Vacations in Private Practice

As I am wrapping up bootcamp interviews for the end of the year, one of the questions I often ask potential bootcampers is "How many weeks do you want to take off per year?"

The most popular response? "um....." Hesitation. 

When we teach you how to plan your fees, part of the equation is looking at how many weeks off per year you will not be working. Why? We all need to be taking a vacation. It is good for you, good for our community, and good for your clients! With planning you can take time off without worry.

Planning also gives value to the client relationship. Imagine meeting with a client and already knowing the dates you will be out and having a procedure for how you handle that time off with your clients. Setting that structure in place helps the client know what to expect. In my experience, if you don't take a vacation, your clients notice. Their reaction to you taking time off is simply more grist for the mill in your work together. 

But I don't get paid if I don't work!

If you have a fee structure that is set so that you may take time off for vacation, then your vacation time is covered. You need to be setting aside funds from the time you are working to cover your expenses and life while you are on vacation. 

Another route is to have other streams of income in your practice that generate income when you are not there. These avenues vary from having employees to selling books or online courses. But first step is always have a fee structure that supports your vacation time.

But how do you take a vacation (even if it is a staycation) in this field when you are a solo practitioner?

Here's a quick checklist.

  • Give your clients some advanced notice if you don't have a routinely vacation planned. I like to give my clients at least a 2 week notice if not a 4 week. This isn't always possible. Sometimes you might end up with an opportunity at the last minute. No worries, just notify your clients at the earliest convenience. If you take off every 3 months for a week, you can already have this in your informed consent too!
  • Have a back up clinician in place. Talk to a trusted colleague and ask them if they can handle crisis while you are gone. I have a couple people in my professional will that I use. 
  • Turn on your vacation responder for your email. Let people know when you will return their email and give them the contact details of your coverage person.
  • Change your outbound message for voicemail with these same details.
  • Automate your social media and blog posts. I sit here with two weeks of tweets and facebook posts done as I prep for the holidays. It puts my mind at ease.
  • Set some boundaries for yourself. I take off my inbox on my phone so I don't get emails while I am out. This is where you get to really know yourself and what distracts you. Is it facebook? What if you didn't check facebook on vacation? Do what it takes to create space separate from your work. To be perfectly honest, I didn't plan my vacation for the holidays well enough in advance and thus I do have a coaching call while I am away. But, I accept that and learn from it and next year - I won't let that happen. 

The more you take vacations, the more you learn what is best for you in terms of length of your vacations and the process you have in your practice. 

Just know this, when we take vacations we are taking care of ourselves, which does also take care of our clients. If you burn out, you aren't going to be the stellar clinician that your clients deserve and that you deserve. 

Now for some fun, where are you going on vacation next? Share below and let's encourage each other to take time off!


Tech Tuesday: Tool for your Gmail

I love using boomerang to manage my gmail accounts. Want to remember to follow up? Want to schedule an email to go out later? Boomerang can help. This quick video in under 5 minutes shows you how!

Click here to get boomerang for your gmail account

Got other tools you use to manage your inbox? Share them below in the comments.

Urgent: Time to Update your Informed Consent

Updating Informed Consent

If you are like most therapists I know- your paperworks gets updated as little as possible. We try to make it perfect right away. I realized yesterday that I had completely missed an important law that was passed and becomes effective January 1st, 2015. 

It turns out a lot of other therapists have missed the memo as well. And this particular memo is that the mandatory reporting law in California has been expanded. California AB 1775 Child Abuse and Reporting law now requires a therapist to report if they have knowledge that anyone “downloads, streams, or accesses” anything with someone under 18 engaged in obscene sexual conduct. Yes, this can include sexting, past viewing of pornography involving children, etc. I will include resources below for you to check out other articles about this issue. But whether this law impacts you are not- it is time to take a look at your informed consent! 

What should you look for? 

Here is a short list of things you might review and update before the close of the year: 

  1. Have any laws changed that impact your clients (like the one above) you need to include it in writing in your informed consent, inform your clients verbally, and note it in the chart. 
  2. Is it time to update your fees? 
  3. Is it time to update or start enforcing your cancellation policy? 
  4. Have you included information about your electronic health record in your informed consent and how you keep their data secure? 
  5. Are there any patterns or themes driving you crazy in therapy that might be addressed at the start of therapy that you could include in the informed consent document?
  6. Is it time to consider moving to a electronic health record? Now is the time- you could have your clients signing your new informed consent online! 

What about you? What do you need to get done in your private practice before the year's end? We'd love to have you join us for our next free training- check it out and get signed up here

A few articles on the subject from various perspectives: 

Miranda Palmer

I have successfully built a cash pay psychotherapy practice from scratch on a shoestring budget. I have also failed a licensed exam by 1 point (only to have the licensing board send me a later months later saying I passed), started an online study group to ease my own isolation and have now reached thousands of therapists across the country, helped other therapists market their psychotherapy practices, and helped awesome business owners move from close to closing their doors, to being profitable in less than 6 weeks. I've failed at launching online programs. I've had wild success at launching online programs. I've made mistakes in private practice I've taught others how to avoid my mistakes. You can do this. You were called to this work. Now- go do it! Find some help or inspiration as you need it- but do the work!

The tax lesson it took me years to learn

Planning for Taxes in Private Practice

Let's just start by saying I am not a tax expert. I'm not a CPA, or an accountant, or a bookkeeper. I'm a therapist, consultant, and small business owner. I don't have a degree in business, so I learned a few lessons the hard way. This particular lesson wasn't painful per se, but it was important- so I'm excited to share it with you. 

You need to plan for your taxes

Simple right? For those of you dutifully filing your quarterly taxes and feeling smug right now- stick with me for a moment- because you may or may not be actually "planning for taxes." For those of you who haven't been filing quarterly taxes whose stomachs feel ill just thinking about the word taxes- don't worry- we are going to break this down! 

Here is your 6 step plan to planning for taxes in your private practice: 

1. Create a fee that integrates the taxes you will need to pay later in the year. Sit down and talk to your tax person. Don't have a tax person quite yet? Do some research (and consider chatting with one- but minimum you should probably plan for 30% of your fee going to taxes. Yep- that $100/hr just got knocked down to $70 (yes math geeks that is way over-simplified but stick with me!) Getting paid $65/hr by insurance? Carve out $19.50 for taxes. 

2. Have a system for setting aside money for your taxes. Some therapists in private practice have a separate savings account that they transfer money into for taxes, emergencies, and other things not related to regular monthly expenses and their take home pay. 

3. Put quarterly taxes in your calendar with a reminder that pops up 2 weeks prior to the time you need to send them. The check you write isn't random, it is based on your income this year- take a moment to look at where your income is at and adjust accordingly. 

4. Here is the important one- the one that MANY business owners miss. Sit down before the end of the tax year (but close to the end) and calculate what your adjusted gross income is to date. Do your best to guestimate what it will be on the last day of the year. 

5. Determine what tax bracket you are in. If you file taxes with a spouse, you will need to look at the income as a whole. Talk to a CPA, or do some fancy exploring to see if spending money at the close of the year might save you money. Yes, you heard me right- if you are on the cusp of a tax bracket- there are expenses that you might be putting off that might save you money to apply them to this tax year. Unfortunately, you can't apply expenses after the fact. Once January 1st comes- you are done! 

6. As your business profit starts to creep up, make sure to budget to talk to a CPA (even if you are a DIY tax person) to explore whether there are other options to reduce your tax liability- like filing as a S-corp. That topic is a bit too technical for this purposes of this blog. Find someone who really understands the therapy profession and the specific regulations that apply in your state. (This is another reason why spending a few hundreds once a year to talk to a professional is worth it). 

While I learned pretty quickly to put tax time on a calendar and send in those checks, it took me YEARS to really talk to a CPA. Somehow I was fearful- I felt like it was something I could do myself, I felt less than... I don't know all the reasons. But, what I can say is that I handed over more money to the IRS by not using a CPA and planning for how to minimize taxes as my business flourished. 

I've also talked to hundreds of therapists who got into uncomfortable situations with the IRS because they didn't take the time to plan for taxes. And yes, that planning starts with planning for your income goal, setting your fee, and deciding which (if any) insurance contracts to sign. 

Feel empowered? Yay! Feel terrified- definitely schedule a consult with a CPA- you can get more confident!

Tax homework for therapists

Spend a few hours really getting to know your numbers. I know you'd rather ignore this issue until after the holidays- but knowing where your business is at can make your whole year much better! 

Looking for more support on growing a happy practice? Get your mini-business school bootcamp training today!