Licensed social worker, P. K. has been running her own practice in Nebraska for over a year. Like many new solo entrepreneurs, she is still trying to balance the demands of time related to the clinical and administrative tasks that come with being in business for yourself. Here’s how P. K. describes it . . . .
My difficulty is that I have
young kids at home that I really want to be with and so I want to avoid the 40-50 hour work week. Often I find myself doing paperwork at home or making calls on my commute… not the best. And I always feel behind.
I know this is somewhat of a subjective question as everyone works at a different pace, but is there any formula out there to expect X amount of hours of work for every client hour?
I am going to try to schedule this time in my week in versus fitting it in at the beginning or end of my day – or even hoping for a no show just to get some stuff done! Gross!”
Thanks, P.K., for bringing up what is actually two different topics that every mental health professional must learn to manage – one is obviously time management and the other is therapist self-care – both of which impact not only our quality of life but also impacts our client’s quality of care.
The answer Is YES! There is a formula or ratio for administrative to clinical time in the office! And, I think you are going to be shocked to learn that 1:1 is the typical experience for mental health professionals. By that I mean . . . for every clinical hour you spend in the office, you can expect to spend another full hour doing the many administrative things that we do . . . the phone calls, documentation, networking, correspondence, billing, scheduling, building / office maintenance, marketing, drafting of new documents / articles, purchasing / restocking of office supplies, maintenance / repairs on office equipment, housekeeping, consultations, formal and informal professional development, taxes, etc.
If you are seeing forty clients in a week, then YES, you should be exhausted! You are probably working an eighty hour work week if you are actually doing everything you are supposed to be doing! (And, by the way, a “full practice” is considered to be 16-20 clients per week.)
So P. K., here’s my suggestion to you . . . . Take a week or two to consider how many hours per week you really want and need to be working. Then, and only then, adjust your schedule accordingly.
And, if you have difficulty doing that, feel free to drop back in here to chat. You are welcome to contract with me to help you problem solve or develop a plan or simply help hold you accountable to doing what you plan on doing to take better care of you, better care of your family, and better care of you! I’m always happy to help!
I go through the same thing as P. K.,wanting to haven good full client load, mange the administrative stuff and also have time with my two year old. It’s a difficult balance and I always find that I give up something, either a client here or get behind there or something. The question is for me can you runa successful practice and still have plenty of family time?
Brenda and Jill! Welcome back! OK, so here’s the deal . . . . We all get the same 24 hours in a day . . . . No more and no less so . . . the questions are (1) How do you define a “successful” practice? and (2) What do you consider to be “plenty” of family time?
And, if one of those has a higher value to you, you may need to adjust your definition of the other. For example, if “plenty” of family time means you staying home with your children and partner / spouse from 8 a.m. to 8 p.m. Monday through Friday, then you are going to have a difficult time maintaining a full time private practice. However, if a “successful” practice to you can be seeing 5 clients on the weekend and you still be with your family Monday through Friday 8 a.m. to 8 p.m., then you can make this work!
Admittedly, it took me years to find the right work / life balance once I went into private practice. What I have learned is that:
~it’s a matter of recognizing those externally imposed limits (like having only 24 hours in a day, needing 8 hours of sleep, etc.),
~acknowledging your own priorities (I choose to spend 4 hours / night with my partner and dogs), and
~then taking responsibility to maintain healthy boundaries that allow you to reach your goals.
Your definitions of “success” and “plenty” aren’t going to look like anyone else’s. You get to choose what they look like.
I can so relate to P. K. I also have a small child at home and want to spend as much time with him as I can. I end up being stressed due to all the demands of the practice and working alone. I have contracted out my billing to Accupsych (unfortunately, they are not taking new clients at this time) and I have a wonderful stay at home wife that has volunteered to do courtesy calls and scheduling. I can’t imagine not havingthose 2 things in place and yes, still overwhelmed. I will be looking back for suggestions. Thank-you Tamara for the information it was helpful.
Hello!
I’m a music therapist in private practice, and I travel to see clients in nursing facilities and private homes. I use the same 1:1 ratio for clinical and administrative time as a rule of thumb for scheduling. The difference for me is that one clinical hour may be with one client or with a group. When I have more groups, I may not be able to handle as many clinical hours, but I can charge more for groups, so it seems to work out in the end. This was the ratio suggested by my first mentor when I started my practice several years ago.
I like your consideration of how to define a successful practice! As a new professional, I chose private practice over seeking a full-time position as an employee because I wanted to have maximum flexibility to change my work situation when kids came along. My first child was born six months ago, and I have been so grateful that I have been able to cut back on the amount of work I’ve been doing for now so that I can have more time with her and still be active in my profession. The paychecks aren’t as big, but I think the alternative payoff is worth it!
Rachelle! Thanks so much for dropping in here to chat! And, thanks for the re-tweet earlier today, too!
Yes, that flexibility that can come with private practice is DIVINE! That and the fact that I work for my favorite boss in the whole wide world – ME!! How fabulous for you that you have a little one in tow! Yes, I’m thinking that that payoff really is a huge plus. Congrats to you!
I was so happy, Rachelle, to learn about your blog today. It’s really lovely. I’ll be dropping back in there and would encourage the rest of our gang here to drop in and check it out, too! It’s a beautiful example of what a therapist can do with a clinical site online.
Hi, This is a real dilemma, again as you have all mentioned, a subjective one. I love being my own boss but in private practice my case load fluctuates. My goal for a “full case load” is 16-20 x 40 weeks and that takes care of cancelations, no shows and holidays and vacations. That formula has always worked until this year when the market crashed! This year I found myself adjusting my fee, something I never did just to get clients in the door and keep them. Now it is up there and full again. So to fully answer your question, I don’t do insurance, I use Therapist Helper which does billing easily, I request payment and administration issues at the start of a session, or try to stop 5 minutes early to do so, I take notes during session (a hard on to get used to), try as hard as I can to have attorneys or insurance companies, or anyone else wanting a report or case notes to do a phone consultation during lunch. I HATE writing reports! As an experienced (23 years) therapist I don’t hesitate to say 4:00 is my last appointment and not worry about sending them to another therapist. That way evenings are mine. I know another therapist who stops at 3:00. Clients adjust to your schedule if they want YOU. Well, these are a lot of thoughts, Vicki
Hi, Victoria! It’s so nice to have your seasoned voice here – and the seasoning is showing, too. Like you, I’ve found that those good boundaries with time really do pay off and most of us don’t choose those early enough in our practices.
Thanks for the thumbs up on Therapist Helper for billing software. Folks are forever asking and I haven’t billed my clients in years so I am always looking for others’ suggestions.
Amen!
I found much in this post and the comments to take to heart about my own work (writing). The principles of priorities and boundaries are widely applicable–thanks for your wisdom and insights!
Gail, how nice of you to drop back in to chat! I so appreciate you joining in the conversation!
Hi – this is how easily time gets away from me! I am now just reading this post (that I knew would occur) and getting everyone’s feedback. I was thrilled to see all of the comments! I am going to heed Victoria and begin to get rigid with my hours. I have been extremely accommodating to my clients in scheduling… at the expense of my daycare, my kids, my husband, myself!
No more.
I am done with the days of seeing my kids for one hour in the a.m. and not putting them to bed. Talk about burnout! I always justified this with taking Fridays off.
Thanks everyone for moving me toward feeling that it is OK to have limits to when I can help others. It seems counterintuitive to be in a helping profession and have those limits, but ultimately, it is so important for me to be healthy to help others get healthy.
Best wishes all!
Hi, P. K.! Welcome back! I always wonder when I answer someone’s question if I’m missed the mark when they don’t follow back up. I appreciate you taking the time to include your thoughts today. The best thing you can do for your client is to model good boundaries including those around time.
Your clients, your family and you all deserve for you to be living a balanced and fulfilling life.
Solution: Hire an assistant!! Your specialty is therapy, not running errands. Someone out there for $10 an hour, even $15 will be more peace of mind than you know.
Hi, Julie! That’s a great piece of advice!
Where are you and what is it you do?