If your practice or your business lives in your head, it gets expensive.

And it’s not always in obvious ways. More often, the cost shows up as constant cognitive load: remembering what comes next, re-solving the same small problems, rewriting the same emails, chasing the same paperwork, and repeating the same follow-up steps. When the work only exists in memory, delegation becomes harder, consistency slips during busy weeks, and you end up carrying the whole operation alongside your clinical work. This makes you wonder why you wanted to do work for yourself in the first place.

That’s where SOPs come in.

What an SOP Is

A Standard Operating Procedure (SOP) is any repeatable structure that creates a predictable result.

In private practice (or any business), that can look like:

• A checklist

• Templates/scripts (emails, phone scripts, portal messages)

• Decision rules (“If X, then Y”)

• Reminders/automations

• A clear definition of done

• Where it lives

SOPs shouldn’t be complicated; n fact, the SOPs that get used the most are usually the simplest ones.

The Hidden Cost of “Keeping it in Your Head”

When processes live in memory, you tend to see:

• More back-and-forth with clients and support staff

• Inconsistent follow-through

• Dropped steps during busy weeks

• Harder delegation

• Decision fatigue and reduced capacity

SOPs are about making the work visible so it can be repeated by anyone - by you, by a future admin assistant, or by a team.  Don’t fall into the trap of expecting perfection.

SOPs Aren’t Only for Teams

SOPs are useful at every stage of practice.

• Solo clinicians: SOPs act as a memory aid. You stop holding every step in your head.

• Clinicians with part-time admin support: SOPs reduce back-and-forth. Clear handoffs and a shared definition of done save hours.

• Practice owners/directors: SOPs create consistency across people and protect the client experience and your sanity.

Even if you don’t plan to hire soon, SOPs create mental space now and they make growth possible later without chaos.

The Build Once, Use Often framework

In our Build Once, Use Often approach, SOPs are built through three moves:

1) Functions and Responsibilities

Start by naming what repeating work exists in your practice: intake, billing, documentation, scheduling, marketing/referrals, admin/finance.  Also identify who owns it, even if it’s you.

This is the antidote to everything is urgent and everything is mine. You gotta let go to grow!

2) Workflow + Definition of Done

A good SOP starts with the workflow.

At a high level, you’re mapping:

Trigger → steps → decision points → handoffs → done

The most important piece here is the definition of done: what complete and correct looks like. If done isn’t defined, work lingers, follow-up loops multiply, and delegation turns into constant clarification. Trust me, I know from experience.

3) SOP Starter

Once the workflow is clear, you turn it into a reusable how-to:

• A short, numbered step list

• Key decision rules

• Templates/scripts to use

• Common exceptions (“If this happens, do this”)

• Where the SOP lives and how it’s named

This becomes the starter that can be reused for the next workflow and the next.

Common Workflows Worth Standardizing First

If you’re not sure where to begin, start with a workflow you repeat often and that tends to create rework.

Examples:

• Intake and onboarding

• Scheduling + cancellations/no-shows

• Billing follow-up + payments

• Documentation completion standards

• Referral tracking + follow-up

• Onboarding (if you supervise/hire)

A simple rule: pick the workflow that creates the most friction most often.

Tools that Make SOPs Easier to Maintain

As you document and work with Protected Health Information, your SOPs will likely need two homes:

Systems Management (Where SOPs Live)

This is where your templates, checklists, and SOP documents live in an easy-to-access place.

• Google Drive / Google Workspace

• Microsoft 365 / SharePoint

• Dropbox (or similar)

For anything involving PHI, your EHR may remain the appropriate system of record. Many practices keep SOPs and templates in a shared drive and keep client data inside the EHR.

Project Management (Where Work Moves)

This is where tasks and follow-through live.

• Trello

• Asana

• Monday

For very small practices, this can be optional. Some clinicians start with a shared checklist and a calendar reminder before upgrading tools.

A Note on Messy SOP-Building

SOP creation isn’t always neat. Sometimes it looks like giant paper on the wall, post-its, and handwriting small enough that only you can read it. That’s normal.

The point isn’t to create a beautiful document. The point is to get the workflow out of your head so you can refine it, reuse it, and eventually delegate it.  Here’s a pic of what my SOP building process looks like.

A Few Books that Shaped my SOP Thinking

If you like learning from frameworks, these are three helpful references:

• Systemology by David Jenyns: a step-by-step systems thinking approach - document simply and make it repeatable.

• Thinking in Systems by Donella Meadows: a deeper lens on how system parts interact and why small changes can create big results.

• The E-Myth Revisited by Michael E. Gerber: a classic reminder that sustainable businesses are built on clear, repeatable processes.

Want a Guided Practice Version of This?

If reading about SOPs helps, but you want support applying them to your actual private practice workflows, check out our Build Once, Use Often on-demand workshop.

In the workshop, we:

• Choose one repeating workflow (intake, scheduling/cancellations, billing follow-up, documentation, referral tracking, etc.)

• Clarify a definition of done (complete and correct)

• Map the workflow from trigger → steps → decision points → handoffs → done

• Turn the map into an SOP starter you can reuse

• Identify one small change to test right away

Your Next Steps

• Join the free Private Practice Collective community space (updates, events, discussion).

• Access the Build Once, Use Often on-demand workshop if you want guided practice.

• If you’re not ready for the workshop, bookmark this post and use it as your starting point.

• Download the one-page Standard Operating Procedure Snapshot reference sheet for the next time you build or refresh a workflow in your practice.

References

Jenyns, D. (2020). SYSTEMology: Create time, reduce errors and scale your profits with proven business systems. SYSTEMology.

Meadows, D. H., & Wright, D. (2011). Thinking in systems: A primer (Nachdr.). Chelsea Green Pub.