If you are considering starting a mental health private practice, there are 6 specific decisions you must take before you see your first client.  You should address each of these in order.

1.  Are you ready to be in private practice?  Starting your own practice means you are in business for yourself. Make sure you are ready to take the plunge!

• Are you ready to be a business owner and solely responsible for your income? 
• Do you have the necessary credentials? 
• Are you eligible to apply for managed care panels?
• Can you afford the financial overhead as your practice gets off the ground?

2.  Do you have your business structures in place?  I call these the Basic Principles of Practice. They include:

• Making decisions about your business legal entity (sole proprietor, LLC, PC, etc),
• Ensuring you have appropriate liability insurance and other insurance policies (health, life, disability, office). 
• Deciding on your reimbursement policies (Will you accept insurance? If so, which ones? If not, what are your fees? Will you offer a sliding scale?)
• Who is your ideal client?  Will you establish a specialty?

3.  What is the physical set up of your practice?  You need to consider:

• Office space

• Office hours/vacation time

• Emergency coverage

• Billing systems

• Filing systems

• HIPAA compliance

• Reception/client scheduling

• Policies for no shows, non-payment, non-compliance with treatment, emergencies

4.  Who will comprise your adminstrative support team? Who does the following tasks:

• Billing
• Scheduling
• Bookeeping
• Filing
• Marketing
• Do you have an accountant? Lawyer?

5.  Are you prepared to market your services?  How will you market?

• Will you have a website?  Who will design and maintain it?
• Who will design and print your business cards, letterhead?
• How will you inform the community about your services?
• What referral sources should you connect with? How will you communicate with them?

6.  Will you be able to tolerate the ups and downs of owning your own practice? 

• How will you handle slow times in your practice? 
• What will you do when your practice is full and you have a wait list? 
• How will you handle changes in manged care policies and reimbursement rates?
• Are you flexible enough to shift your policies and procedures when you determine certain approaches are not working well?
• Are you open to learning from clinical supervisors and business coaches to continually improve your services and business practices?
• Do you have effective coping and self-care strategies to manage stress?

This may look like a long list, but if you take the time to make the above decisions BEFORE you start to see clients, you will save yourself a lot of time, energy and money.