I’ve been reading Louis Baraja’s 
book, Small Business, Big Life: 5 Steps to Creating a Great Life with Your Own Small Business. In it he lists the 22 Temptations of a Small Business Owner that entrepreneurs often fail to notice and then stumble over while building their businesses.
That list got me to thinking about the many ways that psychotherapists and allied health professionals get tripped up on the way to building their businesses so I decided to share my list of 22 things you say (with a nod t o Louis Baraja) before you even know your private practice is in trouble .
You Know Your Private Practice is in Trouble When You Say . . . .
- “I’ve always been ‘Dear Abbey’ with my friends so I might as well hang my shingle out and charge for it!” Just because you are good at something doesn’t mean that you should do it professionally. And, even if you decide that you want to work in health care, you need to take time to consider the huge differences between working for yourself and working for someone else. Those differences matter.
- “I’m not really sure what I’m doing business-wise . . . but I have a client!” The vast majority of businesses that succeed start with a plan . . . not necessarily a Business Plan but they all have a plan. By that I mean you need to have an understanding of how the business fits into the larger plan for your whole life . . . and how it contributes to that bigger life plan.
- “I haven’t thought about how many hours I want to work or how much money I want to make this year . . . but I know I want to help people. When you enter into private practice especially in health care, you need to begin with the end in mind. The end matters and will actually dictate the choices that you make along the way. By keeping your values and your priorities at the forefront (including how many hours you want to work and how much money you want to make), you will be better able to stay focused on the tasks necessary to achieve your ideal business.
- “I don’t have regular business hours. I work late into the night on my business” and eventually “I’ve burned out.” It’s easy when you’re getting started to over-commit and over-invest in your business. What I know is that you cannot give what you do not have . . . good boundaries, balanced life, energy and focus, etc. Self-care is critical especially at the start of a new practice or a new project. Reinforce those habits now . . . at the beginning. And, if you don’t have them, find a therapist or coach to help you put them in place. Otherwise, you will not survive the demands of private practice.
- “My preference is to hire and network with people just like me.” I know that you’re more comfortable with people just like you (Me, too!) but they won’t help you long term take your business to the next level. Differences in skills, experiences, and even politics will be assets to you in many ways. As long as the people you hire and network with can share your vision for your practice, their differences can serve you well.
- “My business partner and I constantly struggle with the direction of the business.” If that’s true, then you’ve got too many leaders in the room. In your practice, your vision is the one that needs to be the guiding force. Be cautious and be clear about why you want to partner with someone. Often it is a better choice to hire or consult with individuals (assuming they buy in to your vision) rather than bringing in an actual partner (who has a different / competing vision on his own).
- “I am constantly reinventing the wheel.” Take the time to create systems and templates to streamline your work so that as your appointment book begins to fill in, you are able to efficiently delegate or complete your repetitive tasks.
- “I work with everything and everybody.” Don’t say it! Stay focused on your ideal client and market to him or her. Of course, you’ll work with others but target your message and your efforts to working only with your ideal client and withing your niche.
- “I need to work harder at ___________.” [fill in your weakness] Successful entrepreneurs delegate or manage their weaknesses; they focus on their strengths. In fact, Marlane Miller in her book, BrainStyles, says that by focusing on our weaknesses, we just build stronger weaknesses.
- “I can’t spend money until I start making money.” Wrong! Have faith in your calling and invest in your practice. If you aren’t willing to invest in you, don’t expect anyone else to invest in your either!
- “My friend needs a little extra income so I’m going to hire her to do my accounting.” Hire people because they are exquisitely qualified and not because they are your friend and you want to help someone out. You are running a business, not a social service organization.
- “I’m really good at flying by the seat of my pants so I’ll just deal with it when it comes up.” Not a good idea. Take the time to create a plan . . . a blueprint for your practice and for your life. Then, stick to it.
- “I don’t need to hire anyone to do anything. I can do it all myself! (And, besides, I’ll save money doing it this way!) If this is what you’re thinking, then you have some control issues to deal with. You cannot do everything well and if you cannot do it well, you need to find someone i.e hire someone else who will do it well.
- “I’ll hang my shingle out and the masses will come!” No. They won’t. What will get clients is a strategic plan and follow through. Who are you going to talk to about your practice? Where are you going to publicize your practice?
- “In order to open my private practice, I need all the bells and whistles . . . a white noise machine, new office furniture, a posh location, special software to keep my progress notes in, etc.” Not really. What’s going to prepare you to open your private practice is you laying the foundation for name recognition, building trust in the community, and following through on your commitments.
- “I will work with anyone who will pay me.” Another bad idea. Work with your ideal clients. It’s your calling. Refer the others out.
- “This is too hard so I quit.” Many therapists throw in the towel and quit too soon because they didn’t go get the info that they really needed – the business and marketing info that you didn’t get in graduate school. Take the time to learn the info . . . take classes, read articles, interview other more seasoned therapists, hire a business coach. Learn what you need to know in order to jump start your practice.
- “I’m doing great so I’m not going to ask for feedback.” When you’re doing great, is the perfect time to ask for feedback! Learn what you are doing well so that you keep getting that feedback.
- “I know everything there is to know about being in private practice” or “There are things I need to know but I’m not going to pay another professional to get that information because I’m not worth it or I’ll figure it out.” Again, quit fooling yourself and go get the help / info that you need. Hire a counselor or an attorney or a coach or whomever. Don’t just delude yourself into failing. It’s not necessary!
- “I don’t know how to explain to clients why they should work with me.” That’s a really big problem. Then you need help learning to articulate what gifts you bring to your practice. Sign up for a class, hire a coach, work with a copywriter or wordsmith. It’s one of the single most important things you can do to build your reputation in the community.
- “What’s wrong with my clients? They aren’t getting better.” Well, that’s definitely a problem . . . and it’s a bigger problem for you than it is for your clients! If your clients aren’t getting better, you need to change . . . start or stop doing something, learn something new, talk with a consultant, etc. Whatever you do, don’t blame it on “resistent clients.”
- “I don’t need an exit strategy because I’m going to be in this business forever.” Even if you do plan to be in private practice forever, you still need make an exit plan. It will help you focus on building your practice up . . . to promote, to sell, or to expand.
Have you tripped up on these already? Or, do you have other red-flag statements to share?
Tamara,
This is great information for me as I approach my graduation date in spring~ then to begin my private practice. The statements are thought provoking and help me prepare for the day when I hang my shingle.
Hi, Brenda! Congrats on the nearing of graduation! It’s a lot of work getting there but private practice can be great fun! Hope you’ll consider attending Private Practice from the Inside Out Annual Series in 2010!
Great Advise! I have a successful private practice but am always looking for ways to grow, improve, evolve. I like the idea of focusing on my strengths, hiring support, and being able to quickly tell someone what makes me different. I really believe it is a good attribute for therapists to be looking at ways to improve themselves and to be able to move in that direction in a way in which they can actually note their self – improvement. Why? Because isn’t this what we are doing daily with clients? I love what I do, love networking and sharing what I do, it is a big part of my identity. Another healthy attribute would be optimism – helping other therapists get off the ground has been a perk of my work – but I have trouble working with therapists who constantly complain, demand referrals from other therapists, and believe that clients are just going to show up. We have to believe in ourselves, be able to convey a positive message, and do our own work to improve ourselves. Good luck to all who read your post – and thanks Tamara, for your dedication to our profession!
Vivian
Welcome back, Vivian! I’ve missed your voice here!
I chuckled when I read “. . . I have trouble work with therapists who constantly complain . . . .” It’s so much easier, isn’t it, to work with people just like us? And, of course, hard-wiring, circumstances, and choices all play parts in why some of us see that glass half full and others see it half empty but, like you, it’s a much bigger challenge for me to work with those who are constant complainers.
Have you found anything that helps you do better work with those negative, demanding, or tooth-fairy believing therapists? I have! I love a challenging client IF I can find my sense of humor and their sense of humor. (We laugh a lot in my office:) But, if they happen to be negative, demanding, believe in that tooth-fairy and can’t find common ground in humor, I refer them out. I’ve learned that it’s just too hard . . . too costly to invest in those relationships.
I know I’m not meant to work with every therapist who calls. I’ve learned to value my time . . . my energy . . . my spirit and my heart enough to say “thanks, but no thanks” and trust that I’m doing that person a service and also creating and holding space for my ideal clients to make their way to me.