When I first began to contemplate the idea of becoming a therapist I was not even aware of the differentiations among the mental health professions; nor was I aware of what creating a private practice in that field would require. One of the mentors I consulted told me that It would take ten years before I really felt seasoned enough to open a private practice. I told myself that she was mistaken, didn’t really know me and my intellect and determination – but as it turned out she was right on the money. I began my first degree in the field of professional counseling in 1980, and I started a private practice in 1990 – with lots of school, two degrees, work in social services in Massachusetts, and in community mental health in Nashville, in between.
As a seasoned professional counselor, well-grounded in my ability to serve clients, to diagnose and treat, to create treatment plans, to help clients navigate the changes that they desired, I was in a good position. However, clinical expertise is not all that running a private practice requires.
Nowhere in the experience that I had accrued did any course address the issues of starting a business. In fact, the idea that private practice was a business was actively discouraged. We were taught to see ourselves as professionals with a calling, and to hold the idea of “business” with some degree of disdain. To acknowledge that we were in business and that we hoped to make money to sustain ourselves and our families was regarded with condescension.
I noticed that the few men with whom I trained had less difficulty with this issue. The women, however, struggled. What to charge? How much was fair? How can I help those who are struggling financially and who yet need my services? The idea of a business plan didn’t even exist in my consciousness.
What I have learned over these years in practice is that the positives of private practice – no boss, flexible hours, working as much or as little as one desires – do not make the other side of running a business go away. As a solo practitioner, I am responsible for EVERY ASPECT of my business. My first duty is to my clients, with FIRST DO NO HARM as the central ethical mandate. I run my own schedule. I return all phone calls. I keep up with best practices in my field. I attend conferences and make sure that I use continuing education to stay current. However, I also market. I recruit business. I manage online and social media. I create websites (or hire having them created). I am responsible for keeping up with paperwork, for interacting with insurance companies. I clean the office. I vacuum. I take out the trash. I buy supplies – all the way from insurance forms to paper towels. I also manage the bookkeeping and everything related to paying taxes, from quarterly assessments required for solo practitioners to Schedule C profit and Loss statements for income tax purposes. This means keeping excellent records of everything related to the business.
If you want to start your own business as a private practitioner, I recommend the following:
- Talk to someone who has been in successful practice for a while.
- List the pros and cons.
- Recognize your own strengths and weaknesses. Consider hiring others to do things that are not your strengths.
- Have a business plan, an attorney and a bookkeeper, at minimum.
Susan is a communications and relationship specialist, counselor, Imago Relationship Therapist, businesswoman, mother, and proud native Nashvillian. She has been in private practice for over 30 years. As she says, “I have the privilege of helping to mend broken hearts.” Contact Susan at http://www.susanhammondswhite.com
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