Although the majority of those who regularly read and participate in our online community here at Private Practice from the Inside Out are mental health professionals, we also have others in our midst including Certified Professional Accountants, attorneys, educators, and allied health professionals. One of those allied health professionals wrote in the following request for information and asked that I protect her identity. This is what “Amanda” wrote . . . .
Hi, Tamara. I am a speech-language pathologist. After resigning from a position in May (due to my concerns about unethical practices of the agency), I began to develop my own private practice. It’s actually growing faster than I thought it would, and now I have enough clients that it would be difficult for me to continue to see all of these clients if I go back to school or get a new full time job. I am not sure if I will do either of those things yet, but I’m just wondering what appropriate etiquette would entail if I do have to discontinue service.
My regulatory college states that I would be required to refer the clients to another therapist (and there are some other rules), but I’m wondering if you have any recommendations regarding the amount of notice that I should provide (is 4 months enough?) and appropriate wording for the conversation that I would have with the clients. When my colleague moved from private practice into a full time position, it looked so easy, but now I’m wondering if there’s more that needs to be done.”
Hi, Amanda! I’m always happy to talk to health professionals about protocols in their practices and am particularly happy to have your profession represented here. Because I am not a speech-language pathologist, I would first encourage you to get familiar with your professional code(s) of ethics, your regional statutes, and your any licensing requirements that may address this issues. If you are here in the United states, you must also attend to the common standards of practice.
Your practice, like mental health, is relationship-based. For that reason, I would provide as much notice as is therapeutically possible. The four months that you have suggested seems adequate. Once you are clear about a final date of work, I would recommend that you send out written notice letting clients know that you will be helping clients transition to new health care providers over the next four months based on your decision to close your practice on a specific date.
After you send out this notice, I would follow up with face to face conversations with each client to reiterate the above information and allow an opportunity to answer any questions / concerns your client may have.
Then, approximately thirty days prior to the closing of your practice, I would follow up with a more detailed letter that references the previous letter and also
- summarizes your work with this client (including dates, presenting problems, course of treatment, and current status),
- explains your intent to (temporarily?) close your practice on a specific date so that you can pursue further education,
- expresses your gratitude for the opportunity you were given to work with this client,
- provides referrals to other speech-language pathologists whose work you respect, and
- offers any other types of support that you may deem appropriate including literature, websites, organizations, or support groups.
During that final month of work with your clients, I would again reiterate the above and begin the referral process. From a business standpoint, should you intend to resume your work in a private practice (in the same or a community nearby), it would behoove you to also send copies of this same correspondence to each of your referral sources for those clients.
And, don’t forget to put a plan in place for maintaining contact with those referral sources after the closure of your practice and while you are continuing your education. After all, if you don’t do this, I suspect with a two to five year lapse in contact, they will have found new favorite speech-language pathologists and you may have a difficult job getting your foot back in the door for new referrals.
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