These are indeed challenging times for psychologists in independent practice. Medicare and other insurance companies continue to ratchet down their reimbursements for mental health procedures, cheaper and less credentialed counselors and other “providers” continue to compete with us for potential patients and now the economy appears headed for a recession. Many consumers, frightened by the prospect of mounting debt and declining home values, are starting to cut back on discretionary spending. Psychologists are beginning to see the result- fewer new referrals and shorter lengths of treatment. As independent practitioners, we are particularly vulnerable during this economic downturn. We need to take steps to protect our practices during this tough time. We asked members of the Division 42 TIPS Task Force (Tools for Independent Practice Success) and the Membership Committee for their strategies.
Dr. Tammy Martin-Causey recommends:
1. KNOW WHO YOU ARE SERVING - Before designing services for your practice, know who you are serving and what their needs are. Gather demographic data from your area (age, #children, education, SES, primary occupations, ethnicities, religious affiliations, etc). Much of this data is available through your municipalities. Attend community meetings, chamber meetings, social group meetings, and professional meetings for the sole purpose of learning about your community interests and needs.
2. DEFINE YOUR PRACTICE INSTEAD OF LETTING YOUR PRACTICE DEFINE YOU - Spend time up front considering your community demographics, needs of the community and whether you want to design a fee-for-service practice, a managed care practice, or a combination of both. Plan it and design it rather than waiting to see what happens after you “hang
up your shingle”.
3. BE CONFIDENT THAT YOU HAVE THOUGHT CREATIVELY AND FULLY BEFORE DECIDING YOUR COMMUNITY CANNOT SUPPORT A FEE-FOR-SERVICE PRACTICE IF THAT IS WHAT YOU PREFER TO OFFER - your first response may be that your community cannot afford to pay fee-for-service. It may be true that the majority cannot pay for individual rates. But if some can and some can pay group therapy rates and some can pay for a workshop, then you may be able to design a practice that offers services at different price points. Remember, you don’t have to offer every service to every person.
4. IF YOU ARE RISK TOLERANT, TAKE RISKS! Push yourself to the edge of your comfort level with your practice knowing that the payoff can be greater. Consider a bank loan to expand your practice into a new niche or for purchasing an office.
5. POSITIVE ATTITUDE - Your mind can be your own worst enemy when your practice may seem slow or not profitable. Don’t allow those negative thoughts defeat you. If you find yourself in that slump, don’t work harder - pull away for a planning retreat for yourself.
Grasp that creative energy that will cause you to shift into action rather than feeling that there’s no way to dig out of the slump.
6. FOLLOW UP WITH REFERRAL SOURCES - Even if you are not sharing PHI, you can send a nice card saying you received a referral from them and you appreciate their confidence in you and that you enjoy the opportunity to provide the best service you can to the referral. If sharing PHI, a periodic progress report is appreciated and often generates more referrals as it gives the referral source confidence that you are providing quality service.
7. GO THE EXTRA MILE - Keep a customer service mindset. In an era where healthcare can sometimes feel like an assembly line to the patient, make your office and interactions a different experience. Think of value added services you can offer that make clients want to come to you rather than the others on their contact list.
8. HAVE A QUICK RESPONSE TIME TO POTENTIAL CLIENTS - In this day where technology makes information instantly available, realize that your clients are researching the web for clinicians and often have a long list of potential psychologists, counselors, etc. to choose from. They have often read bios and info on each and have narrowed their list to only those they are ready to book an appointment with. When they call for an appointment, they may call several clinicians at once and will either book with the first person they get on the phone or the first one that calls them back.
Dr.Tammy Martin-Causey
www.psycharizona.com
Dr. Pauline Wallin recommmends:
9. DON’T ASSUME PEOPLE CAN’T AFFORD TO PAY YOU- In tough economic times, many people still have disposable income. They spend money on pets, toys, cosmetics, vacations, and personal services because these products and services have perceived value. You need to convince the public that your practice has as much value. You need to promote yourself and your practice now more than ever.
10. WHEN PROMOTING YOUR PRACTICE, EMPHASIZE BENEFITS RATHER THAN FEATURES. You can mention features, but don’t lead with them. Here’s the difference between benefits and features:
Benefits: Helping you overcome shyness; Helping your kids stop fighting; Helping your marriage feel new again.
Features: Cognitive-behavioral therapy; Fellow, American Psychological Association; Difference between a psychologist and a psychiatrist.
11. RESEARCH SHOWS THAT PEOPLE ARE MORE WILLING TO PURCHASE HIGH-PRICED GOODS AND SERVICES WHEN THEY CAN JUSTIFY THE PURCHASE. In your marketing, appeal to these justifiers: Educational value; Relief from stress; Improving the quality of life; Improving social connections; Boosting employability.
12. DO NOT LOWER YOUR FEE. INSTEAD PROVIDE MORE VALUE. – e.g. Take time to offer them a drink – coffee, tea, soda – before each session. After a tough session follow up with a “How are you doing?” phone call. Send birthday cards. Offer 10-minute free consultation between sessions. Offer half-hour sessions to make it more affordable.
13. IN YOUR MARKETING AND YOUR PRACTICE, MAKE IT ALL ABOUT YOUR AUDIENCE AND CLIENTS, NOT ABOUT YOU. It’s not about your training or your experience or your philosophy – it’s about how you can help people with their problems. Brochures, websites and marketing materials should convey this message.
14.CREATE TIPS SHEETS. Give them out to referral sources, and whenever you do a public presentation. The tips sheet will promote you as an expert on your topic. At the bottom, include your contact information, your website, and a tag line of how you help people – e.g., “Helping you discover and use your inner strengths, for a more meaningful life.”
Dr. Pauline Wallin
www.marketwithauthority.com
Dr. Jeff Zimmerman recommends:
15. STAY ON TOP OF COLLECTING FEES AND CO-PAYS AT THE TIME OF VISIT to avoid escalating accounts receivables and to improve cash flow.
16.EXPLORE INTEREST EARNING CHECKING ACCOUNTS and other similar vehicles to maximize on money earned from bank balances that are on hand.
17. MAKE SURE YOU ARE ACCURATELY TRACKING AUTHORIZATIONS and submitting OTRs accordingly to avoid nonreimbursed visits.
18. EXPLORE SHIFTING LONG DISTANCE PHONE SERVICE to a plan with a fixed monthly cost to reduce and fix costs.
19. CONSIDER NEW PRACTICE OPPORTUNITIES THAT INCREASE FEE-FOR-SERVICE billing at higher than managed-care rates
Dr. Jeff Zimmerman
JeffZimm123@gmail.com
Dr. Steve Walfish recommends:
20. STRUCTURE YOUR PRACTICE SO YOU HAVE MULTIPLE INCOME STREAMS. In this way referrals (e.g., income generated) are not dependent upon one source (or limited sources). The wonderful part of private practice is that money can be earned in a multitude of ways. For example, teaching as an Adjunct , supervision of paraprofessionals at an alcohol treatment center , or writing grants for a nonprofit. Do not put all of your eggs in one basket. All referral sources and all consultations end one day.
Dr. Steve Walfish
psychpubs@aol.com
Dr. Debbie Klingender recommends:
21. SEND LETTERS TO (OR CALL) YOUR DIRECT REFERRAL SOURCES (MDs or other therapists, for example) to thank them “out of the blue” for their referrals and for their confidence in you. Remind them that you have enjoyed working with the people they’ve sent your way and indicate that you are able to see new patients at this time.
22. WRITE SOME Q&A STYLE COPY THAT FOCUSES ON A PARTICULAR TYPE OF PROBLEM (e.g., “My doctor says the episodes I’ve been having are panic attacks. How can I make them stop?”) and offers information about how psychotherapy (or how a psychologist) can help with that problem. Even fairly sophisticated readers tend to view these kinds of ads as informative, rather than simply dismissing them as sales pitches.
23. DO A PRINT ADVERTISEMENT (or , better yet, a series of ads) for you local newspaper. Consider talking with the newspaper’s ad director to see whether they plan to produce any special ad sections, such as an “expert advice” page or a health care supplement. You may be able to negotiate a lower rate if the ad director can place multiple ads from allied professionals on one page or in a supplement
24. DIP A TOE IN THE WATERS OF PUBLIC EDUCATION by offering to give a short talk at a civic group meeting. Local Rotary clubs and organizations like the American Association of University Women host speakers at virtually all of their regular meetings. Think about doing a presentation that includes concrete tips for wellbeing that audience members can try immediately (e.g., lead them through a diaphragmatic breathing lesson, or do a brief demonstration of guided imagery to induce relaxation). If your listeners see you in action and experience even a small benefit during your presentation, you’ve just upped the odds that they (or someone they know) will call YOU when they’re looking for a therapist.
Dr. Debbie Klingender
www.wellspringpsych.com
Dr. Nancy Molitor recommends:
25. ACCEPT CREDIT CARDS for payment and run the cards at the end of each day (don’t wait to run cards at the end of each month when some patients will run short in their bank account or be over their limit on their card).Many patients will forget to bring their checkbook at times, almost always will they have a credit card in their wallet.
26. MAKE YOURSELF MORE AVAILABLE. Open up more evening hours or Saturday or Sunday times if necessary. The more flexible you are in scheduling, the more likely you are to secure that new referral and to retain the patients you currently have in practice.
27. JOIN A PSYCHOLOGIST NETWORKING GROUP in your area or start your own network if none is available. Networking not only provides a marketing opportunity for you and your practice, but it allows you to see your competition and to gauge unique gaps and opportunities for practice niches in your area. It’s also a good chance for social support during these tough times!
28. CONSIDER A NEW PRACTICE NICHE OR RETRAINING in a specialty area. Even though this may seem like a more complicated solution , it will yield more revenue for you in the long term. For example, practitioners who specialize with children and/or adolescents, are often the last group to feel the economic pinch .Parents will sacrifice to pay for their children’s treatment (often out of pocket) but will not feel the same way about paying for their own treatment out of pocket.
29. LEVERAGE THE CONTACTS YOU CURRENTLY HAVE IN DIVISION 42 and in your state association and other professional groups. Ask for advice or consultation on practice building or marketing. Write something for the IP, or your state association newsletter to highlight your clinical expertise and enhance your credibility. Volunteer to be part of a task force for 42 or in your state association. Such high profile tasks can result in referrals and in speaking engagements or other opportunities as other psychologists get to know and respect you.
30. THINK OF YOURSELF AS MORE THAN AN HOURLY WORKER. As long as you bill yourself by the hour or the procedure, your income is limited and more vulnerable in these tough economic times. Psychologists who think of themselves in broader roles- as consultants, thought leaders, educators, program planers, strategists or coaches, are more durable and less likely to suffer as much in a recession economy. This is true even if you choose to practice in a more traditional health care setting. The more we all think outside the box, and attempt to discover entirely new models of practice, the more likely we are to survive and thrive in these challenging economic times.
Dr. Nancy Molitor
NMolitor@aol.com
