A Foundation upon Which to Build Your Practice

There are naysayers who claim that it's next to impossible to build a successful private practice in today's distressed health care environment. Although it is certainly more challenging to start up and maintain a private practice today than it was 15 or 20 years ago, I speak with many practitioners, both new and established, who report that they are doing much more than just surviving in these turbulent times. Consequently, I view the prospects for psychologists in private practice more positively than the naysayers. I make this statement, however, with the utmost appreciation for the difficulty and level of commitment this endeavor requires in today's healthcare arena.

In thinking about conversations I've had with practitioners around the country, it seems that those who report that their practices are doing well have certain underlying approaches in common that have enhanced their chances for success. In trying to describe collectively what they are doing, I would say that their actions fall into three general categories. These practitioners:

• creatively apply their experience and training toward a particular practice area or areas;

• remain flexible with regard to the evolving healthcare system; and

• take an active rather than a passive approach to practice building.

These elements are evident for those who are just starting out, those who are changing the direction of their practice, and those who are maintaining their currently successful practice.

Using creativity, as it relates to applying one's specific experience, training and skills, is one of the keys to remaining relevant in today's marketplace. This is not to say that there is no longer a demand for traditional services, only that there is so much more we have to offer and more we need to offer to be optimally competitive. Psychologists are trained to conduct research, teach, evaluate, counsel, and advise both individuals and groups. They are skilled at helping organizations, systems and people get to the root of behavioral problems and solve them. This training, together with a practitioner’s own unique experiences, interests and skills can be a very powerful combination. For example, one psychologist with whom I've recently spoken, a former college athlete, has combined his training and life experience to develop a thriving sports psychology practice working to enhance performance with high school athletes. Another practitioner shared with me how she has used the experience she had in coping with infertility to tailor her practice to working with women and couples who are in the middle of this type of life crisis. Another traditionally trained family therapist I know used his family and systems training to transfer his skills into the business-consulting arena. He now maintains a booming practice working with family-owned businesses.

We must creatively apply our skills if we want to bring to society and the marketplace all that the practice of psychology has to offer. The psychologists I am referring to are succeeding in their efforts in large part because they have found a way to creatively combine their own unique interests, training and skills within the scope of their competence.

No one can predict how present issues in our health care system will ultimately be resolved. (And believe me, I spend a fair amount of time trying to predict this myself.) This is why, if the practice of psychology is to be successful in our health care system which is in a tremendous state of flux, practitioners must remain flexible. For example, practitioners would do well to consider how they can develop a mix of services with alternate referral sources and alternative payment streams. Each practitioner I mentioned above also offers a related but diversified array of services that provides them with some breadth and flexibility during changing times. The sports psychologist I mentioned maintains a small executive coaching practice while also working with depressed and anxious adolescents. He accepts insurance for the latter, but his executive coaching and sports psychology clients pay out of pocket.

In developing a flexible approach to one's practice, it can help to think about your practice like you would any business. Importantly, this does not mean that one has to compromise one's professional values or lose touch with the caring side of the profession, but it does require a willingness to confront what may feel like some harsh realities of the current health care marketplace. Many successful businesses offer an array of products and services. Additionally, investment advisers tell us that to maintain financial security one must have a diverse portfolio of investments. A successful psychology practice can also be helped by providing a diverse set of services. This can be accomplished either by an individual with a variety of services within his or her scope of competence or by joining with a group of practitioners who, together, provide a diverse array of services.

Developing a business plan can be another concrete step in the process of developing a flexible approach to your practice, and is a must for any successful business. A business plan, which also includes a marketing plan, will guide you to reflect upon the following types of questions: What specific service(s) does your practice provide and what need does it fill? Who are the potential clients for your service and why will they purchase it from you? How will you reach your clients? If you are just starting out in practice, where will you get the financial resources to set up your practice? Focusing on these issues helps you get clear about what you’re setting out to do and how you will go about it. Developing a good business plan and taking all the necessary steps to implement it is not always easy, does not guarantee success, and is not something psychologists typically think about. (And, it is not usually taught in graduate school.) However, it is unlikely that you will find many successful businesses that do not have a clear business plan. Tools to aid you in business planning can be found at SBAopens in new window and BRSopens in new window.

Another significant piece to practice building is an active engagement in the process. I have not met one psychologist who reports having a successful practice that does not routinely spend a significant amount of time engaged in professionally related activities outside of his or her office. Psychologists with booming practices are actively involved in their communities, in professional organizations and with their colleagues. They are not waiting for opportunities to come their way. Rather, they are always out looking to create opportunities. They do not rely on insurance companies for the bulk of their referrals. Instead, they conduct outreach in their communities which may often lead to referrals. I recognize that these types of activities can be more comfortable for some than for others. That is one reason why APA along with state and local psychological associations have invested considerable resources in developing a host of programs to help psychologists conduct forums, do workshops, and generally branch out and get involved in the types of activities to which I am referring. If you feel you need assistance in this arena, consider getting involved in some of the volunteer activities your local or state association has available to you. Although these activities are not likely to be a direct route to referrals, they often lead to them indirectly as your professional and community network expands.

Despite hard times and challenges in today's health care arena, psychologists can build successful private practices. Practitioners who are doing well share three common skills: creatively applying their abilities, maintaining a flexible style by adapting and developing new ways to manage obstacles and challenges, and being active both within their professional and civic communities.

The reality is that there is, and likely will always be, a need for the competent provision of psychological services. By being creative, developing a business plan, and taking steps to put that plan into action, you can be well on your way to building a successful practice.