it. I'm still learning. As my dynamics have changed, I was very lucky, I'm still lucky. I was very lucky early on to have sort of an unspoken mentor. There's a practice in the town I used to live in that's much further along. And one of the owners actually reached out to me when I opened in that town, just so sweet and so kind and offered any help. And so I've had the luxury of being able to email her and say, what do you do? And is this completely wrong? Or I was thinking about this, or what vendor might you use for this?

Kadie: That is so nice. It wasn't some sort of competition. It was a helping hand.

Lucie: Listen, that's just the thing. I think emotionally, just the fact that they were so supportive was so huge. In addition to that, when I first heard that they had called, I was like, oh my gosh, they're probably mad. It's competition popping up or whatever. But it wasn't like that at all. It was very much like, there's plenty of work to go around. Welcome to the community. Anything we can do to help. And they were true to their word. So I often will email this particular owner that I'm still in contact with. I've actually gone and met with them and looked at their clinic and that type of thing. So lucky to be able to do that.

Lucie: But some of the big struggles truly are, you don't know what you don't know. Does that make sense? Like you don't even know what your questions are until it comes up. You have this great idea, I'm going to start a practice. And then one answer to a question leads you to another question.

Kadie: Exactly.

Lucie: I did go, there was a university in my old town and they had a small business administration. And I did go early on and sit down, and with the empty notebook, I'm like, okay, so I don't even know what I'm supposed to be asking. And they kind of walked me through, first you need to figure out a location and you need to figure out sort of a hypothetical budget. What would rent look like? If you had to order everything, how much would that be? Contact those vendors. Every test that you would want, what you have to have to open your doors. And so that was very helpful to have that kind of framework in mind.

Lucie: I think, again, I'm still learning. I don't have all the answers by a long shot. I think you're constantly learning just like with our profession. I think the biggest tips, those are some tips I would give, especially if you can find someone that you can email because we're all so busy and it's very hard to respond to emails and all of that good stuff. But I do try to remember that when people reach out to me because I'm still in that situation. I still have questions.

Lucie: Really it is, I guess it depends on your personality too. People think you're going to go into private practice and it's going to be so easy and you're going to have all this free time and you're just going to be able to set your schedule. And perhaps some people can do that, surely. But it's kind of all consuming at times. There's plenty of weekends that I work and do things. So I would consider that and consider what your strengths and weaknesses are, where that's concerned, being organized.

Kadie: What are some organizational tools that have helped you? Do you use an EMR system? Do you use paper and pencil? Are you private pay?

Lucie: Organization is not my strength. So that's full disclosure. I was paper and pen when I first started off a long time ago, really more like Word document kind of thing. I do have an EMR and I have QuickBooks online. The person that works with me is just amazing at keeping me on track and sort of helping me to keep things organized. But yes, I utilize it all. And for some people, the extra cost, checks and balances. But for me, it saves me money in the long run to utilize those things because it keeps me very organized and on track.

Kadie: Right, yes. You were just saying how you've invested in this office help and you're saying it's worth your time and time is money. What is your advice to private practice owners as far as having those separate accounts for your business? What do you set aside percentage wise per month to give yourself?

Lucie: I think that is something that's a little challenging to wrap your head around before you start. I think it's such a great question. I think it's a question people are probably not sure if they can ask. I wish I had someone to tell me what they were doing in the beginning. So I pay, first of all, I pay quarterly taxes. I have a great CPA. I am very lucky to come from a family of attorneys so that wasn't a big cost for me, but I do have a CPA that I pay. I put like 35% aside, but I will tell you that I overshoot every single year.

Kadie: That's a good thing.

Lucie: Because I'm just, again, that organizational thing, I'm always nervous about that. And we have estimates. Your CPA, what happens is, and I guess I should say it from the other side first. If you have a good accounting system or QuickBooks or whatever you're using, you're going to be able to see your profit and loss. And so you'll be able to tell what you're bringing in. It's going to take a little while to have an average and there are going to be some out of the ordinary expenses when you're starting out where maybe you need to buy a new test.

Lucie: I just had to buy one. One of the things we do in our clinic, I also have a little certification in reading. So we've got some reading costs associated with that. And in fact, Megan, who works with me, we're talking about this today, how I just spent a good deal of money last month on some of that stuff. So my profit loss margin didn't look so great. It was a little out of whack and now I've got to write myself a check and you're like, wow.

Lucie: Well, the fact that I put 35% aside, I always have a little cushion for those things, if that makes sense. I'm not in this huge multidisciplinary practice in a giant city. And I think there are amazing pros to those things, but the pro for me not being in that situation is I have a very controlled sort of atmosphere. I know exactly what I've got coming and going and there's not a lot of balls in the air at the same time.

Lucie: So after you get your accounting stuff, the profit and loss report or whatever, and it's run, you can see what you've got. And then I will write myself a check from that. And as far as accounting goes, I have a business account, certainly. I have the LLC and tax ID, all that good stuff. I have a business account and everything goes into that. I run everything through that business. It doesn't matter if it's contract work or whatever, it's all going to run through the LLC. Checks that vendors might write to me are going to be to my LLC. And if I have somebody under me doing contract work, I pay them through that same account. Bank statements or whatever, you might have it online and it's automatic. And then you can sort of reconcile all of your records and then, based on that, I will write myself a check out of that LLC's account for the month.

Kadie: Yes, absolutely. It's so complicated though, for those who haven't quite gotten started yet.

Lucie: It is. And I'll be the first to tell you that it is not for the faint hearted. Honestly, in getting back to being sort of honest with yourself about strengths and weaknesses, I am not the most organized. I'm not completely disorganized either, but that is not necessarily my strong suit. And neither is money. The trade off, I guess, is that I'm all in for kids. So I may not know exactly what the schedule looks like or whatever the case may be. I've got to double check what report I've got to get finished and my paperwork's all on time and all of that. Thank goodness for all the help in those areas.

Lucie: But what I wish someone had told me when I started out, honestly, is it is all going to be okay. It really, really is. It doesn't seem like that sometimes. And it is, if you're emotionally invested, especially the way that I know that I am, it is hard to leave it at the office. When you go home, it's very hard. I often am thinking about kids and what we could have done or whatever. But the money side for me has never really stressed me out. And if I can do that, if I can handle the organization side and the money side, anybody can. Truly, if you love what you're doing and you're in it for the right reasons, it's going to work out.

Kadie: I'm with you. I felt organized sometimes, but then you have to think about, okay, what if you have three cancellations on this one day, but you've got an eval the next day? Do you kind of have that number in your head like, oh shoot, we're getting below this number for this week with these cancellations and now I have to worry? Or do you just feel like it all evens out?

Lucie: I have days where I know a number just from days gone by of people that I worked with. They would say, here's the magic number or whatever. So I've not forgotten that number. But to tell you that I check it on a daily basis, I really don't. I don't even check it on a monthly basis. I can tell you, it does always work out. I'm in South Louisiana. Mardi Gras is huge here. So we have Mardi Gras next week and we're getting cancellations left and right.

Kadie: Priorities, right?

Lucie: Right. And then the week after that, my husband, he's precious. That's also huge. You've got to have a great support system. He won a trip for his work. So it's probably one of the few times I'm like, okay, now I'm going to be out like a week and a half. From a business standpoint, that's a little scary. But if you're meant to do something, and for me, we're Christians and that's what we base our work off of. And I know that's not everybody's story, but that is definitely our story. And we just have faith that whatever is supposed to be, will be. And I can tell you, I've been doing this since 2011. It's always worked out. It's not always been easy, but it has always worked out.

Kadie: Well, that is amazing to hear and reassuring for our listeners. So what's in your future plans?

Lucie: Megan's laughing because that's always like the million-dollar question. I am just interested in everything. I have a hard time focusing. I love the reading side of things. I love working with kids with autism, love language. I don't know. My answer could change by tomorrow. I truly am at a stage in my career. I'm 46 years old. I've been doing this a little while now. I really would like to become more involved with helping speech therapists coming up behind me. Really passionate about that. I really love doing evaluations, because I was doing a little bit of that with the school system. I do evaluations all the time, but doing them contract-wise.

Lucie: And I want people coming into this field, especially into the pediatric side of things, to be in love with what they're doing. There are a lot of kids out here that need our help and a lot of families that need our help. And it's not just about that time you're in the session. So I would love to see a future where I learn from, too, but also help people coming up behind me to do this side of things better and just fall in love with what they're doing. I don't know what that looks like. I don't think that would pay very much. But that's okay.

Kadie: It would be fulfilling, though, to spread those branches and help others who are going to also pursue private practice.

Lucie: That's kind of how I feel with the podcast. Because like you said, you're serving the children and that wasn't for me. Listen, here's the thing. It's not for everybody. I was not meant to work in the adult setting. The road that I've walked has been, now in hindsight and all these years looking back, was completely designed to put me in the pathway of children. And if that's not your path, that's not what you're supposed to be doing.

Lucie: We have been praying and kicking around the idea of doing a nonprofit. You want to talk about having no idea what you're doing. People listen, I have no idea what I'm doing.

Kadie: The moment you do that, you have to come back and fill me in on the podcast.

Lucie: Right, right. And again, I've taught. There's a wonderful place a couple of towns away that has a very successful, thriving, reaching lots of kids and lots of families. They have a nonprofit over there and I've had phone conversations and emails with her. But man, it's like a mountain I've never seen before. Just like this was ten years ago or whatever.

Kadie: That would be amazing though. And think about it, you probably felt this exact way about the private practice journey before and now it's nothing.

Lucie: For sure, yeah. I'll have to listen to some podcast on nonprofits.

Kadie: Is there any additional comments, any motivation to share with our listeners?

Lucie: Just do what you love. It takes up so much of our time. If you're planning on having kids or you have a family already, know that you're not going to always have the answers. Marsha, the one that answers all my calls and emails, told me a long time ago, and I'm still learning this, I do as I say not as I do, but she told me a long time ago, the work will always be there. Turn the lights off, shut the door, go home to your family or your loved ones. Because in private practice, it can be constant, but you're in charge of it. You've got to decide what's most important.

Lucie: And I'm learning this as I'm literally saying it. I'm not the best at it. I'm trying to be better. But you've got to take care of yourself so that you can take care of these families and these kids or adults or whoever you're working with.

Kadie: Yes. You have to set boundaries. And like you said, it sounds like you're taking notes for yourself still in that regard.

Lucie: For sure. And it's all self-inflicted. I'm all in or all out. That's just my nature. But it's going to be okay. And I'm talking to others at this point. It's all going to be just fine. And above all else, just take care of other people. Just be kind to other people. And it will be okay. It's all going to be good. It can be great.

Kadie: Thank you so much. You are so fun to talk to. 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.