10 Things to Think About Before You Open a Private Practice

photo courtesy of freedigitalphotos.net/Ambro

photo courtesy of freedigitalphotos.net/Ambro

Like most aspiring psychologists, you either planned to enter private practice one day, or you have thought about it.  According to a recent survey I conducted over the PPA listserv, the top goal of respondents (N = 76) was to work in full-time private practice.  If this is a goal for you, there are many things to think about.  I encourage you to formulate a plan and to consider at least these ten things before you start.

  1. What kind of business model are you interested in? Would you like to join an existing group? Form one with colleagues?  Go completely on your own?  Each has its pros and cons, with cost being a major factor.  If you join a group, most things will be taken care of for you (office space, referrals, supplies, billing), usually in return for a percentage of your fees.  If you start a group, you will likely split all costs with your partners.  And, of course, if you go on your own, then you’re on your own.  As a solo practitioner, you will have to either find your own space, or you could sublet from another practitioner (paying a set amount or a percentage of your fees for use of the office).
  2. Where will you practice? Do you like a specific location- because it’s close to home; accessible by public transportation; near a hospital or college; or not saturated with other therapists? Where you practice may depend on a number of factors, but most of all it will need to be accessible to your desired client base.
  3. Do you have malpractice insurance- and does it cover private practice? Before you begin working in private practice you need to have liability insurance. Get a policy if you don’t have one, or check to see that an existing policy covers private practice and meets the required limits.
  4. Do you plan to accept insurance, or do you want a fee-for-service practice? Most psychologists would love to forego insurance networks, but oftentimes, at least some involvement with insurance is necessary. Being on insurance panels can help you to get more referrals, although there is more paperwork and additional things to consider.  Your ability to work on a fee-for-service basis will depend on your location, who you work with, your expertise, and your ability to market.  If you’re in an affluent area, for example, you will have more clients willing and able to pay out-of-pocket for services.  And similarly, if you’re regarded as an expert in something, people will more readily pay for your services or travel to see you.  To get a sense of what kind of model to adopt, consult with colleagues, or browse online directories to see which insurances, if any, other providers accept.
  5. Market yourself online- to potential clients and colleagues. Do you want to be a generalist or a specialist? Either way, you must have an online presence (I can’t tell you how many psychologists still don’t).  You can design a professional-looking website on your own using services like WordPress or Vistaprint- or have one built professionally.  You should also create listings on search engines, like Google, Yahoo, and Bing.  You might even create professional Facebook or Twitter accounts.  As well, you should keep an updated Linkedin profile, complete with your practice information and photo.  Many psychologists find it beneficial to sign up for professional directories like Psychology Today.  When you have an online presence, you establish yourself in a way that makes you not only easy to find, but gives colleagues and potential clients information about you and your work.
  6. Get printed materials. Business cards, brochures, and even pens or other materials can help you to market your practice. Many online services do this cheaply.  You can mail materials to other professionals, or hand them out in person.  Look for any and every opportunity to get your name out there.  Set up coffee or lunch meetings; bring business cards to conferences; present at schools or community centers; or volunteer at community events.  You can also make handouts with useful information to distribute at physician’s offices.
  7. Make connections- and nurture them. Follow up after meetings, send a brief note to acknowledge a referral, and let others know when you have sent a referral their way. Find mentors.  Be sure to connect with professionals you would like to collaborate with, including psychiatrists, primary care physicians, school counselors, and others, keeping in mind where potential clients are and who your referral sources might be.
  8. Consult with other professionals. When you refer a client to another professional, get a release to speak with him or her. Request releases to speak with teachers, school counselors, or pediatricians.  If a client had a previous therapist, request to contact him or her.  When you work closely with these professionals, not only are you providing good care, but others get to know you and your work.
  9. Get the necessary forms. In private practice you will need all of your own clinical forms, including: consent forms; office policies; HIPAA notices; releases of information; evaluations; treatment plans; and so forth. However, try not to reinvent the wheel.  Books like The Paper Office, by Ed Zuckerman, are a great resource, and you may find information available online too.
  10. Get an accountant. When I heard this, I worried that it was going to be way out of my budget, which wasn’t the case at all. My accountant and I meet just a few times a year and she’s available whenever I have questions.  This is essential to be sure you’re finances are in order, and for me it helped to ease my anxieties about taxes.  Speak with colleagues about who they would recommend.

I hope this is helpful in covering some of the basics, should you be doing private practice now or in the future.  Best of luck in all your endeavors!

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About Dr. Jesse Matthews

I'm a private practice psychologist in Chester Springs, PA. I provide counseling and coaching services to people ages 12 and up. Specialties include: depression; addiction/substance abuse; relationships; anxiety; ADHD and behavioral issues; and Autism/Asperger's.
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