The pros and cons of private practice

I remember when my private practice supervisor in San Francisco told me, “You have to learn how to market yourself.” I wasn’t quite sure what she meant at the time. I was so used to intake coordinators assigning me clients

at my other 2 internship sites in the East Bay. People all over the community would call these sites based on their reputation in the community. I had very little trouble getting my weeks filled with clients. I’m glad my supervisor warned me, because 5 years into being licensed, I am still working hard to market myself, and learning new things about marketing all the time.

Do I regret my decision to go into private practice? One million percent “no.” I really love being in private practice. Honestly, though, I don’t have much to contrast it with, especially because I never worked with the Department of Mental Health. All I have to contrast it with is community counseling centers operated by large churches, and Glendale Unified School District, where I worked part time as a counselor. I do have friends who told me about the DMH paperwork they had to fill out, and about the types of clients they saw in DMH, but that’s about it.

This is what I love about Private Practice

The Flexibility!!

I love being able to set my own hours. Currently, on the days that I have evening groups, I choose to start seeing clients at 1pm. This means I can use the entire morning time to either exercise, run errands, or work on other aspects of my practice. On the days that I do not have evening groups, I choose to start seeing clients at around 9am, and finish seeing clients at around 3pm, and use the rest of the day to exercise, run errands, or work on other aspects of my practice. 

I get to choose when I go on vacation, and I do not have to get approval from a boss.

I get to choose which types of client cases I will accept, rather than having them assigned to me.

I get to choose what I will name my practice.

I get to choose where I will set up my practice.

I get to choose what my office looks like, its dimensions, its furniture, its look, its vibe.

I get to choose what things I will do on the side to supplement my private practice income, because again, I get to choose how many hours I will see clients in a day or week. This leads me to the other main thing I love about Private Practice …

The Scalability!

By scalability, I mean if the opportunity ever comes, I can make the practice (and the revenue) grow to any size I want. As I try a variety of things, there is always the potential that some aspect of the practice will become the sweet spot of high demand. This is what we are all striving for, for our service or product to be in high demand, and to attach a price for this service that matches its value. Being in private practice allows me to experiment with so many things that can eventually lead to this discovery.

What I do not like about Private Practice

Until I find the sweet spot, there will be discouraging and stressful times of limited clients. Oftentimes, this has little to do with whether we are a good therapist or not. That’s what is frustrating. The seasons of low clientele can make us question whether we are doing good work. If we add this self-doubt to the low revenue, that’s a double whammy. 

The unpredictable times of low income make it difficult to budget. 

Private practitioners need to supply their own health insurance. DMH often provides fantastic benefits, as well as a salary, and so budgeting is quite easy. 

Taxes and bookkeeping. Ugh. I really dislike this part of my work. It takes way more time and effort than I want it to, but I’m hoping that it gets easier over time.

Like I mentioned in the previous post, so far it’s been tough to become a sole breadwinner for my family through just seeing clients. I feel like I need to do something on the side (or found a group practice) in order to scale my business. The good thing is that I’m in a position where I can keep discovering what that something is!

I’d love to hear about your experience as well. Do my pros/cons resonate with you? What would you add to the list? Do you have a different experience? If you love NOT being in private practice, please share your experience! 

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