I have been a therapist since 1980. I have been in private practice since 1986. When I was in graduate school I was described by one of my professors as, “a shark looking for knowledge.” I think this was a very true analogy; I loved the study of clinical psychology and thrived in the academic environment.
When I sat for my licensing test, I was either so naive, or so well prepared, that I was not nervous at all. I remember thinking that all the people around me looked scared. I wondered if I was fooling myself about being ready for the “big test”.
I tell you this because even though my graduate school training prepared me well for the licensing exam and most aspects of my chosen profession, it was woefully lacking in one critical area—the business of therapy.
During my first professional job interview I hit home run after home run with my answers to the treatment oriented questions. Then came a question I did not anticipate, “What salary range are you expecting?” I honesty did not know what the three member panel was asking me. Their next question was, “Are you comfortable collecting fees from clients?” This question could have been spoken in Swahili. Collect fees? I had no idea what they were talking about. (I was politely not invited to work at that for-profit establishment.)
My “money” education was infinitesimal. As a graduate student I was broke, so money was a non-issue. I had none, so I didn’t think about it. (If it wasn’t for the kind ladies at the hospital cafeteria, I would have starved during my dissertation research year.)
My only formal education was in my Clinical Interview class. The textbook was, The Psychiatric Interview (1971) by Mackinnon and Michels. It must have been a popular text as I have noticed it on many of my colleagues’ bookshelves. In the section “General Principles of the Interview” there is a section on “Fees:”
With private patients, the subject of fees usually does not arise until the end of the interview. The doctor can wait until the patient raises the issue, which may not happen for two or three visits. If the interviewer suspects that the patient cannot afford a private fee, he can mention the subject at the time when the patient is on the topic of his finances. If the patient describes difficult financial problems, but plans to continue therapy, the doctor might ask, “How do you expect to manage the cost of private treatment?” If the patient has no realistic plan, the interviewer could explore the meaning of this behavior.
Over the years, I have heard thousands of stories about money issues and private practice. Most of the private practitioners I know are amazingly well prepared to deal with our profession’s complex issues, and amazingly unprepared to run a private practice business.
A colleague of mine recently closed his 15 year old practice choosing to teach instead. Knowing what the local junior college paid, I wondered how he was going to make ends meet.
“Are you going to miss the income from your private practice?” I asked, at his going out of business party.
“I won’t miss the monthly $400.00 phone bill, it kept me up at nights,” he snapped.
At first, I thought he was joking, but he wasn’t. He was angry, and as the floodgates of his emotions opened he said, “I’m just tired of being used. Insurance companies ripping me off, patient no-shows, and constantly having to ‘loan money’ to the practice, it wore me out.”
I felt so bad for my friend. How is it that this amazing clinician was having money problems? The answer—he did not know how to run a business.
By taking the courses offered at Private Practice Graduate School, you will know how to grow and run a private practice business.
You are allowed to make real money as the owner of a private practice. Take a little time to learn how and by so doing, alleviate some of your professional stress.
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Psychologist, Marriage and Family Therapist, Clinical Social Worker, Licensed Professional Counselor, Mental Health Counselor, Certified Alcohol and Drug Abuse Counselor
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