8 Tips for Establishing a Private Practice

The Bureau of Labor Statistics predicts faster than average growth for counselors between 2008 and 2018. As our field grows, more and more counselors break away from the pack to pursue private practice. 

Each clinician has his or her own impetus for this risk-laden, self-employment venture. Some of these motivations include the desire for autonomy, more money, fewer administrative tasks, flexibility, and the ability to pursue opportunities that might not exist in traditional employment.

Starting a private practice can be the most exciting, yet most intimidating, step you will take in your career. It helps to have some guidance along the way, and it is critical to get the support you need while making this fabulous ?leap of faith.? Here are a few tips to get you going, and keep you going.

#1: Stop putting it off until you are ‘ready’

Once you decide owning your own private practice is what you want, it’s important to be prepared for taking the leap into private practice. Few of us ever really feel ready, but that’s to be expected.

Those butterflies in your stomach will keep you on your game; they will keep you excited and wide-eyed. Being excited about your work can help you to become incredibly successful.

If you are working for someone else, probably 50 percent to 75 percent of the revenue you generate is left on the table for your employer. You do the math—how much money is it costing you each month that you put off establishing your own private practice?

The golden handcuffs of traditional employment (predictable income, benefits, guaranteed clients) can be very comforting for some, but are quite costly for those who want to own their own business.

To make the leap to private practice, you’ll need to: set up your business (find space, an accountant, and the tools you will need for record-keeping); get yourself ready (get your credentials in place, obtain a federal ID number); and put in place a marketing strategy. These tasks don’t have to be overwhelming if you have some guidance and a system.

#2: Make it your ‘dream’ practice, right from the start

Now that you’ve taken the leap, be sure you customize your practice. Take the time to dream. Where do you want to work? What will your office look like? Which days will you work? How many hours a day will you work? What types of clients will you see? How many clients a day will you see?

If you set up your practice and find yourself: grumbling about the long drive to your office; annoyed that your first client is at 8 a.m.; frustrated that you don’t have a window or that your office is not soundproof enough—you will have no one to blame but yourself.

Take the time to really think through what you want your work schedule and surroundings to be like, and then set up your office the way it will work best for you. You may not get every item on your wish list right away, but don’t be afraid to try to set it up just the way you want—it is your business!

#3: Set up your practice so that it makes you ‘flush’ as soon as possible

I haven’t paid rent in my practice for more than 18 years. I work with my mentoring clients to help them achieve that goal for themselves right away. There is nothing more freeing than knowing that the money you make is yours (and Uncle Sam’s) to keep.

On the days you are not see-ing clients, consider renting out your space in order to pay your rent. You can help out a couple of colleagues who only need part-time space by charging reasonable rent, and they will help you out by covering your expenses.

Perhaps you can teach a couple of courses a year at a community college and earmark that money as your rent fund.

At some universities, you can teach a couple of courses a semester and be eligible for their benefits package. An extra bonus is that teaching can keep you fresh and on your game. Perhaps you can do a monthly seminar in your office or in the workplace of one of your referral sources. See if you can set up the seminar so that it brings in enough revenue to pay your rent. You do the seminar and, boom, your rent is covered.

#4: Create a culture that will keep you healthy and wealthy

Many private practitioners make themselves sick with worry and paranoia that other clinicians will take their clients or take over their referral sources. They become very closed and competitive, thinking they are protecting their investment. Wrong.

A spirit of collaboration will take you much farther than that boat anchor called competition. Sad as it is, there are enough sick and troubled people to go around.

Do your job—provide great service and value—and you won’t have to think about what others are doing around you. In fact, you will find that your colleagues can be a great source of referrals to your practice. And it is great to have good relationships with other clinicians for times that you need someone to cover your practice when you’re away on vacation, for supervision, and for joint-venture projects.

If you spend your career looking over your shoulder, you will never get ahead—you’ll just keep walking into walls.

#5: Be ‘real’ about your business

Private practitioners wear many hats in their business. You will certainly be a clinician, but you will also be running a business.

A big part of private practice is marketing. Don’t be mistaken, and don’t try to close your eyes to that fact. If you want to establish and develop a successful business, you must sell yourself and your practice.

Private practice is not for everyone. It’s an opportunity that brings with it a huge responsibility for marketing and sales. If that is not okay with you (and if you don’t want to hire someone to do it for you), save yourself a lot of time and money by facing that fact before you make your decision to venture into it.

The good news is that marketing your practice does not have to be overwhelming, and you don’t have to be salesman and motivational speaker Zig Ziglar to be successful. You can learn about it on your own or with the help of a good mentor who can help you with some strategic marketing plans that will set you up for success.

You’ll save yourself a lot of time if you seek out some private-practice coaching. Find someone who has walked the road before you; a mentor or coach who has lots of experience in the business of private practice. The right person can help you identify your niche, create your marketing materials, and pinpoint ways for you to stand out among the pack of private practitioners.

#6: Make relationships that will support you for a lifetime

So you’ve accepted the fact that marketing is part of the gig. The great news is, the type of marketing that is most efficient and effective in our field involves our specialty—relationships!

Your strategic marketing will include developing and nurturing new and ongoing relationships with your clients and your ?customers? (referral sources). People buy from people. People may (and hopefully do) refer to you because of your clinical skills.

You want people to think of you first when they know someone who needs mental health counseling, and you want them to continue to refer to you over and over again because of your relationship skills. You’ll be surprised at the things you can do to build relationships in your community that will bring you referrals again and again. Your phone will keep ringing as long as you keep nurturing those relationships.

#7: Think about winding down before you even start

Every good businessperson knows that regardless of what your business is, part of the planning is a good exit strategy. You may be young and hungry now, but the time will come when you run out of time or energy or when you want to devote your time and energy to other pursuits.

You will want to have a plan in place for winding down and transitioning out of your private practice and into your idea of retirement or other ventures. Acknowledging this will allow you to look at your practice in ways that will take you beyond the ?dollars for hours? mentality in which we are all conditioned to work.

Push yourself to explore and develop ways to generate significant income that is not tied to your time and efforts. For example, you can sell niche-related products, or create videos and other media to sell to your clients and others.

Webinars and teleseminars are great ways to provide services to many people (from all over the world) at one time, increasing the return on investment of your time.
Generating multiple streams of income is a great way to help you to bring in more money now and in the future. Get the information you need to set up a great business plan that includes your exit strategy right from the start.

For ideas on ways to create a successful private practice right out of the gate, find a mentor or private practice coach you can trust to give you guidance, encouragement, and information. It really can help to have someone to take you, step by step, through the process of establishing and growing your practice. Investing in this service will get you going much more quickly, and it will continue to benefit you for the rest of your career.

#8: A word of caution

Though private practice can be wonderful, it isn’t for everyone. Try your hand at part-time private practice to build up your client load, and also to see if you really do like it.

In surveys, private practice seems to be everyone’s ideal, but some counselors find being in a solo private practice very trying and lonely. For some mental health counselors, the ideal is actually a group practice that has counselors, social workers, and psychologists so that supervision can be done from a multidisciplinary perspective. And while mentors are important, life-long supervision is a must, especially for private practitioners.

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  1. David Westcott /Reply

    Thank you, Dr. Deb Legge, for your example and your offer to help build the private practice of our dreams. My colleagues and I are seeking to specifically offer private interactions, “off of the grid” so to speak, paying entirely out-of-pocket. We think this niche marketing may appeal to clients who wish to maintain an extra level of privacy and/or avoid having a substance abuse /mental health diagnosis being attached to their health record. Any suggestions or feedback greatly appreciated!

    Most Cordially,
    David Westcott, MS, LMHC

    1. legge /Reply

      @ David – Having a 100%, private pay, private practice is absolutely do-able (I did it for the first half of my career, and still I am at more than 75% private pay/out of network). You must still clearly define your target markets (who you will serve) and your “big result” (the biggest thing(s) they will get when they work with you. You’ll also have to define your “ideal client” within that target market — and in this case, one of the qualities is that they can afford to pay out of pocket — and get to know them like the back of your hand (their needs, desires, and biggest problems). Once you have that in place you can develop a marketing system that will get you noticed and allow you to build the credibility, likability, and trust you need to get people to do business with you. You can learn what you need to know, and get support and guidance to get you moving in the right direction when you are a member of the Influential Insider’s Circle mastermind coaching group. Check it out here; I hope to see you there!

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