1. THE CURRENT STATE
OF
MY PRACTICE
Steven Walfish, Ph.D.
Private Practice 101: Boot Camp
The Practice Institute
2. 2
Income/Outflow
• Making a profit in private practice is a simple
concept:
Have more money come in than goes out
• Therefore, it is important to know where your
money flows in from and where your money
flows out to
3. 3
Where Does Money Come From?
What percentage of your income comes from:
• Psychotherapy
• Assessment
• Consultation
• Writing
• Teaching
• Research
• Developing Specialized Products and Lines of
Business
4. 4
Where Does My Money
Go?
• Bank Charges
• Parking
• Billing/Collecting
• Photocopying and
• Books and Journals Printing
• Capital Equipment • Postage
• Continuing Education • Professional Services
• Dues for Professional • Psychological Tests
Associations • Rent
• Insurance
• Telephone
• Marketing
• Office Personnel
• Office Supplies
5. 5
Income Sources
How many income sources do you have within
the categories?
•For example, who sends you customers or
income/work opportunities? Are they physicians,
attorneys, EAPs, the Internet, former clients?
6. 6
Income Sources - Quality
What are the quality of these sources?
•Do they provide referrals that generate small,
medium or large amounts of income?
•Do they pay quickly and reliably?
•How much administrative time is involved in
getting paid?
•If they do not provide large income do they
produce anything else of value to you? e.g.
meaningful work, the possibility of other large
sources of income?
7. 7
Income Sources - Insurance
• If you take insurance which pay the best?
Cigna vs. UBH. vs. Value Options vs.
Magellan vs. TriCare vs. BC/BS vs. Medicare vs.
Medicaid vs. Workers Comp vs. ? ? ?
If you have a full practice it is helpful to know this
information so you can systematically begin to:
(a) ask the company to negotiate higher
reimbursement from the lower payors or
(b) wean yourself away from them the lower
payors.
8. 8
Shaping Your Practice Towards Income
• If you know where your income is generated
from, or where it could be generated from, then
you can potentially shape your practice towards
higher income activities.
• For example, when I lived in Washington State
SSI paid $145 per evaluation and Workers Comp
$120 per hour for therapy.
• 10 hours of each per week = $69,600 + $57,600
for a total gross income of $127,200 for 20 hrs a
week for 48 weeks per year
9. 9
Outflow of Monies
The amount of money that goes out often
depends on your own values about money,
how much you want to do yourself, and how
much you value your time.
10. 10
Values about Money
• Do you need top quality, class-A everything?
• What kind of an impression do you want to
make on your clients?
Where you practice, the furniture that you have
in your office, the amenities offered - all
communicate things to your clients.
11. 11
How Much Do You Want to Do Yourself?
• How much control do you need?
• Do you feel comfortable delegating?
• Do you have the personality to do most things
on your own? (e.g., if you have ADD we
suggest not doing your own billing!)
12. 12
How Much Do Your Value Your Time?
• Time is a limited commodity
• If you delegate your billing it comes with a cost.
However, if you do the billing yourself that
takes your time.
• Same with charting your notes or dictating your
notes.
13. 13
Earning/Saving Money While Standing Still
How else can you increase your bottom line?
Some examples:
• Renegotiating your phone bill
• Moving to a less expensive office
• Changing to banks who offer better terms
• Renegotiating a loan
• Getting rid of a land line
