Autonomy. Freedom. Setting your own hours and fees. Office space above that swanky coffee shop and down the street from the gym.
Who wouldn’t want to open their own practice right from the start?
If you’re a new therapist ready to hang your freshly minted credentials, or even a few years in and itching to be your own boss, a quick Google search offers no shortage of Internet candy promising assistance for a smooth transition into private practice.
But is that really the best step for you or those you hope to help?
Dr. Michael Dorsey, Co-Founder and Director of the Institute for Behavioral Studies at Endicott College, doesn’t think so.
“One of the biggest challenges that I see new people face is the temptation to walk out of a master’s program, sit for the exam, become licensed, and then want to go open up your private practice. I counsel them against that from Day 1,” he says.
How to Stack the Odds in Your Favor for the Best Chance at Success
Forbes.com warns that 8 out of 10 small businesses ultimately fail. That number might not be so dramatic for those in the private healthcare arena, but even there the fail rate is nearly 50% after four years in operation.
“You can walk out and get referrals Day 1,” says Dr. Dorsey, “but the risk of doing that is just huge. There are so many things you need to know that we don’t train you in….We don’t train you in human resources, we don’t train you in liability insurance. How do you sign a lease for an office? What’s a triple net lease? How do you balance your books and pay sales tax or income tax on people? What’s FICA? We don’t teach you that kind of stuff.”
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– Dr. Michael F. Dorsey, LABA, BCBA-D
Going into private practice demands a certain amount of business know-how and an entrepreneurial spirit. From billing to marketing to scheduling, you’ll spend a fair amount on time handling business functions completely unrelated to the ABA assessment and therapy you’ve been trained in.
With current changes in healthcare laws and the insurance system, even long-time private practitioners feel overwhelmed by the business side of things and are moving to group therapy practices.
Your First Years in Practice Are About Learning the Ropes… A Mentor Can Help
But even if you succeed on the business end, are you truly a successful therapist? Are you offering your clients the best care they need to work through challenges ranging from autism to addiction to traumatic brain injury?
Think about this: If you needed surgery to remove a brain tumor who would you prefer to do the surgery: The doctor fresh out of school working alone in his private practice, or the one working under a seasoned surgeon giving input along the way?
Working closely with more experienced ABA therapists and consulting with them frequently is actually something that will build your confidence and empower you to provide clients with the best possible care. This will effectively accelerate your rate of professional development, allowing you to marshal the experience of others, put that experience to work in your own practice and observe the results.
“When you get your license, you are still a beginner therapist and will be relatively inexperienced for at least 10 years,” writes Dr. Andrew Klafter, a private psychiatric practitioner in Cincinnati, Ohio. “The most important way to improve your skills as a therapist is to present your work to a more experienced and more knowledgeable therapist on at least a weekly basis.”
Some will argue that a degree and certification would be adequate in preparing you to offer professional ABA services and doesn’t require a period of post-graduate mentorship. Dr. Dorsey disagrees.
“Yes, you’ve got all of the courses, yes you’ve got 1,500 hours of experience, but you’re not ready to go out all by yourself. Go work under somebody who is a mentor, figure out what the world is all about before you take off on your own.”
– Dr. Michael F. Dorsey, LABA, BCBA-D
He explains that if you join a group practice you’ll probably start out providing direct service while gaining input from experienced colleagues regarding behavioral plans. Eventually you will be asked to start supervising a few technicians and paraprofessionals, overseeing the assessments, modifying teaching plans, and writing behavioral work plans.
“Then promotions start happening….You get promoted to a management role and you’re running a program with 15 to 20 BCBAs working under you. So over time it kind of works its way up, and you end up wishing you had an MBA.”
But through this experience you as a BCBA practitioner build a strong foundation for your future private practice.
Once this foundation is solid, you can focus on learning the ins and outs of the business side of things while ensuring nothing gets in the way of providing clients with the best service.
Finding Experienced ABAs that You Believe In… and that Believe in You
Dr. Dorsey encourages newly certified BCBAs to take full advantage of the camaraderie and support available to them through the best practitioners in the ABA professional community.
“The way to go figure that stuff out is to go find somebody who is running a highly ethical successful organization, and apply for a job and be honest with them…say, ‘Look, I’d like to come, I want to learn from you, but I want you to know my hope going into this is five years from now I’d like to open up my own program.’”
Some practices even have formal mentorship programs you can join. Pierre Louis, BCBA with Brett DiNovi & Associates explains that their company pairs new hires with an experienced BCBA or clinical coordinator who they meet with weekly. These young practitioners learn the nuts and bolts of the program, gaining skills in billing, treatment plan templates and time management.
Even if there isn’t a formal mentorship program available, actively seek out guidance from experienced practitioners within the group or institution you join, and make it clear right from the initial interview that this is what you want.
Not every practice has a heart for mentorship, Dr. Dorsey admits. When you share your long term goals for becoming a private practitioner some practices will suggest you search elsewhere.
But it’s worth continuing the search, he emphasizes. “Others will say, ‘I understand that, that’s where I was when I was you. Come on, come to work for us, we’ll help you get started.’”