Do Solo Therapists Actually Need an EHR?

If you're a solo therapist in private practice — especially one who works primarily with private-pay clients — you've probably been told you need an Electronic Health Record system. The recommendations usually point to platforms like SimplePractice, TherapyNotes, or Jane App. They cost anywhere from $49 to $99 a month. And they come packed with features designed for multi-provider clinics, insurance billing, and telehealth infrastructure.

But here's the question nobody seems to ask: do you actually need all of that?

What an EHR is really built for

Electronic Health Records exist to solve a specific problem: coordinating care across multiple providers, standardizing documentation for insurance and regulatory compliance, and creating auditable records for large organizations. They were designed for hospitals, group practices, and clinics where multiple people touch the same patient file.

If you're a solo practitioner seeing 15–25 clients a week, you don't have a care coordination problem. You don't have a multi-provider scheduling conflict. You probably don't need a client portal, automated insurance claims, or SOAP note templates designed to satisfy auditors you'll never meet.

What solo therapists actually use

Talk to solo therapists about their daily workflow and the list is surprisingly short. They need to track who their clients are and when they last met. They need to jot session notes — not necessarily in a structured clinical template, but enough to remember what was discussed and what to follow up on. They need a calendar. And they need a way to send invoices.

That's it. Client tracking, session notes, scheduling, and invoicing. Four things. Most EHR platforms charge $50–$100/month and bundle these four things with dozens of features you'll never touch.

The cost of overbuying

At $59/month — the mid-tier SimplePractice plan — you're spending $708 a year on practice management software. Over five years, that's more than $3,500. For a tool where you use maybe 20% of the features.

That's not a technology problem. It's a purchasing problem. You wouldn't lease a 12-passenger van for your solo commute. The same logic applies to software.

When you do need an EHR

To be fair, there are situations where a full EHR makes sense. If you bill insurance, you need claims management and clearinghouse integration. If you have multiple providers in your practice, you need role-based access and shared calendars. If you offer telehealth as a core service, you need integrated video. If you work in a state or specialty that requires structured SOAP or DAP notes for auditing, you need compliant templates.

But if none of those apply to you — if you're a private-pay solo practitioner who sees clients in person or handles telehealth through a separate tool — a full EHR is overkill.

The alternative

What solo therapists actually need is a lightweight practice management tool: something that handles clients, notes, scheduling, and invoicing without the bloat, the complexity, or the price tag. Something that respects the simplicity of how you actually work.

How do TinyPractice, manual tracking, and SimplePractice compare?

The question isn't whether EHRs are good software. They are. The question is whether they're the right software for you. For a lot of solo therapists, the honest answer is no.