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15 thoughts on “What I Wish I’d Known Before Starting A Private Practice

  • November 9, 2011 at 5:50 pm
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    Another great post! I wish I had known ahead of time that the process of getting on insurance panels took several months. I knew it would be confusing and disorganized at times and was prepared for a lot of paperwork. Maybe it was the timing of the applications, the economy, or that San Diego is saturated with therapists, but I hadn’t anticipated such a long process.

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  • September 12, 2012 at 2:29 pm
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    I could relate to everything said in this post! Well done. I have been in the restarting mod for several months now, I took a “sabbatical” of my own making for several years and now I am starting over. The 2 most important things I wanted to do differently and have are mentioned in your post. Avoid isolation and don’t work 24/7. I am in a group practice that is one step better for my niche as it is a holistic healing center with alternative practitioners. 2nd, I have short office hours for getting and returning calls and emails. I carefully screen clients before beginning with them by offering a 30 minute no-cost phone meeting and therefore don’t need emergency numbers to be reached at other times. I know not everyone can do this, but it’s what I want this time around. Last but not least, i would say to those beginning new, if you find something isn’t working well for you, change it right away. Thanks for all you offer us Julie.

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  • January 16, 2013 at 11:25 am
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    I have a question I haven’t been able to find addressed anywhere. It’s not about private practice, but about employment for therapists, and I couldn’t find anywhere else to ask it. My wife is 66 and about to become licensed as an MFT. She’s got plenty of financial work to do already (trust income, taxes, stocks) so I don’t think she’s eager to take on all the additional work of running a private practice; with the limited time she has to practice (she’s 66), she wants to spend as much of it as possible actually doing therapy, especially if it involves children and adolescents. She has a doctorate (sociolinguistics) and now three MAs, and she’s an excellent therapist. But she’s also 66 – have I already mentioned that? This is weighing on her. I wonder if anyone has written about age discrimination in hiring by public or private mental health agencies. Age discrimination is rampant in general, but I’d think there might be less of it in agencies because of the nature of the profession, where maturity and life experience should actually be valued, even if the person might not be working for many more years. OTOH, hiring these days is down across the board in agencies. Any information or suggestions would be most welcome.

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    • January 16, 2013 at 11:41 am
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      William, you raise an excellent question and one that I haven’t addressed on this blog. While I can’t speak for large agencies or clinics, as a private practice clinic owner here are some things that I would consider when interviewing that may be helpful tips for your wife as she interviews. I don’t think age itself is an issue in this field, like it might be in other fields. Wisdom and experience can add to excellent clinical skills.

      1) Become tech-savvy – I’ve found that the many applicants age 55+ aren’t as comfortable with technology, online charting, blog posting, and social media interaction.

      2) Maintain strong professional boundaries with clients – In my own very limited hiring experience it seems that older women have a more difficult time setting appropriate professional boundaries with clients. While this may sound stereotypical, it has been my experience.

      3) Good communication skills – Developing the ability to give and accept difficult feedback.

      4) Be open to your own therapy – I only hire people who have or are open to doing their own therapy so they are better able to discern their own issues from their clients.

      I hope this helps William. Thanks for you excellent questions. Your wife is lucky to have such a supportive husband.

      Best, Julie

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  • March 6, 2013 at 8:50 am
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    I also learned the hard way about taxes when my accountant told me I owed the IRS 14K, in addition to needing to pay estimated taxes. This caused me tremendous stress as I was just a year or two into full time private practice. I ended up switching accounting firms and now meet with my accountant quarterly to review my financials. Even though this costs a bit more, I haven’t had any more tax surprises.

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    • December 28, 2013 at 9:39 am
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      Wow Dennis.. Sounds like we had the same accountant. Mine kept assuring me I was “doing just fine” and then surprised me with a $11,000 tax bill! I, too, switched accountants and now have someone who has me pay quarterly. I also take 30% off the top of everything I collect and put it in a special savings acct for taxes only. It was a hard and expensive lesson!

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  • April 15, 2013 at 7:23 pm
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    I was an independent contractor and I am leaving to start my own practice. I was accepted in network with compsych so far and Cigna declined.
    How can I make sure to get accepted by BCBS of Lil, aetna and in network providers.
    I have clients who want to follow me and I am worried they wont be able to if I am not accepted in network.

    I love the advice

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  • April 24, 2013 at 3:53 pm
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    My wife is a LCSW and would like to get her own practice. The problem is she has a full time job , however wants to transition into a office with at least one other clinicians . She would like to get a idea of how to pay the clinicians as she ( my wife will be working in the office as well part time. What is reasonable to pay someone and to attempt a decent profit at the end of the day. Also. How many Insurance panels are reasonable getting started ? Thanks for any help.

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  • January 31, 2014 at 12:24 pm
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    99% of my clients come through my website. When I first set it up it was very bland, and extremely brief – bullet points only. Then I read a few blog posts from Robert Middleton (actionplan.com). One of the central ‘take aways’ was to not be afraid of writing a lot of information on the site. You want people to call you to tell you there and then they want to work with YOU. They need to know you know your stuff. It worked.

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  • April 3, 2014 at 8:11 am
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    Great people here, hopefully someone can give me a tip or two ..

    I’m leaving a community mental health agency, where I worked with seriously emotionally disturbed/polysubstance using teens and their families. I’ll be contracting for a therapist who is leaving his job and has a somewhat – established practice for himself in the psych testing market – but I will need to generate my own business under a commission split with him.

    I have two questions that I’m a bit confused about:

    1) I’m not afraid to represent myself/services – but don’t know what advertising venues to invest marketing time/money?

    With the above in mind, I have thought of advertising in Psychology Today – but wonder if it’s the best online venue for attracting new clients – tand if others here have different/better ideas for getting off the ground?

    I would genuinely appreciate feedback about who’s had luck with various advertising sources ..

    2). I don’t know where to begin/the mechanics involved in joining insurance panels. Is there a best source or way to get this process started – and any tips on where to information on how to join them?

    I’ll be expected to put the 2 things above-mentioned pieces into place rather quickly and feel anxious. Thanks for the offer advice you can give!

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  • June 14, 2014 at 6:29 pm
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    How do you protect yourself and the client if you are just a psychotherapist with a master degree. There is no regulatory board oar state testing required for this position.Help!

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  • July 10, 2014 at 1:27 pm
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    Hi, I am into private practice for last 2 year’s, i always keep wondering, when will i become “busy”. specially so when i see my own juniors and my few seniors who have thier established private clinic by virtue of thier doctor parents. since me being first doctor in my whole family, i need tremendous patience in waiting to see my practice growing. i am from India. felt nice to read the post

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  • July 22, 2014 at 9:18 am
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    Thanks for a great post! I have an alternative therapy business which I set up in April last year. It is my true passion and something I know I excel at. My background is in business so I have covered all the social media advertising, had great reviews about my website and paying for advertising yet I still can’t get new clients. I have so many emotional highs and lows that it is exhausting. I have written articles too and managed to have a feature written about me and my business in a national newspaper. Where am I going wrong?? Some weeks I literally have no one and then other weeks a couple of people!

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  • February 26, 2017 at 2:13 am
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    Great advice that still applies today. I graduate in August and looking into doing private clients on a part time basis while I work full time for an agency.

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  • August 14, 2017 at 5:44 pm
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    Excellent advice, well written! It is hard to put that marketing hat on for some, but it is a crucial element in sustaining your business. Hire someone for marketing if you must!

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