Hi Atreides,
I came across this post and wanted to add my 2 cents. FYI I’m an integrative psychiatrist in private practice in Los Angeles. Harvard undergrad, USC med school, UCLA residency. I also have self-taught myself a lot about business.
First of all, don’t be discouraged that you don’t have patients yet. To have a private practice is essentially to be an entrepreneur, and to be a successful entrepreneur you have to have an iron will and not get discouraged prematurely. Most psychiatrists (and physicians in general) suck at business -- so you only need to be average to be successful. If you are above average, you can be very successful and also feel very rewarded by the amount of impact you have with patients.
Setting Fees:
The first advice I want to give you is to
reverse your thinking about how you’re setting your fees. Your thought process is “set high fees and lower them if I can’t get patients,” but instead it should be “set moderate to high fees and if I don’t get enough patients, increase my value.” People do not pay cash for a psychiatrist when they can get the same service covered by insurance -- they pay cash when either an insurance-based psychiatrist isn’t available OR when they want a level of service they can’t get elsewhere. You want to be in the latter category.
I have been surprised to discover there really is no fee that patients won’t pay, as long as you provide enough value (AND clearly communicate that value on your online assets, such as your website, but can also be youtube videos, social media, etc). When I started I charged $375 for an intake… now I charge up to $1500. And my practice is full and I have a waiting list.
Mentally, it’s easier to start with lower or moderate fees and then increase them as you become more confident in your ability to provide value. If you start with fees that are too high, you may give up too soon. But I promise you that the limiting factor is not your fees, but the patient’s perceived value of what you do (and their ability to find you).
Distractions:
Next… anything about needing the perfect website, needing to incorporate, talking to an accountant, to a lawyer, needing the perfect office policies, or any of this ridiculous back and forth about whether you’d be violating Canva’s TOC is a distraction. The ONLY important thing is that you GET PATIENTS IN THE DOOR (metaphorical door if you’re doing video only).
As physicians we can get obsessed with dotting our i’s and crossing out t’s because it feels easier and “productive,” but really what you need to do is put yourself out there and do the uncomfortable task of marketing yourself so patients can find you. You can figure all of that other stuff AFTER you’ve had your first patient.
When I got my first patient (back in the day when we did things in person) I didn’t have office furniture, a billing system, or an EHR. I figured all of that stuff after the fact. Yes, it feels more stressful (and slightly chaotic) to do it this way, but you waste WAY less time and you make progress faster. Focus on figuring out things “just in time” rather than “just in case.”
Marketing & Your Unique Selling Proposition:
Now I want to cover another topic that hasn’t been mentioned in other comments… your Unique Selling Proposition, or USP. This is a general business term. Essentially, why should a patient see you are opposed to any other psychiatrist? If you are not clear on what makes you and your practice unique, and you don’t communicate that clearly in your online assets or conversations with patients, then you are a (highly-trained) commodity.
If there is nothing that differentiates you then you will be getting the most annoying kinds of patients -- those that are shopping based on cost, lack of boundaries, willingness to prescribe controlled substances, etc. The patients you want are the ones who are shopping based on value… how much you can help them, and how positive you make the treatment process and relationship.
Getting Patients:
The fastest way to get patients, like others have already said, is Psychology Today. Make a profile that’s better than your competition. Have a clear photo that’s professional, and communicate your USP and the benefits of working with you as well as your “features,” i.e. specific treatment modalities. Don’t use medical jargon -- use the language that your patients speak.
I don’t recommend Google ads right out of the gate. Yes, you can definitely get patients and build a practice with Google ads, but it has a learning curve, and people give up to soon. To start Google ads you have to be mentally prepared to lose $500-1000 on learning before you make a positive ROI (return on investment).
The first phone conversation you have with a potential new patient is essentially a sales conversation where you are communicating your value (it’s not just about screening out bad patients). These conversations are very valuable in the beginning for learning, even if all of those patients you speak to don’t end up scheduling. Later on when you’re busier, you want to be more aggressive about screening out those who won’t schedule. Now I make it very hard for patients to schedule with me (they have to click on a couple links, check boxes that they’ve read my fees, fill out an online form, etc), but that’s because my practice is full and I don’t have time for a lot of non-clinical phone calls.
The conversation about how to have value is a longer one, but essentially you need to:
- Sell the patients what they want so you can give them what they need
- Value the relationship above all else… good treatment comes from a good relationship
- Provide a level of service and care beyond what others can provide (I’m not talking about appeasing or catering to unreasonable patients, that’s something else)
To answer some of your other questions:
EHR: Luminello. I don’t know about Charm, but a couple of dollars extra is worth spending if it will save you time and reduce your headache.
Telepsych platform: Doxy free - I’m 4+ years into my practice and I still use Doxy free, and just pay for a $10 day pass on the days that I need it.
Website: Wordpress absolutely is the best, but it has a learning curve. Maybe in 6 months to a year you can upgrade, but Wix is fine for now.
Logo: who cares, I didn’t have a logo until I was 4 years into my practice. Patients don’t care about your logo or website design, they care about your website copy/content (ie the words).
Insurance: Absolutely not, it will not be worth the admin to accept insurance for such a small practice.
Email: gmail is fine for short term but ultimately you want to use Google Apps for business (maybe $5/month to have a domain-branded email).
Corp: Not needed. Be grossing at least $10k/month before you start a corp. Benefits are for taxes only, not liability.
Billing: Credit card only. Multiple good options for merchant account, I use quickbooks (for merchant and creating invoices, not for accounting).
Intake Forms: IntakeQ. They do billing too. Yes, Luminello does intake forms but in private practice, time = money and intakeQ is much more seamless. I use this for scheduling and email reminders as well. They also do billing via Stripe. Don't be penny wise but pound foolish by trying to save a few dollars here and there on your software solutions, because the right solutions will save you a TON of time.
I hope this was helpful and good luck!
Elana
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