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Graduate Students Contemplating Starting an Independent Practice: Reality or Fantasy?
Mike Gallardo, MA
Division 42 Student/New Professional Representative
As most graduate students progress through their training in
psychology, they soon begin to realize that a core component for many of them is
missing: How to start and successfully maintain an independent practice. Many
students get introduced to managed care as a reality and might become dismayed
by such a reality. For many students, without the proper knowledge and guidance,
the thought of private practice may become just a fantasy rather than a reality.
Division 42, APA’s Division of Independent Practitioners,
realized that many students were not properly prepared to graduate, become
licensed, and eventually begin an independent practice. APAGS and Division 42
recently collaborated to establish a mentoring listserv that is open to all
students and professionals wishing to be mentored into private practice (to
subscribe to the Mentors listserv, send a message with
the words "subscribe mentors" in the body of the message, without the
quotes). Some of the questions and issues discussed over this list include, but
are not limited to:
- What is the future of private practice?
- Should I do a post-doc or a psychological assistantship?
- How do I acquire an office and get referrals?
- Which insurance companies should I try to join, or should
I join any at all? Are their restrictions for psychologists who wish to
join managed care panels?
- What are the licensing laws? What are the appropriate
steps to take to become licensed?
- Are there informed consent and ethical guidelines that I
need to pay particular attention to in a private practice or if I’m on a
managed care panel?
- How does one obtain business knowledge necessary to
successfully run a private practice?
- What are the appropriate steps to take to become
licensed?
It seems that more and more students today are graduating
without the proper knowledge to begin an independent practice. There are also
many different perspectives about the feasibility and viability of having a
private practice, which can sometimes confuse students. If private practice is
something you want to pursue, or learn more about, joining Division 42 as a
student affiliate can help. For the past five years, Division 42 has focused on
strategies and resources to help practitioners thrive in practice without being
diminished by managed care. In fact, the division offers a variety of useful
pamphlets and educational videos regarding this topic. If you are interested in
learning more about Division 42, visit their Web site at: www.division42.apa.org.
Marketing Tips
Marketing oneself can be very a difficult task. Here are some
marketing tips that have been provided by psychologists over the Mentors
listserv. (Note: None of the tips offered below are
intended to constitute legal advice. Psychologists and those in training are
urged to consult with their attorney before entering into any form of contract
negotiation.)
- Build a reputation that demonstrates competence and
respect. This can be the most important aspect to maintaining a practice.
- Consider who your likely referrals might be. Once you can
identify referral sources and your consumer group, you can offer to provide
presentations/talks in the community to increase your exposure and build a
reputation as an expert in a particular area. One example might be to
provide in-services (trainings) to nursing home staff on how to identify
symptoms of depression or how to respond to aggressive patients (Of course,
some types of training should be provided by licensed psychologists and both
students and new psychologists preparing for independent practice must
ensure that any service they provide is delivered within their scope of
licensure and competence).
- Identify all of the possible settings in which you could
provide services and then begin tailored outreach efforts that are
setting-specific.
- Clearly identify and cultivate your niche or specialty
area. If you can identify yourself as someone who can provide services that
are needed or that no one else is currently providing, you will have a
strong starting point from which to build.
- Join an established full or part-time practice. Be cautious
when signing contracts. It is best to have your attorney read the contract
first. Remember, you can negotiate. You don’t have to accept the terms of
the contract as written. Working in a solo private practice can be very
isolating. However, working in a group practice keeps you connected to your
colleagues and it helps with ensuring that you are up-to-date regarding
practice issues, while reducing the likelihood of ethical violations that
can happen when one is isolated.
- Develop a business plan. Every plan should be
individualized and it should carefully outline the parameters of your
practice.
- Your private practice is a business. There are challenges
in maintaining an effective private practice when dealing with paperwork,
confidentiality, fee collecting, and staffing issues, while maintaining the
highest level of care.
- Join your local, state, and national psychological
associations. This is essential, because it connects you to the psychology
world at large, as well as your colleagues. This is probably the best way to
connect with professionals in the field. APAGS and your local and state
psychological associations help you develop your professional identity, as
well as provide guidance and resources about how to plan for your career.
- Joining managed care panels can be useful, particularly
when starting out. Division 42 offers valuable advice about doing this
without negating your goals. For example, consider offering a sliding fee
scale, obtain part time jobs while you build your practice, think about
opening an office in a rural or less populated area, and find ways to
broaden your practice to include testing evaluations, consulting, etc.
- Clearly identify your goals for a post-doctoral internship
or psychological assistantship. Decide what states you would like to become
licensed in, look at their hours requirements for licensure, and negotiate
your post-doctoral experiences accordingly. It can be very difficult to
obtain hours for licensure, so the earlier you start investigating
licensure, the better. Each state varies in the number of hours and time
required to obtain a license. Visit your state psychological association Web
site for information on how to contact the appropriate licensing board in
that state to learn about their licensure requirements.
There are innumerable issues to consider when prepare for and
obtaining licensure, as well as beginning a practice. It can become overwhelming
at times. My advice? Remember what originally attracted you to psychology and
wanting to practice, and make decisions accordingly. Apathy towards the field
and independent practice is an increasing feeling among some. However, I
encourage you to stay focused and reflect back to reasons that you chose this
field. Stay true to yourself and your goals. The opportunities are endless. If
you can identify what you want, you can get it. If you decide that you truly
want to practice independently, use Division 42 as a resource. They are eager to
mentor students and new psychologists because they remain passionate about
private practice and the members have been successful in maintaining their
practices.
This article first appeared in the Spring 2001 Edition of the APAGS
Newsletter, Vol. 13(2)
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