I have had MANY lengthy phone conversations with families who are trying to decide if my professional skills, which are all fee-for-service/private pay, are the best fit for their family. I never try and sell a family anything, rather I educate and provide my honest professional opinion. Sometimes financially I am not the best for for a family but they remember my knowledge and refer to me others. In some cases families have even come back to me after less than satisfactory experiences in other settings. I really feel that taking a few extra minutes to help a parent or guardian be a better advocate for their child can go a long way, for the patient and your professional reputation.
Another fun fact about my practice is in 2012 my life moved to Maui, Hawaii and so did my business. I had no idea how things were going to work in Hawaii since I didn't have any established referral sources let alone any knowledge of even what sort of services were needed on island. It has been a whole new learning experience maneuvering through new systems and establishing my presence in a community that thrives on word of mouth relationships. After about 6 months on island I managed to again work full time for Jabbermouths Therapy.
Personally I would say I am a very driven person, competing in triathlons and since moving to Maui, outrigger canoe paddling. A strong drive and willingness to step outside of your comfort zone are vital to making a fee-for-service private practice work.