How We Built Our Dream Practice: Innovative Ideas for Building Yours, by Dave Verhaagen, Ph.D., and Frank Gaskill, Ph.D., TPI Press, 2014.
Providing mental health services (therapy, testing, consultation-liaison services, and more) is increasingly challenging and stressful. Mental health professionals (MHPs) face pressures from Managed Care Organizations, expectations to be part of Accountable Care Organizations, competition from MPHs with less training, and more. Those of us in independent practice (individual or small group settings – not employed by someone else) are finding it increasingly difficult to survive – to say nothing about trying to thrive in our chosen field. This book will challenge your assumptions about what you need to do to survive- and thrive- in the era of health care reform.
Dave Verhaagen and Frank Gaskin have written an exceptional book that describes their own struggles as they developed their group practice, Southeast Psych, in Charleston, S.C. They have clearly survived, and have gone on to achieve remarkable successes – and are thriving. They uses several themes to advise us how to do better for ourselves. First, they (repeatedly!) remind us that we are both health care professionals and are running, or part of, a business. We need to educate ourselves about basic business skills, including marketing. A particularly helpful distinction is the difference between typical marketing (in their terms, “selfish and self-centered”- “here is my card, please send me referrals”) and what they call “relational marketing” (reaching out the community to learn about their needs and to collaborate to solve problems).
Frank and Dave obviously cannot provide a complete practice-oriented business course in their 151-page book, but they provide excellent tips, stories that illustrate their advice, and references to business resources that we can follow up on for our own development. It was a good reminder of how my own clinical training was strong (I think) on clinical skills but weak (for sure!) on business skills. Some MHPs may chafe at being told that they need to learn some things about the business world, but Dave and Frank make it very, very clear that those of us who hope to practice in a “ivory tower,” with only clinical skills, are going to have a very rough time of it in the current practice environment.
Another theme: they acknowledge that most of us need to start out as generalists, but also advocate that we need to note what types of services we enjoy providing, what types of patients/clients we prefer to work with, and what services we are, simply put, best at providing. We need to take this self-knowledge and develop a more specialized niche of services for our community.
Here are a few more: they are strong advocates for collegial relations with our peers and others in our community; we should be generous with our time, offer to mentor colleagues, be eager to learn from others, and to focus on building relationships as we work to inform the community about our practice. They also advocate for “abundance thinking” – there is always a niche for MHPs who excel and who connect with their community. This may seem like a stretch, but they provide ample examples from their own experiences, in what sounds like a competitive market, in support of this attitude.
Here is their most important advice: you have innovate, be different than the average MHP who is providing the services that you provide, and be willing to take chances. You cannot just provide “therapy for depression and anxiety,” with a quiet waiting room and a consulting room with a soothing decor. That is what everyone is doing. You need to do something that makes your practice stand out – and it has to be welcoming to people and provide helpful and memorable experiences. They support this with examples from their own practice, which includes spaces for a coffee shop, bookstore and a video studio. And, they clearly have fun with their practice -and admonish to do this for ourselves.
The 10 chapters provide advice about real world challenges and problems that we will face when developing our own practice. Each chapter provides information and resources that were probably not part of the typical training program. It is highly recommended to read one chapter at a time, think about your own situation, and reflect on whether you can change something to make your own practice more effective. You are probably going to find that this book stimulates a lot of ideas; some may be challenging, some may be more doable, but all are likely to help you with your own practice challenges.