It’s warm and spring has come to the Northeast US! This is a time for new growth as well as a good point to look back at the first three months of 2010 and take stock of progress in your business.

What I learned from giving 20 free coaching sessions

Getting Serious about Your Business

photo by Tilton Lane via Flikr

I know so many of you are hoping to build thriving, lucrative practices.  You want to help as many people as you can and make a good living.  To help you along the way may I offer a bit of advice?

You Can’t Just Sit There

As I talk to struggling therapists one theme tends to emerge and it sounds like this,

“I understand the business stuff, but I just want to sit in my office and see clients face-to-face. How do I make a good living doing that?”

You don’t. Please don’t shoot the messenger….. you just can’t build a thriving practice that brings in good money by sitting in your office.

To grow a small business that is always busy and sufficently lucrative you need to get out of the office both in your community and online, talk to people, listen to their needs and tell them about how you help.  You also need to plan to develop multiple income streams because eventually face-to-face therapy as your sole way of making money hits a ceiling. You can only see so  many clients in any given week and you can only raise your fees so high.  Imagine if you fill your practice and max out how much you can charge in the next year.  That would be great, but also a huge bummer when you realize you will never get a signficant raise in your salary ever again. (And don’t even think that insurance companies are going to raise your rate……you will see a real unicorn before that happens.)

If you are completely and utterly disillusioned with the idea that you must get out of the office and create new income streams your best option is to work for somebody else who does the marketing and business-y stuff on your behalf.  They get the referrals and you can sit in your office and work with people face-to-face all day.  That is a fine career.

But if you want to strike out on your own and build your personal practice….you need to get moving!

Ready to build a practice that allows you to leverage your expertise to make the money you deserve? Sign up for my RSS feed to get updates sent directly to you! Or register for my free e-course: The Way of the Biz Savvy Therapist: 8 Ways To Help More People, Make More Money and Enjoy Your Life.

I know I’m always nagging at you to choose a practice specialty. Now I should probably give you a few tips on HOW to do that. Wouldn’t that be helpful?

Let’s start here:  Who is your ideal client?

But, before I start discussing your  ideal clients, I need to remind you I’m big on building innovative practices.  Innovative as in “new,” “creative,” “not already done.”

What is done now are generalist, pseudo-specialty practices. These are businesses that serve everyone, or say they specialize in working with adults, children, or couples. In my mind, these are not specialties, they are categories and do nothing innovative or exciting.

So, let’s talk about your ideal clients, shall we?

From the outset, I must tell you a hard fact:  You are not good at treating everyone.  In fact, there are some people you have no business treating at all. For me, this is anyone over the age of 50.  Never in all my training did I ever work with someone over the age of 50.  Who should you never work with?

The good news is, there are lots of people out there who you are very qualified to help and I want you to focus on them.

And I  want you to focus so hard, in fact, that you are going to determine a specific group of people you are fabulous at helping.  This will be your specialty. It will grow your practice beyond measure.  Without a specialty you cannot market (well, you can, but it will be a complete waste of time and money) or grow your business.  This is not a scare tactic, it is how small business works in 2010. I don’t have time to go into the reasons for this in detail.  If you want to hear more about it, listen to my “Way of the Biz Savvy Therapist” audio (also free on the blog!).

So, let’s do a little exercise on your ideal clients.

1. Write down the qualities of the people you have worked with in the past:  men, women, children, ages, diagnoses, etc.
2. Which of these clients do you feel you were most effective at helping? Who do you help best?
3. Which clients did you enjoy working with the most?  Which cases allowed you to use your best skills and feel fulfilled?

Now look at your lists. Is there any overlap (I sure hope so)?  Do you see a pattern?  Can you discern a specialty?

But, what exactly is a specialty?

A specialty typically  has 2 main elements:

1. a specific demographic of people (children, adolescents, women, men, singles, couples, gay men, lesbian women, etc.)
2. with a specific concern/diagnosis (grief, PTSD, anxiety, chronic pain, obesity, depression, ADHD, autism, high blood pressure, etc.)

Some examples:

Children with ADHD

Women/men with chronic pain

Men of retirement age

Divorcing couples who disagree on parenting arrangements

Singles who are looking for a life partner

Women with fibromylasia

Depressed/anxious teens

Post-partum women

Cancer survivors

Men/Women in recovery from alcohol/drug abuse

Parents of children with special needs

Executives with health concerns related to stress

Parents who have lost a child

Athletes trying to improve performance

Unemployed people looking for work

Artists blocked in the creative process

Make sense? The possibilities are endless.

For those of you afraid of a specialty

I know for many of you, those specialties look too narrow. You want to open your doors to more people because you worry that there will not be enough clients in one specialty area to fill your practice.

But the truth is, there are MORE than enough clients for each specialty. In fact, by specializing you make it easier for people to send you referrals or to choose to call you up and make an appointment. For example, if you just completed treatment for breast cancer, but feel overwhelmed, anxious and scared that it will reoccur, or that your daughter might eventually get diagnosed, would you rather talk to a therapist who seems nice, but is not a specialist in this type of thing, or would you rather talk to someone who works exclusively with cancer survivors?  Given the choice, who would you choose?  Would you travel 10, 20, 40 miles to meet with this person if they really understood you?  Would you be willing to pay out of pocket for such a specialist?

Imagine this scenario for parents of children with special needs, or someone who struggles with chronic pain.  When you specialize, and offer high quality care, people will seek you out. Your practice will be full.

In my own experience, I specialize in working with children with executive dysfunction (most diagnosed with ADHD, autism or learning disabilities) and their families. I have clients drive up to 75 miles to come to my office.  And I have coaching clients all over the US.  Many pay me out of pocket.  Does my specialty seem narrow?  Absolutely!  And it is that narrow specialty that I attribute to my success.

Action step:

Do the ideal client exercise above.  Do some serious thinking about your specialty area.  Try to come to terms with your internal process and emotions about identifying a treatment specialty. If it feels uncomfortable, that is fine, but don’t allow yourself to get scared back to a generalist model because it is comfy and safe.  If this exercise really freaks you out, send me an email or talk this out with a colleague or friend (ideally one who understands business).   The truth is, there is no risk in establishing a specialty. If you try it for a few months and it doesn’t pan out you can always go back to the generalist way of things. But I know you won’t have to go back there.  Try it for awhile and see how it feels.  The truth is you will need to know who your ideal client is before building any more pieces of your business. So take some time with this and let me know if you need help.

And comment below about your specialty area, or what your considering, or where you are stuck. We need some more activity here on the blog! Let’s work together, rather than sit with all this newness alone!

I just did a quick search on Google’s Keyword Tool. This is a  nifty tool to use when you are considering using Google Adwords to promote your website. You type in a word or phrase and Google tells you how many people are using those words in online searches for information on that topic.

In my search for search terms people use to find help in and around the internet, I discovered a HUGE discrepancy between the numbers of people looking for specific therapy/therapists and the number of therapists looking for information on how to build a web site.

Check out the numbers below. These reflect the actual numbers of a local search by these words or phrases in November 2009. “Local” means the United States.

Now for those looking for therapy information online:

It looks like a bit more  than 4000 people are looking for information on building a website for their practice.  But over 500,000 are looking for therapists online!!

Whoa!

Over half a million people need your help and expertise. Please don’t make it hard for them to find you….

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I want to make something perfectly clear. Starting, growing, marketing, and making money as a small business person is not hard, complicated, or rocket science. In fact, the fundamentals are easy:

1. Do good work that is effective and helpful.

2. Identify what you are marketing (specific service for a specific person with a specific issue).

3. Tell people about it in a compelling way.

That’s it.  Trust me, going to grad school, passing all those tests, getting licensed–those required a lot more brain power than the business side of practice.

But building a practice is not easy.  Why? It requires a lot of time, energy, consistency and focus. To build a practice you need to do something other than be a good therapist.  You actually need to do lots of things. And do them often, regularly, on a schedule.  This takes discipline and organization.

I talk to a lot of practitioners and clinicians every day. All of them want to build a great business and have wonderful, exciting ideas. But when we start to discuss the actual steps to make these visions a reality, I hear some version of, “But that requires WORK!” or “I don’t have time for that.” My response to that is: Work for somebody else who is doing the work and dedicating the time. Harsh? Maybe. Reality? Yes.

So we need to accept that,  yes, building a business requires work and time.  But there are rewards in being self-employed that trump working for somebody else, which is why entrepreneurs in every industry dig in and do the work and dedicate the time.

For instance, I work 3 days from home and love that flexibility. But I work from home, I don’t go out for coffee, do laundry, exercise, chat on the phone with friends. I work.

What do I do?  Write content for my blogs and newsletters (this stuff doesn’t write itself!), tweet, build relationships online with business partners, develop new clinical and BizSavvy programs, manage the business side of my practice (administrative, phone calls, etc).

I don’t mean to be a downer, but I see too many business of practice coaching “gurus” telling folks that it is easy to build a practice, that the money flows in effortlessly, clients are knocking down your door once you have a web site.  I think we call that “magical thinking.”

On the positive side, I’ve built my practice from the ground up while a mom of a young son, being home 3 days a week (and working some of that time), and with a husband that travels for business often.

While it does require work it does not require 80 hours a week of work. It just depends on how organized and efficient you can be. Or want to be.

The truth is, to have a successful practice you have to WANT it, and WORK for it. Once you get your head around those realities,the rest  is not so hard.

They physician networking site, www.Sermo.com, just announced they have started a Practice Mangement Exchange for their members, where "Physicians Turn to Social Media to Share Peer-to-Peer Advice and Solve Real-World Business Challenges."

Good for them! Do you think we as mental health businesses need to do the same?

Curious about Sermo.com? I am.  Here is some of their info:

"Sermo is the largest online physician community in the US. It’s where practicing US physicians—spanning 68 specialties and all 50 states—collaborate on difficult cases and exchange observations about drugs, devices and clinical issues. And find potentially life-saving insights that have yet to be announced by conventional media sources.

Sermo is a real-time meeting place where physicians get help with everything from patient care to practice management. They’ve described it as “therapeutic,” a “virtual water cooler” and “vital to my everyday practice.”

Yeah, we totally need this for mental health care practitioners.  What do you think?

I've been asked a few times about what to name a private practice.  I hope this video helps a bit. It isn't complicated, but you need to keep a few legal things in mind. I am not a lawyer, so for the real scoop, please seek qualified legal counsel.

Let me know your thoughts in the comment section below.

If you're reading this blog, you most likely help people for a living.  And you probably get very little recognition for your good, maybe lifesaving, work.

As someone who helps for a living, you may often feel tired, overwhelmed, confused about what you hear, see and experience during the daily requirements of your work.

Many of the people you help are disadvantaged: either financially, emotionally, cogntively, socially.  They are needy. You are a part of their support team.

You are often with people during their darkest hours.  Grief, loss, suicidal, homicidal, in the ambulance, in the hospital, in prison, removed from home, losing parents, losing a child, losing a spouse, in pain, in crisis, crying, screaming, desperate.

I know how you feel.  I have been in all those places at some point with my clients.

It is rewarding, exhausting, very, very, very important work.

Your work has the potential to be life changing, life saving.  You do the work others can't imagine, don't have the guts to do.  I wish a had a dime for every time someone has said to me, "I could never do what you do." (I'm not sure if that is a compliment…)

And because you work so hard to make other's lives better, you deserve to make a good living.

It is OK to make money helping others.

People pay good money for experiences such as attending sporting events, going to Disney World, buying designer handbags.  You help change lives: They can pay you.

Yes, some people cannot afford much and need help.  You can help them and still make money.  It's not hard, but does require an open mind, open heart and a clear understanding of the value of your skills.

There is no shame in getting paid to do important work.  Making money does not mean you care less, or are out to profit from others' pain.

Making money means you value yourself and your work.  It's ok because the more money you can make, the more people you can help and that is a very good thing.

Many of you are interested in how to start receiving private practice referrals from physicians.  A great professional relationship with a few well-established physicains can fill your practice quickly.  Here are X steps to initiate physician referrals:

1.  Do evidence-based interventions for problems doctors requently see in their offices.  You do not need to do manualized work, but be up-to-date on the latest research and "what works."  Focus on treating anxiety, depression, stress, lack of focus, children's behavior, managing chronic pain or illness. 

2.  Follow-up with your current clients PCPs (with their permission, of course).  Get written permission from your current clients to contact their primary care docs to coordinate care.  Then follow up with a simple letter stating that you are seeing their patient to treat their condition, goals for the treatment and recommendations for continued therapeutic or medical follow up.

3.  Write brief letters of introduction to those physicians you would like to work with. Keep these short and to the point. State who you are, your specialty, clients you work with. You want to clearly articulate how your services can help the doctor and his/her patients.  This letter should not be a summary of your credentials.

4.  When you start to receive referrals from doctors, develop a system to consistently follow up with them regarding their patients as outlined in #2 above. Do this consistently and watch the referrals role in.

5. Be really good at what you do. Be client friendly, return calls, have an attractive office.  Your clients will tell their doctors about your great treatment and great service (I call this developing "raving fans")and THAT is what allows doctors to trust you are taking good care of their patients, which encourages more referrals.

Lot of people visit my blog from Google searches like these:

“Private Practice Start Up”

“How to Start a Private Practice”

“Mental Health Private Practice Business”

I’m glad to see so many of you with a desire to get started on your private practice journey. Here are 10 things you should know as you consider building your own practice.

1.   A private practice is a business.  If you start from this mindset, everything else will be easier to accomplish.

2.   There are lots of administrative tasks you must do as a private practice business owner.  You will do much more than sit with clients all day.  These are time consuming and sometimes tedious.  It is all part of running a business.

3.   You will be solely responsible for the success (or failure) of your private practice.

4.   You need to market, network, and get your name out there if you have any hope of filling your practice.

5.   You will have more success as a specialist who treats specific conditions and populations.  No one wants to work with a generalist who just does “therapy.”

6.   Dealing with managed care sucks (I know that doesn’t sound professional, but there is no nice way to say it). 

7.   You will not change managed care.  They will pay you what they pay you.  The Federal Government can’t seem to change them, so you won’t either.  Accept what they are, what they pay, or don’t.  Just do not get stuck being frustrated with them.

8.   You must have a flexible business model.  Health care reform may radically change how all health care services are delivered and paid for.  Those who adhere to rigid paradigms of quality care may not survive in business for very long.

9.   Positive thought and action will serve you better than fear and frustration.  There are many, many private practice opportunities available to us. We just need to be open to implementing them. Feel stuck or overwhelmed? Adopt a problem solving mindset.

10. You will be more successful collaborating with others, rather than going it alone.  Growing a practice is work and can be overwhelming.  Joining a practice building group, business development program and/or hiring a coach can be a great way to accelerate your learning, generate more referrals and feel part of a group going through similar experiences.

Want to learn more about building your private practice?  Sign up for my free report, "8  Easy to Implement, Low Cost Ways to Market Your Private Practice."