by Lynn Grodzki,LCSW, MCC
Private Practice Success Newsletter 7/4/13
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This July 4th weekend is a celebration of independence. How important is independence to you, as the owner of a private practice?
For most therapists and other helping professionals in business, autonomy is a key value and one reason why they built a practice. But achieving autonomy in private practice is not always easy or without conflict. This month, learn how to become more independent in your practice, and then click onto the link at the end of the article to see a checklist of items that can help your practice stay stronger and self-sufficient over time.
My colleague Dana Ackley, author of the book, Breaking Free of Managed Care, sees one major challenge to independence for those in private practice — too many feel trapped into low paying insurance contracts or other deeply discounted sliding scale plans as a means of survival. When I interviewed Dana in 2007, he told me that in his opinion, the relationship between private practitioners and insurance companies was similar, at its worst, to an abusive marriage, maintained out of the false belief that “I can’t get along with him or her.”
Walking Down a Different Street
If we stay with the theme of dependency, think about this story, often told in 12-step programs, about a person who walks down a street absentmindedly and falls into a pothole. If the person keeps walking down the same street, they have a good chance of falling again and again into the pothole, evoking Rita Mae Brown’s definition of insanity — doing the same thing over and over again, but expecting different results. Recovery begins when the person makes a conscious choice to walk down a different street.
Even in uncertain times, can your private practice walk down a different street? The new street might be named “Autonomy.”
If you are compelled to sign up with insurance companies and accept discounted fees, you as the business owner can still be actively thinking about steps to more autonomy.
For those practices where finances are not an issue, do you need more control in other ways to feel secure and independent? Are you overwhelmed with the work of the business you are in? It’s time for a change.
Autonomy Actions:
* Become a good business owner and manager. Make time for all necessary business tasks (filing, note taking, billing, marketing, networking, etc.) Get over it, this is just what it takes to be successful and secure in business.
* Have a plan. Make a list of goals each month. Stay in action. Get support to stay on track with your goals.
* Control your calendar and schedule, so that you don’t feel overwhelmed or at the whim of clients or circumstance. Work reasonable hours and take vacations or stay-cations to be healthy and refreshed.
* Accept that being visible, with some form of marketing and networking is part of your responsibility as a business owner. Learn to face the public squarely, feeling equal to other health-related and service-oriented professionals.
* Have a financial plan to know what you need to earn and how to translate it into your business decisions and monthly goals. Don’t make decisions based on fear.
* If you are reliant on insurance, managed care, EAPs or other discounted fees, aspire to a “blended practice” – a healthy mix of discount and full fees. Diversify services to keep a healthy mix of clients and fees. (I help professionals use strategies like the above to keep earnings up even during tough economic markets. Click here to take a next step for more business support.)
Questions to Ponder:
1. What are my unhealthy dependencies right now (over-reliance on insurance panels, EAPs, too few referral sources, etc.)?
2. What are my healthy dependencies right now (peer support or supervision groups, good referral sources, other business organizations that help me build community)?
3. How do I explain my practice and my services without jargon or medical/therapeutic terminology so that the public can understand what I have to offer?
4. What ways do I have to meet the public on a regular basis (community events, associations, networking, marketing, advertising)?
5. Am I being a good boss to myself?
Autonomy can be achieved by seeing your practice as an entity that serves your needs as much as you serve its needs. Above all, make sure that your practice is operating in a professional manner.
Reducing Insurance Dependency
Try these actions to help you reduce your ties to insurance fees:
1) Find ways to diversify, so that you have a service (or several) to add into the mix that is outside of insurance (training, coaching, teaching, supervision, etc.)
2) Streamline your methods of admin, note taking, and billing so that you are as profitable as possible given the low fees of insurance
3) Take a few but not all insurances (get off of any insurances that don’t pay in a timely way or are difficult to deal with)
4) Make a case for full-fee payment on your website and in other places to help potential clients have some choice
5) Build your existing reputation so that clients come for you, not just for generic counseling – which offers more chances for those without the insurances you offer to consider seeing you anyway
6) Use some of the packaging ideas in my books to offer a more consumer friendly approach to fees
Create a plan and then go step by step, slowly, so that you don’t disrupt the status quo of your business. I have helped many therapists create and implement financial plans to get free of managed care, diversify, leverage with more groups or classes, and find other ways to increase their incomes.
Checklist: Go from a Hobby to a Business
Put a check next to each statement that is true. Try to check off more statements as true over time.
- I assess and correct any unprofessional, unethical or amateurish policies and procedures in my business.
- I surround myself with other entrepreneurial colleagues who want me to succeed.
- I am becoming more pragmatic and optimistic in my thinking about business each month.
- I know how to set a future goal and not be deterred by negative, self-sabotaging beliefs.
- I am accountable to others for achieving my monthly business goals.
- I am comfortable talking about the positive aspects of my work (my strengths and talents).
- I understand the difference between a fear-based and a love-based practice.
- I educate existing clients how to get the most from my services so that they can become my ideal clients.
- I organize my calendar to reflect a balance of work and quality non-work time.
- I set monthly goals and enjoy achieving them.
- I model the strategies of other successful businesspeople.
- My practice operates from a model of abundance (enough time, money, clients, opportunities, ideas, referral sources to help me succeed) instead of deprivation.
Hope this helps you stay strong in uncertain times!
