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Friday 11 May 2012

Private Practice: Can you afford an assistant?

The Friday series based on my book Private Practice Made Simple (available from and continues, and we are in the midst of financial planning.
Spring in Vancouver.

When people first start a private practice they have plenty of time on their hands. The phone isn't exactly ringing off the hook, and the clients are few and far between.

This is fine. There's plenty to do at this stage anyway. Systems need to be set up. Forms need to be written. The website needs developing. A reputable printer needs to be found.

If all of these tasks get done, sooner or later the practice will begin to fill up. And sooner or later you will find yourself racing from client to photocopier to printer to office supply store, wondering why you ever thought private practice might be an enjoyable way to make a living.

But hey, can you really afford an assistant?

If you're thinking of a full-timer, no: you probably don't. But a part-time assistant can be an enormous boon, and although it will cost money, a good assistant will make you money in the long run.

This week's form is designed to show how. Here it is:

Let's lead you through the exercise, and work out an example as we go:

Step 1

How many hours of admin work does your practice generate in an average week? If you don't know, consider keeping a diary for a week - but be prepared for a shock when you discover just how much time you are spending on tasks for which you aren't paid. Example: let's guess 15 hours.

Step 2

Let's face it: You will never get rid of all the nonclinical work. Some things, like doing a final check before sending the taxes to your accountant, or the new pamphlet to the printer, you will have to do yourself. And sometimes a bit of admin work can make a nice break from the emotionally involved work of seeing clients. So estimate how many of the hours in Step 1 you will keep for yourself. Example: Let's say you keep 5 of the 15 hours.

Step 3

Subtract the hours in Step 2 from those in Step 1, and you have the number of hours of work you could cede to an assistant.  Example: 15 - 5 = 10 hours.

Step 4

Your assistant probably won't work as quickly as you. You understand the business a bit better (at least for now), and you are motivated to be efficient. As well, your assistant will get stuck and need to consult with you about some tasks. So take the hours in Step 3 and multiply them by 1.25 to get a rock-bottom estimate of the number of hours your admin work will take them, and by 1.75 to get a more generous (and realistic) estimate. Note that I'm not saying assistants are slow - I am routinely surprised at the efficiency with which our clinic assistants work. But I have a bias to underestimate things in the planning process, and when you first start hiring assistants your workplace will not be organized to maximize the gains from their talents. Example: 10 x 1.25 = 12.5, and 10 x 1.75 = 17.5 hours. 

Step 5

Estimate how much you will pay your assistant per hour. Example: Let's say $15.

Step 6

Now multiply the hourly rate in Step 5 by each of the two hours-of-work estimates that you came up with in Step 4. This is how much it will cost you to get an assistant to work those hours.  Note that this is a rough estimate, and doesn't include benefits that you might pay (unless you include them in the hourly rate when you do your estimates). Example: $15 x 12.5 hours = $187.50; $15 x 17.5 hours = $262.50.  

Step 7

Now divide the amounts in Step 6 by the hourly fee you charge clients. This gives you the number of extra hours that you would have to see clients in order to pay for your assistant.  Example: Let's say your hourly rate is $100. This means that if you saw about 2 extra clients a week, you could get an assistant to work for you for 12.5 hours; and that if you saw about 3 extra clients you could get 17.5 hours of assistant time.

In effect, seeing just one extra client per week would allow you to purchase several hours of an assistant's time. For most therapists, it translates to between 4 and 18 hours of assistant time for every hour of billable client time. You can see that if the administrative burden of your clinic is preventing you from seeing more clients, hiring an assistant may be a very good idea. On the other hand, if you are barely scraping by and the extra clients don't seem to be available, then hiring an assistant may not be such a good idea.

For more on the nuts and bolts of working with assistants, I will refer you to the Chapter 8 of Private Practice Made Simple. 

Next week:  We jump ahead to the forms from the chapter of Private Practice Made Simple on burnout - and how to prevent it.

A BONUS: Does your practice will involve diagnosing clinical depression? Maybe my online course "Diagnosing Depression Using DSM-5" can help. Click here to access this $25 course for 80% off, or just $5.

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Want more information on operating a private psychotherapy practice? 

Check out my book Private Practice Made Simple.  It contains information on starting a practice, creating a space, designing a website, getting referrals, managing finances, avoiding burnout, and much more.

The book is available at bookstores, from the Changeways Clinic website, and through Amazon here.

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