PICK 42
The Business of Pratice: PICK 42 and Practice Development
By Kalman M. Heller, Ph.D. and Kim Ricketts, M.Ed.
In recent years, psychologists have increasingly responded to the challenges of managed care by learning and applying business strategies to their mental health practices. Division 42 has taken a leadership role in this by offering a steadily increasing supply of new materials and workshops to be used by psychologists to develop their practices. PICK 42 represents another step in this process by providing concise updates that can be used to develop practice niches. The concept of building a practice through the use of specialized areas of clinical focus is well-established. It is easier to educate the public and other professionals about how you can help them when you are able to focus on a particular area of need. It offers the potential to create innovative services in the niche area and can increase the potential to reach the private pay market.
Marketing is a wonderful tool to apply to mental health practice. It is not about giving up one’s sense of professionalism or ethics. In fact, it promotes the strongest of professional standards that we are committed to: constantly seeking the highest level of professional competence; always searching for the best ways to serve those who need our help. Mental health’s failure to adopt marketing principles as a cornerstone of training its professionals is one of the key reasons we face the current challenges in the marketplace. We have not committed sufficient resources to educate the public about the benefits of our services. Instead for decades we practiced in relative silence and the result is that the public, corporate America, and the government have not made mental health services a priority. We are first committing resources to this process but we have a lot of catching up to do. By each psychologist committing to the concepts of marketing, it serves to create a greater awareness and a stronger demand for our services. In addition, it provides each of you with the tools and strategies that will ensure increased success.
Supply and Demand
One of the current myths that has been perpetrated by the managed care industry is that there are too many therapists. This is simply not true. In fact, if we do a proper job in educating and motivating people to make increased use of our services, there is actually a shortage of therapists! This is especially true if we expand our roles beyond the traditional pathology-oriented providers of psychotherapy and create more preventive and wellness interventions.
Current estimates indicate there are about 300,000 licensed therapists in the U.S.. Research suggests that at any given moment at least 15-20% of the population has a diagnosable mental health problem. Unfortunately, barely a third of those who need our services seek them out. Utilization rates are usually reported to be in the 5-8% range. There are more than 250 million people in the U.S.. This means, conservatively, there are about 40 million prospective patients who need our services. You can easily double that number if you include those who would benefit from a range of wellness interventions (e.g., behavioral healthcare, corporate services). With 80 million prospective clients, each licensed therapist has nearly 300 potential clients to serve at any given moment, substantially more than could be helped if we could get even half of those people to seek our services.
What is marketing?
So how do you fill up your practice — and do so in ways that generate desired revenues? That’s what marketing teaches you. Marketing is an attitude. It is a way of thinking about your professional life and the needs of your community that leads to recognizing special opportunities that will provide the best match between your skills, interests, and the needs of others. A marketing attitude means that you are always looking for creative ways to help people, always alert to new information that can be translated into meaningful services. For example, when reading that more policemen die from self-inflicted gunshots than by bullets fired by criminals, it points to a strong need for services to an incredibly stressed and vulnerable population. There are opportunities for screening, training, crisis intervention, and marital and family interventions to help reduce this terrible statistic. Similarly, when you read that most couples do not get any help at the time of a miscarriage or about the incidents of harm perpetrated by poorly trained/supported au pairs or that the majority of post-surgery cardiac patients do not continue to take their medications or stick with recommended lifestyle changes, you will immediately think about services you could develop to help reduce the incidence of negative outcomes in your community.
Marketing is about commitment and persistence, about a willingness to self-promote (which is one of the most uncomfortable challenges for psychologists), about educating others, and, most of all, about planning. It requires that you give careful thought to the purpose of your practice, to the way in which it fits into your life, to the skill and knowledge you bring, to the vision you have for what your practice should look like in a few years, to the external barriers to your success, and to the competition seeking the same goals.
For example, a female psychologist who did a lot of work with adolescents wanted to expand her practice. She recognized that there were many therapists in the area serving the same population, so she was going to need to differentiate herself from the competition. Upon reflection, she realized that she was particularly skilled at working with depressed female teenagers. She developed a marketing plan that including giving presentations on the subject to community groups, helping the local high school to develop a brochure for staff and parents on identifying depression in adolescents, and building her relationship with local guidance counselors through face-to-face meetings. By identifying this specialty, which was a major concern in the community, she got people’s attention and before long had more business than she could handle.
Another psychologist whose practice had been waning for a few years, realized his most satisfying patient was one who was dealing with recovering from cancer. It turns out this psychologist had also recovered from cancer. By using this special knowledge and contacts he had developed from his own medical experience, he began to build a growing practice specializing in working with cancer patients.
Many psychologists are developing interests in working with people who have chronic medical illness. There are a growing number of post-graduate institutes where you can receive the necessary knowledge if you are not already an expert in this area. Similarly, many psychologists are exploring contributions they can make in the corporate world. A psychologist who started from scratch to make this transition developed a two year plan that involved getting training, supervision, and learning how to network his way into opportunities to do a variety of services including communication workshops, stress management seminars, and executive coaching. Another psychologist focused more on team building skills to develop a consultation practice while another used his background as a family therapist to build a family business consultation practice. These types of transitions to new markets take longer than just focusing on a clinical subgroup you already have experience with and building it into a specialty niche. Either way, remember that marketing is not meant to be a quick fix but a long-term solution to having the practice you want.
As you can see, there are many options available. The PICK 42 program will provide you with basic, up-to-date information on current theory and practice in a number of potential niche areas along with recommended readings and a few ideas for marketing. If you combine this with readings and/or workshops on marketing, you should be able to create a plan that successfully expands your practice. What can be particularly gratifying is that you may unleash some creative thinking that results in innovative services that are particularly effective in serving your targeted population. Marketing not only leads to successful practices, it puts fun back into our work.
The next part of the marketing section is a self-assessment form developed by Kim Ricketts, M.Ed., Senior Partner of Strategease Consulting, LLC. This will be followed by a Marketing Resource List.
Start by using the marketing checklist to assess what you need to do to position your practice as being marketing-based. Don’t be discouraged if you can only answer “YES” to a few questions. The purpose is to help you focus on what you need to do and where to start. Then review the questions under the practice profile section in order to help create the Mission, Vision, and Goals for your marketing plan.
Marketing Checklist
Mission Statement: This is the stated purpose of your practice. What makes it unique? How does it express your professional goals? How does it fit into your personal life? EVERYONE associated with your practice should know the Mission.
My practice has this in place:
YES NO SOMEWHAT
Vision: This is a 3-5 year projection of what you would like your practice to look like; identify the key changes needed to achieve this vision. This should emerge from your internal and external assessments with a particular focus on anticipated changes in your needs, the community’s needs, and the climate for practice. EVERYONE associated with your practice should know the Vision.
My practice has this in place:
YES NO SOMEWHAT
Values: This is a unique marketing tool that more and more businesses, regardless of their field or industry, are beginning to use. Understanding the values that govern your practice is particularly helpful in making many of your business decisions. Communicating these values to your community is particularly reassuring to your clients. EVERYONE associated with your practice should know the Values.
My practice has this in place:
YES NO SOMEWHAT
Specific Goals and Tactics: Plans for the coming year including measurable goals (e.g., to increase referrals or income by a specific amount), dates for achieving these goals, and the marketing or promotional tactics to be used to achieve these goals.
My practice has this in place:
YES NO SOMEWHAT
Financials: Projected income and expenses for the coming year; projected financial needs to achieve strategic vision; methods for financing the growth of the practice.
My practice has this in place:
YES NO SOMEWHAT
Promotional Tactics Checklist
There are more than two dozen ways of promoting your practice. (The books in the Resource List will provide you with a more detailed description of the options available to you.) What follows is a description of some of the more frequently used tactics. Be sure to keep track of which promotional tactics have generated referrals by always ascertaining how the patient heard about you.
Brochure: Some practices have a standard, 3-fold brochure and some use a one or two-sided flier format. It is a matter of preference, funds, and/or style. The key things to remember are:
• Always have a brochure, flier, or printed marketin piece describing your practice and/or your niche
• Your brochure reflects you — make sure it conveys the image you want to project
• Use color!! The paper. The ink. Just use it!
• Emphasize the benefits of your services, not your credentials
My practice has this in place:
YES NO SOMEWHAT
Advertising: Yes it can be expensive but so is your time and this is an effective way to develop name recognition and bring in new business.
A few tips:
• Local newspapers, specialty newspapers, or organizational newsletters that serve your targeted community are the best print media resources for a modest budget.
• Consistency is the key. Avoid one-shot ads. It may take months before you get responses. It’s like building a relationship with the readers.
• Cable TV or regular TV in off hours can be very affordable and effective. (For example, if your target audience is patients suffering from depression or PTSD, since they usually have trouble sleeping, early a.m. commercials can be very effective!)
My practice has this in place:
YES NO SOMEWHAT
Yellow Pages: Always be listed but ads are variable in effectiveness, depending upon your community. Best way to check is look at the last three years of your section and see if therapists are repeating their ads. If not, it’s not effective. The usual rules apply: emphasize outcomes, avoid clutter, emphasize what makes you unique, use a headline that will grab the reader’s attention, you don’t need to be the biggest ad to get responses.
My practice has this in place:
YES NO SOMEWHAT
Public Relations: Finding free ways to get your name in front of people.
• Offer to write a regular column for a local paper — mental health issues have a strong reader appeal, especially about parenting and relationships.
• If not a regular column, at least an occasional one on a specialty topic.
• Offer to write a column in area corporate newsletters or non-mental health association newsletters (e.g., state bar association)
• Offer to speak at community organizations (business, religious organizations, schools). Give your expertise away. Be sure to target populations that are most relevant to your niche.
• Create a press release form and send it to the local paper every time you do something. Give them a good photo to use. They have a need to fill up all those pages every week!
My practice has this in place:
YES NO SOMEWHAT
Professional/Business & Community Associations: Join local associations, especially those that include your target populations, e.g., Chamber of Commerce, Fraternal, State Psychological Association committees, local community improvement groups.
My practice has this in place:
YES NO SOMEWHAT
Practice Profile
In order to adequately and effectively develop a niche practice, it is recommended that the practitioner conduct a brief, internal assessment. This requires answering questions about how your practice operates (intake, billing, record keeping), where it operates (location, office set-up and furnishing, public access, handicap access), whom it serves (number of referrals, types and sources of referrals) and its effectiveness (Is it growing? Are people benefitting? How are you perceived in the community?). Again, use the Resource List for reading more detailed descriptions of an internal analysis. One brief but effective technique is to conduct a SWOT analysis of your practice (Strengths, Weaknesses, Opportunities, Threats). This can provide a basic profile to help in planning further practice development.
SWOT Analysis:
List five items in each of the following categories that best describe your practice (in general and/or specific to the niche specialty):
STRENGTHS (What makes your practice effective, different, or special?)
1.
2.
3.
4.
5.
WEAKNESSES (In what areas does your practice need to improve?)
1.
2.
3.
4.
5.
OPPORTUNITIES (Where are there opportunities for you do enhance your practice and improve your chances of achieving your goals?)
1.
2.
3.
4.
5.
THREATS (Aside from internal weaknesses listed above, what are real threats to the success of your practice?)
1.
2.
3.
4.
5.
Marketing Resource List
Ackley, D. (1997). Breaking free of managed Care: A step-by-step guide to regaining control of your practice. New York: Guilford Press.
Browning, C., & Browning, B. (1986). Private practice handbook. Los Alamitos, CA: Duncliff’s International.
Friedman, R., & Altman, P. (1997). How to design, develop, and market health care seminars. Sarasota, FL: Professional Resource Press.
Heller, K. (1997). Strategic marketing: How to achieve independence and prosperity in your mental health practice. Sarasota, FL: Professional Resource Press.
Kolt, L. (1996). Business and marketing manual for therapists, 3rd ed.
Kolt Leadership Group, 7590 Fay Avenue, Suite 503, La Jolla, CA 92037; (619) 456-2005.
Lawless, L. (1997). Therapy, Inc. New York: Wiley.
Levine, M. (1993). Guerilla P.R. New York: HarperCollins.
Levinson, J. (1993). Guerilla marketing. Boston: Houghton Mifflin.
Practice Strategies. 12 issues, $79. Gayle Tuttle. (202) 452-0109.
Psychotherapy Finances. 12 issues, $79, Herbert Klein. (800)869-8450.
Rust, R. Zahorik, A. & Keiningham, T. (1996). Service marketing. New York: HarperCollins.
World Wide Web Sites:
Psych Central: www.grohol.com
HealthGate: www.healthgate.com
American Psychological Association: www.apa.org
Kalman M. Heller, Ph.D., Practice Development Consultant, www.drheller.com
Kolt Leadership Group, www.kolt.com
Yenney, S.L. (1994). Business strategies for a caring profession. Washington, D.C.: American Psychological Association.
Kim Ricketts, M.Ed, Senior Partner, Strategease Consulting, LLC.
Kalman M. Heller, Ph.D., author of Strategic Marketing: How To Achieve Independence and Prosperity In Your Mental Health Practice, has been a key member of the PICK 42 Committee.