Yes, it only works for me because I don't want to work more than I do.
If I did little things like participate in any of the LISTSERVs I am on, went to the networking events from local organizations, and reached out retiring psychiatrists then I would probably be sitting on 20-30 hours per week.
I also am very selective on self-referrals for therapy, preferring to refer out and only take on people who were referred to me for therapy by someone who knows my therapy style. If I were less selective and agreed to do therapy with everyone who asks, I would be sitting at 20+ with just my current panel.
I really dropped the ball about a year ago. There was this psychiatrist who had fallen ill and more than one person suggested I reach out to him to see about taking over some of his panel. He also took only the insurance I accept. He died a few months after people suggested I contact him and I didn't. I've had a handful of his patients find me organically, but I probably could have ended up with a hundred or more from his practice of 700+. The ones who came to me said that the doctor died without any communication, they found out because he wasn't at the appointment they had scheduled or because they read his obituary in the newspaper.
This is to say, rubbing elbows with the psychiatrists over 80 with recent health challenges might be a decent strategy to grow without "advertising" formally. You might end up with illegible hand-written records and regimens that sound a couple decades off.
As an example, this week I worked 13.5 hours and billed $4,126. I have been averaging 95% collection over the past 12 months, so let's call it $3,919.7. That comes out to $290 per hour, though one of those hours was pro-bono. Ignore that hour and it's $313.57 per hour.
Last week I worked 6.25 hours and billed 2773. Assuming 95%, that is $2,634.35 or $421/hour. Again, there was a pro-bono hour.
Over the two weeks it works out to $331/hour. You can see how the variable pay might really bother some people, and motivate some people to work more hours to make more money.
I think I've mentioned this elsewhere, but any more than this and I would like to hire some office manager or something. The problem is paying them enough that they would want to take the job / you might as well be there 32+ hours a week and bring in over $so they can also be making full time money. Paying out the $80k+ that would be expected for someone of that role (including benefits) in this region of the country would make me want to work more to cover that increased overhead.
I'd rather just work the 10-15 hours and figure it out myself with low overhead. It's a trade-off. Instead of working hard now to fat fire or something I'm just planning to always work 10-20 hours. Maybe I'll change my mind when my kids are in school and being home becomes boring.
