I’ve been reading Louis Baraja’s book, Small Business, Big Life: 5 Steps to Creating a  Great Life with Your Own Small Business.  In it he lists the  22 Temptations of a Small Business Owner that entrepreneurs often fail to notice and then stumble over while building their businesses.

That list got me to thinking about the many ways that psychotherapists and allied health professionals get tripped up on the way to building their businesses so I decided to share my list of 22 things you say (with a nod t o Louis Baraja) before you even know your private practice is in trouble .

You Know Your Private
Practice is in Trouble When You Say . . . .

1. “I’ve always been ‘Dear Abbey’ with my friends so I might as well hang my shingle out and charge for it!” Just because you are good at something doesn’t mean that you should do it professionally.  And, even if you decide that you want to work in health care, you need to take time to consider the huge differences between working for yourself and working for someone else.  Those differences matter.
   
2. “I’m not really sure what I’m doing business-wise . . . but I have a client!” The vast majority of businesses that succeed start with a plan . . . not necessarily a Business Plan but they all have a plan.  By that I mean you need to have an understanding of how the business fits into the larger plan for your whole life . . . and how it contributes to that bigger life plan.
   
3. “I haven’t thought about how many hours I want to work or how much money I want to make this year . . . but I know I want to help people. When you enter into private practice especially in health care, you need to begin with the end in mind.  The end matters and will actually dictate the choices that you make along the way.  By keeping your values and your priorities at the forefront  (including how many hours you want to work and how much money you want to make), you will be better able to stay focused on the tasks necessary to achieve your ideal business.
   
4. “I don’t have regular business hours.  I work late into the night on my business” and eventually “I’ve burned out.” It’s easy when you’re getting started to over-commit and over-invest in your business.  What I know is that you cannot give what you do not have . . . good boundaries, balanced life, energy and focus, etc.  Self-care is critical especially at the start of a new practice or a new project.  Reinforce those habits now . . . at the beginning.  And, if you don’t have them, find a therapist or coach to help you put them in place.  Otherwise, you will not survive the demands of private practice.
   
5. “My preference is to hire and network with people just like me.” I know that you’re more comfortable with people just like you (Me, too!) but they won’t help you long term take your business to the next level.  Differences in skills, experiences, and even politics will be assets to you in many ways.  As long as the people you hire and network with can share your vision for your practice, their differences can serve you well.
   
6. “My business partner and I constantly struggle with the direction of the business.” If that’s true, then you’ve got too many leaders in the room.  In your practice, your vision is the one that needs to be the guiding force.  Be cautious and be clear about why you want to partner with someone.  Often it is a better choice to hire or consult with individuals (assuming they buy in to your vision) rather than bringing in an actual partner (who has a different / competing vision on his own).
   
7. “I am constantly reinventing the wheel.” Take the time to create systems and templates to streamline your work so that as your appointment book begins to fill in, you are able to efficiently delegate or complete your repetitive tasks.    
   
8. “I work with everything and everybody.” Don’t say it!  Stay focused on your ideal client and market to him or her.  Of course, you’ll work with others but target your message and your efforts to working only with your ideal client and withing your niche.
   
9. “I need to work harder at ___________.” [fill in your weakness] Successful entrepreneurs delegate or manage their weaknesses; they focus on their strengths.  In fact, Marlane Miller in her book, BrainStyles, says that by focusing on our weaknesses, we just build stronger weaknesses.
   
10. “I can’t spend money until I start making money.” Wrong!  Have faith in your calling and invest in your practice.  If you aren’t willing to invest in you, don’t expect anyone else to invest in your either!
    
11. “My friend needs a little extra income so I’m going to hire her to do my accounting.” Hire people because they are exquisitely qualified and not because they are your friend and you want to help someone out.  You are running a business, not a social service organization.
    
12. “I’m really good at flying by the seat of my pants so I’ll just deal with it when it comes up.” Not a good idea.  Take the time to create a plan . . . a blueprint for your practice and for your life.  Then, stick to it.
    
13. “I don’t need to hire anyone to do anything.  I can do it all myself!  (And, besides, I’ll save money doing it this way!) If this is what you’re thinking, then you have some control issues to deal with.  You cannot do everything well and if you cannot do it well, you need to find someone i.e hire someone else who will do it well. 
    
14. “I’ll hang my shingle out and the masses will come!” No.  They won’t.  What will get clients is a strategic plan and follow through.  Who are you going to talk to about your practice? Where are you going to publicize your practice?
    
15. “In order to open my private practice, I need all the bells and whistles . . . a white noise machine, new office furniture, a posh location, special software to keep my progress notes in, etc.” Not really.  What’s going to prepare you to open your private practice is you laying the foundation for name recognition, building trust in the community, and following through on your commitments.
    
16. “I will work with anyone who will pay me.” Another bad idea.  Work with your ideal clients.  It’s your calling.  Refer the others out.
    
17. “This is too hard so I quit.” Many therapists throw in the towel and quit too soon because they didn’t go get the info that they really needed – the business and marketing info that you didn’t get in graduate school.  Take the time to learn the info . . . take classes, read articles, interview other more seasoned therapists, hire a business coach.  Learn what you need to know in order to jump start your practice. 
    
18. “I’m doing great so I’m not going to ask for feedback.” When you’re doing great, is the perfect time to ask for feedback!  Learn what you are doing well so that you keep getting that feedback.
    
19. “I know everything there is to know about being in private practice” or “There are things I need to know but I’m not going to pay another professional to get that information because  I’m not worth it or I’ll figure it out.” Again, quit fooling yourself and go get the help / info that you need.  Hire a counselor or an attorney or a coach or whomever.  Don’t just delude yourself into failing.  It’s not necessary!
    
20. “I don’t know how to explain to clients why they should work with me.” That’s a really big problem.  Then you need help learning to articulate what gifts you bring to your practice.  Sign up for a class, hire a coach, work with a copywriter or wordsmith.  It’s one of the single most important things you can do to build your reputation in the community.
    
21. “What’s wrong with my clients?  They aren’t getting better.” Well, that’s definitely a problem . . .  and it’s a bigger problem for you than it is for your clients!  If your clients aren’t getting better, you need to change . . . start or stop doing something, learn something new, talk with a consultant, etc.  Whatever you do, don’t blame it on “resistent clients.” 
    
22. “I don’t need an exit strategy because I’m going to be in this business forever.” Even if you do plan to be in private practice forever, you still need make an exit plan.  It will help you focus on building your practice up . . . to promote, to sell, or to expand.

Have you tripped up on these already?  Or, do you have other red-flag statements to share?

Tags: Priorities, Strategic Plan, Systems, Vision

When I left employment to begin my own private practice in 1991,

"Question Marks on the Wall" by Lone Black Rider / Filip Bunkens

I started by identifying therapists that I believed to be highly successful.   Then, I picked up the phone, introduced myself, and asked if I could take them to lunch or coffee to pick their brains about being in private practice. Whether you are just starting out in private practice or are wanting to revitalize your practice, that’s a good place for you to start, too.

Most mental health professionals will be flattered if you call.  Let’s face it, it’s an ego boost when someone else thinks that you are successful.  And, many mental health professionals really enjoy mentoring others in the field.

Once you’ve made your phone calls and scheduled your lunches, here are 20 questions for you to ask:

1. How long have you been in private practice? This is really important.  you want to identify therapists who have longevity in the field.  They are who you can really learn from.
2. How did you learn what to do when you were ready to go into private practice? If it worked for him, there’s a good chance that at least part of his learning can work for you, too.
3. What do you know now that you didn’t know when you got started about being in private practice? You might as well learn it now rather than wait.
4. How did your clients initially learn about your services and how do your clients learn about your services now? You want to know about how it was in the beginning for them.  Back then, they were probably on a shoestring budget at best (perhaps like you are now) and still they survived.  In the process of learning what they did back then and what they do now to get clients, you’ll most likely hear how their income and their efforts have changed and refocused.  
5. What mistakes did you make in your early years of private practice? Find out now so that you don’t have to reinvent the wheel.
6. What critical decisions did you need to make about your private practice and why? You may choose to make different decisions but it is often helpful to understand why someone in private practice makes the decisions that they make . . . about policies, workload, billing and fees, etc.
7. Did you ever have a mentor?  Do you now? And, how did you find one? One of the fastest ways for you to jump start your practice is to have a personal mentor to shepherd you on your journey.  Hiring a business coach is one way to find a mentor but it is certainly not the only way.
8. How much time do you set aside to work on the business (not the clinical) of private practice? Successful therapists in private practice spend time visioning, developing, and implementing new ways to grow their businesses.
9. What is your biggest challenge now? Challenges continue throughout the life cycle of a private practice.  Challenges happen; they do not disappear.
10. How long did it take you to turn a profit? The Small Business Administration says that most small businesses fail within the first 5 years and that most successful small businesses take 3-5 years to turn a profit.  I’ve certainly taken it take less time to break even or fail.  However, be wary of those who promise that you’ll be earning big money fast.  Research clearly shows to slow and steady is the way to build a strong foundation for a long-term practice.
11. What do you believe causes a practice to succeed?
12. What do you believe causes a practice to fail?
13. What type of clients do you see? Remember this when you need to refer a client of your own to another therapist.
14. What type of clients do you refer out? If this is a population / issue that interests you, make sure this therapist knows that.  If it is not, then keep an ear open so that you can refer another professional to this therapist.  This is how you network.
15. What resources can you recommend to me as a new therapist that can help me get started on the right track? He may have a favorite website on developing a private practice or an online diagnostic code finder. He may know another therapist looking to share an office or a CPA who can help you set up your quarterly tax payment.  Or, he may have a favorite book or magazine or office supply store to send you to.
16. What do you do to take care of you? Balancing work and home (much less children and additional schooling) is one of those topics that is hardly addressed while you are in school.  Take time to identify now how you will put systems of self care in place.
17. How has your practice changed over the last X (number) of years? It’s important to understand about the life cycle of a practice.  Once it’s up and running, it doesn’t necessarily stay up and running at that level.  Change happens . . . a group practice moves in next door, the local school system has an unexpected need for counselors, an army base closes, you get new clinical training, etc.  Your practice’ life cycle will be different than the therapists’ that you are interview but it is helpful to be reminded that change happens and what you need to do to recognize it as another opportunity for growth.
18. What is the hardest thing about being in private practice? Again, what is hard for him may not be hard for you but knowing about the challenges helps you prepare for them from the beginning.
19. How is your personal life affected by being in private practice? Your professional life and your family’s lives will be impacted by your decision to practice mental health.  When you are in private practice, that impact is even greater.
20. What precautions do you take to keep you and your clients safe in your office? This is another area that is not adequately addressed in graduate school.  There are many things you can do to increase your safety.  Learn about them now.

Remember to take pen and paper with you so that you can take notes.  I’m sure you’ll think of more questions along the way!

If you use this list, I hope you’ll drop back in and let me know how the questions worked for you.  Are there other questions that would be helpful to ask other therapists?

And, if you are a therapist who has been in private practice for a while, why don’t you drop in here  and answer all 20 of these for us.  It’s a good way to introduce yourself and your practice to our community!

Tags: Mentor, Network, Self Care, Vision

Health care professionals often forget that the general public is yet another constituent of  the educational community.  As such, it is another potential focus for your marketing in an attempt to get referrals from the school system.

Research has shown that the public perception of problems faced by schools is often very different than educator’s perceptions.  That discrepancy opens up many opportunities for you to orchestrate community dialogue and related services to facilitate constructive feedback and input between these two groups.

Listed below are some of the ideas that I have collected . . . .  Some of them I’ve tried; some of them I’ve only heard about.

"Woods Waterfall Door II" by John Banks

• Hold a focus group.
• Host a town “chat” at the local library.
• Facilitate a problem-solving group.
• Conduct research on a perceived problem.
• Write letters to the editor addressing the concerns of the public.
• Start a book club that deals with education-related issues.
• Create a collaborative education-community visioning group to set goals for the school system.

What’s going on in your community?  What has worked for you? I’m sure that you have other ideas and experiences to share.  Take a minute to add your thoughts below as we begin to mine the many opportunities related to public perception of school problems.

Related Posts

Back-to-School Marketing for Your Private Practice

K-12 Support to Feed Your Private Practice

Tags: Collaborate, Letter to the Editor, School, Vision