How and When To Be Professional in Private Practice

Part of the allure of having your own practice is creating your own rules: starting and ending your work days when you want, going on vacations without asking permission, getting away from dress codes and bureaucracy.  There are ways in which being overly professional hinders your practice, like with website copy. Sometimes people go a little overboard with their freedom and it can impact their relationships with their clients and their reputation in the community. Here are some guidelines to keep you from stepping in it.

1. Wear what you want and what’s comfortable. Wear those open toe shoes and jeans. Personally, I wear a fair amount of business casual because I like it. I bring a slightly different energy when I feel dressed up than when I’m in jeans. But that’s me. Whatever works for you, works for you. I would, however, recommend not wearing your typical yoga clothes (unless you’re a yoga or movement therapist). Your clients may feel that they’re interrupting your day of self-care instead of coming to a usual work day.

2. Show up to your office BEFORE your client. Get there at least 15-20 minutes before their schedule appointment. Set your stuff down. Get grounded in your work you. It’s not the end of the world if you walk in with them every now and then, but giving yourself some time and space to be at work before engaging on such a deep level is likely to increase your effectiveness and concentration.

3. Show up to all appointments. I know that sounds obvious and most of the time when clinicians double book or don’t show up to an appointment it’s because they don’t have an effective or consistent scheduling system. You’re way more likely to miss something or double book if you keep more than one calendar for work. Pick one and stick with it, whether it’s paper or digital.

4. Turn your phone on silent and don’t touch it without a legitimate clinical reason. I hope you’re surprised that some clinicians text or answer the phone during session. From what I’ve heard from clients, it happens. The only time I pick up my phone is to provide a referral’s phone number or recommend an App whose name I’ve blanked on. If you have a personal reason to answer your phone, like you’re wife is going to go into labor any time now, let your clients know before you get started so it isn’t off-putting if you scramble to answer.

5. Call potential clients back as soon as possible, yes even when you’re full. Remember that it’s hard for people to call to make an appointment. They often have to muster courage and maybe did a ton of research to find you. Leaving them hanging isn’t respectful of their process or their time. Calling them back will take 5 minutes of your time and will make a big difference for them if you’re giving some referrals you trust.

6. Be smart with your social media. Use the security settings available for your personal pages. If you’re using business social media profiles, be mindful of what you post rather than just throwing something up there because you like the headline. Have a social media policy and be explicit about it.

7. Be smart with your email. Go HIPAA-compliant with a service like Hushmail and if you’re emailing more than one person at once BCC them. Let me repeat, BCC them. Do NOT put everyone’s name in the To: field. If you do that, you committed a HIPAA breach and may have to report yourself to your board.

8. Have a tidy office. You may not be the tidiest person, that’s okay at home and in your car. Your office is a different story. A junked up office communicates that you don’t care about the space. It communicates that you are overwhelmed. It would make me, as a client, concerned about confidentiality if I saw papers that looked like they had been haphazardly placed within view of the client’s seat. It’s distracting as hell for any clients who are tidy people. It doesn’t have to be spotless or perfectly decorated or vacuumed weekly, but papers on the ground, books on all the surfaces, 3 dirty coffee mugs and the distinct smell of something rotting creates a barrier to treatment. Take an hour or two and get your office in order.

9. Hold your financial boundaries. If your financial policy states that no shows pay full fee, charge full fee. You are modeling boundaries for your clients in every interaction and just like in parenting, if you say you’re going to so something, you need to follow through. Don’t have a financial policy? Create one. Talk about it in your first session with your clients so they are clear. Does knowing you need to follow through on your boundary make you want to be more lax on the stated consequence? You probably need to do some work around that. This is your business, your livelihood. If you aren’t full now you will be and you’ll have clients who want to se you but you can’t squeeze in. When someone no shows or cancels last minute it takes healing away from someone who wanted it. It also takes resources away from you and your practice. Someone deciding to sleep in shouldn’t impact your bottom line. Charge them and talk about the possible clinical issue that created the no show in the next session.

10. Always follow your License’s Codes of Ethics. It doesn’t matter that you don’t have a boss. It doesn’t matter if you take insurance or not. If you have any question about your planned intervention or an interaction you have with a client outside of session, call the board or the attorneys that work with your liability insurance. Talk with your colleagues. Weird stuff comes up. Maybe your small town makes it impossible to NOT have a dual relationship and your kid’s teacher is your client. Maybe you wind up at a small dinner party and a client is there. Maybe you just realized that the “one that got away” your client is talking about is your best friend before you met her. Just consult and document and do the next right thing.

Agree or Disagree? Anything important that I missed? Let us know in the comments!

Allison Puryear is an LCSW with a nearly diagnosable obsession with business development. She has started practices in three different states and wants you to know that building a private practice is shockingly doable when you have a plan and support. After retiring her individual consultation services, she opened the Abundance Party, where you can get practice-building help for the cost of a copay. You can download a free private practice checklist to make sure you have your ducks in a row, get weekly private practice tips, listen to the podcast, hop into the free Facebook Group. Allison is all about helping you gain the confidence and tools you need to succeed.