When analyzing whether you want to start your own practice there are various variables to look at when evaluating the pros and cons.
- The first variable is in the area of independence or being your own boss.
Now to some people that spells freedom and a breath of fresh air but to others it can be terrifying. Being your own boss allows you to set the direction of the business, and your client types, and determine what you charge and how much time you want to spend in business related activities and personal activities. However, you are your own boss so if you need any assistance you will need to get creative because you are the boss. You will need to surround yourself with good advisers and friends who can assist you when you need assistance. Another con is that you are the administrator, the accountant, the marketing person, and the HR person. As well, being isolated can be a real struggle for practitioners who are just starting out. Make sure you work to build a professional support network quickly to combat this isolation.
- The second variable is the idea of being able to be flexible in setting up your business.
You are able to set up the schedule that works for you, how much work you will take and how much time you will take off. You can easily adapt and change the work environment as well as deciding what type of services you will or will not perform. The problem is that when you are starting out you will have very little "down time" and can burn yourself out if you are not able to walk away from work at the end of the day. If you get sick, or a family member gets sick, or you want professional development, the cost is out of your own pocket. The business expenses are covered solely by you; so it can make you feel pressured to keep long hours to get ahead.
- The third variable is choosing your clients.
You are the one to decide which clients you will and will not see. What niche do you want to service and what is outside your area of specialty? You can have a very specialized service or a more general service, but be careful not to get too broad or too far outside where you are comfortable. However that is a con of being your own boss - knowing how to have enough clients by having a broad enough client base that you will be able to support a practice and get it off the ground, but not so broad that you are outside your comfort level of service or be unable to provide quality service.
- The fourth variable is that you are able to set up office parameters.
You will be the one to decide which policies and procedures to follow and determine what paperwork is carried out and how record-keeping will occur. However the con in all of this is that hours spend on office function are non-billable hours so when calculating your rates you need to keep that in mind. Billing, filing, and record keeping are important, but you may want to hire a part time office administrator or find electronic options that speed up some of these processes to help yourself in these areas. Another area of concern is that you are setting up your business to be compliant with the privacy laws of your region. All records have very specific requirements for storage and many businesses are not following the requirements and could inadvertently be breaking the law.
- The fifth variable to consider is the environment.
When you set up your own business you are able to make decisions on your work setting, how your office space is set up, whether you rent an office location or work from home, where your work location will be and so on. Some people are able to go where the clients are; some are able to rent space from other practitioners, and some can work out of hospital or clinic locations. The disadvantage of starting up a private practice is that you will be covering all the expenses as well for space, furnishings, technology setup, and any staff you hire.
Some clinicians are moving to electronic medical record storage to cut down on the amount of space needed for record storage. This is a great way to reduce the use of paper, follow privacy law best practices, and speed up record keeping.
The Canadian Electronic Information System is one such EMR service. The Guardian EMR app is able to operate on any browser on any device. It is easy to use due to its minimalist design and it securely stores your client's health records.
- The sixth variable to consider is the financial aspect of starting a private practice
The benefit of being your own boss is that you have the ability to set your rates based on your level of education and training, the demand for your services in the area you live, and the client's ability to pay. However you must remember that you cannot make financial decisions for your client. This concept is discussed in the How to Start a Private Practice Course offered by E-HIS.
The vulnerability that you face as your own boss is dealing with market fluctuations, economic downturns and currently a unexpected global pandemic - such as what we are dealing with now with COVID-19. The local economy often will dictate prices you are able to charge, the ability of the client to afford the services and the ever changing business costs.
However you cannot live in fear either so make sure you do your research before deciding where to set up your practice so that you are more confident that the area you live can support your practice. Some clinicians work part-time for the public sector and build up their private practice on the side. This is a very good option to consider if you are unsure if there is enough client base in your area of specialty.
- The seventh consideration when setting up your practice is to evaluate your professional skills.
You as the owner have the total control to set up your professional practice based on your level of training. To expand your expertise, you can continue to expand your knowledge by taking continuing education in various areas where you see a need. Building up your professional skills will help you hone your practice and decide what your professional focus will be.
The challenge for any practitioner is the need to keep current in your field. The medical field is always discovering new techniques to help clients or there is new research so it is hard to a sole practitioner to keep up with the knowledge explosion. Remember that it is important to continue doing professional development to enhance your skills, but the downside is that when you are training these hours are non-chargeable.
Here again, companies such as E-HIS are offering courses online that can expand your skillset. As well they are encouraging you to set up your own training courses to help other practitioners gain further education in various topics.
- The eighth variable to think about when deciding whether to go into private practice is accountability. Who are you responsible to?
Opening a private practice is a way that you can display who you are. Your reputation will build based on the type of service you provide so make sure you are following best practice in your field. You have the ability to set up your practice how you want, without limits of having someone saying whether you can or cannot do something. The success if your practice is under your control. The disadvantage is that their are fewer options for peer evaluation unless you search them out. Make sure you begin networking with others to help yourself be accountable. Another disadvantage is that you are solely responsible for any errors that occur - clinical or business management errors. Therefore, make sure that your have liability insurance, but don't let fear hold you back. Do your research, make your plan and then move forward.
https://cpa.ca/cpasite/UserFiles/Documents/publications/PAA%20Guidebook.pdf accessed March 18, 2020
Watson, Heidi. Your Dream-Your Life Private Practice Workbook, Electronic Health Information System. accessed at https://www.e-his.ca/product/how-to-start-a-private-practice-workbook/