Private Practice Management Tips with Adriana Alejandre, MA LMFT
Jennifer: What are some of your favorite systems and ways that you keep your practice running smoothly/organized?
Adriana: When I was in my private practice internship, we used Simple Practice, but now that I am licensed I decided to go to Excel to create my own system. I have coded patients for confidentiality and created formulas to associate their fees and tax deductions. I like to things manual, such as date of service, time, payment type and compiling superbills. I maintain forms that need to be distributed to patients at the end of the month, print and hand out the following week, then I note it on their printed progress note. I maintain a caseload of 20 patients per week so having manual paperwork is doable for me and helps me stay on top of my cases. When clients terminate, their files are uploaded on the “Termination” hard drive. All documents are encrypted in an encrypted laptop that lives in the locked cabinet in the office. Although I am under 30, I still like to keep it old school.
Jennifer: What do you outsource in your practice?
Adriana: My practice is out of network with all insurances so I only choose to outsource my marketing, logo design and website service. I was using TherapySites for my website service but have recently switched to SquareSpace, in which I happily edited the template copy myself. For marketing I am on Psychology Today and run an ad on GoogleAd or boost my blogs on Facebook. My promotional items are from various companies but I have spent under $300 so far on a set of 300 pens, 25 brochures, 310 stress balls, business cards, gift bags and goodies to go in the marketing bags.
Jennifer: How did you learn how to effectively run your business. Did you have a mentor?
Adriana: I owe a lot to my former supervisor, Laurel Wiig, who hired me at her practice, Porter Ranch Counseling. Dr. Wiig showed me all the ropes and it took me one full year to learn to learn the administrative side of private practice because my brain did not want to understand the concept of out-of-network benefits. She taught me about websites and SEO’s, encouraged me to create goodie bags to local doctors and introduce myself to the community. Since then, I have connected with other therapist-friends in private practice and learn another world about private practice in my two favorite Facebook community platforms, Abundance Practice Builders and Selling the Couch. At this point, reading blogs, listening to podcasts and practicing the skills are helping me to run my business.
Jennifer: If you could go back and do something differently in terms of business management and organization, what would you have started right away?
Adriana: What comes to mind with this question is marketing. I shied away from meeting many people when I began in 2015 because I did not have the confidence then. By now I would have had my contacts organized better. Creating my filing cabinets and folders of interventions took two years for me. This (system) could have easily been organized much quicker and I regret not having it done when I began. With time, I have also learned the importance of doing notes in a timely fashion. Writing notes to me feels similar to writing a college essay, but after having experienced the pain of procrastination and scary things we hear in about the ethics of keeping notes up-to-date, I do not skip a beat in this area anymore.
Jennifer: How many clients do you typically see in a day and how did you make this decision?
Adriana: I became a mother when I was a teenager, so I have been working two jobs for some time. When I received my intern number, I worked at a non-profit and held a private practice internship, both part-time. At the nonprofit, I would start at the hour and see seven clients back-to-back, with a lunch break, of course. Then, at my private practice internship, client amount depended on the day due to child care. Now that I am licensed, I have chosen to stay at four clients on average and on my longer days I can see up to six. My longer days begin at 3 p.m. and end at 7 p.m. They are intentionally set after days I see clients in the morning only.
Jennifer: What are your boundaries around answering work email?
Adriana: I include the hours I can respond to in my informed consent. Although I state that I will respond within 24 hours Monday-Friday, and 48 hours Saturday-Sunday, I also include that I will not reply outside of the 9 a.m. to 5 p.m. hours with emails, texts or calls. The hours get extended if I am on a weekend getaway. None of my patients have had a problem with this (approach).
Jennifer: Tell me about some of your favorite self-care practices during your workday and on the weekend.
Adriana: During the workday, I appreciate riding my beach cruiser with my son and walking my dog. On those days when I feel so tired after work I love watching doctor shows on Netflix, enjoying a sports game on TV and spending time with family. We lie close to a church so if we do pass the church, I like to pray as I pass by, or enter the church for serenity. I live in Los Angeles, and I really enjoy hunting people who sell fruit, going to Santa Barbara for Freebirds burritos and what I most have time for is hiking with my boyfriend and dog. Everyday I practice deep breathing and grounding techniques using my senses when I drive, because again, I live in Los Angeles and traffic is aggravating at times.
Jennifer: What are some of your best tips for work/life balance as a self-employed therapist?
Adriana: As we all know, private practice can be quite isolating and being at home for myself can be lonely as well since it is just me, my boyfriend, son. This is a big reason why I adopted our beloved family dog. When they are away at work, school or camp, I found myself buried in paperwork. Fast forward to many self-care lessons learned, here are the ones I hold close to my heart:
- Run away from work when at home
- Set digital limits to enjoy your own presence and of those around you
- Exercise, Exercise, Exercise, whether it’s physically or mentally with meditation, or both. This can be done at home and at the office.
- Select your niche to keep you happy both at work and at home, and to avoid burnout
- Temper expectations of patients and your responsibilities at home. Sometimes as a mom, I can’t be Superwoman and I’ve learned to be okay with that.
Adriana Alejandre, MA, LMFT Lic#98925 Counseling and Trauma Therapy
Rollin, J. (2017). Private Practice Management Tips with Adriana Alejandre, MA LMFT. Psych Central. Retrieved on September 20, 2017, from https://pro.psychcentral.com/private-practice-management-tips-with-adriana-alejandre-ma-lmft/0020444.html