Three Reasons You Never Want a Waitlist In Your Practice

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3 reasons to avoid a waitlist in private practice

I actually got the idea for this post after listening to one of the Practice of the Practice podcasts several weeks ago. Joe told a story from early on in his career, about meeting with his brother and being so excited to say that he had a waitlist in private practice. Joe’s brother responded with something like, “Do people actually wait around for counseling?” This conversation got me thinking about my own experience with waitlists in our practice and why it just doesn’t make sense to have one. Here’s why:

1. A Waitlist Provides False Security

When I first started out and was building a caseload, I desperately wanted a waitlist. To me, having a waitlist meant that I had “made it”. I had more people who wanted to see me than I actually had room for. How affirming! It also created, what I realize now was, a false sense of security. Having a waitlist meant that I had people already queued up should any of my current clients suddenly drop out of therapy.

Back in the beginning, losing even two or three clients a week represented a significant portion of income. I wanted as much reassurance as possible that I wasn’t going to go broke. In other words, I was scared of failing in private practice, and I thought a waitlist provided insurance against failure. Unfortunately, Joe’s brother’s question hit the nail on the head: I’ve found that people on a waitlist don’t tend to actually, you know, wait. There are exceptions, but most folks get on the list and then call other therapists who can get them in sooner.

This issue came up again for me just in the past few months when I was deciding whether to hire another therapist. We were full and had a lengthy waitlist going. So, I bought into the belief that a new therapist would have a full caseload very quickly. Well, turns out that literally no one from that waitlist came on board by the time our new therapist started.

2. A Waitlist Creates More Work

Maintaining a waitlist might not seem like a lot of effort. That said, when you’re starting out and – if you’re like me – do everything yourself, each little administrative task adds up. First you have that conversation on the phone about how you’re not taking new clients, but would this person like to be on the waitlist? It requires some explanation of how the waitlist works, how long it might be, and the process for getting in for therapy once an opening is available.

You’ll likely take some demographic info so that you can get back in touch. Then you have to actually maintain the waitlist via a spreadsheet or some other document. Where do you keep that? How often do you check it? If you do have an opening, you then have to make that call back to see if the person is still interested. They’re likely not, so you just wasted all time or effort spent after the first initial phone call.

3. A Waitlist Means Lost Income

It’s simple. If someone is waiting on a waitlist, they aren’t being seen. Speaking personally, I waited way too long to hire someone else, because I was afraid I wouldn’t have enough clients to fill their caseload. In my mind that meant a waitlist of 15-20 folks. Again, false security. From a business perspective, you’re making passive income with the very first client assigned to a contractor or employee of your practice.

If you’re not interested in growing your practice by hiring other clinicians, maybe this is less concerning. If you are interested in growing your practice, the moment to do so is the instant you have your first waitlist client. As our practice has grown, we’ve found that folks overwhelmingly want to be seen as soon as possible. Having therapist availability is super important. We get many clients simply because we have enough therapists to offer fairly immediate openings. More clients = more income and more people getting the help they need!


Dr. Jeremy Sharp is a licensed psychologist and clinical director at the Colorado Center for Assessment & Counseling. He also offers consulting services for mental health practitioners who want to develop or grow psychological assessment services in their practices via the Testing Psychologist (