We’re excited to introduce you to the always interesting and insightful Josh Fulwiler. We hope you’ll enjoy our conversation with Josh below.
Hi Josh, thanks for joining us today. We’d love to hear the backstory of how you established your own practice.
After completing my fellowship in autism testing and diagnosis, I was interested in working in an area where services were in high need; my wife, Coco Cockrell, is originally from north Mississippi, where there were virtually no psychological assessment services. The decision seemed like an easy one, and since I established my practice in 2018, I’ve had the opportunity to work with over 1200 children and families. However, going into solo private practice was more challenging than expected. Many of the lessons learned from working in a large academic medical center don’t translate as effectively to small business ownership; having to learn to manage costs with unpredictable flows of revenue was the initial challenge. Because my services are billed through insurance, I often don’t receive payment for six to eight weeks from the time I see a patient–which makes navigating the day-to-day expenses of a business more tricky! The other challenge that is specific to young professionals entering the medical field: insurance reimbursement rates don’t increase yearly to reflect inflation or other rising costs.
At the same time, my wife started her personal training and physical fitness company, body therapy by coco, where she taught group classes, provided one-on-one coaching, and developed personalized exercise and dietary plans for her clients. However, she was also a solo provider–and she experienced similar difficulty growing with her success. Because of these factors, and the continual overwhelming need for these services (I have a waiting list that is over a year long!), we’ve had to innovate and seek creative solutions–so in 2025 we will be transitioning our efforts to build a new, nonprofit approach to wellness services.
Our aim is to combine efforts, allow us to serve more people and provide training opportunities for the next generation of mental health professionals, meeting two key needs of our community. Working with several other community volunteers, we will be opening a new center that provides psychological testing services to families at no cost, instead relying on donations and grants and allowing clinical trainees to gain valuable experience; additionally, we will be able to offer training and group workshops both in specialized areas and to the general population. These services are difficult to incorporate into a typical for-profit model, and the experiences we’ve had with our more traditional single-owner businesses taught us to find solutions while remaining committed to our values. Understanding different models for service delivery is invaluable to learn what directions to go, so to young professionals who are looking to start their practice–take advantage of any opportunities to learn different ways to be successful, and use previous experience – both the positive and negative ones – to synthesize what works for you!
As always, we appreciate you sharing your insights and we’ve got a few more questions for you, but before we get to all of that can you take a minute to introduce yourself and give our readers some of your back background and context?
I have been a clinical psychologist since 2018, after specializing in pediatric psychology and autism assessment during my fellowship. Prior to that, I was a yoga instructor- a practice I continue on a personal level. Coco is a dancer by training, and she and I met working at a local studio; we began teaching together and developing personal programs and workshops. We each established our respective businesses in 2018 – she started body therapy by coco, and I opened Cardinal Clinical Consulting. However, our shared interests and passions helped us realize that combining our skills and strengths provides for a more holistic approach to wellness- and to our business!
How about pivoting – can you share the story of a time you’ve had to pivot?
I tend to be very planned out with things, from my graduate education to starting my clinical practice, so pivoting to something new can be challenging! But realizing that there are different ways to accomplish goals is an important life lesson – and over this past year, Coco and I have adapted our ideas about respective business models. Though it is helpful to have examples of success from others, we’ve learned that it’s also important to innovate. It’s rare for independent business owners to embrace a nonprofit model, but our pivot to this approach has opened a wide range of new opportunities. We decided to form a nonprofit organization to reduce the reliance on the traditional billing approaches that can be restrictive and inefficient–in my field, it”s limited to specific insurance agreements or patients who have the resources to self-pay, and in Coco’s area, fitness and wellness services are often considered a luxury. However, both these aspects are so important to wellness that adjusting to a more inclusive approach allows us to see the next year as one of exciting opportunities – which is what comes from making a pivot!
Any stories or insights that might help us understand how you’ve built such a strong reputation?
The key we’ve each found to building a reputation is involvement in the community. That can take many forms – volunteering, hosting events, or just being involved in local activities. Couple that with consistent, quality work, and word of mouth spreads. Another key factor is not staying restricted to your typical field in terms of networking; I think our ability to get out of our usual social circles has been so helpful to connect with new clients, collaborators, and supporters.
Contact Info:
- Website: https://cardinalclinical.com
- Instagram: bodytherapybycoco
Image Credits
Corrie Cockrell and Josh Fulwiler