In this episode, Gordon talks about the balance between the clinical vs. business side of running a private practice. Even though there are some overlaps of clinical processes and business processes, it is usually helpful to keep things separate. Gordon talks about having a good handle on how you spend your time and having processes in place to manage the various aspects of operating a private practice as a counselor, therapist, psychologist or social worker.
One of the top things that clinicians in private practice struggle with is having the knowledge they need to run the business side of a practice. I found this out in a recent survey I did with the counselors and therapists that follow the Practice of Therapy. Of course, this is no real big surprise.
Choosing a career as a counselor or therapist usually comes from deep personal convictions. Most of us in the helping professions do it because we truly want to help people and make a difference in their lives. Our professions are focused on helping people through emotional difficulties and relationship struggles in life. The work is both rewarding and hard.
Our training as mental health professionals prepares us for our work with clients in the therapy room. What it doesn’t prepare us for, is the management of the business side of being in practice. And this is especially true for those practitioners that choose to go into private practice.
Like it or not, when you are in private practice you are running a business. You not only have to focus on the clinical side of practice management (the documentation, treatment plans, coordination of care, etc) but the business processes that will give you the cash flow you need to stay in practice. A lot of times it can be overwhelming and feel like the paperwork takes more of our time than the actual clinical work.
Business vs. Clinical Processes
One of the things that anyone in private practice needs to figure out is the overlap between the business and clinical sides. For the most part, they do need to be kept separate. And so understanding the different things we do to run a private practice.
Most doctors and large medical practices have this figured out. All of the business stuff is handled by the receptionist or billing person. You pay them and they collect all of your insurance information etc. They really do not talk with you about what you are seeing the doctor for. It’s all done out front or in a business office.
The clinical side of things is handled in the exam room with the nurses and doctors. You never really talk to them about how you are paying for things. All that was handled by the other people.
For clinicians running a solo or small private practice, we don’t really have the luxury of having a large staff to handle the business side of things. We have to do both business and clinical, and a lot of times, all in the same room! (Here’s another article I wrote for the folks at “Better”, that talks more about collections and the money conversation with clients.)
Keeping the Processes Separate
Despite the fact that there is some overlap between your clinical and business processes, it is a good idea to keep separate documentation for each. For example, an accounting system that does not use client names. Here’s what I mean by that.
I have both a practice management system I use (TherapyAppointment.com) and an accounting system application. The practice management system tracks and keeps individual client clinical records and what they have paid and their insurance information. It can also generate individual bills for me to send to clients. But it does not track any of my business expenses.
The accounting system does track when I get paid by a client but just records it as “session income” without a name attached. It also tracks my business expenses and bills I need to pay.
Here’s a short list of clinical vs. business processes
Clinical
- Session notes
- Treatment Plans
- Intake processes
- Appointment Calendar and reminders
- Filing Insurance Claims
- Receiving payments from clients
- Coordination of care with other healthcare providers
Business
- Tracking practice income
- Business expenses and overhead
- Paying bills due
- Profit and loss tracking
- Budgeting and cash flows
- Marketing
- Paying contract counselors or employees
Knowing how your time is spent
An important part of having your private practice processes running smoothly is to understand how your time is spent on the various processes. Also, it is good to know how much time you are spending on the various tasks. This is where doing a time study can come in handy. Simply take a week and start documenting how you spend your time and track it.
Working more efficiently
One of the people I follow and put a lot of stock in is Michael Hyatt. He’s one of those productivity gurus and has developed several systems for getting the most out of your time. (I’ve taken a few of his courses and belong to his “Platform University” ). He touts that value of learning to automate your processes. Michael breaks it down this way:
- Evaluate – look at and track your daily tasks. Figure out how much time you are spending on each and then prioritize them.
- Eliminate– start eliminating those things that use up your time, but really do not give you any return on your time investment. Find your time wasters and cut them out.
- Delegate– if it is a task you can’t eliminate and it sucks the energy out of you, delegate it. Hand it off to someone else (the perfect reason to have a virtual assistant).
- Automate– if you are doing repetitive tasks that are essential, figure out a way to automate it. Create template and documents that you can simply cut and paste. Also, find apps and other ways to streamline those repeated tasks (an example of this would be to use something like Buffer for social media. Another example is to pay as many of your bills as possible using autopayments).
- Consolidate– what you can’t eliminate, delegate or automate you should consolidate. A simple way to think about this is to learn the art of batching tasks or creating “theme” days. For example, I always get my documentation done on Wednesday mornings. It’s on my calendar and I knock it out in one sitting.
Ultimately, having a balance between the clinical and business side of private practice means having the processes in place to make the best use of your time. Keeping the business and clinical processes separate does help you better determine how to spend your time and where you need to focus.
Your time is one of your most valuable commodities. Your success depends on being able to do those things that will propel you forward. Know how you are spending your time. Do what you can to evaluate, delegate, automate and consolidate. It will only add to your success and make your private practice much less stressful to run.
Resources Mentioned
Private Practice Resources Page
Meet Gordon Brewer, MEd, LMFT
Gordon is the person behind The Practice of Therapy Podcast & Blog.He is also President and Founder of Kingsport Counseling Associates, PLLC. He is a therapist, consultant, business mentor, trainer, and writer. PLEASE Subscribe to The Practice of Therapy Podcast on iTunes, Stitcher and Google Play. Follow us on Twitter @therapistlearn and Pinterest “Like” us on Facebook.