Dream, dream, dream… 

Isn’t it the dream of every aspiring young psychologist to be in private practice? Working for yourself, building your own legacy? But what does this really mean?

As incredible as it might sound at first glance, a private practice can be an expensive and lonely endeavour, at least in the beginning. If you truly desire that independence, it may still be worth it though! From personal experience, I can say that the independence is a definite plus. I’ve personally been lucky enough in most of my jobs to have autonomy over my work, but there were always little things (and some big things) that I knew I wanted to do differently. I have worked in schools, clinics, other psychologists practice’s, and hospitals; and am now running my own practice that is slowly building with a team around me. So the following is based on my own experience as well as the stories of other psych’s.

There are a few pros and cons that I will discuss in this post, but most of all, the primary consideration is what you want out of your practice – if you ask yourself this question and the answer includes collaboration, consultation, or team work, then you need to think on the value of going off on your own and how you might ensure these features remain even when you are working independently. There are many positives in working for another clinic, psychologist, hospital, or school, and each depends on your own style and desire for your career growth and learning. At the end of the pros and cons discussion, I’ve included some suggestions for making private practice less lonely. Hope this helps in whatever you’re choosing 🙂

The Private Practice Pro List

1. INDEPENDENCE! You are your own boss. You make the rules.
2. CHOICE! You get to decide what the business will look like and how you want it to operate. You can be creative and imaginative. You may have the dream already in mind, or it may grow as you grow the business. But this is definitely the fun part!
3. FLEXIBILITY! You choose what hours you will work, and how many or how few. This is the beauty of your independent practice – and can be attained as a contractor in other settings as well, but ultimately may be the primary reason that people go into private practice.
4. FINANCIALS! You have the opportunity to make the money and not hand over part of your worth to the employer. Of course, it’s not quite as exceptional as it looks at first glance, since you have more overhead and costs – since these are things we “pay” for by working for someone else.
5. SPECIALIZING! You get to decide what exactly you want to specialize in. You determine your role and what population you will serve.

The Private Practice Con List

1. INDEPENDENCE… that’s right. This is a con as well. You are on your own. The choices you make are for good or bad, in sickness and in health (hehe). 
2. RESPONSIBILITY. You are responsible for any and all things that happen in your practice. No clinical director is going to set the stage or advise you on your practice – you are that person now. You will need to worry about your own insurance, legal and ethical issues. While this is always a fact in psychology, the pressure is there in a more real way. You need to think about all the angles and cannot assume someone has already done so for you. 
3. ADMINISTRATIVE. You need to consider business and administrative demands in addition to your time doing what you love (presumably). Sure, you could hire someone to worry about your scheduling, billing, and accounting, but in the beginning there will be a high price for this and you may not be ready to pay for staff when you’re just starting to build clientele. Consider – scheduling, reminder calls, billing, invoicing, insurance billing, paying the bills, accounting, etc. 
4. OVERHEAD. If you are renting your own space, you will need to consider the costs of furnishing, printing, faxing, phone and internet, cleaning fees, and security.
5. ADVERTISING & MARKETING. This can be costly and time consuming. If you are on your own, you will need to set a budget for yourself as you grow and decide how much to invest in marketing your services.
6. SPECIALIZED vs. BROAD. I know – this was a pro above, but the thing is that you need to decide what makes the most sense, and in the beginning, specializations may not be as lucrative or supportive to growth until you have a name and reputation for yourself. So, you will need to determine whether or not it makes sense to be more broad, at least at first.

TIPS

So, even though the pros and cons list consists of different amounts on both sides, the value of each pro and con is to be determined by you. #1 on the pros list might completely outweigh all other cons; you may even love the administrative and business end of things! As always with pros and cons lists, it can’t simply be a numbers game. So here are some simple tips from my own experience that may help you whether you decide to open the exciting new private practice, or if you decide you simply want aspects of it in your agency-based career.

• Collaboration and consultation are incredibly important and valuable. Not only are these important to the profession as a whole, but in private practice it is critical to maintain this connection to a team or colleague. If you do not have such a network, build one by seeking out psychologists in your area and arranging to meet on a monthly or bimonthly basis. Or simply create an online forum that is private and allows you to connect with each other electronically. This is especially important if you are working in a remote area. 
• If you are overwhelmed by the above cons, you might simply seek out someone else in private practice and see if you can work with them in their practice. You could arrange a wage agreement that is very lucrative for both and allows you to forget about the cons list. 
• Pay for convenience. In the beginning, you may be inclined to stay cheap and low cost, but some things must be paid for. You will save a substantial amount of time if you have a strong scheduling and secretarial software that integrates your website, payments, and accounting software. It’s worth the monthly cost.
• Decide where to invest your marketing dollars and focus on that consistently for a set amount of time before switching. A lot of marketing in one or two places can amount to more positive gains, versus spreading your dollars too thin.
• Keep your network strong. Know the services in your area and talk with other professionals. Cross referrals can be an extremely important asset of your business growth and can help you feel more connected.
• Know your emergency services and specialists in the area. When you know these people or where to send your clients when you are feeling out of your depth, you will feel more secure and strong in your practice. You will also be known for being ready with supports and access to supports for clients in need.

Good luck with your efforts and know that it is not a quick process. But if you are patient and you think through the business plan, you will be able to develop the practice of your dreams 🙂