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How to Afford Your Private Practice:
Ways to Fund Starting Up and How to Keep It Going Strong
By Dr. Chris E. Stout and Grace Wang
Introduction
This chapter will examine the costs and approaches to meeting the expenses that are
involved in starting a private practice. Readers may be surprised in realizing what should be
considered in calculating the cost of doing business when opening and running a private practice.
Likewise, they may be surprised with the options available to them for paying off these expenses as
well.
Welcome to being an entrepreneur!
Many clinicians may not consider themselves entrepreneurs or small (or large) business
owners, but they are. Many healthcare providers may not have academic training or any prior
experience in business operations, management, budgeting, marketing, contracting, or the other
myriad of associated aspects of running a practice. But regardless of this, in order to be successful
and sustainable in their work of helping others, they will need to. And arguably, the most critical
aspect of establishing and running a practice is the financial.
Maintaining a practice is predicated on being able to earn as much as it costs to provide the
service(s), and maintaining a livelihood predicated on being able to make a profit. If a clinician
cannot breakeven vis-à-vis costs of operation and fees collected, he or she will go out of business at
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best, and bankrupt at worst. If a clinician cannot make a profit, then he or she will need another
form of income for financial support (via a spouse/partner, a trust-fund, a “day-job,” etc.).
What is it going to cost?
Herein the authors will assume that you have already passed your licensing exam to
practice. We strongly encourage readers to consider including any student loan indebtedness as
part of the expense-of-doing business in calculating your monthly costs. What follows is a list of
items to consider (Stout, 1996; Stout and Grand, 2004). Please note that the list is not necessarily
comprehensive and you should add additional items idiosyncratic to your practice’s need. List your
monthly costs as follows.
OFFICE SETUP
Rent (consider security deposit as additional costs at startup, but just list monthly): $__________
Utilities: $__________
Furnishings (divide startup cost by 12 months to calculate monthly amount,
maintain on ledger until paid in full): $__________
Telephone service and equipment: $__________
Answering service/system: $__________
Business stationery (divide by 12 months to calculate monthly amount): $__________
Office supplies (monthly average): $__________
Marketing costs: (estimate and divide by 12 months to calculate monthly amount): $__________
TECH
Computer (divide startup cost by 12 months to calculate monthly amount,
maintain on ledger until paid in full): $__________
Software (divide startup cost by 12 months to calculate monthly amount, maintain
on ledger until paid in full): $__________
Internet /Wi-Fi: $__________
Wireless phone: $__________
Website domain (divide startup cost by 12 months to calculate monthly amount): $__________
Web site design (divide startup cost by 12 months to calculate monthly amount,
maintain on ledger until paid in full): $__________
Web site hosting and maintenance: $__________
INSURANCES
Liability insurance (divide by 12 months to calculate monthly amount): $__________
Other insurance(s) (General liability, Fire, Disability, Health, Life, Renters, etc.,
divide by 12 months to calculate monthly amount):
OUTSIDE FEES
$__________
Attorney fees (divide startup cost by 12 months to calculate monthly amount,
maintain on ledger until paid in full): $__________
Annual incorporation fees (divide by 12 months to calculate monthly amount): $__________
Consultant fees (divide by 12 months to calculate monthly amount): $__________
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Accountant fees: (divide by 12 months to calculate monthly amount): $__________
Office expenses (e.g., photocopier lease, cleaning service, etc.): $__________
Secretarial services: $__________
Billing services: $__________
FEES OF THE PROFESSION
Professional dues (add all and divide by 12 months to calculate monthly amount): $__________
Books (estimate all and divide by 12 months to calculate monthly amount): $__________
License renewal costs (divide by 24 if you pay this every other year): $__________
Subscriptions (add all and divide by 12 months to calculate monthly amount): $__________
Continuing education (include parking, tuition/fees, travel expenses): $__________
Networking and business entertainment costs (estimate): $__________
Student Loan(s): $__________
DEDUCTIONS
State taxes (divide by 12 months to calculate monthly amount): $__________
Local taxes (divide by 12 months to calculate monthly amount): $__________
Federal (divide by 12 months to calculate monthly amount): $__________
Retirement funds (SEP, Roth IRA, etc.): (estimate and divide by 12 months to
calculate monthly amount): $__________
MISCELLANEOUS
Supervision: $__________
Commuting costs (Train, Parking, Tolls, Gas, Car payment, servicing, insurance): $__________
TOTAL: $__________
Note: This list does not include any expenses for political contributions, clinical materials (such a test kits,
forms, etc.), wireless phone handset cost, business application fees (such as “Doing Business As” (DBA) notice,
service marks, incorporation costs, etc.), or any other specialty equipment/materials (e.g., neuropsychological
test equipment, biofeedback equipment, etc.).
How do I compare…?
The authors thought it may be of interest for readers to see how your expenses compare to
a small, unscientific poll of practitioners from around the United States. We sent out a quick
survey to the List Serves of the American Psychological Association’s Division 42 (Independent
Practice), the Illinois Psychological Association, and some practitioners one of the authors (CES)
knew. Twenty individuals responded.
We found that expenses varied dramatically from practice to practice. For instance, a
suburban home practice or an urban practice that shares a building with other businesses can
significantly cut down on rent costs. On the other hand, a practitioner in the city may choose to
pay more for rent, so long as amenities like quality library access, internet access, secretarial
services, mail service, a faculty lounge, or office machinery are included in the cost. Some
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practitioners strike up creative rent agreements – for instance, one respondent pays $15/hour for
rent, only pays for the sessions she has, and agrees to pay $50/month if no sessions are scheduled.
In addition, over half of the respondents said that utilities like heat, electric, and water are
included in rent.
Phone costs also varied considerably. Some practitioners use their personal cell phones and
attribute half of its cost to the business. Others use a free Google voice number and have calls
forwarded to their personal cell phone. More costly options include a combination of separate
phone lines, multiple landlines (up to four or five), private voicemail, and answering services.
While over half of respondents do not have employees or contractors to factor into their
budget, some practitioners choose to hire bookkeepers, technicians, secretaries, or additional
clinicians. The cost of these workers could be as low as $2400/year or as high as $30,000/year.
Other costs include software, office supplies, marketing, parking or transit, training, testing
materials, subscriptions, website maintenance, and donations.
Any surprises? Those responding were primarily from the Midwest and in suburban and/or
urban locations, so rents and the like will certainly co-vary as a function of that. The average
number of years in private practice was about 19, ranging from less than one year to 35 years. The
mean length of time in practice of this group was 15.5 years, ranging from one year to about 35
years. More on this group’s experiences below, but let’s return to your costs of practice.
Do the Math: Is Your Business Viable?
Next, calculate the sum of the above applicable items. This total will be your Practice Costs,
or PC. Use these formulas to calculate your Hourly Cost. Note, this is the COST of doing
business, not what your fee or cost to your patients is.
(X clinical service hours) x (Y number of weeks worked annually) = Total Annual Hours
Worked
For example, (30 hours worked per week) x (48 weeks) = 1440
Next, (Total Annual Hours Worked) x (80% [based on -20% for bad debt, missed sessions,
etc.]) = Total Billable Annual Hours
For example, 1440 x 80% = 1152
So, (Practice Costs)/(Total Billable Annual Hours) = Hourly Cost
Hypothetically, if PC = $95,000, then $95,000/1152 = $82.47/hour. Thus, in this case, it
costs $82.47/hour to deliver that hour of therapy. In other words, assuming you have annual
practice costs of $ 95,000 and you plan to work 30 clinical hours per week for 48 weeks per year
(figuring four total weeks of vacation). In this hypothetical that would be 1440 billable hours
worked, minus 20% for bad debt, missed sessions, etc., equals 1152 revenue generating hours
annually. This suggests that roughly to cover your annual costs, you need to generate at least
$82.47/hour. If you add a modest 5% profit margin it becomes $86.59/hour, or $90.74/hour for
a 10% profit margin.
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Of course, adding more hours worked (either more hours per week or more weeks per year)
can reduce the Hourly Cost figure, or could perhaps allow for a greater margin of profit. In better
understanding the relationship of cost and productivity, one can more clearly understand how
those with busy practices, low practice costs, and sufficient fees can do very well, versus those with
high overhead costs, few service hours, or anemic payments.
So how do you finance your startup practice?
There are a number of options available, but perhaps not all are a good fit and, frankly, not
all may be available, as one colleague noted regarding her experience in the early 1990s:
“I tried to get a small business loan but was told that I didn’t have established credit as a business,
although… had an LLC, a license, a registered name, colleagues that I shared an office with who
could vouch for me, and established income. My understanding at the time was that I couldn’t get the
loan because I was a ‘woman’ just starting out in practice. That’s what the loan officer told me.”
From our sample of respondents, we learned that they initially financed their practice’s startup by:
Personal savings 78 %
Combination of personal savings and credit card 11 %
Equity from a whole life insurance policy that had been given to me when I got
married, that I repaid within a year.
5.5 %
Loan from family member 5.5 %
We also asked if there were any expenses that were a surprise. We found that a few
unexpected costs were licensing and credentialing (if you hire a company to do it for you),
continuing education, computers and software, toys and books, lack of corresponding revenue
increases due to managed care, accounting services and tax preparation, commercial enterprise
pricing (as opposed to residential pricing), and furniture costs, which can be as much as $2000.
The group also individually identified their greatest difficulty in getting their practice
started. Interestingly, the majority of respondents noted that getting clients and a steady referral
base was their most difficult hurdle in getting started, but others said that it was finding office
space, creating a business plan/infrastructure, charging clients and collecting fees, dealing with the
anxiety of leaving what’s familiar to start something new, and even patience (and boredom!) when
dealing with the growing process.
Our last question was to learn, if they could go back in time to when they first started their
private practice, what would they do differently? Several said that they would invest in marketing
by developing a niche, advertising in Psychology Today, being involved in the community, and
creating a website immediately. Others focused on networking and recommended collaborating
with other professionals, finding quality partners with good business sense and an entrepreneurial
spirit, or asking a friend for guidance through the process. Still others emphasized the business
aspect of the practice and said that they would hire a manager, learn about accounting or when to
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pay themselves, spend less time trying to get referrals from physicians, and adjust as the industry
adjusts. More advice focused on cost-savings, and the respondents said they would have liked to
have known that cell phone bills are tax-deductible, to join a cost-sharing group, to buy more
affordable furniture, or to opt for a smaller office where rent is cheaper.
Where to get money to start your practice
There are many sources of capital available, from banks, to life insurance
companies to even crowdfunding. Each source has its advantages and some are better
suited to specific financing needs than others. You should assess your options to choose
the most appropriate financing source that you can qualify for and feel most comfortable
with. What follows are some avenues to consider.
Loans (Debt Financing)
There are several types of institutions that provide debt financing (i.e., they loan you
money and you are obliged to repay it, with interest). These include:
1. Commercial banks
2. Leasing companies
3. Thrift institutions
4. Life insurance companies
5. Commercial finance companies
6. Other sources (loans from relatives, SBA, crowdfunding, etc.)
1. Commercial Banks. Short-term credit from commercial banks is an extremely popular source of
financing for all types of businesses, including mental health practices. In recent years, some banks
have set up professional divisions with personal bankers who are experienced in meeting the needs
of healthcare providers.
Bank borrowing may be the least expensive source of debt financing for secured and
unsecured working capital loans, equipment loans, and real estate loans. A practice may develop a
relationship with a local commercial bank that assists in the practice's financial planning process.
Larger, group practices may fare better with qualifying for such a loan.
Short-term loans offered by commercial banks have several unique characteristics.
• They are usually extended for a period of 90 days or less and may be secured or unsecured,
depending on the amount of risk the bank faces.
• When a bank loan is secured, the lender normally executes a security agreement in which
the practice pledges a certain business asset as collateral.
• A practice may pledge is its accounts receivable (billings to clients and third-party payers for
services rendered but not yet collected) as an asset. The amount in accounts receivable is an
asset that represents money owed to the practice.
• A commercial bank may also require your personal guarantee based on your personal assets.
• If the practice does not pledge any collateral against the loan, the bank may extend the loan
on the practice's full faith and credit.
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2. Leasing Companies. Leasing has become an increasingly popular source of debt financing.
Almost any type of property can be leased:
• Computer systems
• Equipment
• Furniture
• Office space
As an alternative to normal debt financing, leasing offers you greater flexibility and
convenience because the lessor (the institution, usually the bank, holding the lease) takes on some
of the responsibilities of ownership, including maintenance and disposal. If you are reluctant to
borrow, leasing can be an attractive alternative. The interest rate on the lease will most likely be
somewhat higher than a loan extended by a commercial bank because the lessor assumes greater
responsibility. Commercial banks and financial services companies are among the institutions that
offer lease arrangements.
3. Thrift Institutions. Thrift institutions include savings and loan associations, mutual savings
banks, and credit unions. These institutions have traditionally been a source of debt financing for
borrowers purchasing homes or durable goods. These organizations were deregulated in 1982 and
have become an alternative way to finance professional practices, office buildings and equipment.
Practices seeking debt financing from thrift institutions can expect an environment and terms
similar to those of commercial banks.
Thrift institutions offer a wide range of services, such as:
• Leasing
• Credit cards
• Electronic funds transfer
• Commercial lending
4. Life Insurance Companies. Life insurance companies offer limited financing to healthcare
practices in the form of secured real estate loans. Some healthcare buildings are financed by
mortgage loans granted by insurance companies. Low-cost loans are also available from life insurers
based on the cash value of a provider's life insurance policies.
5. Commercial Finance Companies. These are an alternative source for borrowers with high-risk
credit ratings. These companies generally finance credit sales as well as provide funds for short-
term purposes. They borrow large sums from investors and bankers and then lend them directly to
businesses. As a result, their interest rates will almost always be higher than banks, thrift
institutions, and life insurance companies; and the terms of the loan reflect the borrower's risky
credit rating. Examples of these terms would be:
• Minimum cash balance requirements
• Collateral requirements, including personal assets
• Remedies for the finance company in the event of default
Commercial finance companies also provide other services, such as financing and factoring
accounts receivable. Because your accounts receivable can be fairly accurately valued and are
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usually easily converted to cash, they are suitable assets to pledge. As accounts receivable are
collected, the indebtedness is reduced. When the full value of the receivable is not pledged,
collections made in excess of the borrowed amount are returned to the practice.
Receivables may actually be sold to a financial institution. Commercial finance institutions
prefer the sale be made "with recourse," meaning the risk of the account remains with the practice.
If the accounts receivable are purchased from the practice without recourse, the process is called
factoring. When a lending institution factors receivables, it assumes the credit risk and the service
is more expensive to the practice. Usually, a factor charges a performance commission on invoice
amounts and interest at a 3% to 4% increase over the prime lending rate.
The advantages of receivables financing are obtaining funds quickly and having a more
rapid cash flow. Factoring shifts the risk and inconvenience of credit collection to the factor, but
both these practices are costly and may make the practice appear to be financially unsound and
risky. Selling receivables is not advised unless you are making a large one-time repayment such as
an IRS bill or working out a plan to recover from a not-too-fun catastrophic event such as a natural
disaster. Providers who sell their receivables to cover monthly operating expenses are borrowing
against their own future. It is like borrowing against next month's paycheck to pay this month's
bills.
Once you have selected a bank, consider consolidating all accounts, including personal,
business, savings, and pension accounts. By increasing the volume of business you offer the bank,
you will increase in importance from the bank's perspective. This may result in preferential
treatment for services or more favorable loan terms. Establishing a strong relationship and staying
with a bank that provides superior service may be a valuable resource for you and your practice.
6. Other sources
Credit cards
Some of those in our survey noted running up a tab on their credit cards. This high risk
and high interest cost, and is not recommended.
Family/Friends Loan
This can also be risk-laden and may run the risk of damaging important relationships if
payments are late, or unexpected difficulties arise. If this route is chosen, it may be a wise idea to
have a clearly articulated contract drawn up and certainty that both parties very clearly understand
and agree to the terms before executing it.
Small Business Administration Loan
An often overlooked route for finding a loan is to go through the U.S. Small Business
Administration (SBA). The SBA offers a variety of loans, including a general loan and an
equipment/real estate loan, both of which are available to medical facilities like hospitals and
clinics.
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For example, Dr. Steven Solomon of La Jolla, CA, provides intimacy therapy services to
couples. He applied for an SBA 7(a) loan and was approved for $100,000.00. He used the funds
for computers, equipment, and training (U.S. Department of Commerce, n.d.).
Crowdfunding
Some mental health providers who want to start their own private practice have turned to
more modern routes to obtain financial assistance. Within the past decade, crowdfunding has
increased in popularity. While a private practice is the typical crowdfunding benefactor, we found
that individual providers have raised as much as $4,000 using crowdsourcing websites. It seems
mental health providers tend to use gofundme.com as their crowdfunding website as opposed to
others, such as indiegogo.com or kickstarter.com.
For example, a Marriage and Family Therapist in California with a goal of raising $6,842,
has raised $950 in six months to go toward her private practice that would aim to serve veterans
and their families. She specifies that donations would go to rent, a computer and a printer, and
telephone service for six months. A mental health therapist in Bellevue, WA, has raised $1,299 of
$7,000 in 14 months. She wants to help members of the LGBTQ community and she indicates
that donations will go to licensing costs, business cards, office space, professional organization fees,
a website, insurance, and a business license. She wants to raise enough funds to cover expenses for
six months as she builds her client base.
A professional counselor in Brainerd, MN raised $1,230 of $2,700 in 16 months. Her goal
is to start a private practice to help people experiencing anger, anxiety, and depression, among
other things. She also offered counseling sessions to donors as a “perk” or a “thank-you” for their
assistance. A psychotherapist in Portland, OR who had already begun her private practice, raised
$675 of $2,000 in 14 months. Her goal was to pay off expenses like overhead costs and student
loans as she continues to build a client base. Finally, a counselor in Guaynabo, Puerto Rico raised
$4,300 of $5,000 in eight months. Her goal was twofold: to help people recover from trauma and
to mentor students, graduates, and professionals in order to raise the standards in that geographic
area for the profession.
How lenders evaluate borrowers
Lenders make decisions about loans based on their knowledge of the borrower and the
business. You will make a positive impression on the lending officer with a well-prepared and
complete set of informational documents. The principal document used to indicate your
creditworthiness is the business plan. (Websites such as BizHumm offer free templates:
http://bizhumm.com/dashboard/library/ )
Another key factor in the loan process is the lender’s impression of your credibility. The
lender gains this perception from face-to-face contact with you (and your associates if you have
them) and with the information provided to support the loan request. If you are borrowing funds
for the first time, you can expect to provide more information to the loan officer than if you have a
credit history with the bank.
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Once you have established credibility, you must work to maintain it. You must continue to
produce results that are consistent with your business plan objectives and financial projections. If
you repeatedly return to the lender for expenses that were not properly considered in the business
plan, you will decrease your chances of getting favorable terms.
When this author (GW) investigated Bank of America’s small business healthcare loans,
doctoral-level psychologists, licensed clinical social workers, and licensed clinical professional
counselors are not eligible for this loan—only MDs. Furthermore, CitiBank also has a loan for
healthcare professionals starting their own practice, but it is currently geared toward physicians. Of
course, if you are a MD, this would not be a problem. If you are not, a strategic approach may be
to partner with a MD. But such an approach must be considered in a context of other practice
aspects, not solely for access to debt financing.
Key information for loan applications
Lenders consider three essential items when deciding whether to lend money:
1. How will the funds be used?
2. How much money is needed?
3. How will the money be repaid?
The data needed to answer those questions will depend on several things:
1. Your previous relationship with the bank
2. The purpose of the loan
3. The amount of the loan
4. The percentage of total expenditure being sought (for example, a practice borrowing $5,000
to purchase office furniture valued at $15,000 is borrowing only 33% of the total
expenditure, which will be more favorably considered than a loan request of $12,000 for
the same purpose).
Different banks require different levels of detail. For example, if a sole practitioner or a
group with less than three providers applies for a loan at a local bank, the lender may rely more on
personal financial information than on the practice's operating information. On the other hand, if
a large practice is financing real estate or a series of capital projects, the institution may require a
projected or pro forma* financial statement showing the capability of the practice's operations and
ability to repay the debt. Therefore, it is important to have as much information as possible going
into the process.
1. How the funds will be used. You may want to borrow funds to finance start-up or expansion.
When you are starting or expanding a practice, you may need money for working capital, to
purchase equipment, and to pay for improvements to the office. The lender needs to know how
the funds will be used so the bank can obtain a security interest if property and equipment are
being acquired. If the funds are to be used for working capital, the bank will require some other
form of payment assurance. Knowing how the funds will be used also helps determine the interest
rate and term of the loan. For example, the term of a loan to purchase a computer system would
probably equal the useful life of the equipment.
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2. How much money is needed. The size of the loan depends on several factors.
a. Determine the total planned expenditures and the amount that will be financed. This
relates to the planning process as discussed earlier. You may invest some of your own funds
and borrow only a portion of the total.
b. Include the expenditures in the business plan developed to support the loan application.
This pro forma business plan shows your future needs as well as the level of debt you can
repay.
c. The bank must understand how the loan relates to your strategic plan. For example, if
you are adding providers and need $100,000 to expand, will that amount be used for
working capital and improvements? Will another loan be required for related issues? You
may find it easier to repay excess funds than to obtain additional funding if the size of the
first loan is insufficient.
3. How the loan will be repaid. You will be expected to demonstrate to the bank your ability to
repay the loan. The main evidence is your business plan, which illustrates the ability to repay the
debt from projected income in excess of expenses. You may also need a contingency plan showing
what steps you would take if the financial projections proved incorrect. The contingency plan may
indicate a source of repayment other than practice income, such as a guarantee based on your
personal assets. (Portions of the last section of this chapter have been adapted from Stout &
Grand (2004), with permission from the publisher, Wiley & Sons).
Conclusion
Healthcare providers who want to start a private practice are not just clinicians. They are
entrepreneurs. As such, they must consider the details of business management. They can no
longer merely be occupied with the question, “Will my patient recover?” Rather, they must also
consider, “Will my business succeed so that my patient can recover?”As you mull over the
beginnings of your private practice, calculate your expenses, and explore your options for paying
them off, remember that this chapter is only the beginning of the resources available to you.
References
Stout, C. E. (1996). What Should Psychotherapy Cost? Illinois Psychologist, Spring, 24 - 26.
Stout, C.E. and Grand, L. (2004). Getting started in private practice. New York: John Wiley &
Sons.
U.S. Department of Commerce. Small Business Administration. (n.d.). SBA loan keeps couples
together (n.d.). Retrieved from https://www.sba.gov/offices/district/ca/san-diego/success-
stories/sba-loan-keeps-couples-together
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How Does It Work?
I have a model that I have found over the years works pretty
well and efficiently. You may already know that I was invited by the
President of the American Psychological Association to serve on the
APA Task Force on Future Roles of Psychologists and published a
number of articles on the topic and that this area was a major focus
when I served as President of the Illinois Psychological Association.
You may already be familiar with my
books, Getting Started in Private Practice
(Wiley, 2006),
http://www.amazon.com/Getting-Started-Private-Practice-
Complete/dp/0471426237/ref=la_B003MROVZ8_1_1?s=bo
oks&ie=UTF8&qid=1387499433&sr=1-1
and Getting Better at Private Practice
(Wiley, 2012) http://www.amazon.com/Getting-
Better-Private-Practice-
Started/dp/0470903988/ref=la_B003MROVZ8_1_4_tit
le_1_pap?s=books&ie=UTF8&qid=1387566503&sr=1-4
along with a number of books on practice
and related issues:
http://www.amazon.com/Chris-E.-
Stout/e/B003MROVZ8
And I have a number of PPTs up on practice matters
as I present a fair amount, too. Here is a sample, but do feel
free to drill around as well:
http://www.slideshare.net/drchrisstout1/dr-chris-stout-
getting-better-at-private-practice
13
Curated Library
Wouldn’t it be great if…
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emails, most of which are not helpful…but still be able to stay on top of
what’s going on and important to you?
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If you are interested in gaining access to the Curated Library you will find an
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dozen newsfeeds and publications where I collect the best content I come across that is relevant to
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development.
The result is that you can have access to an ever-updating-obsolete-proof online library. It doesn’t
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 Social media tools
 Start-up help
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 Website tools
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A one year All-Access Pass Subscription is $75, or a One-Time Life-Time Subscription is $150.
Just send an email with your request to DrChrisStout@gmail.com and you’ll receive the PayPal
instructions and your “Library Card” for immediate access. You have a 30 day, money back
guarantee if you are not satisfied with your Subscription for any reason.
Membership
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I am now offering a new option that may be of interest. For a single, onetime charge of
$650 you can have one 60-minute 1:1 consultation, and up to 12 email exchanges over the course
of a year’s time as a Professional Member.
In addition you will have a
one-year subscription to access the
Curated Library’s materials, 24/7,
that will provide you with all the tools
and information to advance your
knowledge, practice, and career—at no
additional cost. Members will also get
access to free links for:
 Business Plan Templates and
Checklists
 Marketing Plan Templates and
Checklists
 Social Media Training &
Software
 Essential SEO Tools
 Financial Projections
Template
 Essentials for Cloud-based
Services
1:1 Consultation
I have a limited number of slots available at any given point in time for individualized
consultation. Generally I meet with someone 3 - 8 times depending on your needs and goals, on a
once-every-2-or-3-week schedule. The meetings can be via the phone or at my Bolingbrook office.
All meetings are 60 minutes long. I tend to be very directive, network connecting, content heavy,
and task oriented (but not at the cost of being supportive, and if I can, a dash of humor when I
can muster it). Frequently, I will work in between our meetings compiling tools, readings and
resources relevant to your needs that I will email to you.
Charges are $425 for the first meeting and $375 for the subsequent ones. A single
payment for 6 sessions is discounted 10% for $2400. Please directly be in touch via
DrChrisStout@gmail.com
15
My Clients also have the opportunity to gain an introduction to doing
their own consulting through Maven and GLG
How would you like to
 Expand Your Consulting
Opportunities?
 Earn consulting fees of $150
and more, generally via
telephone consultations?
 Educate business and
investment leaders”
 Network with global leaders?
 Participate at your
convenience?
I can make a personal referral to GLG
which provides:
 11,000+ consultations each
month
 35,000+ GLG News posts
authored by Council
Members
 60,000+ paid survey
respondents
 Be confident of privacy and
integrity
 850+ client firms worldwide
And I can also recommend you to
Maven
16
Join the list of organizations and individuals I have worked with…
17
Free content is always available at
SlideShare
http://www.slideshare.net/drchrisstout1
and LinkedIn
https://www.linkedin.com/today/posts/drc
hrisstout
Courses
Coming soon…!
And finally…
https://youtu.be/jITlVpJUaN0

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How to afford your private practice ways to fund starting up and how to keep it going strong

  • 1. 1 How to Afford Your Private Practice: Ways to Fund Starting Up and How to Keep It Going Strong By Dr. Chris E. Stout and Grace Wang Introduction This chapter will examine the costs and approaches to meeting the expenses that are involved in starting a private practice. Readers may be surprised in realizing what should be considered in calculating the cost of doing business when opening and running a private practice. Likewise, they may be surprised with the options available to them for paying off these expenses as well. Welcome to being an entrepreneur! Many clinicians may not consider themselves entrepreneurs or small (or large) business owners, but they are. Many healthcare providers may not have academic training or any prior experience in business operations, management, budgeting, marketing, contracting, or the other myriad of associated aspects of running a practice. But regardless of this, in order to be successful and sustainable in their work of helping others, they will need to. And arguably, the most critical aspect of establishing and running a practice is the financial. Maintaining a practice is predicated on being able to earn as much as it costs to provide the service(s), and maintaining a livelihood predicated on being able to make a profit. If a clinician cannot breakeven vis-à-vis costs of operation and fees collected, he or she will go out of business at
  • 2. 2 best, and bankrupt at worst. If a clinician cannot make a profit, then he or she will need another form of income for financial support (via a spouse/partner, a trust-fund, a “day-job,” etc.). What is it going to cost? Herein the authors will assume that you have already passed your licensing exam to practice. We strongly encourage readers to consider including any student loan indebtedness as part of the expense-of-doing business in calculating your monthly costs. What follows is a list of items to consider (Stout, 1996; Stout and Grand, 2004). Please note that the list is not necessarily comprehensive and you should add additional items idiosyncratic to your practice’s need. List your monthly costs as follows. OFFICE SETUP Rent (consider security deposit as additional costs at startup, but just list monthly): $__________ Utilities: $__________ Furnishings (divide startup cost by 12 months to calculate monthly amount, maintain on ledger until paid in full): $__________ Telephone service and equipment: $__________ Answering service/system: $__________ Business stationery (divide by 12 months to calculate monthly amount): $__________ Office supplies (monthly average): $__________ Marketing costs: (estimate and divide by 12 months to calculate monthly amount): $__________ TECH Computer (divide startup cost by 12 months to calculate monthly amount, maintain on ledger until paid in full): $__________ Software (divide startup cost by 12 months to calculate monthly amount, maintain on ledger until paid in full): $__________ Internet /Wi-Fi: $__________ Wireless phone: $__________ Website domain (divide startup cost by 12 months to calculate monthly amount): $__________ Web site design (divide startup cost by 12 months to calculate monthly amount, maintain on ledger until paid in full): $__________ Web site hosting and maintenance: $__________ INSURANCES Liability insurance (divide by 12 months to calculate monthly amount): $__________ Other insurance(s) (General liability, Fire, Disability, Health, Life, Renters, etc., divide by 12 months to calculate monthly amount): OUTSIDE FEES $__________ Attorney fees (divide startup cost by 12 months to calculate monthly amount, maintain on ledger until paid in full): $__________ Annual incorporation fees (divide by 12 months to calculate monthly amount): $__________ Consultant fees (divide by 12 months to calculate monthly amount): $__________
  • 3. 3 Accountant fees: (divide by 12 months to calculate monthly amount): $__________ Office expenses (e.g., photocopier lease, cleaning service, etc.): $__________ Secretarial services: $__________ Billing services: $__________ FEES OF THE PROFESSION Professional dues (add all and divide by 12 months to calculate monthly amount): $__________ Books (estimate all and divide by 12 months to calculate monthly amount): $__________ License renewal costs (divide by 24 if you pay this every other year): $__________ Subscriptions (add all and divide by 12 months to calculate monthly amount): $__________ Continuing education (include parking, tuition/fees, travel expenses): $__________ Networking and business entertainment costs (estimate): $__________ Student Loan(s): $__________ DEDUCTIONS State taxes (divide by 12 months to calculate monthly amount): $__________ Local taxes (divide by 12 months to calculate monthly amount): $__________ Federal (divide by 12 months to calculate monthly amount): $__________ Retirement funds (SEP, Roth IRA, etc.): (estimate and divide by 12 months to calculate monthly amount): $__________ MISCELLANEOUS Supervision: $__________ Commuting costs (Train, Parking, Tolls, Gas, Car payment, servicing, insurance): $__________ TOTAL: $__________ Note: This list does not include any expenses for political contributions, clinical materials (such a test kits, forms, etc.), wireless phone handset cost, business application fees (such as “Doing Business As” (DBA) notice, service marks, incorporation costs, etc.), or any other specialty equipment/materials (e.g., neuropsychological test equipment, biofeedback equipment, etc.). How do I compare…? The authors thought it may be of interest for readers to see how your expenses compare to a small, unscientific poll of practitioners from around the United States. We sent out a quick survey to the List Serves of the American Psychological Association’s Division 42 (Independent Practice), the Illinois Psychological Association, and some practitioners one of the authors (CES) knew. Twenty individuals responded. We found that expenses varied dramatically from practice to practice. For instance, a suburban home practice or an urban practice that shares a building with other businesses can significantly cut down on rent costs. On the other hand, a practitioner in the city may choose to pay more for rent, so long as amenities like quality library access, internet access, secretarial services, mail service, a faculty lounge, or office machinery are included in the cost. Some
  • 4. 4 practitioners strike up creative rent agreements – for instance, one respondent pays $15/hour for rent, only pays for the sessions she has, and agrees to pay $50/month if no sessions are scheduled. In addition, over half of the respondents said that utilities like heat, electric, and water are included in rent. Phone costs also varied considerably. Some practitioners use their personal cell phones and attribute half of its cost to the business. Others use a free Google voice number and have calls forwarded to their personal cell phone. More costly options include a combination of separate phone lines, multiple landlines (up to four or five), private voicemail, and answering services. While over half of respondents do not have employees or contractors to factor into their budget, some practitioners choose to hire bookkeepers, technicians, secretaries, or additional clinicians. The cost of these workers could be as low as $2400/year or as high as $30,000/year. Other costs include software, office supplies, marketing, parking or transit, training, testing materials, subscriptions, website maintenance, and donations. Any surprises? Those responding were primarily from the Midwest and in suburban and/or urban locations, so rents and the like will certainly co-vary as a function of that. The average number of years in private practice was about 19, ranging from less than one year to 35 years. The mean length of time in practice of this group was 15.5 years, ranging from one year to about 35 years. More on this group’s experiences below, but let’s return to your costs of practice. Do the Math: Is Your Business Viable? Next, calculate the sum of the above applicable items. This total will be your Practice Costs, or PC. Use these formulas to calculate your Hourly Cost. Note, this is the COST of doing business, not what your fee or cost to your patients is. (X clinical service hours) x (Y number of weeks worked annually) = Total Annual Hours Worked For example, (30 hours worked per week) x (48 weeks) = 1440 Next, (Total Annual Hours Worked) x (80% [based on -20% for bad debt, missed sessions, etc.]) = Total Billable Annual Hours For example, 1440 x 80% = 1152 So, (Practice Costs)/(Total Billable Annual Hours) = Hourly Cost Hypothetically, if PC = $95,000, then $95,000/1152 = $82.47/hour. Thus, in this case, it costs $82.47/hour to deliver that hour of therapy. In other words, assuming you have annual practice costs of $ 95,000 and you plan to work 30 clinical hours per week for 48 weeks per year (figuring four total weeks of vacation). In this hypothetical that would be 1440 billable hours worked, minus 20% for bad debt, missed sessions, etc., equals 1152 revenue generating hours annually. This suggests that roughly to cover your annual costs, you need to generate at least $82.47/hour. If you add a modest 5% profit margin it becomes $86.59/hour, or $90.74/hour for a 10% profit margin.
  • 5. 5 Of course, adding more hours worked (either more hours per week or more weeks per year) can reduce the Hourly Cost figure, or could perhaps allow for a greater margin of profit. In better understanding the relationship of cost and productivity, one can more clearly understand how those with busy practices, low practice costs, and sufficient fees can do very well, versus those with high overhead costs, few service hours, or anemic payments. So how do you finance your startup practice? There are a number of options available, but perhaps not all are a good fit and, frankly, not all may be available, as one colleague noted regarding her experience in the early 1990s: “I tried to get a small business loan but was told that I didn’t have established credit as a business, although… had an LLC, a license, a registered name, colleagues that I shared an office with who could vouch for me, and established income. My understanding at the time was that I couldn’t get the loan because I was a ‘woman’ just starting out in practice. That’s what the loan officer told me.” From our sample of respondents, we learned that they initially financed their practice’s startup by: Personal savings 78 % Combination of personal savings and credit card 11 % Equity from a whole life insurance policy that had been given to me when I got married, that I repaid within a year. 5.5 % Loan from family member 5.5 % We also asked if there were any expenses that were a surprise. We found that a few unexpected costs were licensing and credentialing (if you hire a company to do it for you), continuing education, computers and software, toys and books, lack of corresponding revenue increases due to managed care, accounting services and tax preparation, commercial enterprise pricing (as opposed to residential pricing), and furniture costs, which can be as much as $2000. The group also individually identified their greatest difficulty in getting their practice started. Interestingly, the majority of respondents noted that getting clients and a steady referral base was their most difficult hurdle in getting started, but others said that it was finding office space, creating a business plan/infrastructure, charging clients and collecting fees, dealing with the anxiety of leaving what’s familiar to start something new, and even patience (and boredom!) when dealing with the growing process. Our last question was to learn, if they could go back in time to when they first started their private practice, what would they do differently? Several said that they would invest in marketing by developing a niche, advertising in Psychology Today, being involved in the community, and creating a website immediately. Others focused on networking and recommended collaborating with other professionals, finding quality partners with good business sense and an entrepreneurial spirit, or asking a friend for guidance through the process. Still others emphasized the business aspect of the practice and said that they would hire a manager, learn about accounting or when to
  • 6. 6 pay themselves, spend less time trying to get referrals from physicians, and adjust as the industry adjusts. More advice focused on cost-savings, and the respondents said they would have liked to have known that cell phone bills are tax-deductible, to join a cost-sharing group, to buy more affordable furniture, or to opt for a smaller office where rent is cheaper. Where to get money to start your practice There are many sources of capital available, from banks, to life insurance companies to even crowdfunding. Each source has its advantages and some are better suited to specific financing needs than others. You should assess your options to choose the most appropriate financing source that you can qualify for and feel most comfortable with. What follows are some avenues to consider. Loans (Debt Financing) There are several types of institutions that provide debt financing (i.e., they loan you money and you are obliged to repay it, with interest). These include: 1. Commercial banks 2. Leasing companies 3. Thrift institutions 4. Life insurance companies 5. Commercial finance companies 6. Other sources (loans from relatives, SBA, crowdfunding, etc.) 1. Commercial Banks. Short-term credit from commercial banks is an extremely popular source of financing for all types of businesses, including mental health practices. In recent years, some banks have set up professional divisions with personal bankers who are experienced in meeting the needs of healthcare providers. Bank borrowing may be the least expensive source of debt financing for secured and unsecured working capital loans, equipment loans, and real estate loans. A practice may develop a relationship with a local commercial bank that assists in the practice's financial planning process. Larger, group practices may fare better with qualifying for such a loan. Short-term loans offered by commercial banks have several unique characteristics. • They are usually extended for a period of 90 days or less and may be secured or unsecured, depending on the amount of risk the bank faces. • When a bank loan is secured, the lender normally executes a security agreement in which the practice pledges a certain business asset as collateral. • A practice may pledge is its accounts receivable (billings to clients and third-party payers for services rendered but not yet collected) as an asset. The amount in accounts receivable is an asset that represents money owed to the practice. • A commercial bank may also require your personal guarantee based on your personal assets. • If the practice does not pledge any collateral against the loan, the bank may extend the loan on the practice's full faith and credit.
  • 7. 7 2. Leasing Companies. Leasing has become an increasingly popular source of debt financing. Almost any type of property can be leased: • Computer systems • Equipment • Furniture • Office space As an alternative to normal debt financing, leasing offers you greater flexibility and convenience because the lessor (the institution, usually the bank, holding the lease) takes on some of the responsibilities of ownership, including maintenance and disposal. If you are reluctant to borrow, leasing can be an attractive alternative. The interest rate on the lease will most likely be somewhat higher than a loan extended by a commercial bank because the lessor assumes greater responsibility. Commercial banks and financial services companies are among the institutions that offer lease arrangements. 3. Thrift Institutions. Thrift institutions include savings and loan associations, mutual savings banks, and credit unions. These institutions have traditionally been a source of debt financing for borrowers purchasing homes or durable goods. These organizations were deregulated in 1982 and have become an alternative way to finance professional practices, office buildings and equipment. Practices seeking debt financing from thrift institutions can expect an environment and terms similar to those of commercial banks. Thrift institutions offer a wide range of services, such as: • Leasing • Credit cards • Electronic funds transfer • Commercial lending 4. Life Insurance Companies. Life insurance companies offer limited financing to healthcare practices in the form of secured real estate loans. Some healthcare buildings are financed by mortgage loans granted by insurance companies. Low-cost loans are also available from life insurers based on the cash value of a provider's life insurance policies. 5. Commercial Finance Companies. These are an alternative source for borrowers with high-risk credit ratings. These companies generally finance credit sales as well as provide funds for short- term purposes. They borrow large sums from investors and bankers and then lend them directly to businesses. As a result, their interest rates will almost always be higher than banks, thrift institutions, and life insurance companies; and the terms of the loan reflect the borrower's risky credit rating. Examples of these terms would be: • Minimum cash balance requirements • Collateral requirements, including personal assets • Remedies for the finance company in the event of default Commercial finance companies also provide other services, such as financing and factoring accounts receivable. Because your accounts receivable can be fairly accurately valued and are
  • 8. 8 usually easily converted to cash, they are suitable assets to pledge. As accounts receivable are collected, the indebtedness is reduced. When the full value of the receivable is not pledged, collections made in excess of the borrowed amount are returned to the practice. Receivables may actually be sold to a financial institution. Commercial finance institutions prefer the sale be made "with recourse," meaning the risk of the account remains with the practice. If the accounts receivable are purchased from the practice without recourse, the process is called factoring. When a lending institution factors receivables, it assumes the credit risk and the service is more expensive to the practice. Usually, a factor charges a performance commission on invoice amounts and interest at a 3% to 4% increase over the prime lending rate. The advantages of receivables financing are obtaining funds quickly and having a more rapid cash flow. Factoring shifts the risk and inconvenience of credit collection to the factor, but both these practices are costly and may make the practice appear to be financially unsound and risky. Selling receivables is not advised unless you are making a large one-time repayment such as an IRS bill or working out a plan to recover from a not-too-fun catastrophic event such as a natural disaster. Providers who sell their receivables to cover monthly operating expenses are borrowing against their own future. It is like borrowing against next month's paycheck to pay this month's bills. Once you have selected a bank, consider consolidating all accounts, including personal, business, savings, and pension accounts. By increasing the volume of business you offer the bank, you will increase in importance from the bank's perspective. This may result in preferential treatment for services or more favorable loan terms. Establishing a strong relationship and staying with a bank that provides superior service may be a valuable resource for you and your practice. 6. Other sources Credit cards Some of those in our survey noted running up a tab on their credit cards. This high risk and high interest cost, and is not recommended. Family/Friends Loan This can also be risk-laden and may run the risk of damaging important relationships if payments are late, or unexpected difficulties arise. If this route is chosen, it may be a wise idea to have a clearly articulated contract drawn up and certainty that both parties very clearly understand and agree to the terms before executing it. Small Business Administration Loan An often overlooked route for finding a loan is to go through the U.S. Small Business Administration (SBA). The SBA offers a variety of loans, including a general loan and an equipment/real estate loan, both of which are available to medical facilities like hospitals and clinics.
  • 9. 9 For example, Dr. Steven Solomon of La Jolla, CA, provides intimacy therapy services to couples. He applied for an SBA 7(a) loan and was approved for $100,000.00. He used the funds for computers, equipment, and training (U.S. Department of Commerce, n.d.). Crowdfunding Some mental health providers who want to start their own private practice have turned to more modern routes to obtain financial assistance. Within the past decade, crowdfunding has increased in popularity. While a private practice is the typical crowdfunding benefactor, we found that individual providers have raised as much as $4,000 using crowdsourcing websites. It seems mental health providers tend to use gofundme.com as their crowdfunding website as opposed to others, such as indiegogo.com or kickstarter.com. For example, a Marriage and Family Therapist in California with a goal of raising $6,842, has raised $950 in six months to go toward her private practice that would aim to serve veterans and their families. She specifies that donations would go to rent, a computer and a printer, and telephone service for six months. A mental health therapist in Bellevue, WA, has raised $1,299 of $7,000 in 14 months. She wants to help members of the LGBTQ community and she indicates that donations will go to licensing costs, business cards, office space, professional organization fees, a website, insurance, and a business license. She wants to raise enough funds to cover expenses for six months as she builds her client base. A professional counselor in Brainerd, MN raised $1,230 of $2,700 in 16 months. Her goal is to start a private practice to help people experiencing anger, anxiety, and depression, among other things. She also offered counseling sessions to donors as a “perk” or a “thank-you” for their assistance. A psychotherapist in Portland, OR who had already begun her private practice, raised $675 of $2,000 in 14 months. Her goal was to pay off expenses like overhead costs and student loans as she continues to build a client base. Finally, a counselor in Guaynabo, Puerto Rico raised $4,300 of $5,000 in eight months. Her goal was twofold: to help people recover from trauma and to mentor students, graduates, and professionals in order to raise the standards in that geographic area for the profession. How lenders evaluate borrowers Lenders make decisions about loans based on their knowledge of the borrower and the business. You will make a positive impression on the lending officer with a well-prepared and complete set of informational documents. The principal document used to indicate your creditworthiness is the business plan. (Websites such as BizHumm offer free templates: http://bizhumm.com/dashboard/library/ ) Another key factor in the loan process is the lender’s impression of your credibility. The lender gains this perception from face-to-face contact with you (and your associates if you have them) and with the information provided to support the loan request. If you are borrowing funds for the first time, you can expect to provide more information to the loan officer than if you have a credit history with the bank.
  • 10. 10 Once you have established credibility, you must work to maintain it. You must continue to produce results that are consistent with your business plan objectives and financial projections. If you repeatedly return to the lender for expenses that were not properly considered in the business plan, you will decrease your chances of getting favorable terms. When this author (GW) investigated Bank of America’s small business healthcare loans, doctoral-level psychologists, licensed clinical social workers, and licensed clinical professional counselors are not eligible for this loan—only MDs. Furthermore, CitiBank also has a loan for healthcare professionals starting their own practice, but it is currently geared toward physicians. Of course, if you are a MD, this would not be a problem. If you are not, a strategic approach may be to partner with a MD. But such an approach must be considered in a context of other practice aspects, not solely for access to debt financing. Key information for loan applications Lenders consider three essential items when deciding whether to lend money: 1. How will the funds be used? 2. How much money is needed? 3. How will the money be repaid? The data needed to answer those questions will depend on several things: 1. Your previous relationship with the bank 2. The purpose of the loan 3. The amount of the loan 4. The percentage of total expenditure being sought (for example, a practice borrowing $5,000 to purchase office furniture valued at $15,000 is borrowing only 33% of the total expenditure, which will be more favorably considered than a loan request of $12,000 for the same purpose). Different banks require different levels of detail. For example, if a sole practitioner or a group with less than three providers applies for a loan at a local bank, the lender may rely more on personal financial information than on the practice's operating information. On the other hand, if a large practice is financing real estate or a series of capital projects, the institution may require a projected or pro forma* financial statement showing the capability of the practice's operations and ability to repay the debt. Therefore, it is important to have as much information as possible going into the process. 1. How the funds will be used. You may want to borrow funds to finance start-up or expansion. When you are starting or expanding a practice, you may need money for working capital, to purchase equipment, and to pay for improvements to the office. The lender needs to know how the funds will be used so the bank can obtain a security interest if property and equipment are being acquired. If the funds are to be used for working capital, the bank will require some other form of payment assurance. Knowing how the funds will be used also helps determine the interest rate and term of the loan. For example, the term of a loan to purchase a computer system would probably equal the useful life of the equipment.
  • 11. 11 2. How much money is needed. The size of the loan depends on several factors. a. Determine the total planned expenditures and the amount that will be financed. This relates to the planning process as discussed earlier. You may invest some of your own funds and borrow only a portion of the total. b. Include the expenditures in the business plan developed to support the loan application. This pro forma business plan shows your future needs as well as the level of debt you can repay. c. The bank must understand how the loan relates to your strategic plan. For example, if you are adding providers and need $100,000 to expand, will that amount be used for working capital and improvements? Will another loan be required for related issues? You may find it easier to repay excess funds than to obtain additional funding if the size of the first loan is insufficient. 3. How the loan will be repaid. You will be expected to demonstrate to the bank your ability to repay the loan. The main evidence is your business plan, which illustrates the ability to repay the debt from projected income in excess of expenses. You may also need a contingency plan showing what steps you would take if the financial projections proved incorrect. The contingency plan may indicate a source of repayment other than practice income, such as a guarantee based on your personal assets. (Portions of the last section of this chapter have been adapted from Stout & Grand (2004), with permission from the publisher, Wiley & Sons). Conclusion Healthcare providers who want to start a private practice are not just clinicians. They are entrepreneurs. As such, they must consider the details of business management. They can no longer merely be occupied with the question, “Will my patient recover?” Rather, they must also consider, “Will my business succeed so that my patient can recover?”As you mull over the beginnings of your private practice, calculate your expenses, and explore your options for paying them off, remember that this chapter is only the beginning of the resources available to you. References Stout, C. E. (1996). What Should Psychotherapy Cost? Illinois Psychologist, Spring, 24 - 26. Stout, C.E. and Grand, L. (2004). Getting started in private practice. New York: John Wiley & Sons. U.S. Department of Commerce. Small Business Administration. (n.d.). SBA loan keeps couples together (n.d.). Retrieved from https://www.sba.gov/offices/district/ca/san-diego/success- stories/sba-loan-keeps-couples-together
  • 12. 12 How Does It Work? I have a model that I have found over the years works pretty well and efficiently. You may already know that I was invited by the President of the American Psychological Association to serve on the APA Task Force on Future Roles of Psychologists and published a number of articles on the topic and that this area was a major focus when I served as President of the Illinois Psychological Association. You may already be familiar with my books, Getting Started in Private Practice (Wiley, 2006), http://www.amazon.com/Getting-Started-Private-Practice- Complete/dp/0471426237/ref=la_B003MROVZ8_1_1?s=bo oks&ie=UTF8&qid=1387499433&sr=1-1 and Getting Better at Private Practice (Wiley, 2012) http://www.amazon.com/Getting- Better-Private-Practice- Started/dp/0470903988/ref=la_B003MROVZ8_1_4_tit le_1_pap?s=books&ie=UTF8&qid=1387566503&sr=1-4 along with a number of books on practice and related issues: http://www.amazon.com/Chris-E.- Stout/e/B003MROVZ8 And I have a number of PPTs up on practice matters as I present a fair amount, too. Here is a sample, but do feel free to drill around as well: http://www.slideshare.net/drchrisstout1/dr-chris-stout- getting-better-at-private-practice
  • 13. 13 Curated Library Wouldn’t it be great if… …there was a way to not have to be on a million ListServs getting 2 million emails, most of which are not helpful…but still be able to stay on top of what’s going on and important to you? …not worrying about missing something important while away on vacation from email or just during busy times? If you are interested in gaining access to the Curated Library you will find an overwhelming, and growing “hand-selected” collection of materials (PDFs, books, PowerPoints, etc.). If you join A Life in Full as Subscriber, you benefit from my almost daily review of over two dozen newsfeeds and publications where I collect the best content I come across that is relevant to the Library and to you. Then two to four times a month I upload this content into a special DropBox account that I link to you. You can then read it when it convenient for you. It’s searchable too! You can rest assured you will never miss anything of importance to your work or development. The result is that you can have access to an ever-updating-obsolete-proof online library. It doesn’t get much easier than that! It includes:  Social media tools  Start-up help  Tips on productivity, goal attainment and success  Career tips  Entrepreneur tips  Health, exercise, and wellness methods  Leadership tools  Writing and speaking tools  Some very cool life-hacks  Some very cool travel-hacks  Website tools  Marketing approaches  Clinical practice tools (for clinicians only) A one year All-Access Pass Subscription is $75, or a One-Time Life-Time Subscription is $150. Just send an email with your request to DrChrisStout@gmail.com and you’ll receive the PayPal instructions and your “Library Card” for immediate access. You have a 30 day, money back guarantee if you are not satisfied with your Subscription for any reason. Membership
  • 14. 14 I am now offering a new option that may be of interest. For a single, onetime charge of $650 you can have one 60-minute 1:1 consultation, and up to 12 email exchanges over the course of a year’s time as a Professional Member. In addition you will have a one-year subscription to access the Curated Library’s materials, 24/7, that will provide you with all the tools and information to advance your knowledge, practice, and career—at no additional cost. Members will also get access to free links for:  Business Plan Templates and Checklists  Marketing Plan Templates and Checklists  Social Media Training & Software  Essential SEO Tools  Financial Projections Template  Essentials for Cloud-based Services 1:1 Consultation I have a limited number of slots available at any given point in time for individualized consultation. Generally I meet with someone 3 - 8 times depending on your needs and goals, on a once-every-2-or-3-week schedule. The meetings can be via the phone or at my Bolingbrook office. All meetings are 60 minutes long. I tend to be very directive, network connecting, content heavy, and task oriented (but not at the cost of being supportive, and if I can, a dash of humor when I can muster it). Frequently, I will work in between our meetings compiling tools, readings and resources relevant to your needs that I will email to you. Charges are $425 for the first meeting and $375 for the subsequent ones. A single payment for 6 sessions is discounted 10% for $2400. Please directly be in touch via DrChrisStout@gmail.com
  • 15. 15 My Clients also have the opportunity to gain an introduction to doing their own consulting through Maven and GLG How would you like to  Expand Your Consulting Opportunities?  Earn consulting fees of $150 and more, generally via telephone consultations?  Educate business and investment leaders”  Network with global leaders?  Participate at your convenience? I can make a personal referral to GLG which provides:  11,000+ consultations each month  35,000+ GLG News posts authored by Council Members  60,000+ paid survey respondents  Be confident of privacy and integrity  850+ client firms worldwide And I can also recommend you to Maven
  • 16. 16 Join the list of organizations and individuals I have worked with…
  • 17. 17 Free content is always available at SlideShare http://www.slideshare.net/drchrisstout1 and LinkedIn https://www.linkedin.com/today/posts/drc hrisstout Courses Coming soon…! And finally… https://youtu.be/jITlVpJUaN0