Private Practice in Progress

[ObsequiousAplomb]

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I'll post more elaborately somewhere sometime about this, but I figured I'd drop this update in this thread:

Finished year two of private practice.
Still making good steady growth.
A lot more insurance than private pay, but a good mix of both. I only take the one insurance still.
Haven't spent anything on advertising outside of psychology today. More than half of the patients that come in are direct referrals from someone I know personally. I haven't ever done any outreach to therapists, these are all therapists who have reached out to me.
My website is very simplistic. I pay an annual fee for the domain name that is so low I can't recall off the top of my head. Around $100.
I don't track metadata, but I highly doubt anyone would come to my website 7 times. The closest I can come to thinking of a way to work in the 7 times thing is that it might take a therapist hearing about you 7 times before they start referring to you? I have no clue.

I worked 471 hours last year. My collections amounted to ~$375 hourly, with my expenses amounting to $39 per hour (just under $19k for the year, don't expect them to go up by much this next year despite it seeming like I will increase my hours by 50% or so).
This means my effective rate was ~$335.
It just so happens that my spouse who is employed as a psychiatrist (nocturnist) makes $167.5 per hour.
I'm happy with half the pay for one quarter of the work.

 

[MedMan80]

I'll post more elaborately somewhere sometime about this, but I figured I'd drop this update in this thread:

Finished year two of private practice.
Still making good steady growth.
A lot more insurance than private pay, but a good mix of both. I only take the one insurance still.
Haven't spent anything on advertising outside of psychology today. More than half of the patients that come in are direct referrals from someone I know personally. I haven't ever done any outreach to therapists, these are all therapists who have reached out to me.
My website is very simplistic. I pay an annual fee for the domain name that is so low I can't recall off the top of my head. Around $100.
I don't track metadata, but I highly doubt anyone would come to my website 7 times. The closest I can come to thinking of a way to work in the 7 times thing is that it might take a therapist hearing about you 7 times before they start referring to you? I have no clue.

I worked 471 hours last year. My collections amounted to ~$375 hourly, with my expenses amounting to $39 per hour (just under $19k for the year, don't expect them to go up by much this next year despite it seeming like I will increase my hours by 50% or so).
This means my effective rate was ~$335.
It just so happens that my spouse who is employed as a psychiatrist (nocturnist) makes $167.5 per hour.
I'm happy with half the pay for one quarter of the work.

 

[Stagg737]

I'll post more elaborately somewhere sometime about this, but I figured I'd drop this update in this thread:

Finished year two of private practice.
Still making good steady growth.
A lot more insurance than private pay, but a good mix of both. I only take the one insurance still.
Haven't spent anything on advertising outside of psychology today. More than half of the patients that come in are direct referrals from someone I know personally. I haven't ever done any outreach to therapists, these are all therapists who have reached out to me.
My website is very simplistic. I pay an annual fee for the domain name that is so low I can't recall off the top of my head. Around $100.
I don't track metadata, but I highly doubt anyone would come to my website 7 times. The closest I can come to thinking of a way to work in the 7 times thing is that it might take a therapist hearing about you 7 times before they start referring to you? I have no clue.

I worked 471 hours last year. My collections amounted to ~$375 hourly, with my expenses amounting to $39 per hour (just under $19k for the year, don't expect them to go up by much this next year despite it seeming like I will increase my hours by 50% or so).
This means my effective rate was ~$335.
It just so happens that my spouse who is employed as a psychiatrist (nocturnist) makes $167.5 per hour.
I'm happy with half the pay for one quarter of the work.

For those more inclined for salary comparison, this comes out a little under $160k (effective rate, gross would be $175k) for roughly 10 hrs/wk working 46 weeks in a year. At 30 clinical hours that would be around $475k/yr (effective rate, gross would be $530k). Congrats and keep on killing it!

 

[FatherPsychiatry]

It just so happens that my spouse who is employed as a psychiatrist (nocturnist) makes $167.5 per hour.
I'm happy with half the pay for one quarter of the work.

Awesome, nice work and congratulations on a successful practice!

Curious, how does that make your spouse feel?

 

[Merovinge]

Awesome, nice work and congratulations on a successful practice!

Curious, how does that make your spouse feel?

I'd feel pretty awful making that salary as a nocturnist unless I spent a significant portion of the time sleeping. People were making more than that 10 years ago around me for the few nocturnist jobs available (and there has been 35% inflation since that time for those keeping track at home).

 

[Geraltofrivia]

I'll post more elaborately somewhere sometime about this, but I figured I'd drop this update in this thread:

Finished year two of private practice.
Still making good steady growth.
A lot more insurance than private pay, but a good mix of both. I only take the one insurance still.
Haven't spent anything on advertising outside of psychology today. More than half of the patients that come in are direct referrals from someone I know personally. I haven't ever done any outreach to therapists, these are all therapists who have reached out to me.
My website is very simplistic. I pay an annual fee for the domain name that is so low I can't recall off the top of my head. Around $100.
I don't track metadata, but I highly doubt anyone would come to my website 7 times. The closest I can come to thinking of a way to work in the 7 times thing is that it might take a therapist hearing about you 7 times before they start referring to you? I have no clue.

I worked 471 hours last year. My collections amounted to ~$375 hourly, with my expenses amounting to $39 per hour (just under $19k for the year, don't expect them to go up by much this next year despite it seeming like I will increase my hours by 50% or so).
This means my effective rate was ~$335.
It just so happens that my spouse who is employed as a psychiatrist (nocturnist) makes $167.5 per hour.
I'm happy with half the pay for one quarter of the work.

What the flying F am I doing wrong? I'm having extreme difficulty getting referrals or really anything and have spent a **** ton more on my website than you. I don't take any insurance though. I also don't know very many people though...

 

[ObsequiousAplomb]

Awesome, nice work and congratulations on a successful practice!

Curious, how does that make your spouse feel?

They're super happy.
Their job is overnights in a state hospital with a resident. 1-4 overnight admissions per month, and those don't tend to fall on the nights my spouse works. Either way, my spouse sits in the room quietly while the resident does an interview, on the rare occasion that it happens. After 40 hours overtime is $250/hour.
16 hour shifts means 2 overnights or 3 overnights per week.
Overnights means they get to sleep without two toddlers waking them up through the night. Oddly enough, my spouse sleeps more those nights than I do. Unless an IM or a physical hold or something like that is needed, the resident can usually handle it without my spouse needing to leave the call room.
They're in the overtime pool, so together we hit $550k.

Our schedule means we generally get 4 days off per week together, we put work away mentally on Saturday around noon and it doesn't come up again until Wednesday or Thursday.

 

[FatherPsychiatry]

They're super happy.
Their job is overnights in a state hospital with a resident. 1-4 overnight admissions per month, and those don't tend to fall on the nights my spouse works. Either way, my spouse sits in the room quietly while the resident does an interview, on the rare occasion that it happens. After 40 hours overtime is $250/hour.
16 hour shifts means 2 overnights or 3 overnights per week.
Overnights means they get to sleep without two toddlers waking them up through the night. Oddly enough, my spouse sleeps more those nights than I do. Unless an IM or a physical hold or something like that is needed, the resident can usually handle it without my spouse needing to leave the call room.
They're in the overtime pool, so together we hit $550k.

Our schedule means we generally get 4 days off per week together, we put work away mentally on Saturday around noon and it doesn't come up again until Wednesday or Thursday.

That is a solid gig. Dodging overnight childcare... man there are nights I would gladly take that opportunity for $0 an hour LOL

 

[clozareal]

What the flying F am I doing wrong? I'm having extreme difficulty getting referrals or really anything and have spent a **** ton more on my website than you. I don't take any insurance though. I also don't know very many people though...

You have your answer. It's not about how much you spend on your website. It's about building connections with referral sources.

 

[ObsequiousAplomb]

For those more inclined for salary comparison, this comes out a little under $160k (effective rate, gross would be $175k) for roughly 10 hrs/wk working 46 weeks in a year. At 30 clinical hours that would be around $475k/yr (effective rate, gross would be $530k). Congrats and keep on killing it!

Exact numbers (now that I'm in front of my finances) were:
- $178,136.5 gross
- $18,676.01 expenses
- $159,460.49 net pre-tax

Average days worked per week worked: 3
Average hours per day worked: 3
Most days off in a row: 14, twice

Total time spent on the phone with insurance in 2025: 53 minutes (48 of which were on hold while reading for fun).

 

[smalltownpsych]

What the flying F am I doing wrong? I'm having extreme difficulty getting referrals or really anything and have spent a **** ton more on my website than you. I don't take any insurance though. I also don't know very many people though...

Not accepting insurance will limit you and if you don’t have some sources for referrals then it’s going to be hard to reach the people who are willing to pay for your services. I get patients in my market because of my experience, very few psychologists, and several family practice docs who know my worth. Also, if there was a private pay psychiatrist willing to work with my patients, I would send my people there, but there isn’t. One thing that is important for private pay is to think outside the insurance box which is where all of our training occurs. Just off the top of my head, I am more accessible to my patients and am also more likely to communicate/consult with their families or other providers. Also, I have an extremely helpful and comfortably friendly receptionist and a nicely appointed waiting area with coffee and tea and water bottles. People who have resources to pay out of pocket for expensive services tend to expect a nicer experience than the typical government agency feel that most places have.