So you’ve decided to ditch that ol’ agency job and start your own practice. Or you’ve received an offer you can’t refuse. This is a tough spot, as you might literally be transitioning from team member to competitor!
However, there are things you can do to maintain good relations with your soon-to-be former employer. After all, that group you’re leaving might become a referral source, might welcome you back if you change your mind, or might even buy a company from you someday.
At my practice, we do everything we can to retain and develop our best talent. However, every once in a while we lose a counselor due to career change, family relocation, or even because a team member wants to strike out on his/her own. While every practice is different, below are some general guidelines for leaving an agency or group practice.
1) Don’t take the clients with you
The cardinal sin when leaving a practice is transitioning your caseload to your new practice. Many agencies have clinicians sign an employment agreement that explicitly prohibits this. However, even if you’ve never signed such an agreement, unless you have explicit permission from your employer, taking clients is poor form.
I once interviewed a counselor who had left an agency job to go into private practice. After a few years on her own, she was ready to get back into agency work. I asked her “When you left your last job, what happened to your clients?” She replied,
“Most of them followed me to my new practice.”
“You solicited the clients?”
“I didn’t solicit them. I simply told them that I was leaving, and informed them that they had a choice; stay at the practice, or follow me.”
“How did your employer feel about this?”
“I suppose she didn’t like it. But the clients have a right to see me if they want to.”
I didn’t hire this person. As a counselor, she had worked to maintain her caseload, but it was her employer who had built her caseload. Once her caseload was full, she jumped ship—unfairly benefiting from her employer’s efforts. Her employer found the clients, made the introductions, and provided an environment for her to build strong relationships with those clients. When she offered the clients a “choice” of what to do, the cards were stacked in her favor.
There are several ethical ways to handle clients when leaving a practice. The first is to insist that your clients transfer to another provider, and to help facilitate that transition. Another option is to reimburse the agency an agreed upon sum for marketing and managing expenses it incurred. Third, and perhaps the best way to handle an existing caseload, is to slowly wean down.
Most practices will let clinicians wean down, even as they start building a practice elsewhere. At my practice in Cambridge, one counselor wanted to start a child therapy practice in the suburbs. She spent about a year weaning down her caseload with us. We could not have asked for a better transition: her approach was beneficial for her clients, for the agency, and for her as she was able to earn income while getting her own practice off the ground.
2) Do Give Enough Notice
With some jobs, 2 weeks notice is all an employer needs to arrange for a replacement. In other roles, an employee will sign a multi-year commitment. With private counseling agencies, it often takes around 4 months to get a new provider hired and credentialed.
Good managers are careful not to hire too many clinicians; if they over-hire there won’t be enough clients to go around. Because of this, if a clinician leaves before the practice can replace him/her, that practice might not be able to accommodate all its incoming client leads. Don’t leave the practice understaffed!
However, if there aren’t enough clients to go around, you might not need to give much notice. What’s more, you don’t need to give any notice if:
- The work environment is unsafe
- A supervisor has sexually harassed you
- You have been physically assaulted at work
- Your mental health is seriously endangered by job stress
- You have not been paid agreed upon wages
- Your employer has withheld wages for an unreasonable span of time
- You have been pressured to do something that is unethical or illegal
3) Don’t be Negative or Defame
If you’re leaving a practice, it’s possible the place isn’t lining up with your expectations or career goals. In fact, there might be some things that you downright can’t stand about it. However, don’t be negative on your way out the door (your feet talk loud enough!). When talking with co-workers or others about your resignation, emphasize how the company has benefitted you. Explain that you’re leaving to explore new opportunities. This is professional courtesy, and resisting the urge to jab at your employer evinces that you’re a class act. In fact, it’s important to stay collegial even if your employer isn’t—you’ll come off looking like the grown up.
Note: If you feel there are ethical problems at the practice, your role is to report the situation to the board of licensure, not to complain about “how awful” you think the practice is.
4) Do Write a Letter of Resignation
Always write a letter of resignation. Keep the letter short, and specify one or two ways the company has benefited you. A resignation letter is not a place to air your grievances (ideally, there will be an exit interview for grievances). While in the past resignation letters were printed and signed, today it’s acceptable to tender a letter as an email attachment.
5) Don’t Open Shop Across the Street
Like it or not, there’s a good chance you’ll end up competing with the practice you’re leaving. By putting some geographic distance between you and said practice, you won’t be targeting the exact same client pool. Also, if possible, put a spin on or specialize your new practice so that your service offerings don’t completely overlap.
6) Do Ask for a Letter of Recommendation
Before you leave, ask your direct manager for a letter of recommendation. You never know when you’ll need it, and as time passes it’s easy to lose touch with previous managers. With a letter in hand, you’ll have written documentation of your performance to give to future prospective employers.
7) Don’t Brag About Your New Position / Practice
Even if you just landed your dream job, or are over the moon excited about starting a private practice, don’t brag about it to co-workers. It will spread unrest and create a “grass is greener” effect on your soon to be ex-colleagues. If co-workers ask about your new role, play it cool. Say, “I think it will be a good move for me, as I think working here was also a good move for me.”
8) Do Return Company Property
Return any company property including keys, documents, electronics, and office supplies—no matter how small (e.g., make sure that hole-punch you borrowed makes its way home). The company doesn’t want to chase you down for its property, and you don’t want any reputation damage because items went missing under your watch. Also, be sure to delete all patient contact information and note that in most cases all clinical documentation and psychotherapy notes written during your employment are property of the practice.
9) Take The Small and Long View
Finally, keep these additional two things in mind. First, counseling is a small community. You’ll probably encounter your co-workers and past employer again. And second, careers are long and they take many unexpected twists and turns. You never know how you and the practice that you’re leaving will end up working together in the future.
Recently, I learned that a former team member, who relocated to the Midwest, has decided to move back to the East Coast. She wants to resume her old position, and we’re thrilled to welcome her back. Why? Because she left on good terms, and with good etiquette.
Let’s keep in touch! Sign up to receive our newsletter:
Anthony Centore
Thank you for this article. The thought that transferring to a new job with one’s entire caseload is due to putting the client first is both self-serving and inaccurate in most cases. The therapist is over emphasizing their own importance as a therapist and not considering the cost to a practice. For example, if paid on a salary, the therapist’s pay while building up a caseload is greater than what they are bringing in. If that person were to leave immediately after building a caseload, this would result in a large financial cost to the practice. The practice was paying the salary in good faith that the cost would be recuperated over time through fees collected once the caseload was established. The therapist saved about a year or two’s worth of work and expense. The practice just trained and paid for their own competition.
As an owner of a small practice, I have had many therapists come and go over the years. We are in a small community and often have individuals work with us to get licensed so they can later move on to greener pastures closer to a metropolitan area. As such, transferring with a caseload has not been an issue, but it has given experience in having individuals leave a practice. Each time almost all the clients were able to transfer to the new therapist smoothly. In fact, many performed better with the new therapist. This could be because the new perspective helped further growth. Although I have seen patients that had difficulties transitioning, it has been no more than 1 to 3 clients for a single provider at most. A good case could be made for transferring with a few clients to a new practice, but not an entire caseload.
Terrible terrible advice! Your recommendations are unethical and do not work in the interest of the client. Seek counseling from the board of psychology!
This is overall terrible advice and sounds like the writer runs or works at a poorly run “income over care” type of “practice.” Just because the “agency” built the caseload doesn’t mean they have a right over the patients choice of autonomy. In my experience most of the agencies that abide by this writer’s “tips” tend to have high turnover, high burnout, and low pay…the therapists don’t leave bad jobs they leave bad bosses and bad management. If your agency is sending emails and always stressing “how important productivity and billing is” you can be sure they don’t care about patient care as much as they should. You don’t hear medical practices telling patients they have to stay if their doctor goes to another practice. Shameful and definitely not ethical advice.