I am both the President and one of the founders of Centers for Family Change. Under my direction the Centers for Family Change has become a thriving practice with 4 offices, 20+ therapists, and an excellent reputation in the community.
At this point in my career I have become increasingly interested in sharing my knowledge about practice development and practice management. My approach to to consultation is practice and is designed for those seeking to develop and grow their practices.
For more information contact Peter Perrotta, Ph.D, at 630 586-0900 ext 10, or at cffcperrotta@gmail.com.
Please see below for a series of articles on practice building strategies and ideas.
The 5 Principles for Building of Successful Practice Building
Introduction
In this series of articles I will identify and discuss the 5 principles that therapists need to address in order to build a successful private practice. This principles are the cornerstones for building and growing a successful practice. Subsequent articles will examine issues that practitioners face in building different types of practices.
Principle 1. Define Your Practice
The chances of success in building a practice are likely enhanced considerably if you know what you are trying to build, if you have a clear vision of what you want your practice to be. This vision needs to encompass: the clinical focus of the practice; practice organization, structure and size; and whether the practice is private pay only or accepts insurance. While these issues are quite different, they are critical in determining what type of practice you are trying to build, and what steps and strategies you will need to undertake in order to succeed.
Clinical Focus
The rule of thumb here is that a practice cannot provide all services for all problems. I would argue that this would hold true even if the practice is quite large. While it might be possible to build a large multispecialty practice that has staff with particular expertise in working with all age groups and all types of clinical problems, this is likely to be an unrealistic goal. Moreover, how you define your practice determines what type of clinical skills you (and your associates or colleagues or employees) will need to have, and how you want referral sources and potential clients to think of you. For example, defining a practice as child and adolescent focused will clearly result in your marketing to schools and pediatricians whereas a practice focused on adults would not pursue either of these referral sources. Additionally, I am troubled by clinicians who market a solo or small practice and assert that they work with a large range of problems, that 10-20 problem areas are within their expertise. While even while this might be true for a seasoned group of professionals this type of presentation likely dilutes how others remember and perceive a practice.
Structure and organization of the practice
Private practice can take many shapes and forms, from: solo, to partnership, to group (with one or multiple owners). While initially this may not seem a major decision it is. Many therapists who build a successful solo practice think about taking on a partner or an associate (employee or independent contractor). This is not something that should be entered into casually. Having employees changes your job description from clinician to owner/employer and clinician, and will add many jobs and duties to your workload. Having a partner is akin to getting married: it changes your work life, and thus is not something to consider casually. Managing employees can become the major focus of one’s work in a group practice while negotiating with a partner about the direction and focus of one’s practice can also be demanding. Issues about pay, responsibilities and quality of work need to be considered. How much do you pay employees? How do you do it? Who is responsible for making sure that the billing is done, the stationary is ordered etc.? How do you oversee the work of employees? How will your reputation be affected by your partner’s or employees’ reputation? Do you work with or hire clinicians with different or similar skills and/or clinical orientation as your own? While all of these questions may make solo practice seem more appealing, this is not meant to be the case. The trade off of simplicity for complexity clearly exists but the chance to develop other skills, build an organization, train and collaborate with others, do not exist to anywhere near the same degree in solo practice. Moreover, a group practice offers the potential of greater income. A key question is: which model appeals to you? A second question is: Do I have or am I willing to learn/develop the skills necessary to manage others, run a business?
Insurance versus Private Pay
While it might seem crass to think of who pays the bills as a cornerstone issue, it is. Private pay practices by are likely to be smaller in size, be limited to experienced clinicians with strong credentials, and target specific groups and problem areas. In contrast, insurance based practices offer the opportunity to have a larger and more diverse practice, and to practice in middle and lower middle class communities where self-pay expectations are likely unrealistic. Moreover, it is important to communicate to clients and referral sources not only what problems and issues your practice treats but how treatment is paid for. Many referral sources are concerned about this as are most perspective clients.
Peter Perrotta, Ph.D. 