Private Practice 101: Getting Started

Congratulations!  You have made the decision to go in this rewarding and challenging direction.  You will be your own boss and attract your ideal clients and continue to strive towards your potential.  “Now what?”  “Where do I start?”  “How do I get started?”  This can be overwhelming of course, remember, as you might suggest to a client, take this one step at a time, take baby steps towards your long term professional goals.   Here are some resources and ideas to help you take the first steps in getting set up in private practice. 

First imagine your practice’s course of development.  Will you be leaving your current job and putting all of your energy into building a lucrative practice?  Or will you begin a small practice on the side with the financial support of your current part or full time job?  How would you like your practice to look in one year? In five years?

How many hours do you want to be working?  What will your ideal work-week look like?   How many client hours would you like to fill?  What hours will you be available to see clients?  What sort of clients do you work most effectively with?   Where will your office be located ideally?  What sort of support services will you use (billing, accountant, scheduling, receptionist, coach, etc..)  Spend some time to envision your ideal practice.  You may want to work with a coach to develop this plan.  A great website to supplement your journey is Lynn Grodski’s website www.privatepracticesuccess.com.

Finances most likely will drive your initial start up plan.  Can you afford to leave a steady job with reliable income and depend on your practice?  Most often it is more realistic to begin with a part time office, keep your reliable income and build a practice on the side until you feel confident that the practice will bring in enough to support you.  This is far less stressful, and takes pressure off of you.  Feeling desperate about generating referrals immediately does not create positive energy.   Plus it gives you a chance to test drive the idea of full time practice.  Is it indeed a good fit for you?  You most likely will find areas that will need adjusting.   I initially thought I would be completely independent and do my own billing.  After two months and a few clients, I soon realized that I had no interest in dealing with more paperwork, and would not be getting paid if I did not hire an expert to handle this aspect of my practice.  Based on previous research, what will your overhead look like?  And what is your minimum required income?  This will drive how many clients you will ultimately need to see per week, and what your fees will look like.

Once you develop a general idea of how you will go about starting up, you will need to attend to some details.

Here is a quick checklist of tasks to complete before opening your doors (but by no means a comprehensive list)

*Determine what legal structure will be most appropriate for your new business.  For most of us sole proprietorship makes most sense for starting out.  If you are not yet licensed, you may need to structure your business differently in order to maintain malpractice and liability insurance coverage.   I recommend consulting with the small business association ( www.scorepdx.org ) which offers free consultation and counseling for small business owners.

*Find an office that suites your needs .

*Sign up for malpractice insurance.  Two companies/websites to look into are: www.cphins.com and www.hpso.com.   If you are newly licensed, or a member of ACA or ORCA you may be eligible for discounts on your premium.

*Apply for your NPI number (national provider identification) number which insurance companies will require for billing purposes:  https://www.nppes.cms.hhs.gov/ - 8k

(If you intend to do any insurance billing or provide invoices to your clients in order that they may bill their own insurance company.)  

*Research your county’s requirements regarding a self employment business license.

*If you will be accepting insurance payments, begin the process of applying to provider panels. 

*Identify a billing service unless you will be doing your own billing.

*Develop your policies and procedures, informed consent, intake paperwork

*Develop your disclosure statement and submit it to your licensing board.

*Develop your initial marketing plan (worthy of whole separate article or more).  This may include creating a website & email address, business cards, sending out mailings, networking, advertising in local and/or professional papers and/or getting on to relevant list serves.  Resources I have found helpful are:

www.vistaprint.com for printed materials,

www.networksolutions.com for website management, and

www.psychologytoday.com for online advertising and networking with other therapists.

Set a start date and begin practicing positive thinking for your practice!

________________________________________________________________________

Rachel Starck is a Licensed Professional Counselor in private practice at The North Portland Growth Place, and provides consultation and supervision to other counselors starting in their own private practice.  For more about Rachel’s practice and part time office space go to www.thegrowthplace.com