How to Establish a Private Practice, Part 2: Decisions, Decisions

Now that you have laid the foundation for establishing a private practice, there are some decisions you need to consider:

1) Timing

Only you can determine when the timing is right to take the leap of opening a practice. Remember that there are some start-up costs: you will have to rent space (and possibly furnish it), get malpractice insurance, print business cards and legal documents, etc. You may also choose to launch a website, or hire someone to help you with insurance credentialing. And, since money won't be coming in right away, you'll have to have a little money to play with.

2) Target population

What type of clients do you want to work with? While you may not want to overly limit yourself, having expertise with a specific population or problem helps with marketing and referrals (niche marketing, I think it might be called). Many clinicians will work with a range of clients, but tend to target a particular age group, type of problem, and/or modality (individual, couples, family, group).

3) Schedule

When do you plan to schedule appointments? Are you going to try to do full-time private practice right away, or are you scheduling your practice around another job? How many billable hours do you want to schedule each week? Are you willing to do any evenings or weekends? Consider both your own needs, and the needs of your target population (e.g, children are not usually available weekday mornings).

4) Location

Based on the answers to these questions, you will need to look for office space. Unless you happen to have an office set up in your home, or enough capital to actually buy a space, that means you're looking for a professional rental. Craig's List actually has a section under real estate where professional spaces are listed. The local chapters of various professional associations (NASW, APA, etc) also sometimes post office listings. If you plan to rent full-time office space, you may have more options available than if you want to share an office, but you will also most likely have to furnish it yourself (this is an extra expense...but you can decorate however you want).

Sharing office space can be a good option for people just starting out, and spending fewer hours a week at their private practice. Some clinicians sublet their offices, and other landlords rent office space in time blocks (usually a minimum of 4 hour blocks). These spaces are usually furnished (again, that can be good or bad). When you're looking at offices, make sure to also ask about utilities, services, shared bathrooms, copy machine/fax, waiting areas, etc.

You may have a general (or even specific) idea about the area or neighborhood where you want to locate your practice. However, some flexibility is necessary, based on what office space is actually available, and at what cost. Especially if you are renting less than full time, you may be more limited geographically. As you consider locations, think about where you may be getting referrals, local competition, convenience to transportation options, and overall accessibility.

5) Money

How do you plan to get paid? How much will you charge? Your hourly rate should reflect the going rate in your area. Will you be working with insurance companies? If people are paying out-of-pocket, will you offer a sliding scale? (These questions deserve their own post, to come, but are things to consider as you begin, because they may influence how you market your practice and to whom).

Once you have answered these questions, arranged for office space, etc, it's time to begin the insurance credentialing process (if you plan to accept insurance) and marketing your practice. These will be discussed in the next few posts in this series.