This Month’s Expert: Rebecca W. Brendel, M.D., J.D. HIPAA and Psychiatric PracticeWorking at a salaried job in a clinic certainly has advantages. Your salary is stable. You probably have a benefits package. Your hours are predictable. But at some point, most clinicians entertain the idea of going into private practice. The clinic salary may be small and the benefits package not beneficial enough. The clients may be too similar to each other or seemingly unwilling or unable to improve. The schedule may be predictable but it may not be flexible enough to accommodate family needs. Vacation time is minimal. What at one time seemed like a great job starts to feel restrictive and unrewarding.

Those are all good reasons to think about cutting ties and launching your own practice. But doing so full time can be scary. Unless you have substantial savings, start up can seem impossible. For that reason, many clinicians wade into private work instead of jumping in. Some even find that a balance of part time salaried work and part time private practice balances the need for security with the desire for flexibility and variety. Let’s look at the clear advantages of going into private practice only part time – at least to start.

You have a financial base: By keeping your salaried job, you have the security of a financial base. Although the per hour pay is usually much less than what you can earn privately, it is steady. That can reduce some of the anxiety that goes with starting out on your own.

You retain some or all of your sick time, personal time and vacation time. Until a private practice is well established, it’s difficult to take time off. Your salaried job provides some paid leave while you build your own practice to the point that you feel able to give yourself days off.

You retain your retirement account. Even if it isn’t generous, clinic retirement programs offer a base from which to work. Often, the employer provides some matching funds to your contributions. Being in private work means doing that for yourself. It’s too easy to put it off or to not take care of yourself by creating and maintaining a retirement plan when retirement feels like it is in a distant future.

You don’t have to spend much to capitalize your business: Launching into full time work means investing in a lease, furniture, office equipment and perhaps a commitment to a billing service. Part time work lets you start slow with a minimal cash investment.

You don’t have to commit to renting an office full time. Many successful private practitioners are happy to rent some hours or days to the part-timer. Ideally, you should establish hours on at least a couple of days or evenings each week to ensure that you will be able to reschedule someone who has to cancel or to see a client on an emergency basis.

You don’t have to set up an office: Renting someone else’s space has its advantages. You don’t have to buy furniture. You may be able to negotiate use of a computer and a copier. You probably won’t be expected to do major cleaning. The trade-off, of course, is that you need to accept the style and taste of the renter. The office may not be set up or decorated in ways that are an expression of you.

You can see a different clientele: If your salaried job is in a specialized clinic or setting (substance abuse clinic, inpatient hospital, college counseling services, etc.), your private practice gives you the opportunity to see people with different presenting problems. If you decide to work during the evenings and on weekends, you are more able to see people who have full time jobs, couples, and families.

There’s time to learn the paperwork: Although the quantity of paperwork is the most common complaint of therapists who work for clinics, they usually do have a billing department and office manager who are managing most of it. Once in private practice, you will be on your own to develop the forms, apply to insurance company panels, learn the vagaries of those panels and get into the rhythm of submitting billing and keeping accurate accounts. It can be daunting. Even if you hire a billing company, you will still be required to learn how to use the company’s services well. Part time work lets you ease in and get comfortable with it.

Part time work gives you the time to develop your business skills. To be successful as a full time practice, you will need to become an entrepreneur. That means learning skills in marketing and networking as well as bookkeeping and office management. A part time practice lets you begin to do these things without the pressure that comes with being immediately dependent on getting and keeping enough clients and making enough money to support yourself.

Burn out prevention: If your clinic job requires a “productivity rate” of 35 clients or more a week, in order to earn your salary, it can feel relentless. You schedule 40 or more a week to make sure you make your quota. Sometimes, they all show up which is stressful. More often, not enough show up which is also stressful. By cutting back on the full time job in favor of developing a part time private practice, you can give yourself a break. Since private clients generally pay more than your clinic hourly rate, you can afford to see fewer clients but still make the same income.