Tidying Up My Private Practice Step 3: Business Boundaries

updated 1/25/2023

I know you talk about boundaries in your clinical practice regularly. From the outside looking in, it is always so clear. We can see the places where people aren’t speaking their truth. We can see the impact of putting other people’s needs before our own’s in a way that is unhealthy and detrimental (as opposed to in a giving back, an act of service sort of way).

As we reflect, explore, and delve deeper we can often help our clients create that beautiful connection that lets them see the why and how of this pattern and develop new ways of being.

Why Should You Set Boundaries in Private Practice?

What does this have to do with my business you might be asking. Everything. You bring all of you into your business. All of your amazing experiences, strengths, unique qualities and emotional awareness comes into your business. And, you bring all of your difficult experiences, trauma (resolved and unresolved), weaknesses, lack of awareness, and all the rest of it.

Tips on Boundaries and Running a Private Practice

You Don’t Have to Be Perfect In Business

Before you panic, don’t worry, you don’t have to be perfect to have a successful business! But, you do need to be growing in your awareness and willing to delve deeper and explore the “stuff” that comes up as you move forward in your business. Self-assessment in this area is VERY often missed by therapists. Or, when the awareness comes up, it will lead to a shame spiral of self-doubt, criticism, and shut-down instead of moving towards a plan to explore and progress in this area.

Explore the Emotional Aspects of Your Practice

Here is a list of areas to explore related to the relational and emotional aspects of your business. They are in no particular order of importance. Grab your journal and start exploring as many of these as you feel led to. Get curious.  And know that as you identify areas that don’t feel quite right, it is an opportunity for creating a plan, getting support, leaning in, and growing in this area. It is NOT a judgment on your ability, willingness, capability, etc. of being a successful business owner in private practice!

Areas to Explore:

These are areas to look at broadly. Explore what is working well in these areas. What feels really uncomfortable, and what feels “off” but you just can’t put your finger on:

• Conversations with colleagues in private practice.

• Conversations with colleagues in non-profits or agencies.

• Conversations with an accountant and/or bookkeeper.

• Conversations with my partner or spouse about my business.

• Conversations with medical professionals I know about what I do or with professionals I don’t know.

• Conversations with myself about the status of my business.

• Looking at my bank account, and finances, or talking about my financial situation.

• Conversations with clients and potential clients when the topic is directly or loosely related to money.

• Conversations where I set limits with clients in private practice where they could stop treatment and impact my income.

• Reading about business, business planning, marketing, etc.

Reflect on Those Emotional Areas of Your Practice

What is coming up? These are very broad areas. Are you noticing what areas bring up emotions, numbness, discomfort, confidence, and/or joy? All of these feelings are important indicators of the health of your business and will help you to make choices that will make your business happier, and healthier, and ultimately make your clinical work more effective.

I am including a list of more specific questions to explore below (just scroll down to the bottom of the blog).

What if I am Feeling Shut Down and Need More Help?  

If you’d like some one-on-one with Kelly or me to help take this streamlining thing to the next level and want to uncover what you need to do to seriously up-level your business- we would love to help. Explore more questions below to help you dive deeper.

Questions to Explore About Your Private Practice:

Explore each question and write out a bit about how this impacts you at the moment, as well as the impact it has on you longer-term. You will notice the list is LONG and I could add many more. If you’d prefer, click here to download a printable version of this list.

• How do I feel about developing, sharing, and holding to a cancellation or no-show policy in my practice?

• How do I feel about calculating and charging a fee in private practice that takes care of my financial needs including vacation, sick time, retirement, pieces of training, planning for slow times, etc.?

• How do I feel when someone asks about sliding scale?

• What comes up when I find out a colleague is charging less than me? When they are charging more than me?

• How do I feel when I send a payment to the government for taxes? (Or, have I been avoiding putting time aside to figure out my tax situation?)

• How do I feel when I look at my bank account, do my bookkeeping, or do anything related to money?

• How do i respond (or react) when a client sets a clinical frequency based on their financial needs, and I know they’d get more benefit from more frequent treatment?

• Do I feel pressured to give a referral from a colleague or friend sliding scale?

• How do I feel when I turn sliding scale away? How do I feel when I take every sliding scale? How do I feel long-term about sliding scale?

• How would I feel if/when a sliding scale client goes on a nice vacation, drives up in a beautiful new car, wears designer clothing, etc.?

• How many times over the last week did I say yes to something in my business that I felt uncomfortable about?

• How many times this month have I done something kind for others in my business that ultimately left me overworked, struggling, or feeling not great?

• How many times do I avoid setting limits with clients because I am worried that they will reject therapy (and me)- even though I know it is important for the clinical work to continue?

• How often have I felt burnt out in this week in the last year?

• How often have I questioned whether I should do this work in the last year?

• If I was more secure financially and wasn’t pushing myself to see more clients than my body can handle, how would that impact my life, and my love for this work?

• How do I respond when I feel shamed by a colleague for taking or not taking insurance? For the fee that I charge? For the limits I set?

• How do I feel when someone asks me what I do for a living?

• How does it feel to share about my work face-to-face, on social media, with friends, with strangers, with other professionals?

• How would it feel to pick up the phone to a local primary care doctor and find out about their practice and share about my business?

• What happens when I set aside time to work on an uncomfortable area of my business? Do I hold that appointment sacred or do I avoid it and push it off? What do I tell myself about that?

• What are areas in my practice that when I think about I feel overwhelmed or shut down and how does that impact my business and the rest of my life?

• When I consider getting or asking for help- what comes up for me? How do I feel about needing or wanting help as a business owner?