S10 E4 - The Business of OT: Costs, Recruitment and Sustainability

Running an Occupational Therapy business has always involved more than delivering great clinical care. There are people to employ, systems to manage, invoices to collect and countless decisions about where limited time and money should be spent.

For OTs working within the NDIS, those decisions are becoming increasingly important. Changes to pricing and travel, alongside uncertainty about the future direction of the scheme, are prompting many practice owners to look closely at what it actually takes to run a sustainable service.

From payment processing and recruitment costs to workforce planning and advocacy, understanding the business behind Occupational Therapy has never been more relevant.

The true cost of running an OT practice

One of the challenges of running an allied health practice is that seemingly small costs can add up quickly. Payment processing is a good example.

Offering convenient card payments creates an additional expense for a business. But removing that option may make it harder for clients to pay, particularly families managing regular therapy expenses.

This creates an important balancing act. A payment system might carry transaction fees, but if it means invoices are paid promptly and administration staff spend less time chasing outstanding accounts, that cost may be worthwhile.

Rather than asking only, ‘How much does this system cost?’, practice owners need to consider the bigger question: ‘What does this system save us elsewhere?’

Administration time, unpaid invoices and payment follow-up all have a cost. Looking at the full picture allows practices to make decisions based on the actual impact on the business rather than focusing on one fee in isolation.

Making payment easier can support cash flow

Payment systems are not only a business consideration. They can also affect the client experience.

Families attending weekly or fortnightly therapy may be managing significant expenses. Removing convenient payment options could create additional barriers, particularly for people who rely on credit cards to manage their household cash flow.

At the same time, practices need reliable systems for collecting payment. A busy clinic can have dozens of appointments in a single day, meaning even a small proportion of unpaid invoices can quickly become a significant administrative and financial burden.

There is no single payment model that will suit every practice. The important thing is to understand the trade-off between transaction costs, convenience, administration and the risk of unpaid accounts.

Practices should also check current NDIS and consumer requirements before introducing surcharges, changing payment methods or passing additional costs on to clients. Business expenses cannot automatically be added to an NDIS participant’s invoice simply because the practice incurs them.

Recruitment is another significant business investment

The same cost-versus-value conversation applies to recruitment.

In a competitive OT employment market, recruitment agencies can provide access to candidates and reduce some of the work involved in finding employees. However, that convenience can come with a substantial price tag.

When recruitment fees are calculated as a percentage of a clinician’s first-year salary, the cost can quickly reach thousands of dollars. For a small allied health practice, that money might otherwise contribute to salary, supervision, onboarding, professional development or other supports that directly benefit the new employee.

That doesn’t mean recruitment agencies have no role. A practice that needs to fill a position urgently, has struggled to recruit independently or does not have internal hiring capacity may find considerable value in using an agency.

The key is to understand what you are paying for and whether that model makes sense for your business at that particular time.

OTs can look beyond recruitment agencies too

Understanding recruitment from the employer’s perspective is equal