I Need to Increase My Income: A Private Practice Question, Answer

Hi Anthony,

I have a question regarding expanding my private practice. Here’s my situation: My husband is about to be laid off (within the month) and I need to increase my income; hopefully doubling it over the next couple of years. In preparation, I raised my rates and I now see my maximum load of clients. I have one part time intern employee who sees her maximum load of clients (she is unable to switch to full time), and I just hired one 1099 contractor to do occasional assessments (no therapy clients).
I currently get (and usually refer out) between 1-10 referrals per week, with 4 per week being the average. This isn’t easy: My practice is a very specified niche practice and it is difficult to find appropriate referral sources. It is also hard to find local clinicians who are qualified to work with my specific niche population. In regards to marketing, I regularly speak on a national level, and locally, built a website, and have started a book.

Here are my questions:

1. How many client hours per week is a decent number for a newly hired therapist/1099 contractor?

2. I have learned that even though I get a sufficient number of referrals, due to my specialization, many clients do not want to be referred and thus a new 1099 contractor would probably add 1 – 5 clients per month. Is this a sufficient number to get a great clinician?

3. Do you have any general advice for adding clinicians to my practice?

Thank you very much!!

Warmly,

Needing to Build a Team

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Greetings NTBAT,

Thank you for your question. My responses are below—written alongside your questions.

…. Here’s my situation: My husband is about to be laid off …. In preparation, I raised my rates and see my maximum load of clients.

A: Doubling your rates, and increasing your caseload. Even without the math I can see that this would increase your earnings.

1. How many client hours per week is a decent number for a newly hired therapist/1099 contractor?

A: A fulltime counselor will typically see 30 clients per week. If they are conducting 45 minute sessions, that 26.25 hour a week of face-to-face work with clients. Some full-timers will do more, and some counselors will balk and claim that 30 sessions a week is unreasonable. According to HPSO, fewer than 24 clients a week qualifies one for part-time professional liability insurance.

2. I have learned that even though I get a sufficient number of referrals, due to my specialization, many clients do not want to be referred and thus a new 1099 contractor would probably add 1 – 5 clients per month. Is this a sufficient number to get a great clinician?

A: That sounds a bit light. I don’t know the population you work with, but most providers need about 5 clients a week to build toward a FT caseload. It seems like it’s possible that your practice is too focused on you as the “star”, and because of that you’re struggling to refer clients to your team. Perhaps by helping your team members to build their reputations—perhaps thought writing, or speaking, or other thought leadership of their own. Also, perhaps if new clients simply don’t have the option to see you, they’ll opt for a convenient appointment with a team member you recommend.
3. Do you have any general advice for adding clinicians to my practice?

A: Find clinicians that are both clinically excellent, and a good culture fit. Look for providers with deep roots in your community, who are likely to be with your practice for many years to come.

Thank you very much!!

You’re so welcome.

Check out “How Much Money Can A Counselor in Private Practice Make?” by Anthony Centore