13 Best Practices For Ketamine Therapy Clinics
Synopsis: In this blog, discover 13 best practices to help you start, grow, and refine your ketamine clinic. Learn how to improve patient care and build a thriving practice.
Key takeaway: Running a successful ketamine clinic requires more than just medical expertise. It demands careful patient-centered care, business acumen, and a resilient mindset. By implementing these 13 best practices, clinic owners can navigate challenges with confidence in this growing field of interventional mental health and pain management.
This blog is proudly sponsored by Clifton Insurance Agency, Inc.,a trusted leader in the liability and high risk niche market insurance industry. Mention “Ketamine StartUp” and receive FREE quotes & exclusive policy discounts. Learn more about how they support ketamine clinics here.
Running a ketamine clinic is a roller coaster - thrilling highs, unexpected dips, and the challenge of balancing healing with business.
The Roller Coaster of Running a Ketamine Clinic
Do you enjoy roller coasters? The excitement, the thrill, the anticipation of what’s coming next? Starting a ketamine therapy clinic can feel exactly like that. There are exhilarating highs, unexpected drops, and uncertainties completely outside your control. Being a small business owner is a ride of its own, but this isn’t just any business.
We’re not selling widgets. We’re in the business of healing and transformation. Ketamine therapy changes lives. But doing this work well and sustainably requires a delicate juggling act. Balancing clinical excellence, patient experience, and business operations all at once.
That’s where best practices come in. Since opening our clinic in 2018, we’ve learned invaluable lessons through trial and error. In this blog, we’ll be sharing 13 essential best practices to help you navigate the challenges, avoid common pitfalls, and build a thriving ketamine practice.
Navigating This Blog:
This blog takes a deep dive into each best practice, meaning it's a longer read. If you're short on time or want to go straight to a specific topic, click any of the links below. Or, if you prefer, scroll through and read each section in order.
13 Best Practices For Ketamine Therapy Clinics:
1. Always Have a Staff Member Present During Infusions
A best practice we feel strongly about is ensuring that a staff member is in the room at all times during infusions. Ketamine induces non-ordinary states of consciousness, which can be intense, especially for patients who have never experienced mind-altering or entheogenic substances. Having a trained individual physically present throughout the treatment provides both emotional safety and support.
At our clinic, we always have a staff member—whether it's a nurse, medical assistant, or physician—who is actively monitoring the patient. While some clinics choose to have call buttons or video monitoring, we believe immediate, in-person support is the best. A patient under ketamine can experience time distortion, and a simple delay in response can feel like an eternity, which can cause unnecessary distress.
Beyond medical monitoring, the presence of a compassionate staff member also enhances the therapeutic benefits. When a patient feels safe and supported, they are more able to surrender to the process. Some patients may confront difficult emotions or memories during their infusion, and knowing someone is right there allows them to relax and engage more deeply with the experience.
From a business standpoint, this practice also sets a clinic apart. Many patients who have been to other clinics without this level of attentiveness often express how much safer and more supported they feel when they experience treatment in a clinic where a staff member is fully present.
2. Review Medical Records Before Treatment
As you already know, patients don’t always remember their past medical history. Or don’t have a complete understanding of it. So relying solely on self-reported information can be risky. Therefore, reviewing a patient’s medical records before starting ketamine therapy is a crucial best practice.
By reviewing medical records, you can:
Confirm diagnoses such as major depressive disorder, generalized anxiety disorder, or chronic pain conditions.
Check for contraindications like certain medications, cardiac conditions, or a history of seizures.
Assess past lab results, medication history, and vital signs for a more comprehensive picture of the patient’s health.
This extra step also adds value to the patient experience. Many patients have never had a provider take the time to thoroughly review their records, and they’re often surprised by what they learn. Some even say, "Wow, my doctor never told me that before!" The healthcare system is overburdened, so offering this level of attention and care makes a meaningful difference.
Now, let’s be honest—this process takes time. Requesting medical records requires:
Getting patient consent through a signed release form.
Communicating with previous providers/clinics to retrieve documents.
Waiting for records to be processed and reviewed before treatment can begin.
Some clinics skip this step to fast-track patients into treatment by opting to gather a history directly from the patient. While that approach speeds up onboarding (these clinics have their reasons), we strongly believe the benefits of record review outweigh the delays.
Ultimately, prioritizing safety, accuracy, and patient care should come before simply getting someone into the infusion chair as quickly as possible.
3. Have Emergency Protocols in Place & Train Your Staff Regularly
Medical emergencies are rare in a ketamine clinic. But they do happen. While the vast majority of treatments go smoothly, there will be moments when you need to act fast. If you do this work long enough, you will call 911 at some point.
Some of the most common emergencies include (but are not limited to):
Chest pain – Could indicate a cardiovascular event.
Atrial fibrillation with rapid ventricular response (Afib with RVR)
Seizures – Rare, but can occur in predisposed patients.
Having clear, written emergency protocols in place ensures that when, not if, an emergency occurs, your team knows exactly what to do.
Practice Makes Perfect: Train for Emergencies Before They Happen
As medical professionals, you are already familiar with this concept of being medically prepared and trained for potential emergencies. Here are some things we do at our clinic:
Schedule regular emergency drills – We recommend running quarterly mock scenarios, similar to a Code Blue drill, where your team practices responding to different crises.
Train every staff member – Even if you, as the provider, are experienced in handling emergencies (especially if you're an ER or anesthesia-trained physician), your staff may not be. Your nurses, MAs, and administrative team need to be just as prepared.
New hire emergency training – Any time a new staff member joins, integrate emergency protocol training early so they feel confident handling unexpected situations.
At the end of the day, being proactive is key. Emergencies are rare, but when they do happen, preparation is everything. Train your team, run drills, and have a solid plan.
Preparing for ketamine therapy is like tending a garden. Intentional habits before treatment lead to deeper healing and lasting change.
4. Encourage Patient Preparation Before Infusions
Intentional preparation is key to a patient’s successful ketamine therapy experience. Think of it like planting a garden: before you grow vegetables or flowers, you need to prepare the soil—remove weeds, break up the hard ground, and add fertilizer. Similarly, ketamine therapy works best when patients take time to prepare their minds and bodies beforehand.
Here’s why preparation matters:
Lays the foundation for a more profound experience – Patients who engage in preparation practices often report deeper insights and smoother sessions.
Enhances the effectiveness of ketamine therapy – While IV ketamine is powerful, it is not a magic cure-all. Supporting lifestyle changes before treatment can maximize long-term benefits.
Encourages personal ownership of healing – By actively participating in their preparation, patients shift their mindset from "the cure is in the pill" to "I have agency in my healing process."
At our clinic. (and what we teach our course students) we encourage patients to incorporate simple but impactful lifestyle changes before their treatments, such as:
Journaling – Helps process thoughts, set intentions, and reflect on personal challenges.
Meditation & Mindfulness – Calms the nervous system and fosters mental clarity.
Spending time in nature – Reduces stress and encourages relaxation.
Eating healthier & exercising – Supports overall well-being and brain function.
Encouraging patients to make lifestyle changes during their treatments allows them to leverage ketamine’s catalytic effect. In other words, as patients engage in new habits, the treatment helps solidify positive neural pathways, reinforcing behavioral change.
The goal with preparation is threefold: to prepare their mind and body for the infusion, to lay the groundwork for healthy lifestyle habits, and finally to take ownership of their healing.
Want to learn more about how to help your patient prepare for ketamine therapy? Read our 4 Ways To Help Your Patient Prepare For A Ketamine Infusion blog.
5. Create an Integration Plan After the Infusion
Ketamine therapy is a catalyst, but lasting transformation happens through intentional integration. The experience itself is powerful, but real change occurs when patients take the insights gained during treatment and apply these to their daily lives.
Integration matters for a whole host of reasons, but let’s focus on the following:
Think of ketamine as planting a seed—integration is the ongoing care that helps it grow. Just as a garden needs water, sunlight, and protection from pests, patients need tools and support to nurture their post-infusion growth.
Integration solidifies the benefits of treatment. Patients who actively incorporate small, positive changes into their routines tend to experience longer-lasting results.
This step differentiates your clinic from a "treat-and-street" model. Many clinics administer ketamine and send patients on their way. Providing integration guidance adds immense value to patient care.
So how can you support your patient in integrating their ketamine therapy experience? Encourage patients to choose one tangible action after each infusion; even a small step can make a big impact. Examples include:
Journaling – Reflecting on insights and emotions from the session.
Mindfulness or Meditation – Reinforcing mental clarity and stress reduction.
Gratitude Practices – Shifting focus towards positivity.
Therapy or Integration Coaching – Working with professionals to process the experience.
Physical Activity – Engaging in movement like yoga, swimming, or hiking to support mental well-being.
Notice how these things are a lot similar to the preparatory activities mentioned in the 4th best practice!
From our experience, the most impactful integrative actions are ones that the patient decides on and creates themselves. It may be painfully obvious to you or your staff on what they should do. But what will be most helpful to the patient is what they choose to do themselves.
Now, for some of you reading this, you don’t personally want to provide the integrative support. This is where working with an integration specialist, therapist, psychiatrist, or other mental health professional is key.
Explore the topic of integration in our How To Help Your Patients Integrate After Ketamine Infusions blog
6. Build a Strong Network of Therapists, Psychiatrists, and Coaches
Ketamine therapy is powerful, but lasting change often requires additional mental health support. That’s why creating a referral network of trusted therapists, psychiatrists, and coaches is a crucial best practice.
Why a Support Network is Essential
Some of you are ready to not only provide ketamine treatments but also the psychological and emotional support for your patients. Perhaps you are a psychiatrist and more than equipped to do this. But if you don’t want to do this work or don’t have the capacity to do it, that is where a network is key.
Here are other reasons why building a support network is important:
Not all ketamine patients have existing mental health care providers. Some may need help processing their experience but don't know where to turn.
Integration can bring up deeply buried emotions or memories. Without proper support, patients might struggle to make sense of what they experienced.
If you’re not a psychiatrist or therapist, you need trusted professionals to refer patients to. Having this network in place ensures every patient has access to the right post-treatment care.
It’s also good for business. A strong network creates collaborative referral relationships, meaning providers in your area will also send patients your way.
How to Build a Mental Health Referral Network
When we first started out, we bumbled creating a network for our patients. However, thanks to the mistakes and lessons learned along the way, we developed a simple but highly effective strategy to reach out to local providers. Here’s how to do it:
Search for local therapists, psychiatrists, and integration coaches on Google or professional directories.
Make phone calls and introduce yourself. Let them know you’re opening a ketamine clinic and are looking to collaborate.
Ask about their approach to mental health and psychedelic integration. Some providers may be unfamiliar with ketamine therapy or hesitant about it, while others may be excited to learn more.
Curate a trusted referral list. Not everyone will be a great fit, so create a PDF or database with professionals whose approach aligns with your clinic’s philosophy.
Having a built-in support system not only enhances patient outcomes, it differentiates your clinic. A holistic, patient-centered approach strengthens your relationships within the medical community!
Need some networking tips? Check out our Maximizing Your Network: Building Referral Relationships for Your Ketamine Clinic blog.
Building a successful ketamine clinic takes time. Focus on refining processes, marketing, and networking to create long-term stability.
7. Be Patient: Building a Ketamine Clinic Takes Time
Starting a ketamine clinic isn’t an overnight success story; it’s a slow and steady process. While awareness of ketamine therapy is growing, thanks to media coverage and public discussions, building a sustainable practice still requires patience and persistence.
When we first opened, we only did four infusions in our first month. The demand for ketamine therapy will depend on your local medical community, awareness levels, and patient demographics.
It’s best to assume the beginning will be slow and focus on laying a solid foundation:
Refine your processes. Slow months allow you to streamline intake procedures, patient flow, and operations before things get busier.
Invest in marketing. Build your online presence, optimize your website for SEO, and start engaging with your community.
Network and educate. Connect with local providers and educate them about ketamine therapy’s benefits.
Prepare for the Ebbs and Flows
Most ketamine clinics are cash-pay practices, meaning you won’t have the volume consistency of insurance-based models. There will be seasons of famine and seasons of plenty. Expect fluctuations and embrace the slow periods as an opportunity to improve.
As your patient base grows, you’ll start to see a steady stream of maintenance booster patients returning every few months. This will naturally increase stability over time.
Play the long game. Be patient. Build with intention. Your efforts today will pay off in the years to come.
8. Be Meticulous About Tracking Controlled Substances
Ketamine is a Schedule III controlled substance, which means meticulous record-keeping is non-negotiable. Every milligram and milliliter you receive, administer, or discard must be logged with precision.
Why Accurate Documentation is Critical
Regulatory agencies like the DEA, state medical boards, or pharmacy boards can audit your clinic at any time. If they do, you’ll want to be able to immediately produce accurate records that track every dose of ketamine, midazolam, propofol, or any other controlled substances in your clinic.
Best practices for record-keeping include (but are not limited to):
Logging every package of ketamine as soon as it arrives.
Tracking each milligram administered to patients.
Maintaining an inventory system to prevent discrepancies.
Storing records securely and reviewing them regularly for accuracy.
By keeping your records airtight, you not only stay legally protected but also build confidence in your practice—for yourself, your patients, and any regulatory body that may audit you.
Explore this topic more on our podcast, where we have a conversation with Retired DEA Agent Dennis Wichern on controlled substance compliance and more!
9. Monitor Patients’ Vital Signs During Infusions
Vital signs are called ‘vital’ for a reason. They are critical indicators of a patient’s well-being during ketamine therapy. While the level of monitoring varies from clinic to clinic, we strongly recommend continuous vital sign monitoring for every patient undergoing an infusion.
Why Continuous Monitoring Matters
There’s a common belief that ketamine does not cause respiratory depression. While that’s generally true, certain doses (especially higher ones) and certain patients can experience slowed breathing, hypoxia, or cardiovascular changes. If you aren’t tracking vitals, you could miss an important warning sign.
Continuous monitoring allows for immediate intervention in the following examples:
Blood pressure spikes – If a patient’s BP shoots up significantly (e.g., 220/120), you may need to pause the infusion or administer medication like IV beta-blockers.
Oxygen desaturation – If a patient’s oxygen levels drop, simple interventions like nasal cannula oxygen can prevent complications.
Cardiac arrhythmias – If a patient develops Afib with RVR during the infusion, early detection could change your course of action.
Using Vital Signs to Guide Treatment
Beyond safety, vital signs can provide valuable insight into ketamine’s effectiveness. When monitoring blood pressure, we often see an increase during the infusion, confirming that the ketamine is creating the expected physiological response. So, if a patient’s vitals remain unchanged, this may indicate a need to adjust their dose for future infusions or increase the current infusion slightly.
Why Some Clinics Skip Monitoring, And Why You Shouldn’t
Some clinics choose not to continuously track vital signs, arguing that ketamine has a strong safety profile or that the vital sign monitoring devices (such as the blood pressure cuff) are bothersome to the patient. While this may be their rationale, we believe that best practices prioritize patient safety, comfort, and treatment optimization.
Running a lean operation early on helps you stay financially stable and focused on patient care—minimizing burnout.
10. Keep Your Overhead as Low as Possible, Especially at the Start
One of the most valuable pieces of advice we’ve heard from experienced clinic owners? Start lean.
We’ve interviewed numerous professionals who started ketamine clinics around the same time we did, and they emphasize the same thing: Keep your overhead as low as possible in the beginning.
Why Keeping Costs Low Matters
Starting a clinic is exciting, but before patient volume picks up there will be lean months. The lower your overhead, the less pressure you’ll feel. This will allow you to focus on delivering quality care rather than “moving the meat.”
A large office, an overstaffed team, or unnecessary high-end equipment can create financial stress that forces you to take on more patients than you’re ready for. Thoughtful lean planning can help you avoid burnout or providing compromised patient care.
Wearing Multiple Hats And Why That’s a Good Thing
When we first started our clinic, we did everything ourselves. Sweeping, mopping, dusting, answering phone calls, handling patient paperwork, and more. While initially this made us feel many emotions ranging from frustrated to humbling, this work helped us to:
keep costs down
understand every role in the clinic
train future employees with clear expectations
By taking on these roles early, you develop a deep understanding of your business. Your staff will respect you because they know you’ve done the work yourself. Plus, you will appreciate all their work, since you did it yourself too!
Stay lean, stay patient, and build smart. Your clinic will thank you later.
11. If You Feel Uncomfortable About Treating a Patient, Trust Your Intuition
One of the biggest differences between working in an ER and running a private practice is choice.
In the ER, federal EMTALA regulations require us to evaluate and treat every patient who walks through the doors. But in your private clinic, you have the freedom and responsibility to choose who you treat. If something feels off, trust that instinct. It’s usually there for a reason.
The Role of Intuition in Patient Selection
Not every patient is the right fit for your clinic. Maybe it’s a gut feeling, or perhaps there’s a subtle red flag that’s hard to put into words. If your intuition is signaling a problem, it’s okay to decline.
We've learned this best practice the hard way—treating patients in the past despite feeling uncertain. In most cases, the patients didn’t respond to the treatment or minimally did. Others had unrealistic expectations that couldn’t be met.
Healing Happens in Relationships
Ketamine therapy isn’t just about the medication. It’s about the therapeutic alliance between provider and patient. If that trust isn’t there, the treatment may not be as effective.
Just as we encourage patients to reconnect with their feelings and intuition during integration, we must do the same in our clinical decisions:
If you feel a genuine connection with a patient, that’s a good sign.
If you feel hesitant or uneasy, pay attention—there’s likely a reason.
Trusting Your Instincts Beyond Patient Care
This principle doesn’t just apply to patient selection. It also extends to every business decision you make. Whether you’re choosing vendors, marketing partners, or new staff members, let your intuition be part of the decision-making process.
The more we listen to that inner voice, the more we refine our ability to make decisions that align with our values and the best interests of our clinic. And just like our patients, we keep learning and growing through this process.
12. The Key to Starting Is to Take One Step at a Time
Starting a ketamine clinic can feel overwhelming. With a to-do list that seems to grow longer every day, it’s easy to get stuck in analysis paralysis. But the reality is, the key to success is simple: Take it one step at a time.
There’s an old saying: How do you eat an elephant? One bite at a time. The same principle applies when launching and running a clinic. You don’t have to have every single detail figured out on day one. The goal isn’t perfection—it’s steady, intentional progress.
Techniques to Stay Focused & Avoid Overwhelm
You feel hesitant to take that one step for two reasons: the list looks very long and you don’t know where to start. So what are you to do? Prioritize! To help prioritize tasks and stay on track, we recommend two simple but powerful strategies:
1. Brain Dump Method: Clearing Mental Clutter
One of the biggest causes of stress is an overcrowded mind. When you’re trying to juggle dozens of tasks at once, it’s hard to focus on any of them. The brain dump technique helps clear mental space so you can work with clarity and intention.
Step 1: Write Everything Down – Set a timer for 3-5 minutes and list everything on your mind—clinic tasks, personal to-dos, random worries, big ideas. Get it all out.
Step 2: Circle What You Can Control – Identify the tasks you have direct influence over. If it’s beyond your control (like a licensing board’s processing time), let it go.
Step 3: Apply the 80/20 Rule – Look at your circled tasks and pick the 20% that will make the biggest impact today. If you have 10 items, choose the top 2 that will move the needle.
Step 4: Take Action – Focus only on those high-impact tasks. Once completed, you can revisit the rest. But for now, eliminate distractions and execute.
2. MIT (Most Important Thing): Prioritizing Daily Goals
Another simple but effective approach is the MIT method, which stands for Most Important Thing. Each morning, ask yourself: What is the one thing I need to accomplish today that will have the biggest impact on my clinic’s success?
Instead of getting lost in an endless to-do list, narrow your focus to one high-priority goal each day. This creates momentum and ensures that by the end of the day, you’ve made meaningful progress.
Quality over quantity is the key. Checking off minor tasks might feel productive, but if they don’t move your clinic forward, you’re just spinning your wheels.
Building Your Clinic One Step at a Time
Starting a ketamine clinic is a journey, not a race. The most important thing is to start—even if it’s just one small step. By using tools like the Brain Dump Method and MIT Strategy, you can cut through the noise, focus on what truly matters, and build a clinic that thrives, one intentional step at a time.
There are two more mnemonics we use to help us run our clinic, discover what they are in our Mindset Mnemonics To Help You Build Your Ketamine Practice blog.
13. Expect Challenges And Lean Into Them
Challenges are inevitable. Whether you’re just starting or years into running your ketamine clinic, unexpected obstacles will arise. The key isn’t to avoid them. It’s to lean into them and view them as opportunities for growth.
Anticipate the Unexpected
Some challenges are already on your radar, but others? You won’t even see them coming.
When we first opened our clinic, we were suddenly hit with a ketamine shortage and had to scramble for supply.
Not long after, the COVID-19 pandemic shook the world, disrupting patient care and clinic operations.
And in the future? There will likely be new regulations, controversies, or logistical hurdles that could rattle your practice.
Instead of reacting with fear or frustration, reframe these challenges as part of the journey. These moments test your commitment and refine your resilience. All of which ultimately make your clinic stronger.
You Can’t Control the Future, But You Can Control Your Response
Uncertainty is a part of life. The best thing you can do is control your response to it.
This is how we and many of the successful, heart-centered clinician entrepreneurs out there have done it:
Expect challenges. They’re not a sign that you’re failing—they’re proof that you’re growing.
Adopt a mindset of resilience. If you know difficulties will arise, you won’t be caught off guard. Instead, you’ll be prepared to pivot and adapt.
Stay connected to your “why.” Remember why you started this clinic. Challenges become easier to navigate when your mission remains clear.
Your Challenges Set You Apart
Need a different way to view these challenges? An unexpected benefit of embracing obstacles: Not everyone is willing to push through them.
Many people assume opening a ketamine clinic will be “easy money.” But when faced with the realities—logistical headaches, regulatory hurdles, and patient complexities—many don’t make it past the first year.
By embracing challenges, you’re building a strong foundation that sets you apart from others who might be looking for a quick and easy path. The truth? Running a successful clinic takes work. And by doing that work, you’re creating something truly sustainable, impactful, and patient-centered.
The Ride Continues: Navigating the Ups and Downs of Your Clinic
These 13 best practices are insights we’ve gained from the roller coaster ride of running our ketamine clinic since 2018. Filled with highs, lows, unexpected twists, and loop-de-loops, owning a clinic can be a wild ride. But don’t get us wrong, there are days when things glide along smoothly, like a gentle carousel.
Through all the excitement and uncertainty, one thing remains constant: the incredible impact this treatment has on patients’ lives.
Every challenge is just another turn on the track. Whether you’re just strapping in at the start of your journey or you’ve been running your clinic for years, what’s the next step? Which of these best practices can you implement today to make the experience smoother for both you and your patients?
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In this blog, discover 13 best practices to help you start, grow, and refine your ketamine clinic. Learn how to improve patient care and build a thriving practice.
Discover 13 best practices to help you start, grow, and refine your ketamine clinic. Learn how to improve patient care and build a thriving practice.